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Sample records for af type 2-diabetes

  1. Laktatacidose ved behandling af type 2-diabetes med metformin

    DEFF Research Database (Denmark)

    Holst, Helle; Eldrup, Ebbe; Guldstad, Nana Harriet;

    2012-01-01

    Metformin (MET) is the first-line agent in treatment of type 2 diabetes. However, MET has been associated with lactic acidosis (MALA), a potential but rare complication which has influenced treatment strategies in decades. Recently, guidelines have been changed in regards of age and heart failure...

  2. Interleukin-1 receptorantagonistbehandling af patienter med type 2-diabetes--sekundaerpublikation

    DEFF Research Database (Denmark)

    Larsen, Claus Morten; Faulenbach, Mirjam; Vaag, Allan

    2007-01-01

    Interleukin-1 receptor antagonist (IL-1Ra) expression is reduced in islets of patients with type 2 diabetes. 70 patients with type 2 diabetes were randomized to treatment with anakinra (IL-1Ra) or placebo for 13 weeks. Following treatment glycated hemoglobin was 0.46 percent lower, C-peptide secr......Interleukin-1 receptor antagonist (IL-1Ra) expression is reduced in islets of patients with type 2 diabetes. 70 patients with type 2 diabetes were randomized to treatment with anakinra (IL-1Ra) or placebo for 13 weeks. Following treatment glycated hemoglobin was 0.46 percent lower, C......: 2007-Nov-5...

  3. Glukagonlignende peptid-analoger i behandlingen af type 2-diabetes mellitus--en gennemgang af et Cochranereview

    DEFF Research Database (Denmark)

    Beck-Nielsen, Henning

    2012-01-01

    A Cochrane analysis concluded that glucagon-like peptide-1 (GLP-1) analogues were effective for the improvement of glycaemic control in patients with type 2 diabetes. What is the significance for the treatment of Danish patients with type 2 diabetes? In Denmark, two drugs exist, exenatid and lira...

  4. Kombination af aliskiren og losartan hos patienter med type 2-diabetes og nefropati - Sekundaerpublikation

    DEFF Research Database (Denmark)

    Parving, Hans-Henrik; Persson, Frederik; Lewis, Julia B

    2009-01-01

    We evaluated the renoprotective effects of adding aliskiren to treatment with losartan in hypertensive patients with type 2 diabetes and nephropathy. A total of 599 patients were randomized to six months of treatment with placebo or aliskiren in addition to losartan 100 mg and optimal...

  5. Exanatid--et alternativ til insulin i behandlingen af type 2-diabetes?

    DEFF Research Database (Denmark)

    Kjeldsen, Rasmus; Sandbaek, Annelli

    2008-01-01

    The benefits and drawbacks of exenatide as an alternative to insulin in the treatment of poorly regulated type 2 diabetes are reviewed. Exenatide and insulin have equal effects on HbA1c but exenatide causes weight-loss and improved postprandial glucose control. Nausea is reported by nearly half...... of patients treated with exenatide. Exenatide can be considered in the overweight patient without extremely elevated HbA1c but nausea could pose a substantial hurdle for successful treatment. Udgivelsesdato: 2008-Sep-22...

  6. Glucagon-like peptide 1-baseret behandling af type 2-diabetes mellitus

    DEFF Research Database (Denmark)

    Knop, Filip Krag; Vilsbøll, Tina

    2007-01-01

    GLP-1 is secreted from the small intestine in response to ingestion of nutrients. It has a powerful insulinotropic effect and stimulates beta-cell growth and is therefore being developed for treatment of type 2 diabetes. The GLP-1 analogue, exenatide, is on the market in the USA as an add......-on therapy. Another strategy to increase circulating GLP-1 is to inhibit the enzyme DPP-IV which degrades endogenous GLP-1. GLP-1-based therapy results in HbA1c reductions of approximately 1 percent point, and the lack of serious side effects and the low risk of hypoglycaemic episodes are unique traits....

  7. Fedmekirurgi er mere effektiv end medicinsk behandling til opnåelse af remission af type 2-diabetes

    DEFF Research Database (Denmark)

    Klein, Mads; Rosenberg, Jacob; Gögenur, Ismail

    2013-01-01

    Observational studies have shown that bariatric surgery can lead to remission of diabetes mellitus type 2 (DMII), but randomized controlled trials have been lacking. Recently, randomized controlled trials comparing bariatric surgery with optimal medical treatment in patients suffering from poorly...

  8. Type 2 diabetes models

    DEFF Research Database (Denmark)

    Gram, Dorte Xenia

    2012-01-01

    This chapter deals with type 2 diabetes in vivo models and techniques suitable for testing new anti-diabetic compounds. In particular, the testing of TRP antagonist for beneficial effects against type 2 diabetes is considered. There are many choices of both in vitro techniques and in vivo models......, impaired glucose tolerance, impaired insulin secretion, and insulin resistance in vivo and should, thus, be sufficient to demonstrate preclinical proof of concept of a TRP antagonist in type 2 diabetes in rodents. The experiments are suggestions and could be replaced or supplemented by others....

  9. [Type 2 diabetes complications].

    Science.gov (United States)

    Schlienger, Jean-Louis

    2013-05-01

    People with type 2 diabetes are at increased risk of many complications, which are mainly due to complex and interconnected mechanisms such as hyperglycemia, insulino-resistance, low-grade inflammation and accelerated atherogenesis. Cardi-cerebrovascular disease are frequently associated to type 2 diabetes and may become life threatening, particularly coronaropathy, stroke and heart failure. Their clinical picture are sometimes atypical and silencious for a long time. Type 2 diabetes must be considered as an independent cardiovascular risk factor. Nephropathy is frequent in type 2 diabetes but has a mixed origin. Now it is the highest cause of end-stage renal disease. Better metabolic and blood pressure control and an improved management of microalbuminuria are able to slowdown the course of the disease. Retinopathy which is paradoxically slightly progressive must however be screened and treated in these rather old patients which are globally at high ophthalmologic risk. Diabetic foot is a severe complication secondary to microangiopathy, microangiopathy and neuropathy. It may be considered as a super-complication of several complications. Its screening must be done on a routine basis. Some cancer may be considered as an emerging complication of type 2 diabetes as well as cognitive decline, sleep apnea syndrome, mood disorders and bone metabolism impairments. Most of the type 2 diabetes complications may be prevented by a strategy combining a systematic screening and multi-interventional therapies.

  10. Type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    DeFronzo, Ralph A; Ferrannini, Ele; Groop, Leif

    2015-01-01

    Type 2 diabetes mellitus (T2DM) is an expanding global health problem, closely linked to the epidemic of obesity. Individuals with T2DM are at high risk for both microvascular complications (including retinopathy, nephropathy and neuropathy) and macrovascular complications (such as cardiovascular...... that multiple antidiabetic agents, used in combination, will be required to maintain normoglycaemia. The treatment must not only be effective and safe but also improve the quality of life. Several novel medications are in development, but the greatest need is for agents that enhance insulin sensitivity, halt...

  11. Pomegranate and type 2 diabetes.

    Science.gov (United States)

    Banihani, Saleem; Swedan, Samer; Alguraan, Ziyad

    2013-05-01

    Over the last decade, various studies have linked pomegranate (Punica granatum Linn), a fruit native to the Middle East, with type 2 diabetes prevention and treatment. This review focuses on current laboratory and clinical research related to the effects of pomegranate fractions (peels, flowers, and seeds) and some of their active components on biochemical and metabolic variables associated with the pathologic markers of type 2 diabetes. This review systematically presents findings from cell culture and animal studies as well as clinical human research. One key mechanism by which pomegranate fractions affect the type 2 diabetic condition is by reducing oxidative stress and lipid peroxidation. This reduction may occur by directly neutralizing the generated reactive oxygen species, increasing certain antioxidant enzyme activities, inducing metal chelation activity, reducing resistin formation, and inhibiting or activating certain transcriptional factors, such as nuclear factor κB and peroxisome proliferator-activated receptor γ. Fasting blood glucose levels were decreased significantly by punicic acid, methanolic seed extract, and pomegranate peel extract. Known compounds in pomegranate, such as punicalagin and ellagic, gallic, oleanolic, ursolic, and uallic acids, have been identified as having anti-diabetic actions. Furthermore, the juice sugar fraction was found to have unique antioxidant polyphenols (tannins and anthocyanins), which could be beneficial to control conditions in type 2 diabetes. These findings provide evidence for the anti-diabetic activity of pomegranate fruit; however, before pomegranate or any of its extracts can be medically recommended for the management of type 2 diabetes, controlled, clinical studies, are needed.

  12. Type 2 Diabetes Risk Test

    Science.gov (United States)

    ... Honor Become a Member En Español Type 1 Type 2 About Us Online Community Meal Planning Sign In Search: Search More Sites Search ≡ Are You At Risk? Diabetes Basics Living with Diabetes Food & Fitness In My ... Diabetes and Learning About Prediabetes Type 2 Diabetes Risk Test Lower Your Risk Healthy ...

  13. Glucagon and type 2 diabetes

    DEFF Research Database (Denmark)

    Lund, Asger; Bagger, Jonatan I; Christensen, Mikkel

    2014-01-01

    In normal physiology, glucagon from pancreatic alpha cells plays an important role in maintaining glucose homeostasis via its regulatory effect on hepatic glucose production. Patients with type 2 diabetes suffer from fasting and postprandial hyperglucagonemia, which stimulate hepatic glucose...... production and, thus, contribute to the hyperglycemia characterizing these patients. Although this has been known for years, research focusing on alpha cell (patho)physiology has historically been dwarfed by research on beta cells and insulin. Today the mechanisms behind type 2 diabetic hyperglucagonemia...... or antagonization of the glucagon receptor constitutes potentially effective treatment strategies for patients with type 2 diabetes. In this review, we focus on the regulation of glucagon secretion by the incretin hormones glucagon-like peptide-1 (GLP-1) and GIP. Furthermore, potential advantages and limitations...

  14. Magnesium and type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    Mario; Barbagallo; Ligia; J; Dominguez

    2015-01-01

    Type 2 diabetes is frequently associated with both extracellular and intracellular magnesium(Mg) deficits. A chronic latent Mg deficit or an overt clinical hypomagnesemia is common in patients with type 2 diabetes, especially in those with poorly controlled glycemic profiles. Insulinand glucose are important regulators of Mg metabolism. Intracellular Mg plays a key role in regulating insulin action, insulin-mediated-glucose-uptake and vascular tone. Reduced intracellular Mg concentrations result in a defective tyrosine-kinase activity, postreceptorial impairment in insulin action and worsening of insulin resistance in diabetic patients. A low Mg intake and an increased Mg urinary loss appear the most important mechanisms that may favor Mg depletion in patients with type 2 diabetes. Low dietary Mg intake has been related to the development of type 2 diabetes and metabolic syndrome. Benefits of Mg supplementation on metabolic profiles in diabetic patients have been found in most, but not all clinical studies and larger prospective studies are needed to support the potential role of dietary Mg supplementation as a possible public health strategy in diabetes risk. The aim of this review is to revise current evidence on the mechanisms of Mg deficiency in diabetes and on the possible role of Mg supplementation in the prevention and management of the disease.

  15. [Obesity and type 2 diabetes].

    Science.gov (United States)

    Toplak, Hermann; Hoppichler, Friedrich; Wascher, Thomas C; Schindler, Karin; Ludvik, Bernhard

    2016-04-01

    Obesity and Type 2 Diabetes are nowadays summarized as "diabesity". That is due to the fact that obesity is frequently preceding and the most important risk factor in the increase of Type 2 Diabetes. The body mass index (BMI) is a crude measure of body fatness. Even normal weight persons can have lack in muscles (sarcopenia), which leads to the recommendation to measure waist und body fatness (e.g. BIA). Lifestyle management including nutrition and physical activity are important for diabetes prevention. In the therapy of Type 2 Diabetes body weight is increasingly used as secondary target. Also the choice of the anti-diabetic medication and concomitant medications is increasingly influenced by body weight. The significance of anti-obesity medications in the therapy of type 2 diabetes will have to be clarified by future studies. Bariatric surgery is at present indicated with a BMI above BMI > 35 kg/m(2) and can lead at least to partial diabetes remission but has to be part of a lifelong care concept.

  16. Delaying or Preventing Type 2 Diabetes

    Science.gov (United States)

    ... Problems Diabetes & Sexual & Urologic Problems Preventing Type 2 Diabetes Perhaps you have learned that you have a ... I lower my chances of developing type 2 diabetes? Research such as the Diabetes Prevention Program shows ...

  17. Type 2-diabetes i Danmark

    DEFF Research Database (Denmark)

    Beck-Nielsen, Henning; Henriksen, Jan Erik

    2012-01-01

    Our vision is that the opportunistic screening system will be improved in order to find patients with occult type 2 diabetes (T2D), since an early treatment based on a correct phenotyping is the goal. Individual goals for HbA1c, blood pressure and lipids must be set up, and the number of drugs used...... must fit with the patient's phenotype to avoid polypharmacy. A new flow chart for the organisation of T2D has been formulated giving the general practitioners the role as co-ordinators....

  18. Exercise and type 2 diabetes

    DEFF Research Database (Denmark)

    Karstoft, Kristian; Pedersen, Bente Klarlund

    2016-01-01

    Type 2 diabetes mellitus (T2DM) is associated with metabolic dysregulation and chronic inflammation, and regular exercise may provide a strong stimulus for improving both. In this review, we first discuss the link between inflammation and metabolism. Next, we give an update on the clinical...... metabolic effects of exercise in T2DM patients with special focus on which parameters to consider for optimizing metabolic improvements. We then discuss the mechanisms whereby exercise exerts its anti-inflammatory and related metabolic effects. Evidence exists that interleukin (IL)-1β is involved...... in pancreatic β-cell damage, whereas tumor necrosis factor (TNF)-α appears to be a key molecule in peripheral insulin resistance. Mechanistic studies in humans suggest that moderate acute elevations in IL-6, as provoked by exercise, exert direct anti-inflammatory effects by an inhibition of TNF...

  19. Dietary Sodium Intake in Type 2 Diabetes

    OpenAIRE

    Provenzano, Laura Ferreira; Stark, Sue; Steenkiste, Ann; Piraino, Beth; Sevick, Mary Ann

    2014-01-01

    Patients with type 2 diabetes have an increased risk for cardiovascular and chronic kidney disease. Superimposed hypertension further increases the risk and is associated with increased dietary sodium intake. There are few data available on dietary sodium intake in type 2 diabetes. The aim of this study was to quantify dietary sodium intake in a cohort of self-referred patients with type 2 diabetes and to identify sociodemographic characteristics associated with it. Sodium intake in this coho...

  20. Type 2 Diabetes: What Is It?

    Science.gov (United States)

    ... 2-Year-Old Type 2 Diabetes: What Is It? KidsHealth > For Parents > Type 2 Diabetes: What Is It? Print A A A What's in this article? ... pancreas to make the hormone insulin and release it into the bloodstream. But in people with diabetes, ...

  1. Take Steps to Prevent Type 2 Diabetes

    Science.gov (United States)

    ... En español Take Steps to Prevent Type 2 Diabetes Browse Sections The Basics Overview Types of Diabetes ... 1 of 9 sections The Basics: Types of Diabetes What is diabetes? Diabetes is a disease. People ...

  2. [Chronic nicotinamide overload and type 2 diabetes].

    Science.gov (United States)

    Zhou, Shi-Sheng; Li, Da; Zhou, Yi-Ming; Sun, Wu-Ping; Liu, Xing-Xing; Lun, Yong-Zhi

    2010-02-25

    Type 2 diabetes is a major global health problem. It is generally accepted that type 2 diabetes is the result of gene-environmental interaction. However, the mechanism underlying the interaction is unclear. Diet change is known to play an important role in type 2 diabetes. The fact that the global high prevalence of type 2 diabetes has occurred following the spread of food fortification worldwide suggests a possible involvement of excess niacin intake. Our recent study found that nicotinamide overload and low nicotinamide detoxification may induce oxidative stress associated with insulin resistance. Based on the relevant facts, this review briefly summarized the relationship between the prevalence of type 2 diabetes and the nicotinamide metabolism changes induced by excess niacin intake, aldehyde oxidase inhibitors, liver diseases and functional defects of skin. We speculate that the gene-environmental interaction in type 2 diabetes may be a reflection of the outcome of the association of chronic nicotinamide overload-induced toxicity and the relatively low detoxification/excretion capacity of the body. Reducing the content of niacin in foods may be a promising strategy for the control of type 2 diabetes.

  3. Somatotype in Elderly Type 2 Diabetes Patients

    OpenAIRE

    Buffa, Roberto; Floris, Giovanni; F. Putzu, Paolo; Carboni, Luciano; Marini, Elisabetta

    2007-01-01

    Somatotyping is a practical technique for the description of physique. Individuals with Type 2 diabetes are characterized by physical peculiarities, such as overweight, obesity and a central pattern of body fat distribution. Somatotype applications to diabetes are limited. The objective of this study is to describe the somatotype of elderly type 2 diabetes patients. The sample consisted of 110 patients with type 2 diabetes (45 men, mean age 69.4±7.0 years; 65 women, mean age 72.9±...

  4. Dietary Sodium Intake in Type 2 Diabetes.

    Science.gov (United States)

    Provenzano, Laura Ferreira; Stark, Sue; Steenkiste, Ann; Piraino, Beth; Sevick, Mary Ann

    2014-07-01

    Patients with type 2 diabetes have an increased risk for cardiovascular and chronic kidney disease. Superimposed hypertension further increases the risk and is associated with increased dietary sodium intake. There are few data available on dietary sodium intake in type 2 diabetes. The aim of this study was to quantify dietary sodium intake in a cohort of self-referred patients with type 2 diabetes and to identify sociodemographic characteristics associated with it. Sodium intake in this cohort was far greater than current recommendations. Increased awareness of sodium intake in this population might lead to target interventions to reduce sodium intake and potentially improve long-term outcomes.

  5. Exercise therapy in Type 2 diabetes

    NARCIS (Netherlands)

    S.F.E. Praet (Stephan); L.J.C. van Loon (Luc)

    2009-01-01

    textabstractStructured exercise is considered an important cornerstone to achieve good glycemic control and improve cardiovascular risk profile in Type 2 diabetes. Current clinical guidelines acknowledge the therapeutic strength of exercise intervention. This paper reviews the wide pathophysiologica

  6. [Acatalasemia and type 2 diabetes mellitus].

    Science.gov (United States)

    Góth, László; Nagy, Teréz; Káplár, Miklós

    2015-03-08

    The catalase enzyme decomposes the toxic concentrations of hydrogen peroxide into oxygen and water. Hydrogen peroxide is a highly reactive small molecule and its excessive concentration may cause significant damages to proteins, deoxyribonucleic acid, ribonucleic acid and lipids. Acatalasemia refers to inherited deficiency of the catalase enzyme. In this review the authors discuss the possible role of the human catalase enzyme, the metabolism of hydrogen peroxide, and the phenomenon of hydrogen peroxide paradox. In addition, they review data obtained from Hungarian acatalasemic patients indicating an increased frequency of type 2 diabetes mellitus, especially in female patients, and an early onset of type 2 diabetes in these patients. There are 10 catalase gene variants which appear to be responsible for decreased blood catalase activity in acatalasemic patients with type 2 diabetes. It is assumed that low levels of blood catalase may cause an increased concentration of hydrogen peroxide which may contribute to the pathogenesis of type 2 diabetes mellitus.

  7. Intensive integrated therapy of type 2 diabetes

    DEFF Research Database (Denmark)

    Gaede, Peter; Pedersen, Oluf

    2004-01-01

    effects on long-term outcome. The results from these studies are anticipated to change the future management of type 2 diabetes, and most of the updated national guidelines for the treatment of type 2 diabetes recommend a multipronged approach driven by ambitious treatment targets. The outcome...... of this intensive integrated therapy has, however, only been investigated in a few studies of patients with type 2 diabetes. One of these trials, the Steno-2 Study, showed that intensive intervention for an average of 7.8 years cuts cardiovascular events as well as nephropathy, retinopathy, and autonomic neuropathy......The macro- and microvascular burden of type 2 diabetes is well established. A number of recent single risk factor intervention trials targeting hyperglycemia, dyslipidemia, hypertension, procoagulation, microalbumuria, and existing cardiovascular disorders have, however, shown major beneficial...

  8. Metabolic surgery - cure for type 2 diabetes

    OpenAIRE

    Zeve,Jorge Luiz de Mattos; Tomaz, Carlos Alberto Bezerra

    2011-01-01

    ABSTRACT INTRODUCTION: Type 2 diabetes is a metabolic disease characterized by chronic hyperglycemia associated with several organs damage and failure. It is the most common cause of blindness, amputation and kidney failure in western adults, besides increase the risk of coronary disease and stroke with high mortality of patients. The association of type 2 diabetes with obesity is really significant. Obese diabetic patients had a better glucose control after bariatric surgery even prior to...

  9. Somatotype in elderly type 2 diabetes patients.

    Science.gov (United States)

    Buffa, Roberto; Floris, Giovanni; Putzu, Paolo F; Carboni, Luciano; Marini, Elisabetta

    2007-09-01

    Somatotyping is a practical technique for the description of physique. Individuals with Type 2 diabetes are characterized by physical peculiarities, such as overweight, obesity and a central pattern of body fat distribution. Somatotype applications to diabetes are limited. The objective of this study is to describe the somatotype of elderly type 2 diabetes patients. The sample consisted of 110 patients with type 2 diabetes (45 men, mean age 69.4 +/- 7.0 years; 65 women, mean age 72.9 +/- 7.1 years). The pathological subjects were compared with a control group consisting of 280 healthy individuals (134 men, mean age 74.2 +/- 7.3 years; 146 women, mean age 74.9 +/- 7.4 years). The Heath-Carter somatotype was applied. Diabetic men and women (mean somatotype, respectively: 6.8-5.6-0.6 and 8.6-6.4-0.2) presented significantly higher values of endomorphy than the controls (p = 0.043 in men, p = 0.003 in women); men also had a lower mesomorphic component (p = 0.000). The somatotype method revealed physical peculiarities in type 2 diabetes patients. The marked endomorphy in the pathological individuals can be related to general fatness, which is a well known disease risk factor. The somatotype appears to be a suitable technique for the assessment of physique in type 2 diabetes patients.

  10. Type 2-diabetes. Sociale relationer og sundhedsadfaerd

    DEFF Research Database (Denmark)

    Holm, Astrid Ledgaard; Andersen, Anne Friis; Avlund, Kirsten

    2008-01-01

    INTRODUCTION: Type 2 diabetes is a chronic disease that challenges the Danish health care system and health behaviour is important in connection with rehabilitation. Foreign research shows that social relations are associated with a healthy lifestyle, but this effect has not yet been examined...... thoroughly based on Danish data. The purpose of this study was to examine the association between social relations and health behaviour among adult Danes with type 2 diabetes. MATERIALS AND METHODS: The study design was cross-sectional and based on data from the report ''Sundheds- og Sygelighedsundersøgelsen...... 2000'', published by The National Institute of Public Health; 264 respondents with type 2 diabetes were included in the final study population. Social relations were measured in terms of civil status, social contact and functional network. Health behaviour reflects whether the respondents comply...

  11. Type 2 diabetes sits in a chair

    DEFF Research Database (Denmark)

    Solomon, Thomas; Thyfault, J P

    2013-01-01

    The incidence of type 2 diabetes (T2D) continues to skyrocket across the industrialized world leading to soaring medical costs, reduced quality of life and increased mortality rates. Therefore, a more firm understanding of the development of the disease and effective, low cost therapies for preve......The incidence of type 2 diabetes (T2D) continues to skyrocket across the industrialized world leading to soaring medical costs, reduced quality of life and increased mortality rates. Therefore, a more firm understanding of the development of the disease and effective, low cost therapies....... In this review, we cover these topics and use current scientific evidence to support our belief that 'type 2 diabetes sits in a chair'. We also discuss a relatively new question that has yet to be examined: Would reducing sitting time be an effective treatment for T2D?...

  12. Type 2 Diabetes Mellitus in Youth

    Science.gov (United States)

    Quarry-Horn, Jill L.; Evans, Barbara J.; Kerrigan, James R.

    2003-01-01

    In the United States, the incidence of type 2 diabetes mellitus (DM) in children and adolescents has been increasing at an alarming rate. Early recognition and intervention can delay the onset of type 2 DM and prevent the long-term complications. School nurses have an essential role in implementing the American Diabetes Association (ADA)…

  13. [Surgical treatment of type 2 diabetes mellitus].

    Science.gov (United States)

    Carrillo-Esper, Raúl; Muciño-Bermejo, María Jimena

    2014-01-01

    Sustained remission of type 2 diabetes mellitus and significantly improved hyperlipidemia and arterial hypertension, control has been achieves in both lean and obese patient after bariatric surgery procedures or other gastrointestinal surgical procedures. It has been demonstrated that the metabolic effects of bariatric surgery in these patients derives not only in reducing weight and caloric intake, but also endocrine changes resulting from surgical manifestation gastrointestinal tract. In this article we review the clinical outcomes of such interventions (collectively called "metabolic surgery") and the perspectives on the role that these surgeries play in the treatment of patients with type 2 diabetes mellitus.

  14. [Zinc and type 2 diabetes].

    Science.gov (United States)

    Fukunaka, Ayako; Fujitani, Yoshio

    2016-07-01

    Pancreatic β cells contain the highest amount of zinc among cells within the human body, and hence, the relationship between zinc and diabetes has been a topic of great interest. While many studies demonstrating possible involvement of zinc deficiency in diabetes have been reported, precise mechanisms how zinc regulates glucose metabolism are still far from understood. Recent studies revealed that zinc can transmit signals that are driven by a variety of zinc transporters in a tissue and cell-type specific manner and deficiency in some zinc transporters may cause human diseases. Here, we review the role of zinc in metabolism particularly focusing on the emerging role of zinc transporters in diabetes.

  15. The genetic architecture of type 2 diabetes

    NARCIS (Netherlands)

    Fuchsberger, Christian; Flannick, Jason; Teslovich, Tanya M; Mahajan, Anubha; Agarwala, Vineeta; Gaulton, Kyle J; Ma, Clement; Fontanillas, Pierre; Moutsianas, Loukas; McCarthy, Davis J; Rivas, Manuel A; Perry, John R B; Sim, Xueling; Blackwell, Thomas W; Robertson, Neil R; Rayner, N William; Cingolani, Pablo; Locke, Adam E; Tajes, Juan Fernandez; Highland, Heather M; Dupuis, Josee; Chines, Peter S; Lindgren, Cecilia M; Hartl, Christopher; Jackson, Anne U; Chen, Han; Huyghe, Jeroen R; van de Bunt, Martijn; Pearson, Richard D; Kumar, Ashish; Müller-Nurasyid, Martina; Grarup, Niels; Stringham, Heather M; Gamazon, Eric R; Lee, Jaehoon; Chen, Yuhui; Scott, Robert A; Below, Jennifer E; Chen, Peng; Huang, Jinyan; Go, Min Jin; Stitzel, Michael L; Pasko, Dorota; Parker, Stephen C J; Varga, Tibor V; Green, Todd; Beer, Nicola L; Day-Williams, Aaron G; Ferreira, Teresa; Fingerlin, Tasha; Horikoshi, Momoko; Hu, Cheng; Huh, Iksoo; Ikram, Mohammad Kamran; Kim, Bong-Jo; Kim, Yongkang; Kim, Young Jin; Kwon, Min-Seok; Lee, Juyoung; Lee, Selyeong; Lin, Keng-Han; Maxwell, Taylor J; Nagai, Yoshihiko; Wang, Xu; Welch, Ryan P; Yoon, Joon; Zhang, Weihua; Barzilai, Nir; Voight, Benjamin F; Han, Bok-Ghee; Jenkinson, Christopher P; Kuulasmaa, Teemu; Kuusisto, Johanna; Manning, Alisa; Ng, Maggie C Y; Palmer, Nicholette D; Balkau, Beverley; Stančáková, Alena; Abboud, Hanna E; Boeing, Heiner; Giedraitis, Vilmantas; Prabhakaran, Dorairaj; Gottesman, Omri; Scott, James; Carey, Jason; Kwan, Phoenix; Grant, George; Smith, Joshua D; Neale, Benjamin M; Purcell, Shaun; Butterworth, Adam S; Howson, Joanna M M; Lee, Heung Man; Lu, Yingchang; Kwak, Soo-Heon; Zhao, Wei; Danesh, John; Lam, Vincent K L; Park, Kyong Soo; Saleheen, Danish; So, Wing Yee; Tam, Claudia H T; Afzal, Uzma; Aguilar, David; Arya, Rector; Aung, Tin; Chan, Edmund; Navarro, Carmen; Cheng, Ching-Yu; Palli, Domenico; Correa, Adolfo; Curran, Joanne E; Rybin, Denis; Farook, Vidya S; Fowler, Sharon P; Freedman, Barry I; Griswold, Michael; Hale, Daniel Esten; Hicks, Pamela J; Khor, Chiea-Chuen; Kumar, Satish; Lehne, Benjamin; Thuillier, Dorothée; Lim, Wei Yen; Liu, Jianjun; van der Schouw, Yvonne T; Loh, Marie; Musani, Solomon K; Puppala, Sobha; Scott, William R; Yengo, Loïc; Tan, Sian-Tsung; Taylor, Herman A; Thameem, Farook; Wilson, Gregory; Wong, Tien Yin; Njølstad, Pål Rasmus; Levy, Jonathan C; Mangino, Massimo; Bonnycastle, Lori L; Schwarzmayr, Thomas; Fadista, João; Surdulescu, Gabriela L; Herder, Christian; Groves, Christopher J; Wieland, Thomas; Bork-Jensen, Jette; Brandslund, Ivan; Christensen, Cramer; Koistinen, Heikki A; Doney, Alex S F; Kinnunen, Leena; Esko, Tõnu; Farmer, Andrew J; Hakaste, Liisa; Hodgkiss, Dylan; Kravic, Jasmina; Lyssenko, Valeriya; Hollensted, Mette; Jørgensen, Marit E; Jørgensen, Torben; Ladenvall, Claes; Justesen, Johanne Marie; Käräjämäki, Annemari; Kriebel, Jennifer; Rathmann, Wolfgang; Lannfelt, Lars; Lauritzen, Torsten; Narisu, Narisu; Linneberg, Allan; Melander, Olle; Milani, Lili; Neville, Matt; Orho-Melander, Marju; Qi, Lu; Qi, Qibin; Roden, Michael; Rolandsson, Olov; Swift, Amy; Rosengren, Anders H; Stirrups, Kathleen; Wood, Andrew R; Mihailov, Evelin; Blancher, Christine; Carneiro, Mauricio O; Maguire, Jared; Poplin, Ryan; Shakir, Khalid; Fennell, Timothy; DePristo, Mark; Hrabé de Angelis, Martin; Deloukas, Panos; Gjesing, Anette P; Jun, Goo; Nilsson, Peter; Murphy, Jacquelyn; Onofrio, Robert; Thorand, Barbara; Hansen, Torben; Meisinger, Christa; Hu, Frank B; Isomaa, Bo; Karpe, Fredrik; Liang, Liming; Peters, Annette; Huth, Cornelia; O'Rahilly, Stephen P; Palmer, Colin N A; Pedersen, Oluf; Rauramaa, Rainer; Tuomilehto, Jaakko; Salomaa, Veikko; Watanabe, Richard M; Syvänen, Ann-Christine; Bergman, Richard N; Bharadwaj, Dwaipayan; Bottinger, Erwin P; Cho, Yoon Shin; Chandak, Giriraj R; Chan, Juliana C N; Chia, Kee Seng; Daly, Mark J; Ebrahim, Shah B; Langenberg, Claudia; Elliott, Paul; Jablonski, Kathleen A; Lehman, Donna M; Jia, Weiping; Ma, Ronald C W; Pollin, Toni I; Sandhu, Manjinder; Tandon, Nikhil; Froguel, Philippe; Barroso, Inês; Teo, Yik Ying; Zeggini, Eleftheria; Loos, Ruth J F; Small, Kerrin S; Ried, Janina S; DeFronzo, Ralph A; Grallert, Harald; Glaser, Benjamin; Metspalu, Andres; Wareham, Nicholas J; Walker, Mark; Banks, Eric; Gieger, Christian; Ingelsson, Erik; Im, Hae Kyung; Illig, Thomas; Franks, Paul W; Buck, Gemma; Trakalo, Joseph; Buck, David; Prokopenko, Inga; Mägi, Reedik; Lind, Lars; Farjoun, Yossi; Owen, Katharine R; Gloyn, Anna L; Strauch, Konstantin; Tuomi, Tiinamaija; Kooner, Jaspal Singh; Lee, Jong-Young; Park, Taesung; Donnelly, Peter; Morris, Andrew D; Hattersley, Andrew T; Bowden, Donald W; Collins, Francis S; Atzmon, Gil; Chambers, John C; Spector, Timothy D; Laakso, Markku; Strom, Tim M; Bell, Graeme I; Blangero, John; Duggirala, Ravindranath; Tai, E Shyong; McVean, Gilean; Hanis, Craig L; Wilson, James G; Seielstad, Mark; Frayling, Timothy M; Meigs, James B; Cox, Nancy J; Sladek, Rob; Lander, Eric S; Gabriel, Stacey; Burtt, Noël P; Mohlke, Karen L; Meitinger, Thomas; Groop, Leif; Abecasis, Goncalo; Florez, Jose C; Scott, Laura J; Morris, Andrew P; Kang, Hyun Min; Boehnke, Michael; Altshuler, David; McCarthy, Mark I

    2016-01-01

    The genetic architecture of common traits, including the number, frequency, and effect sizes of inherited variants that contribute to individual risk, has been long debated. Genome-wide association studies have identified scores of common variants associated with type 2 diabetes, but in aggregate, t

  16. Albiglutide for treating type 2 diabetes

    DEFF Research Database (Denmark)

    Brønden, Andreas; Naver, Signe V.; Knop, Filip K.;

    2015-01-01

    INTRODUCTION: Albiglutide is a once-weekly, glucagon-like peptide-1 receptor agonist approved during 2014 in both the US and Europe for the treatment of adults with type 2 diabetes. The recommended dose is 30 mg with the possibility of uptitration to 50 mg based on individual glycemic response...

  17. Arrestin' insulin resistance and type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ A group of biologists at the Institute of Biochemistry and Cell Biology (SIBCB) under the CAS Shanghai Institutes for Biological Sciences (SIBS) reported on 5 Jan, 2009 in Nature that deficiency or dysfunction of a protein called β-arrestin-2 might contribute to the development of type 2 diabetes, hence inspiring research on potential new therapies for this notorious health threat.

  18. Type 2-diabetes hos etniske minoriteter

    DEFF Research Database (Denmark)

    Zander, Mette; Hansen, Caroline Raun; Koefoed, Birgitte Gade;

    2012-01-01

    In general, type 2 diabetes is more common among immigrants than among the inhabitants with a Western background. The higher prevalence among ethnic minorities is probably due to a complex correlation between genetic factors, diet, exercise, linguistic and cultural obstacles, low birthweight and ...

  19. Statin treatment in type 2 diabetes patients

    NARCIS (Netherlands)

    de Vries, Folgerdiena Maria

    2016-01-01

    Type 2 diabetes patients have a higher risk of developing cardiovascular and cerebrovascular diseases, therefore statins are recommended for almost all diabetes patients. Although it has been shown that statins can have substantial health and economic benefits, treatment in clinical practice is ofte

  20. The genetic architecture of type 2 diabetes

    DEFF Research Database (Denmark)

    Fuchsberger, Christian; Flannick, Jason; Teslovich, Tanya M

    2016-01-01

    The genetic architecture of common traits, including the number, frequency, and effect sizes of inherited variants that contribute to individual risk, has been long debated. Genome-wide association studies have identified scores of common variants associated with type 2 diabetes, but in aggregate...

  1. Atherosclerotic plaque burdens in type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ In this issue of the Journal of Geriatric Cardiology,Huang et al. have reported the detection of coronary artery disease with electron-beam computed tomography (EBCT),utilizing non-contrast and contrast imaging techniques (EBCTA) in several subgroups including type 2 diabetes mellitus (DM), impaired glucose tolerance (IGT), coronary heart disease, and normal subjects.

  2. [Type 2 diabetes in children and adolescents].

    Science.gov (United States)

    Hinneburg, Iris

    2014-10-01

    Obesity is one of the main risk factors for developing impaired glucose tolerance and type 2 diabetes in the youth. The patients are at high risk for cardiovascular complications. Yet, meeting therapeutical goals is hard to achieve in many children and adolescents.

  3. An immune origin of type 2 diabetes?

    DEFF Research Database (Denmark)

    Kolb, H; Mandrup-Poulsen, Thomas

    2005-01-01

    Subclinical, low-grade systemic inflammation has been observed in patients with type 2 diabetes and in those at increased risk of the disease. This may be more than an epiphenomenon. Alleles of genes encoding immune/inflammatory mediators are associated with the disease, and the two major...

  4. Type 2-diabetes hos etniske minoriteter

    DEFF Research Database (Denmark)

    Zander, Mette; Hansen, Caroline Raun; Koefoed, Birgitte Gade

    2012-01-01

    In general, type 2 diabetes is more common among immigrants than among the inhabitants with a Western background. The higher prevalence among ethnic minorities is probably due to a complex correlation between genetic factors, diet, exercise, linguistic and cultural obstacles, low birthweight...

  5. Type 2 Diabetes and Uric Acid Nephrolithiasis

    Science.gov (United States)

    Maalouf, Naim M.

    2008-09-01

    Type 2 diabetes is associated with an increased propensity for uric acid nephrolithiasis. In individuals with diabetes, this increased risk is due to a lower urine pH that results from obesity, dietary factors, and impaired renal ammoniagenesis. The epidemiology and pathogenesis of uric acid stone disease in patients with diabetes are hereby reviewed, and potential molecular mechanisms are proposed.

  6. Lixisenatide for type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Christensen, Mikkel; Knop, Filip K; Vilsbøll, Tina

    2011-01-01

    Introduction: Type 2 diabetes mellitus (T2DM) is an increasing health problem worldwide. Glucagon-like peptide-1 (GLP-1) receptor agonists are an expanding drug class that target several of the pathophysiological traits of T2DM. Lixisenatide is a GLP-1 receptor agonist in development for once...

  7. The genetics of type 2 diabetes

    NARCIS (Netherlands)

    Reiling, Hendrik Willem

    2010-01-01

    Type 2 Diabetes (T2D) is a chronic disease, characterized by hyperglycaemia, caused by decreased insulin secretion by beta-cells and insulin resistance of target tissues of insulin. Several risk factors are known, like decreased exercise, ageing and western diet. Also genetic variance can alter susc

  8. Type 2 Diabetes Widespread in Adults

    Science.gov (United States)

    ... be able to prevent or delay type 2 diabetes by cutting calories and increasing your physical activity to lose a modest amount of weight. A major study of people with pre-diabetes showed that lifestyle changes leading to a 5- ...

  9. Mediterranean diet and type 2 diabetes.

    Science.gov (United States)

    Esposito, Katherine; Giugliano, Dario

    2014-03-01

    Consumption of selected dietary components is favourably associated with prevention of type 2 diabetes, but discordant results for some foods or single nutrients continue to appear. The study of complete dietary patterns represents the most adequate approach to assess the role of diet on the risk of diabetes. The term 'Mediterranean diet' essentially refers to a primarily plant-based dietary pattern whose greater consumption has been associated with higher survival for lower all-cause mortality. At least five large prospective studies report a substantially lower risk of type 2 diabetes in healthy people or at risk patients with the highest adherence to a Mediterranean diet. Five randomized controlled trials have evaluated the effects of a Mediterranean diet, as compared with other commonly used diets, on glycaemic control in subjects with type 2 diabetes. Improvement of HbA1c levels was greater with a Mediterranean diet and ranged from 0.1% to 0.6% for HbA1c . No trial reported worsening of glycaemic control with a Mediterranean diet. Although no controlled trial specifically assessed the role of a Mediterranean diet in reducing cardiovascular events in type 2 diabetes, there is evidence that post-infarct or high-risk patients, including diabetic patients, may have cardiovascular benefits from a Mediterranean diet. The evidence so far accumulated suggests that adopting a Mediterranean diet may help prevent type 2 diabetes; moreover, a lower carbohydrate, Mediterranean-style diet seems good for HbA1c reduction in persons with established diabetes.

  10. Depression among type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Taghreed Mohamed El-Shafie ,Entesar Omar A. El-Saghier and Iman ,Kamal Ramadan

    2011-07-01

    Full Text Available Background & Objectives: Diabetes and depression are highly prevalent conditions and have significant impact on health outcomes. The combination of depression with type 2 diabetes is a public health problem. Therefore, we aimed to assess some socio-demographic characteristics of type 2 diabetes and to investigate the relationship between type 2 diabetes and depression among patients aged from 40 to 60 years old. Methods: 125 patients diagnosed with type 2 diabetes attending diabetes clinics in the Al-Zahraa hospital were invited to participate in this cross-sectional study. Patients were interviewed using structured questionnaires to gather data on socio-demographics, clinical, self care compliance, medication usage, and diabetes complications. The MADRS was administered as a screening tool for depression level evaluation. Binary logistic regression model was used to examine association between predictor variables and risk of depression among diagnosed type 2 diabetes at 95% C.I. and P < 0.05. Results: One hundred and twenty five participants completed the interview. More than half of participants were females (58.4% and the mean age was 48 (sd = 5.9, 47.2% hypertensive, and 59.2% on insulin. More than two third (74.4% of patients were depressed; (24.8% mild, 37.6% moderate and 12% severely depressed. Almost four out of five patients (88.8% had diabetes complications, Depression was strongly associated with neuropathy, age, retinopathy, sex and cardiac complications. However, the likelihood of depression was not associated with nephropathy, hypertension and sexual dysfunction. Conclusion: The current study demonstrates a strong correlation between depression and diabetes particularly complications. In particular, patients who are depressed tended to have poorer self-care, more severe physical symptoms and were less likely to adhere to prescribed care regimens. These findings raise the possibility that improving the mental health as part of a

  11. Kirurgisk behandling af type 2-diabetes

    DEFF Research Database (Denmark)

    Olesen, Stine Chabert; Hansen, Dorte Lindqvist; Almdal, Thomas;

    2009-01-01

    on appetite-regulating gut hormone, particularly peptide YY and glucagon-like peptide-1. Nevertheless, other unknown hormones or mechanisms may be involved in the dramatic changes in the glucose metabolism. Development of new drugs and treatments based on the endocrine changes observed after bariatric surgery...

  12. Suboptimal glycemic control in type 2 diabetes

    DEFF Research Database (Denmark)

    Nefs, Giesje; Pouwer, F; Denollet, J;

    2012-01-01

    Recent studies examining the relationship between depression and glycosylated hemoglobin (HbA(1c)) concentrations in patients with type 2 diabetes have yielded mixed findings. One explanation may lie in the heterogeneity of depression. Therefore, we examined whether distinct features of depression...... were differentially associated with suboptimal glycemic control. Cross-sectional baseline data from a dynamic cohort study of primary care patients with type 2 diabetes from the Eindhoven region, The Netherlands, were analyzed. A total of 5772 individuals completed baseline measurements of demographic...... adjustment for the other depression measures (OR 1.33, 1.11-1.59). Alcohol consumption and physical activity met criteria for mediation, but did not attenuate the association between anhedonia and glycemic control by more than 5%. Although diabetes duration was identified as a confounder and controlled for...

  13. Mitochondrial oxidative function and type 2 diabetes

    DEFF Research Database (Denmark)

    Rabøl, Rasmus; Boushel, Robert; Dela, Flemming

    2006-01-01

    The cause of insulin resistance and type 2 diabetes is unknown. The major part of insulin-mediated glucose disposal takes place in the skeletal muscle, and increased amounts of intramyocellular lipid has been associated with insulin resistance and linked to decreased activity of mitochondrial...... oxidative phosphorylation. This review will cover the present knowledge and literature on the topics of the activity of oxidative enzymes and the electron transport chain (ETC) in skeletal muscle of patients with type 2 diabetes. Different methods of studying mitochondrial function are described, including...... biochemical measurements of oxidative enzyme and electron transport activity, isolation of mitochondria for measurements of respiration, and ATP production and indirect measurements of ATP production using nuclear magnetic resonance (NMR) - spectroscopy. Biochemical markers of mitochondrial content are also...

  14. Oral Health and Type 2 Diabetes

    OpenAIRE

    Leite, Renata S.; Marlow, Nicole M.; Fernandes, Jyotika K.

    2013-01-01

    Type 2 diabetes mellitus (T2DM) has been described as a new epidemic. Approximately 285 million people worldwide suffer from diabetes, and this number is predicted to increase by about 50% by year 2030.This article will review oral health manifestations of diabetes, and discuss associations between periodontal disease and diabetes. Although there is a strong body of evidence that supports the relationship between oral health and T2DM, oral health awareness is lacking among patients with diabe...

  15. Green tea and type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Jae-Hyung Park

    2014-03-01

    Full Text Available Green tea and coffee consumption have been widely popular worldwide. These beverages contain caffeine to activate the central nervous system by adenosine receptor blockade, and due to the caffeine, addiction or tolerance may occur. In addition to this caffeine effect, green tea and coffee consumption have always been at the center of discussions about human health, disease, and longevity. In particular, green tea catechins are involved in many biological activities such as antioxidation and modulation of various cellular lipid and proteins. Thus, they are beneficial against degenerative diseases, including obesity, cancer, cardiovascular diseases, and various inflammatory diseases. Some reports also suggest that daily consumption of tea catechins may help in controlling type 2 diabetes. However, other studies have reported that chronic consumption of green tea may result in hepatic failure, neuronal damage, and exacerbation of diabetes, suggesting that interindividual variations in the green tea effect are large. This review will focus on the effect of green tea catechins extracted from the Camellia sinensis plant on type 2 diabetes and obesity, and the possible mechanistic explanation for the experimental results mainly from our laboratory. It is hoped that green tea can be consumed in a suitable manner as a supplement to prevent the development of type 2 diabetes and obesity.

  16. Prevention of type 2 diabetes: a review.

    Science.gov (United States)

    Hussain, A; Claussen, B; Ramachandran, A; Williams, R

    2007-06-01

    One of the major public health challenges of the 21st century is type 2 diabetes. WHO estimates that by 2025 as many as 200-300 million people worldwide will have developed the disease. A distressing increase in children is perhaps the most alarming sign of something going wrong. Roughly half of the risk of type 2 diabetes can be attributed to environmental exposure and the other half to genetics. Central themes for prevention are the risk factors overweight, sedentary lifestyle, certain dietary components and perinatal factors. Overweight is the most critical risk factor, and should be targeted for prevention of type 2 diabetes especially among children and youths. Ethnicity and perinatal factors are also worth considering. Today we know that prevention helps. In the US Diabetes Prevention Programme for high risk individuals, there was a 58% relative reduction in the progression to diabetes in the lifestyle group compared with the controls. Within the lifestyle group, 50% achieved the goal of more than 7% weight reduction, and 74% maintained at least 150 min of moderately intense activity each week. This review discusses different forms of prevention, and proposes first of all to target people with Impaired Glucose Tolerance with increasing activity and altering dietary factors. And secondly, population-based measures to encourage increased physical activity and decreased consumption of energy-dense foods are important, and may target school children and young people, certain ethnic groups and women with gestational diabetes.

  17. The genetic architecture of type 2 diabetes

    Science.gov (United States)

    Ma, Clement; Fontanillas, Pierre; Moutsianas, Loukas; McCarthy, Davis J; Rivas, Manuel A; Perry, John R B; Sim, Xueling; Blackwell, Thomas W; Robertson, Neil R; Rayner, N William; Cingolani, Pablo; Locke, Adam E; Tajes, Juan Fernandez; Highland, Heather M; Dupuis, Josee; Chines, Peter S; Lindgren, Cecilia M; Hartl, Christopher; Jackson, Anne U; Chen, Han; Huyghe, Jeroen R; van de Bunt, Martijn; Pearson, Richard D; Kumar, Ashish; Müller-Nurasyid, Martina; Grarup, Niels; Stringham, Heather M; Gamazon, Eric R; Lee, Jaehoon; Chen, Yuhui; Scott, Robert A; Below, Jennifer E; Chen, Peng; Huang, Jinyan; Go, Min Jin; Stitzel, Michael L; Pasko, Dorota; Parker, Stephen C J; Varga, Tibor V; Green, Todd; Beer, Nicola L; Day-Williams, Aaron G; Ferreira, Teresa; Fingerlin, Tasha; Horikoshi, Momoko; Hu, Cheng; Huh, Iksoo; Ikram, Mohammad Kamran; Kim, Bong-Jo; Kim, Yongkang; Kim, Young Jin; Kwon, Min-Seok; Lee, Juyoung; Lee, Selyeong; Lin, Keng-Han; Maxwell, Taylor J; Nagai, Yoshihiko; Wang, Xu; Welch, Ryan P; Yoon, Joon; Zhang, Weihua; Barzilai, Nir; Voight, Benjamin F; Han, Bok-Ghee; Jenkinson, Christopher P; Kuulasmaa, Teemu; Kuusisto, Johanna; Manning, Alisa; Ng, Maggie C Y; Palmer, Nicholette D; Balkau, Beverley; Stančáková, Alena; Abboud, Hanna E; Boeing, Heiner; Giedraitis, Vilmantas; Prabhakaran, Dorairaj; Gottesman, Omri; Scott, James; Carey, Jason; Kwan, Phoenix; Grant, George; Smith, Joshua D; Neale, Benjamin M; Purcell, Shaun; Butterworth, Adam S; Howson, Joanna M M; Lee, Heung Man; Lu, Yingchang; Kwak, Soo-Heon; Zhao, Wei; Danesh, John; Lam, Vincent K L; Park, Kyong Soo; Saleheen, Danish; So, Wing Yee; Tam, Claudia H T; Afzal, Uzma; Aguilar, David; Arya, Rector; Aung, Tin; Chan, Edmund; Navarro, Carmen; Cheng, Ching-Yu; Palli, Domenico; Correa, Adolfo; Curran, Joanne E; Rybin, Denis; Farook, Vidya S; Fowler, Sharon P; Freedman, Barry I; Griswold, Michael; Hale, Daniel Esten; Hicks, Pamela J; Khor, Chiea-Chuen; Kumar, Satish; Lehne, Benjamin; Thuillier, Dorothée; Lim, Wei Yen; Liu, Jianjun; van der Schouw, Yvonne T; Loh, Marie; Musani, Solomon K; Puppala, Sobha; Scott, William R; Yengo, Loïc; Tan, Sian-Tsung; Taylor, Herman A; Thameem, Farook; Wilson, Gregory; Wong, Tien Yin; Njølstad, Pål Rasmus; Levy, Jonathan C; Mangino, Massimo; Bonnycastle, Lori L; Schwarzmayr, Thomas; Fadista, João; Surdulescu, Gabriela L; Herder, Christian; Groves, Christopher J; Wieland, Thomas; Bork-Jensen, Jette; Brandslund, Ivan; Christensen, Cramer; Koistinen, Heikki A; Doney, Alex S F; Kinnunen, Leena; Esko, Tõnu; Farmer, Andrew J; Hakaste, Liisa; Hodgkiss, Dylan; Kravic, Jasmina; Lyssenko, Valeriya; Hollensted, Mette; Jørgensen, Marit E; Jørgensen, Torben; Ladenvall, Claes; Justesen, Johanne Marie; Käräjämäki, Annemari; Kriebel, Jennifer; Rathmann, Wolfgang; Lannfelt, Lars; Lauritzen, Torsten; Narisu, Narisu; Linneberg, Allan; Melander, Olle; Milani, Lili; Neville, Matt; Orho-Melander, Marju; Qi, Lu; Qi, Qibin; Roden, Michael; Rolandsson, Olov; Swift, Amy; Rosengren, Anders H; Stirrups, Kathleen; Wood, Andrew R; Mihailov, Evelin; Blancher, Christine; Carneiro, Mauricio O; Maguire, Jared; Poplin, Ryan; Shakir, Khalid; Fennell, Timothy; DePristo, Mark; de Angelis, Martin Hrabé; Deloukas, Panos; Gjesing, Anette P; Jun, Goo; Nilsson, Peter; Murphy, Jacquelyn; Onofrio, Robert; Thorand, Barbara; Hansen, Torben; Meisinger, Christa; Hu, Frank B; Isomaa, Bo; Karpe, Fredrik; Liang, Liming; Peters, Annette; Huth, Cornelia; O'Rahilly, Stephen P; Palmer, Colin N A; Pedersen, Oluf; Rauramaa, Rainer; Tuomilehto, Jaakko; Salomaa, Veikko; Watanabe, Richard M; Syvänen, Ann-Christine; Bergman, Richard N; Bharadwaj, Dwaipayan; Bottinger, Erwin P; Cho, Yoon Shin; Chandak, Giriraj R; Chan, Juliana C N; Chia, Kee Seng; Daly, Mark J; Ebrahim, Shah B; Langenberg, Claudia; Elliott, Paul; Jablonski, Kathleen A; Lehman, Donna M; Jia, Weiping; Ma, Ronald C W; Pollin, Toni I; Sandhu, Manjinder; Tandon, Nikhil; Froguel, Philippe; Barroso, Inês; Teo, Yik Ying; Zeggini, Eleftheria; Loos, Ruth J F; Small, Kerrin S; Ried, Janina S; DeFronzo, Ralph A; Grallert, Harald; Glaser, Benjamin; Metspalu, Andres; Wareham, Nicholas J; Walker, Mark; Banks, Eric; Gieger, Christian; Ingelsson, Erik; Im, Hae Kyung; Illig, Thomas; Franks, Paul W; Buck, Gemma; Trakalo, Joseph; Buck, David; Prokopenko, Inga; Mägi, Reedik; Lind, Lars; Farjoun, Yossi; Owen, Katharine R; Gloyn, Anna L; Strauch, Konstantin; Tuomi, Tiinamaija; Kooner, Jaspal Singh; Lee, Jong-Young; Park, Taesung; Donnelly, Peter; Morris, Andrew D; Hattersley, Andrew T; Bowden, Donald W; Collins, Francis S; Atzmon, Gil; Chambers, John C; Spector, Timothy D; Laakso, Markku; Strom, Tim M; Bell, Graeme I; Blangero, John; Duggirala, Ravindranath; Tai, E Shyong; McVean, Gilean; Hanis, Craig L; Wilson, James G; Seielstad, Mark; Frayling, Timothy M; Meigs, James B; Cox, Nancy J; Sladek, Rob; Lander, Eric S; Gabriel, Stacey; Burtt, Noël P; Mohlke, Karen L; Meitinger, Thomas; Groop, Leif; Abecasis, Goncalo; Florez, Jose C; Scott, Laura J; Morris, Andrew P; Kang, Hyun Min; Boehnke, Michael; Altshuler, David; McCarthy, Mark I

    2016-01-01

    The genetic architecture of common traits, including the number, frequency, and effect sizes of inherited variants that contribute to individual risk, has been long debated. Genome-wide association studies have identified scores of common variants associated with type 2 diabetes, but in aggregate, these explain only a fraction of heritability. To test the hypothesis that lower-frequency variants explain much of the remainder, the GoT2D and T2D-GENES consortia performed whole genome sequencing in 2,657 Europeans with and without diabetes, and exome sequencing in a total of 12,940 subjects from five ancestral groups. To increase statistical power, we expanded sample size via genotyping and imputation in a further 111,548 subjects. Variants associated with type 2 diabetes after sequencing were overwhelmingly common and most fell within regions previously identified by genome-wide association studies. Comprehensive enumeration of sequence variation is necessary to identify functional alleles that provide important clues to disease pathophysiology, but large-scale sequencing does not support a major role for lower-frequency variants in predisposition to type 2 diabetes. PMID:27398621

  18. RHEUMATOLOGICAL MANIFESTATIONS OF TYPE 2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Gurinder

    2014-01-01

    Full Text Available AIM : To determine the prevalence of rheumatic musculoskeletal manifestations in type 2 diabetic individuals and compare them with non - diabetic individuals. METHODS: 100 type 2 diabetic patients and 100 age and sex matched individuals were included in the study. Complete musculoskeletal examination was carried out which included examinatio n of shoulder joints , hands , back and knees. Patients were also asked to mark the sites of pain on a mannequin. Intensity of pain was marked on a visual analogue scale. These variables were then evaluated using Chi square test . RESULTS : Prevalence of RMS was found to be much higher in case of diabetic individuals except osteoarthritis. 49 patients out of 100 diabetic patients were found to have some form of rheumatic musculoskeletal manifestations. Diabetic cheiroarthropathy was found in the highest number of cases. A significant relation of these manifestations was found with age , duration of diabetes and glycemic control. A significant relation was also found between these manifestations and chronic microangiopathic complications like retinopathy and neph ropathy. CONCLUSION : A detailed examination of musculoskeletal system is an important part of care in patients with type 2 diabetes and some of the manifestations could be a simple and reliable marker of microangiopathic complications like retinopathy and nephropathy.

  19. "Small Steps, Big Rewards": You Can Prevent Type 2 Diabetes

    Science.gov (United States)

    ... Steps, Big Rewards": You Can Prevent Type 2 Diabetes Past Issues / Winter 2008 Table of Contents For ... million Americans are at risk for type 2 diabetes." "Fifty four million Americans are at risk for ...

  20. Salivary Output in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    T. Radhika

    2014-01-01

    Full Text Available Background: Diabetes Mellitus (DM is a common but complex metabolic disorder affecting various systems in the body. Oral cavity is no exception as this chronic condition exerts a huge impact on oral health. Salivary dysfunction has been reported to be a frequent oral complication in Type 2 diabetics which in turn leads to an array of oral complications because oral health is to a greater extent dependent on the quality and quantity of saliva. Aim: The aim of the present study was to evaluate and compare the salivary flow rate and prevalence of subjective symptoms of xerostomia in diabetics and non-diabetics. Materials and Methods: The study was conducted on 100 type 2 diabetic patients and 50 non-diabetic subjects. Random non-fasting plasma glucose and glycosylated hemoglobin levels were used to determine the diabetic status of the individuals. Unstimulated saliva was collected using “Spit technique”. Stimulated saliva was collected using 2% citric acid. Unstimulated and Stimulated Salivary Flow Rate (USFR and SSFR was calculated for every patient and expressed as ml/min. Xerostomia was evaluated using a multi-item inventory comprising 19 questions. Results: In our study, both whole unstimulated and stimulated salivary flow rates were decreased in diabetics compared to non-diabetics and this difference was statistically significant (p = 0.000. A greater percentage of diabetic patients perceived xerostomia symptoms compared to non-diabetics. Conclusion: Type 2 diabetics have higher prevalence of xerostomia and significantly reduced salivary flow rate compared to non-diabetics. Alterations in salivary flow create an imbalance in the homeostasis of oral environment leading to spectrum of oral ailments in these individuals

  1. Psoriasis er associeret med type 2-diabetes

    DEFF Research Database (Denmark)

    Gyldenl�ve, Mette; Knop, Filip Krag; Vilsb�ll, Tina;

    2013-01-01

    Psoriasis is a chronic inflammatory skin disease with a global prevalence of 2-3%. In recent years it has been established that patients with psoriasis carry an increased risk of type 2 diabetes, but the underlying pathophysiological mechanisms remain unclear. The association is most likely due...... to a combination of shared genes, immunoinflammatory mechanisms and a number of diabetes risk factors in patients with psoriasis. The current review summarises the evidence in the field and calls for attention on diabetes risk assessment, preventive measures and treatment in patients with psoriasis....

  2. Preventive pharmacotherapy in type 2 diabetes mellitus.

    Science.gov (United States)

    Choudhary, Neeraj; Kalra, Sanjay; Unnikrishnan, Ambika Gopalkrishnan; Ajish, T P

    2012-01-01

    Over the last few decades certain demographic changes have been observed worldwide, which have led to an increase in the prevalence of chronic non-communicable diseases. Type 2 diabetes mellitus and associated cardiovascular disease are major contributors to this disease burden leading to rising morbidity and mortality. It is worrisome to see that type 2 diabetes with its micro- and macrovascular complications is occurring in younger populations where it was hitherto unseen. Prevention appears to be an important strategy to reduce the burden of disease. Along with inculcating healthy lifestyle habits across populations, it may be suitable to use preventive pharmacotherapy in those with pre-diabetes and / or other risk factors like obesity, hypertension, and on the like. Metformin, alpha glucosidase inhibitors like acarbose, miglitol, and voglibose, and pioglitazone have all been used with success. The issues of compliance and adverse effects during long-term use have tempered the use of these drugs. The best approach would be to motivate the patient for effective lifestyle changes, and pharmacological management if the lifestyle changes are not successful in achieving their goals.

  3. Type 2 diabetes mellitus as a disorder of galanin resistance.

    Science.gov (United States)

    Fang, Penghua; Shi, Mingyi; Zhu, Yan; Bo, Ping; Zhang, Zhenwen

    2016-01-01

    The increasing prevalence of type 2 diabetes mellitus with its high morbidity and mortality becomes an important health problem. The multifactorial etiology of type 2 diabetes mellitus is relative to many gene and molecule alterations, and increased insulin resistance. Besides these, however, there are still other predisposing and risk factors accounting for type 2 diabetes mellitus not to be identified and recognized. Emerging evidence indicated that defects in galanin function played a crucial role in development of type 2 diabetes mellitus. Galanin homeostasis is tightly relative to insulin resistance and is regulated by blood glucose. Hyperglycemia, hyperinsulinism, enhanced plasma galanin levels and decreased galanin receptor activities are some of the characters of type 2 diabetes mellitus. The discrepancy between high insulin level and low glucose handling is named as insulin resistance. Similarly, the discrepancy between high galanin level and low glucose handling may be denominated as galanin resistance too. In this review, the characteristic milestones of type 2 diabetes mellitus were condensed as two analogical conceptual models, obesity-hyper-insulin-insulin resistance-type 2 diabetes mellitus and obesity-hyper-galanin-galanin resistance-type 2 diabetes mellitus. Both galanin resistance and insulin resistance are correlative with each other. Conceptualizing the etiology of type 2 diabetes mellitus as a disorder of galanin resistance may inspire a new concept to deepen our knowledge about pathogenesis of type 2 diabetes mellitus, eventually leading to novel preventive and therapeutic interventions for type 2 diabetes mellitus.

  4. Renal Biopsy in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Eugenia Espinel

    2015-05-01

    Full Text Available The majority of diabetic patients with renal involvement are not biopsied. Studies evaluating histological findings in renal biopsies performed in diabetic patients have shown that approximately one third of the cases will show pure diabetic nephropathy, one third a non-diabetic condition and another third will show diabetic nephropathy with a superimposed disease. Early diagnosis of treatable non-diabetic diseases in diabetic patients is important to ameliorate renal prognosis. The publication of the International Consensus Document for the classification of type 1 and type 2 diabetes has provided common criteria for the classification of diabetic nephropathy and its utility to stratify risk for renal failure has already been demonstrated in different retrospective studies. The availability of new drugs with the potential to modify the natural history of diabetic nephropathy has raised the question whether renal biopsies may allow a better design of clinical trials aimed to delay the progression of chronic kidney disease in diabetic patients.

  5. Psychological distress, cardiovascular complications and mortality among people with screen-detected type 2 diabetes

    DEFF Research Database (Denmark)

    Dalsgaard, Else-Marie; Vestergaard, Mogens; Skriver, Mette V;

    2014-01-01

    Dette studie undersøger, om psykisk belastning øger risikoen for kardiovaskulær sygdom og død blandt personer med type 2-diabetes. Forfatterne ser også nærmere på, om forskelle i metabolisk kontrol og indtag af ordineret medicin kan forklare dele af en eventuel sammenhæng. Studiet fandt, at 18% a...

  6. Hepatitis C virus and type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    Francesco Negro; Mahnaz Alaei

    2009-01-01

    This review focuses on the relationship between hepat it is Cvirus (HCV) infect ion and glucose metabolism derangements. Cross-sectional and longitudinal studies have shown that the chronic HCV infection is associated with an increased risk of developing insulin resistance (IR) and type 2 diabetes (T2D). The direct effect of HCV on the insulin signaling has been analyzed in experimental models. Although currently available data should be considered as preliminary, HCV seems to affect glucose metabolism via mechanisms that involve cellular pathways that have been implicated in the host innate immune response. IR and T2D not only accelerate the histological and clinical progression of chronic hepatitis C, but also reduce the early and sustained virological response to interferonalpha-based therapy. Thus, a detailed knowledge of themechanisms underlying the HCV-associated glucose metabolism derangements is warranted, in order to improve the clinical management of chronic hepatitis C patients.

  7. Gut microbiota and type 2 diabetes mellitus.

    Science.gov (United States)

    Muñoz-Garach, Araceli; Diaz-Perdigones, Cristina; Tinahones, Francisco J

    2016-12-01

    In recent years, many studies have related gut microbiome to development of highly prevalent diseases such as type 2 diabetes and obesity. Obesity itself is associated to changes in the composition of gut microbiome, with a trend to an overgrowth of microorganisms more efficiently obtaining energy from diet. There are several mechanisms that relate microbiota to the onset of insulin resistance and diabetes, including changes in bowel permeability, endotoxemia, interaction with bile acids, changes in the proportion of brown adipose tissue, and effects associated to use of drugs like metformin. Currently, use of pro and prebiotics and other new techniques such as gut microbiota transplant, or even antibiotic therapy, has been postulated to be useful tools to modulate the development of obesity and insulin resistance through the diet.

  8. Genetics of type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hansen, Lars; Pedersen, Oluf

    2005-01-01

    Throughout the last decade, molecular genetic studies of non-autoimmune diabetes mellitus have contributed significantly to our present understanding of this disease's complex aetiopathogenesis. Monogenic forms of diabetes (maturity-onset diabetes of the young, MODY) have been identified...... and classified into MODY1-6 according to the mutated genes that by being expressed in the pancreatic beta-cells confirm at the molecular level the clinical presentation of MODY as a predominantly insulin secretory deficient form of diabetes mellitus. Genomewide linkage studies of presumed polygenic type 2...... diabetic populations indicate that loci on chromosomes 1q, 5q, 8p, 10q, 12q and 20q contain susceptibility genes. Yet, so far, the only susceptibility gene, calpain-10 (CAPN10), which has been identified using genomewide linkage studies, is located on chromosome 2q37. Mutation analyses of selected...

  9. The Emerging Genetic Architecture of Type 2 Diabetes

    OpenAIRE

    Doria, Alessandro; Patti, Mary-Elizabeth; Kahn, C. Ronald

    2008-01-01

    Type 2 diabetes is a genetically heterogeneous disease, with several relatively rare monogenic forms and a number of more common forms resulting from a complex interaction of genetic and environmental factors. Previous studies using a candidate gene approach, family linkage studies, and gene expression profiling uncovered a number of type 2 genes, but the genetic basis of common type 2 diabetes remained unknown. Recently, a new window has opened on defining potential type 2 diabetes genes thr...

  10. HDL Cholesterol and Risk of Type 2 Diabetes

    DEFF Research Database (Denmark)

    Haase, Christiane L; Tybjærg-Hansen, Anne; Nordestgaard, Børge G

    2015-01-01

    Observationally, low levels of HDL cholesterol are consistently associated with increased risk of type 2 diabetes. Therefore, plasma HDL cholesterol increasing has been suggested as a novel therapeutic option to reduce the risk of type 2 diabetes. Whether levels of HDL cholesterol are causally...... associated with type 2 diabetes is unknown. In a prospective study of the general population (n = 47,627), we tested whether HDL cholesterol-related genetic variants were associated with low HDL cholesterol levels and, in turn, with an increased risk of type 2 diabetes. HDL cholesterol-decreasing gene scores...... and allele numbers associated with up to -13 and -20% reductions in HDL cholesterol levels. The corresponding theoretically predicted hazard ratios for type 2 diabetes were 1.44 (95% CI 1.38-1.52) and 1.77 (1.61-1.95), whereas the genetic estimates were nonsignificant. Genetic risk ratios for type 2 diabetes...

  11. Genetic basis of type 2 diabetes mellitus: implications for therapy

    DEFF Research Database (Denmark)

    Wolford, Johanna K; de Courten, Barbora

    2004-01-01

    in the management of type 2 diabetes include lifestyle intervention through diet modification and exercise, and oral or injected hypoglycemic agents; however, not all individuals with type 2 diabetes respond in the same way to these treatments. Because of variability in the clinical course of the disease......Type 2 diabetes mellitus represents a multifactorial, heterogeneous group of disorders, which result from defects in insulin secretion, insulin action, or both. The prevalence of type 2 diabetes has increased dramatically worldwide over the past several decades, a trend that has been heavily...... influenced by the relatively recent changes in diet and physical activity levels. There is also strong evidence supporting a genetic component to type 2 diabetes susceptibility and several genes underlying monogenic forms of diabetes have already been identified. However, common type 2 diabetes is likely...

  12. Impact of cigarette smoking in type 2 diabetes development

    Institute of Scientific and Technical Information of China (English)

    Xi-tao XIE; Qiang LIU; Jie WU; Makoto WAKUI

    2009-01-01

    Many patients with type 2 diabetes mellitus (DM2) are at risk for micro and macro vascular complications, which could be observed in heavy smokers. Cigarette smoking increases the risk for type 2 diabetes incidence. Nicotine, acknowledged as the major pharmacologically active chemical in tobacco, is responsible for the association between cigarette smoking and development of diabetes. This minireview summarized recent studies on nicotine effects on insulin action and insulin secretion, indicating the impact of nicotine on type 2 diabetes development.

  13. Multidisciplinary management of type 2 diabetes in children and adolescents

    Directory of Open Access Journals (Sweden)

    Michael E Bowen

    2010-07-01

    Full Text Available Michael E Bowen1,2, Russell L Rothman2,31Veterans Affairs Quality Scholars Fellowship Program, Tennessee Valley Healthcare System, Tennessee Valley Geriatric Research Education Clinical Center, Nashville, TN, USA; 2Division of General Internal Medicine and Public Health, Department of Medicine, 3Vanderbilt Eskind Diabetes Center, Vanderbilt University School of Medicine, Nashville, TN, USAAbstract: Although once considered a disease of adults, the prevalence of type 2 diabetes in youth is increasing at a significant rate. Similar to adults, youth with type 2 diabetes are at increased risk for developing hypertension, lipid abnormalities, renal disease, and other diabetes-related complications. However, children and adolescents with type 2 diabetes also face many unique management challenges that are different from adults with type 2 diabetes or children with type 1 diabetes. To deliver safe, effective, high-quality, cost-effective health care to adolescents with type 2 diabetes, reorganization and redesign of health care systems are needed. Multidisciplinary health care teams, which allow individuals with specialized training to maximally utilize their skills within an organized diabetes treatment team, may increase efficiency and effectiveness and may improve outcomes in children with type 2 diabetes. This review article provides a brief review of type 2 diabetes in children and adolescents, provides an overview of multidisciplinary health care teams, and discusses the role of multidisciplinary health care management in youth with type 2 diabetes.Keywords: adolescent, type 2 diabetes, multidisciplinary

  14. Brain imaging in type 2 diabetes.

    Science.gov (United States)

    Brundel, Manon; Kappelle, L Jaap; Biessels, Geert Jan

    2014-12-01

    Type 2 diabetes mellitus (T2DM) is associated with cognitive dysfunction and dementia. Brain imaging may provide important clues about underlying processes. This review focuses on the relationship between T2DM and brain abnormalities assessed with different imaging techniques: both structural and functional magnetic resonance imaging (MRI), including diffusion tensor imaging and magnetic resonance spectroscopy, as well as positron emission tomography and single-photon emission computed tomography. Compared to people without diabetes, people with T2DM show slightly more global brain atrophy, which increases gradually over time compared with normal aging. Moreover, vascular lesions are seen more often, particularly lacunar infarcts. The association between T2DM and white matter hyperintensities and microbleeds is less clear. T2DM has been related to diminished cerebral blood flow and cerebrovascular reactivity, particularly in more advanced disease. Diffusion tensor imaging is a promising technique with respect to subtle white matter involvement. Thus, brain imaging studies show that T2DM is associated with both degenerative and vascular brain damage, which develops slowly over the course of many years. The challenge for future studies will be to further unravel the etiology of brain damage in T2DM, and to identify subgroups of patients that will develop distinct progressive brain damage and cognitive decline.

  15. Exercise Training in Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Bobby Cheema

    2012-08-01

    Full Text Available The Maori and Pacific Islands peoples of New Zealand suffer a greater burden of type 2 diabetes mellitus (T2DM and associated comorbidities than their European counterparts. Empirical evidence supports the clinical application of aerobic and resistance training for effective diabetes management and potential remission, but few studies have investigated the effectiveness of these interventions in specific ethnic cohorts. We recently conducted the first trial to investigate the effect of prescribed exercise training in Polynesian people with T2DM. This article presents the cultural considerations undertaken to successfully implement the study. The research procedures were accepted and approved by cultural liaisons and potential participants. The approved methodology involved a trial evaluating and comparing the effects of two, 16-week exercise regimens (i.e. aerobic training and resistance training on glycosylated haemoglobin (HbA1c, related diabetes markers (i.e. insulin resistance, blood lipids, relevant cytokines and anthropometric and hemodynamic indices and health-related quality of life. Future exercise-related research or implementation strategies in this cohort should focus on cultural awareness and techniques to enhance participation and compliance. Our approach to cultural consultation could be considered by researchers undertaking trials in this and other ethnic populations suffering an extreme burden of T2DM, including indigenous Australians and Americans.

  16. Serum hepcidin concentrations and type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Hepcidin is a peptide hormone with both paracrine andendocrine functions that help in maintaining body ironstores. Type 2 diabetes (T2D) is one of the sequelae ofexcess body iron stores; thus, iron regulatory hormonehepcidin may have a direct or at least an indirect role inthe aetiopathogenesis of T2D. Both human and animalstudies at molecular and genetic levels have attemptedto establish a role for hepcidin in the development ofT2D, and a few epidemiologic studies have also showeda link between hepcidin and T2D at population level,but the findings are still inconclusive. Recent data havesuggested different pathways in which hepcidin could beassociated with T2D with much emphasis on its primaryor secondary role in insulin resistance. Some of thesuggested pathways are via transcription modulator ofhepcidin (STAT3); ferroportin 1 expression on the cellsinvolved in iron transport; transmembrane protease 6enzyme; and pro-inflammatory cytokines, interleukin(IL)-1, IL-6, tumor necrosis factor-α and IL-10. Thisreview briefly reports the existing evidence on thepossible links between hepcidin and T2D and concludesthat more data are needed to confirm or refute hepcidin'srole in the development of T2D. Examining this rolecould provide a further evidence base for iron in theaetiopathogenesis of T2D.

  17. Musculoskeletal pain in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Molsted, S; Tribler, J; Snorgaard, O

    2012-01-01

    The aims were to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes and demonstrate possible associated factors.......The aims were to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes and demonstrate possible associated factors....

  18. Role of IL-1beta in type 2 diabetes

    DEFF Research Database (Denmark)

    Dinarello, Charles A; Donath, Marc Y; Mandrup-Poulsen, Thomas

    2010-01-01

    To understand the role of inflammation as the fundamental cause of type 2 diabetes and specifically to examine the contribution of IL-1beta.......To understand the role of inflammation as the fundamental cause of type 2 diabetes and specifically to examine the contribution of IL-1beta....

  19. Genes and diet in obesity-related type 2 diabetes

    NARCIS (Netherlands)

    Bauer, F.

    2010-01-01

    The prevalence of obesity, defined as a body mass index (BMI) of ?30, and type 2 diabetes is rising rapidly worldwide. It is therefore important to study the underlying, etiologic mechanisms of obesity and type 2 diabetes to gain insight into their development, which could eventually lead to prevent

  20. Efficiently screening heart failure in patients with type 2 diabetes

    NARCIS (Netherlands)

    Boonman-de Winter, Leandra J M; Rutten, Frans H; Cramer, Maarten J; Landman, Marcel J; Zuithoff, Nicolaas P A; Liem, Anho H; Hoes, Arno W

    2015-01-01

    AIMS: Our aim was to develop a screening tool for heart failure in patients with type 2 diabetes. METHODS AND RESULTS: A total of 581 consecutive patients from 21 primary care practices in The Netherlands with type 2 diabetes, in whom the diagnosis of heart failure (HF) was not known, underwent an e

  1. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes

    DEFF Research Database (Denmark)

    Marso, Steven P; Daniels, Gilbert H; Brown-Frandsen, Kirstine;

    2016-01-01

    BACKGROUND: The cardiovascular effect of liraglutide, a glucagon-like peptide 1 analogue, when added to standard care in patients with type 2 diabetes, remains unknown. METHODS: In this double-blind trial, we randomly assigned patients with type 2 diabetes and high cardiovascular risk to receive ...

  2. Type 2 diabetes mellitus : prevention of macrovascular complications

    NARCIS (Netherlands)

    Meeuwisse-Pasterkamp, Susanne H; van der Klauw, Melanie M.; Wolffenbuttel, Bruce HR

    2008-01-01

    Type 2 diabetes mellitus is a disease that affects a rapidly increasing number of patients. Most patients with Type 2 diabetes will develop vascular complications. This may be microvascular disease, such as nephropathy, retinopathy or polyneuropathy, and also macrovascular disease, such as coronary

  3. Vitamin D levels and mortality in type 2 diabetes

    DEFF Research Database (Denmark)

    Joergensen, Christel; Gall, Mari-Anne; Schmedes, Anne;

    2010-01-01

    To evaluate vitamin D as a predictor of all-cause and cardiovascular mortality and risk of progression to micro- or macroalbuminuria in type 2 diabetic patients.......To evaluate vitamin D as a predictor of all-cause and cardiovascular mortality and risk of progression to micro- or macroalbuminuria in type 2 diabetic patients....

  4. IL6 gene promoter polymorphisms and type 2 diabetes

    DEFF Research Database (Denmark)

    Huth, Cornelia; Heid, Iris M; Vollmert, Caren;

    2006-01-01

    Several lines of evidence indicate a causal role of the cytokine interleukin (IL)-6 in the development of type 2 diabetes in humans. Two common polymorphisms in the promoter of the IL-6 encoding gene IL6, -174G>C (rs1800795) and -573G>C (rs1800796), have been investigated for association with type...... 2 diabetes in numerous studies but with results that have been largely equivocal. To clarify the relationship between the two IL6 variants and type 2 diabetes, we analyzed individual data on >20,000 participants from 21 published and unpublished studies. Collected data represent eight different...... countries, making this the largest association analysis for type 2 diabetes reported to date. The GC and CC genotypes of IL6 -174G>C were associated with a decreased risk of type 2 diabetes (odds ratio 0.91, P = 0.037), corresponding to a risk modification of nearly 9%. No evidence for association was found...

  5. Does emotional stress cause type 2 diabetes mellitus?

    DEFF Research Database (Denmark)

    Pouwer, Frans; Kupper, Nina; Adriaanse, Marcel C

    2010-01-01

    , nephropathy, and neuropathy. The exact causes of type 2 diabetes are still not clear. Since the 17th century, it has been suggested that emotional stress plays a role in the etiology of type 2 diabetes mellitus. So far, review studies have mainly focused on depression as a risk factor for the development...... of type 2 diabetes mellitus. Yet, chronic emotional stress is an established risk factor for the development of depression. The present review provides an overview of mainly prospective epidemiological studies that have investigated the associations between different forms of emotional stress...... and the development of type 2 diabetes mellitus. Results of longitudinal studies suggest that not only depression but also general emotional stress and anxiety, sleeping problems, anger, and hostility are associated with an increased risk for the development of type 2 diabetes. Conflicting results were found...

  6. Air Pollution May Raise Risk of Type 2 Diabetes

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163536.html Air Pollution May Raise Risk of Type 2 Diabetes Study ... Feb. 10, 2017 (HealthDay News) -- High levels of air pollution may increase some Hispanic children's risk of type ...

  7. Adiponectin Trajectories Before Type 2 Diabetes Diagnosis

    Science.gov (United States)

    Tabák, Adam G.; Carstensen, Maren; Witte, Daniel R.; Brunner, Eric J.; Shipley, Martin J.; Jokela, Markus; Roden, Michael; Kivimäki, Mika; Herder, Christian

    2012-01-01

    OBJECTIVE The role of adiponectin in the natural history of diabetes is not well characterized. We set out to characterize prediagnosis trajectories of adiponectin in individuals who develop type 2 diabetes. RESEARCH DESIGN AND METHODS In a case-cohort study (335 incident diabetes case and 2,474 noncase subjects) nested in the Whitehall II study, serum adiponectin was measured up to three times per participant (1991–1993, 1997–1999, and 2003–2004). Multilevel models adjusted for age and ethnicity were fitted to assess 13-year trajectories of log-transformed adiponectin preceding diabetes diagnosis or a randomly selected time point during follow-up (year0) based on 755/5,095 (case/noncase) person-examinations. RESULTS Adiponectin levels were lower in diabetes case than in noncase subjects (median 7,141 [interquartile range 5,187–10,304] vs. 8,818 [6,535–12,369] ng/mL at baseline, P < 0.0001). Control subjects showed a modest decline in adiponectin throughout follow-up (0.3% per year, P < 0.0001) at higher levels in women than in men (difference at year0: 5,358 ng/mL, P < 0.0001). Female case and early-onset case (age at diagnosis <52 years) subjects had a steeper decline than control subjects (slope difference −1.1% per year, P = 0.001 in females, −1.6% per year in early-onset case subjects, P = 0.034). In men, adiponectin slopes for case and noncase subjects were parallel. The slope differences by diabetes onset were largely attenuated after adjustment for changes in obesity, whereas the sex-specific slope differences were independent of obesity. CONCLUSIONS Lower adiponectin levels were observed already a decade before the diagnosis of diabetes. The marked sex difference in trajectories suggests that sex-specific mechanisms affect the association between adiponectin levels and diabetes development. PMID:22933430

  8. Poor pregnancy outcome in women with type 2 diabetes

    DEFF Research Database (Denmark)

    Clausen, Tine D; Mathiesen, Elisabeth; Ekbom, Pia;

    2005-01-01

    OBJECTIVE: To evaluate the perinatal outcome and the frequency of maternal complications in pregnancies of women with type 2 diabetes during 1996-2001. RESEARCH DESIGN AND METHODS: Medical records of 61 consecutive singleton pregnancies in women with type 2 diabetes from 1996 to 2001 were studied....... Pregnancy outcome was compared with that of pregnant women with type 1 diabetes during 1996-2000, the background population, and pregnant women with type 2 diabetes during 1980-1992 from the same department. RESULTS: The perinatal mortality in pregnancies complicated by type 2 diabetes (4/61, 6.......6%) was increased four- and ninefold, respectively, and the rate of major congenital malformations (4/60, 6.7%) was more than doubled, although not statistically significant, compared with type 1 diabetic pregnancies and the background population. The glycemic control was similar or better in women with type 2...

  9. Use of Antibiotics and Risk of Type 2 Diabetes

    DEFF Research Database (Denmark)

    Mikkelsen, Kristian; Knop, Filip; Nielsen, Morten Frost Munk;

    2015-01-01

    CONTEXT AND OBJECTIVE: Evidence that bacteria in the human gut may influence nutrient metabolism is accumulating. We investigated whether use of antibiotics influences the risk of developing type 2 diabetes and whether the effect can be attributed to specific types of antibiotics. METHODS: We....... RESULTS: The odds ratio (OR) associating type 2 diabetes with exposure to antibiotics of any type was 1.53 (95% confidence interval 1.50-1.55) with redemption of more than or equal to 5 versus 0-1 prescriptions. Although no individual group of antibiotics was specifically associated with type 2 diabetes...... risk, slightly higher ORs for type 2 diabetes were seen with narrow-spectrum and bactericidal antibiotics (OR 1.55 and 1.48) compared to broad-spectrum and bacteriostatic types of antibiotics (OR 1.31 and 1.39), respectively. A clear dose-response effect was seen with increasing cumulative load...

  10. Lavkulhydratdiæt til patienter med type 2-diabetes

    DEFF Research Database (Denmark)

    Gram-Kampmann, Eva-Marie; Olsen, Michael Hecht; Beck-Nielsen, Henning

    2016-01-01

    Recently, low-carbohydrate diets have increased in popularity as a method to achieve glycaemic control and weight loss in Type 2 diabetes patients. However, there is a lack of consistency and long-term results in existing studies on patients with Type 2 diabetes. In this review, we address current...... knowledge of low-carbohydrate diets and how they affect glycaemic control, diabetic dyslipidaemia, weight and markers of cardiovascular risk, and our aim is to aid medical practitioners in guiding patients with Type 2 diabetes who wish to try a low-carbohydrate diet in order to take control of their disease....

  11. Telemedicine compared with standard care in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Rasmussen, Ole W.; Lauszus, F. F.; Loekke, M.

    2016-01-01

    INTRODUCTION: Good metabolic control is important in type 2 diabetes mellitus to improve quality of life, work ability and life expectancy, and the use of telemedicine has proved efficient as an add-on to the usual treatment. However, few studies in type 2 diabetes patients have directly compared...... telemedicine with conventional outpatient treatment, and we wanted to evaluate whether telemedicine, compared with standard care, provides equivalent clinical outcomes. METHODS: Forty patients with type 2 diabetes mellitus allocated from October 2011-July 2012 were randomized to either treatment at home...

  12. Clinical and biochemical profile of lean type 2 diabetes mellitus

    OpenAIRE

    Punyakrit Deb Barma; Salam Ranabir; Lallan Prasad; Thangjam Premchand Singh

    2011-01-01

    Background: Type 2 diabetes mellitus is the most prevalent form of diabetes worldwide. In western countries majority of the cases are obese. The scenario may be different in certain parts of India. Various studies have reported a high prevalence of lean type 2 diabetes mellitus with a body mass index < 19 kg/m 2 . Materials and Methods: We evaluated 100 cases of lean type 2 diabetes mellitus (62 males and 38 females). Results and Conclusion: The mean duration of diabetes was 51.7 months (rang...

  13. Non-invasive Measurement of Skin Autofluorescence as a Beneficial Surrogate Marker for Atherosclerosis in Patients with Type 2 Diabetes.

    Science.gov (United States)

    Temma, Jin; Matsuhisa, Munehide; Horie, Toru; Kuroda, Akio; Mori, Hiroyasu; Tamaki, Motoyuki; Endo, Itsuro; Aihara, Ken-ichi; Abe, Masahiro; Matsumoto, Toshio

    2015-01-01

    Advanced glycation end-products (AGEs) are thought to play a major role in the pathogenesis of diabetic vascular complications. Skin autofluorescence (AF) was recently reported to represent tissue AGEs accumulation with a non-invasive method. The aim of the present study was to evaluate association between AF value and diabetic vascular complications, such as retinopathy, nephropathy and cervical atherosclerosis using the carotid intima-media thickness (IMT), an established marker of cardiovascular disease in patients with type 2 diabetes. A total of 68 patients with type 2 diabetes were enrolled in a cross-sectional manner. AGEs accumulation was measured with AF reader. Clinical parameters were collected at the time of AF and IMT measurement. Max-IMT was correlated with age and AF (r=0.407, p=0.001), but not with HbA1c, GA, and pentosidine. Also, AF was not correlated with HbA1c, GA and pentosidine, but was correlated with age (r=0.560, p<0.001), duration of diabetes (r=0.256, p<0.05). Multivariate regression analysis revealed that AF, but not age, was an independent determinant of max-IMT. In conclusion, AF might be a beneficial surrogate marker for evaluating carotid atherosclerosis in patients with type 2 diabetes non-invasively. J. Med. Invest. 62: 126-129, August, 2015.

  14. Dietary fats and prevention of type 2 diabetes

    OpenAIRE

    Risérus, Ulf; Willett, Walter C; Frank B. Hu

    2008-01-01

    Although type 2 diabetes is determined primarily by lifestyle and genes, dietary composition may affect both its development and complications. Dietary fat is of particular interest because fatty acids influence glucose metabolism by altering cell membrane function, enzyme activity, insulin signaling, and gene expression. This paper focuses on the prevention of type 2 diabetes and summarizes the epidemiologic literature on associations between types of dietary fat and diabetes risk. It also s...

  15. Impact of type 2 diabetes and duration of type 2 diabetes on cardiac structure and function

    DEFF Research Database (Denmark)

    Jørgensen, Peter G; Jensen, Magnus T; Mogelvang, Rasmus;

    2016-01-01

    BACKGROUND: Contemporary treatment of type 2 diabetes (T2D) has improved patient outcome and may also have affected myocardial structure and function. We aimed to describe the effect of T2D and T2D duration on cardiac structure and function in a large outpatient population. METHODS: We performed...... dysfunction persisted after multivariable adjustment (P=0.013). CONCLUSIONS: In patients with T2D, LV structural and functional alterations persist and are accentuated with increasing diabetes duration despite reductions in overall risk of cardiovascular disease in this patient population....... comprehensive echocardiography on a representative sample of 1004 persons including a representative sample of 770 patients with T2D without known heart disease and 234 age- and sex-matched controls. RESULTS: T2D was associated with increased left ventricular (LV) wall thicknesses and decreased LV internal...

  16. Kvalitetsindikatorer for type 2-diabetes i perioden 2000-2005

    DEFF Research Database (Denmark)

    Kristensen, Jette Kolding; Lauritzen, Torsten

    2009-01-01

    INTRODUCTION: Considerable attention has been given to the screening and optimization of treatment of people with type 2-diabetes in the period 2000-2005. The aim of this paper is to evaluate the prevalence of people with type 2-diabetes and the quality of diabetes care provided in the period 2000...... to 2005. MATERIAL AND METHODS: Using a previously evaluated method, all patients with type 2-diabetes were identified and described on the basis of register data in what was then the County of Aarhus. RESULTS: A total of 11,436 people with type 2-diabetes were identified in the age group 40-70 years......, corresponding to a prevalence of 4.61%. In 2005 58% were in antidiabetic pharmacological treatment, 68% of whom received oral antidiabetic treatment, 15% were on insulin alone and 16% received a combination treatment including insulin and oral treatment. Furthermore, a total of 50% of the included patients were...

  17. Incretin-based therapy and type 2 diabetes

    DEFF Research Database (Denmark)

    Hare, Kristine J; Knop, Filip Krag

    2010-01-01

    This chapter focuses on the incretin hormones, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP), and their therapeutic potential in treating patients with type 2 diabetes. Type 2 diabetes is characterized by insulin resistance, impaired glucose-induced insulin...... secretion, and inappropriately regulated glucagon secretion which in combination eventually result in hyperglycemia and in the longer term microvascular and macrovascular diabetic complications. Traditional treatment modalities--even multidrug approaches--for type 2 diabetes are often unsatisfactory....... Two new drug classes based on the actions of the incretin hormones have been approved for therapy of type 2 diabetes: injectable long-acting stable analogs of GLP-1, incretin mimetics, and orally available inhibitors of dipeptidyl peptidase 4 (DPP4; the enzyme responsible for the rapid degradation...

  18. Barriers to exercise in obese patients with type 2 diabetes.

    LENUS (Irish Health Repository)

    Egan, A M

    2013-07-01

    Although regular exercise is a critical component of the management of type 2 diabetes, many patients do not meet their exercise targets. Lack of exercise is associated with obesity and adverse cardiovascular outcomes.

  19. ATP-dependent potassium channels and type 2 diabetes mellitus.

    Science.gov (United States)

    Bonfanti, Dianne Heloisa; Alcazar, Larissa Pontes; Arakaki, Priscila Akemi; Martins, Laysa Toschi; Agustini, Bruna Carla; de Moraes Rego, Fabiane Gomes; Frigeri, Henrique Ravanhol

    2015-05-01

    Diabetes mellitus is a public health problem, which affects a millions worldwide. Most diabetes cases are classified as type 2 diabetes mellitus, which is highly associated with obesity. Type 2 diabetes is considered a multifactorial disorder, with both environmental and genetic factors contributing to its development. An important issue linked with diabetes development is the failure of the insulin releasing mechanism involving abnormal activity of the ATP-dependent potassium channel, KATP. This channel is a transmembrane protein encoded by the KCNJ11 and ABCC8 genes. Furthermore, polymorphisms in these genes have been linked to type 2 diabetes because of the role of KATP in insulin release. While several genetic variations have been reported to be associated with this disease, the E23K polymorphism is most commonly associated with this pathology, as well as to obesity. Here, we review the molecular genetics of the potassium channel and discusses its most described polymorphisms and their associations with type 2 diabetes mellitus.

  20. [Type 2 diabetes, obesity and nutrition, a paradigm shift].

    Science.gov (United States)

    Bourcelot, Emilie; Combes, Jérôme

    2016-05-01

    Obesity and type 2 diabetes are two complex and multifactorial chronic diseases. Nutritional management is based on an educational and bio-psycho-sensory approach centred on the patient using cognitive-behavioural and emotionally-focused therapy tools.

  1. Increased risk of type 2 diabetes in elderly twins

    DEFF Research Database (Denmark)

    Poulsen, Pernille; Grunnet, Louise G; Pilgaard, Kasper

    2009-01-01

    OBJECTIVE: Genetic susceptibility, low birth weight (LBW), and aging are key etiological factors in the development of type 2 diabetes. LBW is common among twins. It is unknown whether twin status per se is associated with risk of type 2 diabetes, and valid concordance rates of type 2 diabetes...... in twins on a lifetime perspective are lacking. RESEARCH DESIGN AND METHODS: A clinical study was done on a population-based cohort of same-sex elderly monozygotic (MZ) and dizygotic (DZ) twins (n = 297) and singleton control subjects (C) (n = 71) including measures of anthropometry and glucose tolerance....... In addition, type 2 diabetes incidence cases in twins (n = 626) and singletons (n = 553) were identified through the National Diabetes Register. RESULTS: Twins were more abdominally obese, insulin resistant, and glucose intolerant, as evidenced by a higher A1C (%) (means +/- SD) (MZ: 6.0 +/- 1.0, DZ: 5...

  2. Metformin Still Best as First Type 2 Diabetes Treatment

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162835.html Metformin Still Best as First Type 2 Diabetes Treatment ... 2017 (HealthDay News) -- Newly updated guidelines reaffirm that metformin is the first-line drug for people with ...

  3. Anaemia and kidney dysfunction in Caribbean Type 2 diabetic patients

    OpenAIRE

    Seales Dawn; Nwagbara Emeka; Jones-LeCointe Altheia; Ezenwaka Chidum E; Okali Fidelis

    2008-01-01

    Abstract Background Anaemia has been shown in previous studies to be a risk factor for cardiovascular disease in diabetic patients with chronic kidney disorder. This study was aimed to assess the prevalence of anaemia and kidney dysfunction in Caribbean type 2 diabetic patients that have been previously shown to have a high prevalence of the metabolic syndrome. Methods 155 type 2 diabetic patients and 51 non-diabetic subjects of African origin were studied. Anthropometric parameters were meas...

  4. Origin and therapy for hypertriglyceridaemia in type 2 diabetes

    OpenAIRE

    Pang, Jing; Chan, Dick C.; Watts, Gerald F.

    2014-01-01

    Hypertriglyceridaemia (HTG) is a risk factor for cardiovascular disease (CVD) in type 2 diabetes and is caused by the interaction of genes and non-genetic factors, specifically poor glycaemic control and obesity. In spite of statin treatment, residual risk of CVD remains high in type 2 diabetes, and this may relate to HTG and atherogenic dyslipidemia. Treatment of HTG emphasises correcting secondary factors and adverse lifestyles, in particular, diet and exercise. Pharmacotherapy is also requ...

  5. Linagliptin: farmacology, efficacy and safety in type 2 diabetes treatment

    OpenAIRE

    Guedes, Erika Paniago; Hohl, Alexandre; de Melo, Thais Gomes; Lauand, Felipe

    2013-01-01

    Type 2 diabetes mellitus (T2DM) has a high prevalence and incidence around the world. The complex pathophysiology mechanism is among the barriers for diabetes treatment. Type 2 diabetes patients have dysfunction in incretin hormones (as glucagon-like peptide-1 or GLP-1, and glucose-dependent insulinotropic polypeptide or GIP). By inhibiting the dipeptidyl peptidase-4 (DPP-4) enzyme, it is possible to slow the inactivation of GLP-1 and GIP, promoting blood glucose level reduction in a glucose-...

  6. Sulphonylurea monotherapy for patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hemmingsen, Bianca; Schroll, Jeppe B; Lund, Søren;

    2013-01-01

    Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. Whether sulphonylureas show better, equal or worse therapeutic effects in comparison with other antidiabetic interventions for patients with T2DM remains controversial.......Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. Whether sulphonylureas show better, equal or worse therapeutic effects in comparison with other antidiabetic interventions for patients with T2DM remains controversial....

  7. Relation between ADIPOQ Gene Polymorphisms and Type 2 Diabetes

    OpenAIRE

    Zhi-Peng Li; Mei Zhang; Jie Gao; Guo-Yan Zhou; Shuang-Qing Li; Zhen-Mei An

    2015-01-01

    Objective: The manuscript investigates the relation between adiponectin gene (ADIPOQ) polymorphisms and type 2 diabetes mellitus (T2DM) in a Chinese population. Methods: We designed a case-control study involving 340 normal glucose tolerant (NGT) subjects and 340 type 2 diabetes patients. Three SNPs (rs182052, rs1501299, and rs7627128) were genotyped by TaqMan methods. Results: We found that rs7627128, rs1501299 and rs182052 were significantly associated with T2DM. Haplotypes analysis indicat...

  8. Impact of cigarette smoking in type 2 diabetes development

    OpenAIRE

    Xie, Xi-tao; Liu, Qiang; WU, JIE; Wakui, Makoto

    2009-01-01

    Many patients with type 2 diabetes mellitus (DM2) are at risk for micro and macro vascular complications, which could be observed in heavy smokers. Cigarette smoking increases the risk for type 2 diabetes incidence. Nicotine, acknowledged as the major pharmacologically active chemical in tobacco, is responsible for the association between cigarette smoking and development of diabetes. This minireview summarized recent studies on nicotine effects on insulin action and insulin secretion, indica...

  9. Treatment of dyslipidemia in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Vijayaraghavan Krishnaswami

    2010-12-01

    Full Text Available Abstract Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Although low-density lipoprotein cholesterol levels may be normal in patients with type 2 diabetes, insulin resistance drives a number of changes in lipid metabolism and lipoprotein composition that render low-density lipoprotein cholesterol and other lipoproteins more pathogenic than species found in patients without type 2 diabetes. Dyslipidemia, which affects almost 50% of patients with type 2 diabetes, is a cardiovascular risk factor characterized by elevated triglyceride levels, low high-density lipoprotein cholesterol levels, and a preponderance of small, dense, low-density lipoprotein particles. Early, aggressive pharmacological management is advocated to reduce low-density lipoprotein cholesterol levels, regardless of baseline levels. A number of lipid-lowering agents, including statins, fibrates, niacin, and bile acid sequestrants, are available to target normalization of the entire lipid profile. Despite use of combination and high-dose lipid-lowering agents, many patients with type 2 diabetes do not achieve lipid targets. This review outlines the characteristics and prevalence of dyslipidemia in patients with type 2 diabetes and discusses strategies that may reduce the risk of cardiovascular disease in this population.

  10. Prevalence of lean type 2 diabetes mellitus in recently diagnosed type 2 diabetes mellitus patients

    Directory of Open Access Journals (Sweden)

    Prateek Chaudhary

    2013-01-01

    Full Text Available Introduction: Obesity has always been thought to be a risk factor for diabetes; however, some studies in India have reported that even lean people are prone to diabetes. We conducted this study to see if this holds true for this part of the country. Objectives: To determine the prevalence of lean type 2 diabetes mellitus (DM in recently diagnosed type 2 DM in Manipur. Materials and Methods: All recently diagnosed type 2 DM patients, within a period of 24 weeks, who attended the endocrine clinic of RIMS from Jan to Dec 2012 are included in the study. Exclusion criteria are patients with chronic diseases. Results: Out of the 181 recently diagnosed diabetics 3.9% had a BMI of <19 kg/m 2 of which five are females (5.4% of female patients and two are males (2.2% of male patients. Mean age of Lean diabetics is 54.86 ± 15.32, mean fasting glucose is 212 ± 105.5 mg% and mean postprandial glucose is 351.57 ± 167.79 mg%. DM complications were observed in 28.6% of the Lean diabetics. Conclusion: Our study shows a low prevalence rate of Lean DM in recently diagnosed type 2 DM.

  11. Lifestyle intervention for type 2 diabetes patients: trial protocol of The Copenhagen Type 2 Diabetes Rehabilitation Project

    DEFF Research Database (Denmark)

    Vadstrup, Eva S; Frølich, Anne; Perrild, Hans

    2009-01-01

    BACKGROUND: Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non......-pharmacological treatment of type 2 diabetes are developed and evaluated. The Copenhagen Type 2 Diabetes Rehabilitation Project aims to evaluate the effectiveness of a new group-based lifestyle rehabilitation programme in a Health Care Centre in primary care. METHODS/DESIGN: The group-based diabetes rehabilitation....... During the recruitment period of 18 months 180 type 2 diabetes patients will be randomized to the intervention group and the control group. Effects on glycaemic control, quality of life, self-rated diabetes symptoms, body composition, blood pressure, lipids, insulin resistance, beta-cell function...

  12. Plasma and muscle myostatin in relation to type 2 diabetes.

    Directory of Open Access Journals (Sweden)

    Claus Brandt

    Full Text Available OBJECTIVE: Myostatin is a secreted growth factor expressed in skeletal muscle tissue, which negatively regulates skeletal muscle mass. Recent animal studies suggest a role for myostatin in insulin resistance. We evaluated the possible metabolic role of myostatin in patients with type 2 diabetes and healthy controls. DESIGN: 76 patients with type 2 diabetes and 92 control subjects were included in the study. They were matched for age, gender and BMI. Plasma samples and biopsies from the vastus lateralis muscle were obtained to assess plasma myostatin and expression of myostatin in skeletal muscle. RESULTS: Patients with type 2 diabetes had higher fasting glucose (8.9 versus 5.1 mmol/L, P<0.001, plasma insulin (68.2 versus 47.2 pmol/L, P<0.002 and HOMA2-IR (1.6 versus 0.9, P<0.0001 when compared to controls. Patients with type 2 diabetes had 1.4 (P<0.01 higher levels of muscle myostatin mRNA content than the control subjects. Plasma myostatin concentrations did not differ between patients with type 2 diabetes and controls. In healthy controls, muscle myostatin mRNA correlated with HOMA2-IR (r = 0.30, P<0.01, plasma IL-6 (r = 0.34, P<0.05 and VO2 max (r = -0.26, P<0.05, however, no correlations were observed in patients with type 2 diabetes. CONCLUSIONS: This study supports the idea that myostatin may have a negative effect on metabolism. However, the metabolic effect of myostatin appears to be overruled by other factors in patients with type 2 diabetes.

  13. Changes in the structural and biochemical composition of the arterial wall in type 2 diabetes patients

    DEFF Research Database (Denmark)

    Rørdam Preil, Simone

    nedbrydningen. Flere studier har vist, at rygning påvirker den arterielle stivhed, mens andre studier peger mod, at cystein proteasen calpian-1 øger mængden af matrix metalloproteinasen 2 (MMP-2), som nedbryder bl.a. elastin. Vores hypotese i studie III gik både ud på, at calpain-1 kunne være forøget hos...... patienter med type 2 diabetes, hvorved den vil føre til forøget kollagen indhold, forøget MMP-2 og reduceret elastin i arterierne, og at rygning kunne have en indvirkning på mængden af disse molekyler. Niveauet af MMP-2, calpain-1 og actin α smooth muscle blev målt ved hjælp af western blotting i mammaria...... ikke påvirkede mængden af calpain-1, MMP-2, desmosine og hydroxyproline i den human arterie væg, mens mængden af desmosine var nedsat i arterier fra ryger og tidligere rygere sammenlignet med ikke rygere. Et andet protein der ligeledes er involveret i den strukturelle sammensætning af arterievæggen er...

  14. Blood metals concentration in type 1 and type 2 diabetics.

    Science.gov (United States)

    Forte, Giovanni; Bocca, Beatrice; Peruzzu, Angela; Tolu, Francesco; Asara, Yolande; Farace, Cristiano; Oggiano, Riccardo; Madeddu, Roberto

    2013-12-01

    Mechanisms for the onset of diabetes and the development of diabetic complications remain under extensive investigations. One of these mechanisms is abnormal homeostasis of metals, as either deficiency or excess of metals, can contribute to certain diabetic outcomes. Therefore, this paper will report the blood levels of chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), mercury (Hg), nickel (Ni), lead (Pb), selenium (Se), and zinc (Zn) in subjects with type 1 diabetes (n = 192, mean age 48.8 years, mean disease duration 20.6 years), type 2 diabetes (n = 68, mean age 68.4 years, mean disease duration 10.2 years), and in control subjects (n = 59, mean age 57.2 years), and discuss the results indicating their possible role in diabetes. The metal concentrations were measured by sector field inductively coupled plasma mass spectrometry after microwave-induced acid digestion of blood samples. The accuracy was checked using a blood-based certified reference material, and recoveries of all elements were in the range of 92-101 % of certified values. Type 1 diabetes was found to be associated with Cr (p = 0.02), Mn (p < 0.001), Ni (p < 0.001), Pb (p = 0.02), and Zn (p < 0.001) deficiency, and type 2 diabetes with Cr (p = 0.014), Mn (p < 0.001), and Ni (p < 0.001) deficiency. These deficiencies were appreciated also subdividing the understudied patients for gender and age groups. Furthermore, in type 1 diabetes, there was a positive correlation between Pb and age (p < 0.001, ρ = 0.400) and Pb and BMI (p < 0.001, ρ = 0.309), while a negative correlation between Fe and age (p = 0.002, ρ = -0.218). In type 2 diabetes, there was a negative correlation between Fe and age (p = 0.017, ρ = -0.294) and Fe and BMI (p = 0.026, ρ = -0.301). Thus, these elements may play a role in both forms of diabetes and combined mineral supplementations could have beneficial effects.

  15. Origin and therapy for hypertriglyceridaemia in type 2 diabetes.

    Science.gov (United States)

    Pang, Jing; Chan, Dick C; Watts, Gerald F

    2014-04-15

    Hypertriglyceridaemia (HTG) is a risk factor for cardiovascular disease (CVD) in type 2 diabetes and is caused by the interaction of genes and non-genetic factors, specifically poor glycaemic control and obesity. In spite of statin treatment, residual risk of CVD remains high in type 2 diabetes, and this may relate to HTG and atherogenic dyslipidemia. Treatment of HTG emphasises correcting secondary factors and adverse lifestyles, in particular, diet and exercise. Pharmacotherapy is also required in most type 2 diabetic patients. Statins are the first-line therapy to achieve recommended therapeutic targets of plasma low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol. Fibrates, ezetimibe and n-3 fatty acids are adjunctive treatment options for residual and persistent HTG. Evidence for the use of niacin has been challenged by non-significant CVD outcomes in two recent large clinical trials. Further investigation is required to clarify the use of incretin-based therapies for HTG in type 2 diabetes. Extreme HTG, with risk of pancreatitis, may require insulin infusion therapy or apheresis. New therapies targeting HTG in diabetes need to be tested in clinical endpoint trials. The purpose of this review is to examine the current evidence and provide practical guidance on the management of HTG in type 2 diabetes.

  16. Linagliptin: farmacology, efficacy and safety in type 2 diabetes treatment.

    Science.gov (United States)

    Guedes, Erika Paniago; Hohl, Alexandre; de Melo, Thais Gomes; Lauand, Felipe

    2013-05-22

    Type 2 diabetes mellitus (T2DM) has a high prevalence and incidence around the world. The complex pathophysiology mechanism is among the barriers for diabetes treatment. Type 2 diabetes patients have dysfunction in incretin hormones (as glucagon-like peptide-1 or GLP-1, and glucose-dependent insulinotropic polypeptide or GIP). By inhibiting the dipeptidyl peptidase-4 (DPP-4) enzyme, it is possible to slow the inactivation of GLP-1 and GIP, promoting blood glucose level reduction in a glucose-dependent manner. Linagliptin is a highly specific and potent inhibitor of DPP-4 that is currently indicated for the treatment of type 2 diabetes. Clinical studies with linagliptin demonstrated efficacy in reducing glycated hemoglobin (HbA1c) levels in type 2 diabetes patients, while maintaining a placebo-like safety and tolerability profile. Linagliptin has an interesting pharmacokinetic profile in terms of its predominantly non-renal elimination and the main implication of this characteristic is that no dose adjustment is necessary in patients with renal disease. Also, no dose adjustment is required in patients with hepatic insufficiency, as well in elderly or obese patients. This article will review the pharmacokinetic profile, efficacy data and safety aspects of linagliptin in type 2 diabetes patients.

  17. ABC transporter genes and risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Schou, Jesper; Tybjærg-Hansen, Anne; Møller, Holger J;

    2012-01-01

    risk of type 2 diabetes in the general population is unknown. RESEARCH DESIGN AND METHODS: We tested whether genetic variation in the promoter and coding regions of ABCA1 and ABCG1 predicted risk of type 2 diabetes in the general population. Twenty-seven variants, identified by previous resequencing...... of the variants examined, ABCG1 g.-530A>G, predicted a decreased risk of type 2 diabetes in the CCHS (P for trend = 0.05). Furthermore, when validated in the CGPS or in the CCHS and CGPS combined (n = 40,600), neither the two loss-of-function mutations (ABCA1 N1800H, ABCG1 g.-376C>T) nor ABCG1 g.-530A>G were...... associated with type 2 diabetes (P values >0.57 and >0.30, respectively). CONCLUSIONS: Genetic variations in ABCA1 and ABCG1 were not associated with increased risk of type 2 diabetes in the general population. These data were obtained in general population samples harboring the largest number...

  18. Focus on Vitamin D, Inflammation and Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Marcelo Macedo Rogero

    2012-01-01

    Full Text Available The initial observations linking vitamin D to type 2 diabetes in humans came from studies showing that both healthy and diabetic subjects had a seasonal variation of glycemic control. Currently, there is evidence supporting that vitamin D status is important to regulate some pathways related to type 2 diabetes development. Since the activation of inflammatory pathways interferes with normal metabolism and disrupts proper insulin signaling, it is hypothesized that vitamin D could influence glucose homeostasis by modulating inflammatory response. Human studies investigating the impact of vitamin D supplementation on inflammatory biomarkers of subjects with or at high risk of developing type 2 diabetes are scarce and have generated conflicting results. Based on available clinical and epidemiological data, the positive effects of vitamin D seem to be primarily related to its action on insulin secretion and sensitivity and secondary to its action on inflammation. Future studies specifically designed to investigate the role of vitamin D on type 2 diabetes using inflammation as the main outcome are urgently needed in order to provide a more robust link between vitamin D, inflammation and type 2 diabetes.

  19. Increased cancer mortality in type 2 diabetes (ZODIAC-3)

    NARCIS (Netherlands)

    Ubink-Veltmaat, L. J.; Kleefstra, N.; Kollen, B. J.; Bilo, H. J. G.; Landman, G.

    2008-01-01

    Background: It is unclear whether there is a relationship between type two diabetes and cancer mortality. It also is unclear whether obesity and body mass index (BMI) are associated with cancer in type 2 diabetes patients. Patients and Methods: In 1998, 1,145 patients with type two diabetes mellitus

  20. Atypical diabetes in children: ketosis-prone type 2 diabetes.

    Science.gov (United States)

    Vaibhav, Atul; Mathai, Mathew; Gorman, Shaun

    2013-01-08

    Ketosis-prone type 2 diabetes mellitus also known as atypical or flatbush diabetes is being increasingly recognised worldwide. These patients are typically obese, middle-aged men with a strong family history of type 2 diabetes. The aetiology and pathophysiological mechanism is still unclear but some initial research suggests that patients with ketosis-prone type 2 diabetes have a unique predisposition to glucose desensitisation. These patients have negative autoantibodies typically associated with type 1 diabetes but have shown to have human leucocyte antigen (HLA) positivity. At initial presentation, there is an impairment of both insulin secretion and action. β Cell function and insulin sensitivity can be markedly improved by initiating aggressive diabetes management to allow for discontinuation of insulin therapy within a few months of treatment. These patients can be maintained on oral hypoglycaemic agents and insulin therapy can be safely discontinued after few months depending on their β cell function.

  1. Charcot-Marie-Tooth disease complicating type 2 diabetes.

    LENUS (Irish Health Repository)

    Win, Htet Htet Ne

    2012-02-01

    Although both conditions are relatively common, there are very few descriptions of type 2 diabetes mellitus coexisting with Charcot-Marie-Tooth disease (CMT). This case report and literature review describes a 53-year-old Irish man who presented with type 2 diabetes and significant neuropathy, and who was subsequently diagnosed with CMT type 1A. This case report will also discuss how to differentiate diabetic neuropathy from a progressive hereditary neuropathy and how coexistence aggravates the progression of neuropathy thus necessitating early diagnosis.

  2. Charcot-marie-tooth disease complicating type 2 diabetes.

    LENUS (Irish Health Repository)

    Win, Htet Htet Ne

    2011-07-01

    Although both conditions are relatively common, there are very few descriptions of type 2 diabetes mellitus coexisting with Charcot-Marie-Tooth disease (CMT). This case report and literature review describes a 53-year-old Irish man who presented with type 2 diabetes and significant neuropathy, and who was subsequently diagnosed with CMT type 1A. This case report will also discuss how to differentiate diabetic neuropathy from a progressive hereditary neuropathy and how coexistence aggravates the progression of neuropathy thus necessitating early diagnosis.

  3. Gestational Diabetes Mellitus: A Positive Predictor of Type 2 Diabetes?

    OpenAIRE

    Rice, Gregory E.; Illanes, Sebastian E.; Murray D. Mitchell

    2012-01-01

    The aim of this paper is to consider the relative benefits of screening for type two diabetes mellitus in women with a previous pregnancy complicated by gestational diabetes mellitus. Recent studies suggest that women who experience GDM are at a greater risk of developing type 2 diabetes within 10–20 years of their index pregnancy. If considered as a stand-alone indicator of the risk of developing type 2 diabetes, GDM is a poor diagnostic test. Most women do not develop GDM during pregnancy a...

  4. Heterogeneity of pre-diabetes and type 2 diabetes

    DEFF Research Database (Denmark)

    Faerch, Kristine; Hulman, Adam; Solomon, Thomas

    2016-01-01

    Type 2 diabetes is a heterogeneous disease with large variation in the relative contributions of insulin resistance and beta cell dysfunction between subtypes and individuals. Some of these differences are reflected in the way people are diagnosed. However, differences in glucose regulation exist...... among individuals even in those with comparable diagnostic glucose levels. In this review we address the heterogeneity of pre-diabetes and type 2 diabetes with special emphasis on differences in the pathophysiology and treatment responses related to the diagnostic criteria. We also discuss whether novel...... in individuals with different clinical characteristics at diagnosis, may contribute to optimising strategies for management of hyperglycaemia in both pre-diabetes and type 2 diabetes....

  5. Genetic association analysis of LARS2 with type 2 diabetes

    DEFF Research Database (Denmark)

    Reiling, E; Jafar-Mohammadi, B; van 't Riet, E;

    2010-01-01

    AIMS/HYPOTHESIS: LARS2 has been previously identified as a potential type 2 diabetes susceptibility gene through the low-frequency H324Q (rs71645922) variant (minor allele frequency [MAF] 3.0%). However, this association did not achieve genome-wide levels of significance. The aim of this study...... was to establish the true contribution of this variant and common variants in LARS2 (MAF > 5%) to type 2 diabetes risk. METHODS: We combined genome-wide association data (n = 10,128) from the DIAGRAM consortium with independent data derived from a tagging single nucleotide polymorphism (SNP) approach in Dutch...... individuals (n = 999) and took forward two SNPs of interest to replication in up to 11,163 Dutch participants (rs17637703 and rs952621). In addition, because inspection of genome-wide association study data identified a cluster of low-frequency variants with evidence of type 2 diabetes association, we...

  6. PCSK9 genetic variants and risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Schmidt, Amand F; Swerdlow, Daniel I; Holmes, Michael V;

    2016-01-01

    a standardised analysis plan, meta-analyses, and weighted gene-centric scores. FINDINGS: Data were available for more than 550 000 individuals and 51 623 cases of type 2 diabetes. Combined analyses of four independent PCSK9 variants (rs11583680, rs11591147, rs2479409, and rs11206510) scaled to 1 mmol/L lower LDL......BACKGROUND: Statin treatment and variants in the gene encoding HMG-CoA reductase are associated with reductions in both the concentration of LDL cholesterol and the risk of coronary heart disease, but also with modest hyperglycaemia, increased bodyweight, and modestly increased risk of type 2...... diabetes, which in no way offsets their substantial benefits. We sought to investigate the associations of LDL cholesterol-lowering PCSK9 variants with type 2 diabetes and related biomarkers to gauge the likely effects of PCSK9 inhibitors on diabetes risk. METHODS: In this mendelian randomisation study, we...

  7. Job strain as a risk factor for type 2 diabetes

    DEFF Research Database (Denmark)

    Nyberg, Solja T; Fransson, Eleonor I; Heikkilä, Katriina;

    2014-01-01

    OBJECTIVE: The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress...... at work, defined as "job strain," is associated with incident type 2 diabetes independent of lifestyle factors. RESEARCH DESIGN AND METHODS: We extracted individual-level data for 124,808 diabetes-free adults from 13 European cohort studies participating in the IPD-Work Consortium. We measured job strain...... with baseline questionnaires. Incident type 2 diabetes at follow-up was ascertained using national health registers, clinical screening, and self-reports. We analyzed data for each study using Cox regression and pooled the study-specific estimates in fixed-effect meta-analyses. RESULTS: There were 3,703 cases...

  8. Intensified multifactorial intervention and cardiovascular outcome in type 2 diabetes

    DEFF Research Database (Denmark)

    Pedersen, Oluf; Gaede, Peter

    2003-01-01

    , and autonomic neuropathy (secondary end points) was diminished by about 60% in the intensively treated group. In conclusion, an intensified and goal-oriented multipronged approach to the treatment of type 2 diabetes reduces cardiovascular events, as well as nephropathy, retinopathy, and autonomic neuropathy......-risk type 2 diabetic patients with microalbuminuria-a strong risk factor of both macrovascular and microvascular complications-aged 55.1 years, who were randomly assigned to a conventional or an intensive, multifactorial intervention for a period of 7.8 years. In the intensive group, a stepwise treatment...... plan was adopted involving both continuous lifestyle education and motivation and an ambitious goal-oriented pharmacological treatment of known modifiable risk factors. The conventional group was treated in accordance with national guidelines for type 2 diabetes with less stringent goals. The specific...

  9. Incretins, insulin secretion and Type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Vilsbøll, Tina; Holst, Jens Møller

    2004-01-01

    the genes encoding their receptors have been deleted. In patients with Type 2 diabetes, the incretin effect is either greatly impaired or absent, and it is assumed that this could contribute to the inability of these patients to adjust their insulin secretion to their needs. In studies of the mechanism...... of the impaired incretin effect in Type 2 diabetic patients, it has been found that the secretion of GIP is generally normal, whereas the secretion of GLP-1 is reduced, presumably as a consequence of the diabetic state. It might be of even greater importance that the effect of GLP-1 is preserved whereas...... the effect of GIP is severely impaired. The impaired GIP effect seems to have a genetic background, but could be aggravated by the diabetic state. The preserved effect of GLP-1 has inspired attempts to treat Type 2 diabetes with GLP-1 or analogues thereof, and intravenous GLP-1 administration has been shown...

  10. Brain-derived neurotrophic factor (BDNF) and type 2 diabetes

    DEFF Research Database (Denmark)

    Krabbe, K. S.; Nielsen, A. R.; Krogh-Madsen, R.;

    2006-01-01

    Aims/hypothesis  Decreased levels of brain-derived neurotrophic factor (BDNF) have been implicated in the pathogenesis of Alzheimer's disease and depression. These disorders are associated with type 2 diabetes, and animal models suggest that BDNF plays a role in insulin resistance. We therefore...... explored whether BDNF plays a role in human glucose metabolism. Subjects and methods  We included (Study 1) 233 humans divided into four groups depending on presence or absence of type 2 diabetes and presence or absence of obesity; and (Study 2) seven healthy volunteers who underwent both a hyperglycaemic...... and a hyperinsulinaemic-euglycaemic clamp. Results  Plasma levels of BDNF in Study 1 were decreased in humans with type 2 diabetes independently of obesity. Plasma BDNF was inversely associated with fasting plasma glucose, but not with insulin. No association was found between the BDNF G196A (Val66Met) polymorphism...

  11. Weight Changes following the Diagnosis of Type 2 Diabetes

    DEFF Research Database (Denmark)

    Olivarius, Niels de Fine; Siersma, Volkert Dirk; Køster-Rasmussen, Rasmus;

    2015-01-01

    Aims: The association between recent and more distant weight changes before and after the diagnosis of type 2 diabetes has been little researched. The aim of this study is to determine the influence of patients’ weight history before diabetes diagnosis on the observed 6-year weight changes after...... diagnosis. Methods: A clinical cohort study combined with self-reported past weight history. In total 885 patients aged ≥40 years and newly diagnosed with clinical type 2 diabetes were included. Body weight was measured immediately after diabetes diagnosis and again at the 6-year follow up examination...... weight change after diagnosis. Conclusions: During the first on average 5.7 years after diagnosis of type 2 diabetes, patients generally follow a course of declining average weight, and these weight developments are related primarily to recent weight changes, body mass index, and age, but not to the more...

  12. Genetic susceptibility to type 2 diabetes and obesity

    DEFF Research Database (Denmark)

    Grarup, Niels; Sandholt, Camilla H; Hansen, Torben;

    2014-01-01

    During the past 7 years, genome-wide association studies have shed light on the contribution of common genomic variants to the genetic architecture of type 2 diabetes, obesity and related intermediate phenotypes. The discoveries have firmly established more than 175 genomic loci associated...... with these phenotypes. Despite the tight correlation between type 2 diabetes and obesity, these conditions do not appear to share a common genetic background, since they have few genetic risk loci in common. The recent genetic discoveries do however highlight specific details of the interplay between the pathogenesis...... of type 2 diabetes, insulin resistance and obesity. The focus is currently shifting towards investigations of data from targeted array-based genotyping and exome and genome sequencing to study the individual and combined effect of low-frequency and rare variants in metabolic disease. Here we review recent...

  13. The changing world demography of type 2 diabetes

    DEFF Research Database (Denmark)

    Green, Anders; Hirsch, Niels Christian; Pramming, Stig Krøger

    2003-01-01

    In recent years it has been estimated that the current global prevalence of type 2 diabetes amounts to about 150 million patients. Projections suggest that by the year 2025 the number of prevalent patients in the world will reach approximately 300 million. It is assumed that the increase in the n......In recent years it has been estimated that the current global prevalence of type 2 diabetes amounts to about 150 million patients. Projections suggest that by the year 2025 the number of prevalent patients in the world will reach approximately 300 million. It is assumed that the increase...... indicators. We suggest that the currently available methods for the estimation of the future global burden of type 2 diabetes mellitus yield underestimates. Further modifications and validity tests of the modelling techniques are necessary in order to develop a reliable instrument to globally monitor...

  14. ASSESSMENT OF MAGNESIUM STATUS IN TYPE 2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Sangeeta

    2016-02-01

    Full Text Available BACKGROUND Global burden of type 2 DM is raising. The condition is characterized by established decreased insulin secretion and insulin action. Many factors are responsible for this. Magnesium deficiency is commonly reported in type 2 DM. Decreased magnesium level may worsen insulin sensitivity and insulin action. Routinely, this biochemical alteration in type 2 diabetes is not addressed by the physicians. AIM OF THE STUDY To evaluate the levels of serum magnesium in patients of type 2 DM visiting our hospital to highlight this issue in our population. MATERIALS AND METHODS The study was conducted on 50 patients of type 2 DM and 50 healthy controls who were age and sex matched. Fasting blood sugar and serum magnesium were estimated by fully automatic analyzer in all the subjects. RESULTS The level of serum magnesium in type 2 diabetes were found to be decreased as compared to control and the results were compared and analysed by student’s ‘t’ test. The difference was significant. CONCLUSION In this study, we found serum magnesium level of type 2 diabetics significantly lower than healthy control subjects (P<0.001. Low magnesium levels may be the risk factor for the associated increased inflammation, oxidative stress, hypercoagulability and dyslipidemia in type 2 diabetes. Magnesium supplementation or dietary intake of magnesium rich food is beneficial to avoid and delay complication of type 2 DM.

  15. Effectiveness of a brief theory-based health promotion intervention among adults at high risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Juul, Lise; Andersen, Vibeke Just; Arnoldsen, Jette;

    2016-01-01

    Dette studie evaluerer effekten af et kort gruppebaseret kommunalt kursusforløb til personer med høj risiko for at udvikle type 2-diabetes. Deltagerne blev rekrutteret via almen praksis og randomiseret til at deltage i kurset (intervention) eller efter 12 måneder (kontrol). Effekten blev målt eft...

  16. Renal and hepatic transporter expression in type 2 diabetic rats.

    Science.gov (United States)

    Nowicki, Michael T; Aleksunes, Lauren M; Sawant, Sharmilee P; Dnyanmote, Ankur V; Mehendale, Harihara M; Manautou, José E

    2008-01-01

    Membrane transporters are critical for the uptake as well as elimination of chemicals and by-products of metabolism from the liver and kidneys. Since these proteins are important determinants of chemical disposition, changes in their expression in different disease states can modulate drug pharmacokinetics. The present study investigated alterations in the renal and hepatic expression of organic anion and cation transporters (Oats/Octs), multidrug resistance-associated proteins (Mrps), breast cancer resistance protein (Bcrp), P-glycoprotein (Pgp), and hepatic Na(+)-taurocholate cotransporting polypeptide (Ntcp) in type 2 diabetic rats. For this purpose, type 2 diabetes was induced by feeding male Sprague-Dawley rats a high fat diet followed by a single dose of streptozotocin (45 mg/kg, i.p., in 0.01 M citrate buffer pH 4.3) on day 14. Controls received normal diet and vehicle. Kidney and liver samples were collected on day 24 for generation of crude plasma membrane fractions and Western blot analysis of Oat, Oct, Mrp, Bcrp, Pgp, and Ntcp proteins. With regards to renal uptake transporters, type 2 diabetes increased levels of Oat2 (2.3-fold) and decreased levels of Oct2 to 50% of control kidneys. Conversely, efflux transporters Mrp2, Mrp4, and Bcrp were increased 5.4-fold, 2-fold, and 1.6-fold, respectively in type 2 diabetic kidneys with no change in levels of Mrp1, Mrp5, or Pgp. Studies of hepatic transporters in type 2 diabetic rats reveal that the protein level of Mrp5 was reduced to 4% of control livers with no change in levels of Bcrp, Mrp1, Mrp2, Mrp4, Ntcp, or Pgp. The changes reported in this study may have implications in type 2 diabetic patients.

  17. Serum 25(OH)D and incident type 2 diabetes

    DEFF Research Database (Denmark)

    Husemoen, L. L. N.; Skaaby, T.; Thuesen, B. H.

    2012-01-01

    Mild to moderate vitamin D insufficiency has been proposed as a risk factor for several common chronic diseases including type 2 diabetes. This study aimed to examine the association between serum 25-hydroxy vitamin D (25(OH)D) and incident diabetes.......Mild to moderate vitamin D insufficiency has been proposed as a risk factor for several common chronic diseases including type 2 diabetes. This study aimed to examine the association between serum 25-hydroxy vitamin D (25(OH)D) and incident diabetes....

  18. Dark adaptation during transient hyperglycemia in type 2 diabetes

    DEFF Research Database (Denmark)

    Holfort, Stig Kragelund; Jackson, Gregory R; Larsen, Michael

    2010-01-01

    It was the purpose of the present study to examine dark adaptation in subjects with type 2 diabetes during transient hyperglycemia. Twenty-four subjects with type 2 diabetes and minimal diabetic retinopathy were randomized to undergo an oral glucose tolerance test (OGTT) or to remain fasting. Dark...... to rod-cone break -26%; time to rod intercept -16%, rod sensitivity recovery slope (log units/min) +35%), whereas no measurable change in cone adaptation was seen. The results are consistent with rod adaptation being limited by glycemia and with rod adaptation being delayed in subjects with diabetes...... compared with healthy subjects, the delay being reversible in response to hyperglycemia....

  19. Sleep Disturbances and Glucoregulation in Patients with Type 2 Diabetes

    OpenAIRE

    2014-01-01

    We investigated the frequency of sleep disturbances and the association between sleep disturbances and glucoregulation in type 2 diabetic patients. The frequency of sleep disturbances in 614 type 2 diabetic patients was investigated using validated sleep questionnaires. There were 381 male and 233 female patients. The mean age was 59.7 ± 11.1 yr; the mean body mass index was 24.9 ± 4.4 kg/m2; the mean HbA1c was 7.8% ± 1.5%; and the mean duration of diabetes was 10.3 ± 8.4 yr. The questionnair...

  20. Exercise interventions to prevent and manage type 2 diabetes

    DEFF Research Database (Denmark)

    Dela, Flemming; Prats Gavalda, Clara; Helge, Jørn Wulff

    2014-01-01

    Physical training is known to markedly increase insulin-mediated glucose uptake. This effect occurs predominantly in skeletal muscle and it has been shown in healthy individuals, people with impaired glucose tolerance and in patients with type 2 diabetes. The mechanism/s behind this adaptation...... training on insulin secretion, which is, however, known to decrease in the trained compared with the untrained state in healthy people. In patients with type 2 diabetes, in whom the β-cells have lost the capacity to secrete sufficient insulin in order to maintain normal glucose tolerance, the response...

  1. Interleukin-1-receptor antagonist in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Larsen, Claus M; Faulenbach, Mirjam; Vaag, Allan

    2007-01-01

    BACKGROUND: The expression of interleukin-1-receptor antagonist is reduced in pancreatic islets of patients with type 2 diabetes mellitus, and high glucose concentrations induce the production of interleukin-1beta in human pancreatic beta cells, leading to impaired insulin secretion, decreased cell...... proliferation, and apoptosis. METHODS: In this double-blind, parallel-group trial involving 70 patients with type 2 diabetes, we randomly assigned 34 patients to receive 100 mg of anakinra (a recombinant human interleukin-1-receptor antagonist) subcutaneously once daily for 13 weeks and 36 patients to receive...

  2. Hierarchical clusters in families with type 2 diabetes

    Science.gov (United States)

    García-Solano, Beatriz; Gallegos-Cabriales, Esther C; Gómez-Meza, Marco V; García-Madrid, Guillermina; Flores-Merlo, Marcela; García-Solano, Mauro

    2015-01-01

    Families represent more than a set of individuals; family is more than a sum of its individual members. With this classification, nurses can identify the family health-illness beliefs obey family as a unit concept, and plan family inclusion into the type 2 diabetes treatment, whom is not considered in public policy, despite families share diet, exercise, and self-monitoring with a member who suffers type 2 diabetes. The aim of this study was to determine whether the characteristics, functionality, routines, and family and individual health in type 2 diabetes describes the differences and similarities between families to consider them as a unit. We performed an exploratory, descriptive hierarchical cluster analysis of 61 families using three instruments and a questionnaire, in addition to weight, height, body fat percentage, hemoglobin A1c, total cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein. The analysis produced three groups of families. Wilk’s lambda demonstrated statistically significant differences provided by age (Λ = 0.778, F = 2.098, p = 0.010) and family health (Λ = 0.813, F = 2.650, p = 0.023). A post hoc Tukey test coincided with the three subsets. Families with type 2 diabetes have common elements that make them similar, while sharing differences that make them unique. PMID:27347419

  3. Genetic association analysis of LARS2 with type 2 diabetes

    NARCIS (Netherlands)

    E. Reiling (Erwin); B. Jafar-Mohammadi (Bahram); E. van 't Riet (Esther); M.N. Weedon (Michael); J.V. van Vliet-Ostaptchouk (Jana); T. Hansen (Torben); R. Saxena (Richa); T.W. van Haeften (Timon); P.P. Arp (Pascal); S. Das; M.G.A.A.M. Nijpels (Giel); M.J. Groenewoud (Marlous); E.C. van Hove (Els); A.G. Uitterlinden (André); J.W.A. Smit (Jan); A.D. Morris (Andrew); A.S.F. Doney (Alex); C.N.A. Palmer (Colin); C. Guiducci (Candace); A.T. Hattersley (Andrew); T.M. Frayling (Timothy); O. Pedersen (Oluf); P.E. Slagboom (Eline); D. Altshuler (David); L. Groop (Leif); J.A. Romijn; J.A. Maassen (Johannes); M.A. Hofker (Marten); J.M. Dekker (Jacqueline); M.I. McCarthy (Mark); L.M. 't Hart (Leen)

    2010-01-01

    textabstractAims/hypothesis: LARS2 has been previously identified as a potential type 2 diabetes susceptibility gene through the low-frequency H324Q (rs71645922) variant (minor allele frequency [MAF] 3.0%). However, this association did not achieve genome-wide levels of significance. The aim of this

  4. Self-care interventions in type 2 diabetes

    NARCIS (Netherlands)

    Kleefstra, Nanne

    2010-01-01

    The aim off this thesis was to study the effectiveness of some of the self-care interventions in patients with type 2 diabetes mellitus (T2DM). The self-care interventions that were studied were chromium and cinnamon supplements, a device that aims to lower blood pressure (device guided breathing ex

  5. Telemedicine compared with standard care in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Rasmussen, O. W.

    2015-01-01

    Objectives: For patients with T2DM does telemedicine, compared with standard care, provide equivalent clinical outcomes? Methods: Forty patients with type 2 diabetes mellitus allocated from October 2011 until July 2012 randomized to either treatment at home by video conferences only or the standard...

  6. Fibrillary glomerulonephritis in a patient with type 2 diabetes mellitus.

    NARCIS (Netherlands)

    Gielen, G.A.; Wetzels, J.F.M.; Steenbergen, E.; Mudde, A.H.

    2006-01-01

    We report a 62-year-old man with documented type 2 diabetes mellitus and hypertension, who presented with a rapid deterioration in renal function. The sudden decrease in renal function in this well-controlled diabetic patient prompted us to consider a nondiabetic and nonhypertensive cause. The urina

  7. Cardiac abnormalities in youth with obesity and type 2 diabetes

    Science.gov (United States)

    Childhood obesity has been linked to cardiovascular disease (CVD) risk in adulthood. Of great concern is the expected increase in the population's CVD burden in relation to childhood obesity. This is compounded by the risk related to chronic hyperglycemia exposure in youth with type 2 diabetes. We h...

  8. Gender Difference in Care of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Aamod Dhoj Shrestha

    2013-03-01

    Conclusions: The result of this study provided evidence that there are gender differences in reporting of symptoms, mode of diagnosis and certain self-management behaviors. Therefore there is a need to design gender specific behavior change communication strategies for better management of type 2 diabetes. Keywords: diabetes care; gender; self-efficacy; self-management.

  9. On the origin of obesity and type 2 diabetes

    NARCIS (Netherlands)

    Elbers, C.C.

    2010-01-01

    The incidence of type 2 diabetes (T2D) is rising rapidly worldwide and there are already more than 180 million diabetic subjects. T2D risk factors include ethnic background, age, hypertension, overweight, increased abdominal fat, and lack of physical exercise. Obesity is considered to be the most im

  10. Screening for type 2 diabetes in general practice

    NARCIS (Netherlands)

    Janssen, P.G.H.

    2008-01-01

    The presented studies were conducted within the framework of the international ADDITION study (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care), a randomised controlled trial in 3,057 screen-detected type 2 diabetic patients. The aim of ADDITIO

  11. Dietary intake of carotenoids and risk of type 2 diabetes

    NARCIS (Netherlands)

    Sluijs, I.; Cadier, E.; Beulens, J. W J; van der A, D. L.; Spijkerman, A. M W; van der Schouw, Y. T.

    2015-01-01

    Background and aims: Carotenoids may reduce diabetes risk, due to their antioxidant properties. However, the association between dietary carotenoids intake and type 2 diabetes risk is still unclear. Therefore, the objective of this study was to examine whether higher dietary carotenoid intakes assoc

  12. Thiazolidinediones and blood lipids in type 2 diabetes

    NARCIS (Netherlands)

    van Wijk, JPH; de Koning, EJP; Martens, EP; Rabelink, TJ

    2003-01-01

    We evaluated study population characteristics and treatment effects on blood lipids between studies in which either rosiglitazone (RSG) or pioglitazone (PIO) was investigated in patients with type 2 diabetes. We performed a summary analysis of all published double-blind, placebo-controlled studies w

  13. Type 2 diabetes prevention from research to practice

    NARCIS (Netherlands)

    Duijzer, G.

    2016-01-01

    INTRODUCTION Diabetes is a worldwide epidemic, causing a high disease and economic burden. Type 2 diabetes, the most common form of diabetes, is associated with overweight and obesity and an unfavourable lifestyle, including unhealthy diet and physical inactivity. Over the last two

  14. Increased gluconeogenesis in youth with newly diagnosed type 2 diabetes

    Science.gov (United States)

    The role of increased gluconeogenesis as an important contributor to fasting hyperglycaemia at diabetes onset is not known. We evaluated the contribution of gluconeogenesis and glycogenolysis to fasting hyperglycaemia in newly diagnosed youths with type 2 diabetes following an overnight fast. Basal ...

  15. Mortality in people with type 2 diabetes in the UK

    NARCIS (Netherlands)

    Mulnier, H.E.; Seaman, H.E.; Raleigh, V.S.; Soedamah-Muthu, S.S.; Colhoun, H.M.; Lawrenson, R.A.

    2006-01-01

    Aims Under-reporting of diabetes on death certificates contributes to the unreliable estimates of mortality as a result of diabetes. The influence of obesity on mortality in Type 2 diabetes is not well documented. We aimed to study mortality from diabetes and the influence of obesity on mortality in

  16. Prescribing quality indicators of type 2 diabetes mellitus ambulatory care

    NARCIS (Netherlands)

    Martirosyan, L.; Braspenning, J.; Denig, P.; de Grauw, W. J. C.; Bouma, M.; Storms, F.; Haaijer-Ruskamp, F. M.

    2008-01-01

    Background: Existing performance indicators for assessing quality of care in type 2 diabetes mellitus (T2DM) focus mostly on registration of measurements and clinical outcomes, and not on quality of prescribing. Objective: To develop a set of valid prescribing quality indicators (PQI) for internal u

  17. Genetic risk profiling for prediction of type 2 diabetes

    NARCIS (Netherlands)

    R. Mihaescu (Raluca); J.B. Meigs (James); E.J.G. Sijbrands (Eric); A.C.J.W. Janssens (Cécile)

    2011-01-01

    textabstractType 2 diabetes (T2D) is a common disease caused by a complex interplay between many genetic and environmental factors. Candidate gene studies and recent collaborative genome-wide association efforts revealed at least 38 common single nucleotide polymorphisms (SNPs) associated with incre

  18. Diet, intermediate risk markers and risk of type 2 diabetes

    NARCIS (Netherlands)

    Sluijs, I.

    2011-01-01

    This thesis aimed to study the relation of diet with risk of type 2 diabetes and intermediate risk markers of diabetes. We investigated the effect of cis9, trans11 conjugated linoleic acid (c9,t11 CLA) supplementation on pulse wave velocity and cardiovascular risk factors in a randomized, controlled

  19. Using Drosophila to discover mechanisms underlying type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Ronald W. Alfa

    2016-04-01

    Full Text Available Mechanisms of glucose homeostasis are remarkably well conserved between the fruit fly Drosophila melanogaster and mammals. From the initial characterization of insulin signaling in the fly came the identification of downstream metabolic pathways for nutrient storage and utilization. Defects in these pathways lead to phenotypes that are analogous to diabetic states in mammals. These discoveries have stimulated interest in leveraging the fly to better understand the genetics of type 2 diabetes mellitus in humans. Type 2 diabetes results from insulin insufficiency in the context of ongoing insulin resistance. Although genetic susceptibility is thought to govern the propensity of individuals to develop type 2 diabetes mellitus under appropriate environmental conditions, many of the human genes associated with the disease in genome-wide association studies have not been functionally studied. Recent advances in the phenotyping of metabolic defects have positioned Drosophila as an excellent model for the functional characterization of large numbers of genes associated with type 2 diabetes mellitus. Here, we examine results from studies modeling metabolic disease in the fruit fly and compare findings to proposed mechanisms for diabetic phenotypes in mammals. We provide a systematic framework for assessing the contribution of gene candidates to insulin-secretion or insulin-resistance pathways relevant to diabetes pathogenesis.

  20. Implementation of locally adapted guidelines on type 2 diabetes

    NARCIS (Netherlands)

    van Bruggen, Rykel; Gorter, Kees J.; Stolk, Roland P.; Verhoeven, Rob P.; Rutten, Guy E. H. M.

    2008-01-01

    Objective. To assess the effects of a facilitator enhanced multifaceted intervention to implement a locally adapted guideline on the shared care for people with type 2 diabetes. Methods. During 1 year a cluster-randomized trial was performed in 30 general practices. In the intervention group, nurse

  1. Diet, lifestyle and type 2 diabetes in China

    NARCIS (Netherlands)

    He, Y.

    2014-01-01

    Background Over the past two decades, China has been undergoing rapid socio-economic and nutrition transitions. Along with these transitions, chronic non-communicable diseases, such as obesity and type 2 diabetes, are becoming serious public health problems. However, only few studies on determinan

  2. Albuminuria : A target for treatment of type 2 diabetic nephropathy

    NARCIS (Netherlands)

    de Zeeuw, Dick

    2007-01-01

    Both renal and cardiovascular morbidity and mortality is increased markedly in patients with type 2 diabetes. Besides the classic risk factors and markers such as glucose, blood pressure, blood lipid profile, and lifestyle (smoking, overweight), novel risk markers are identified, among them urine al

  3. Glucocorticoids and Type 2 Diabetes: From Physiology to Pathology

    Directory of Open Access Journals (Sweden)

    Guido Di Dalmazi

    2012-01-01

    Full Text Available Type 2 diabetes mellitus is the result of interaction between genetic and environmental factors, leading to heterogeneous and progressive pancreatic β-cell dysfunction. Overweight and obesity are major contributors to the development of insulin resistance and impaired glucose tolerance. The inability of β cells to secrete enough insulin produces type 2 diabetes. Abnormalities in other hormones such as reduced secretion of the incretin glucagon-like peptide 1 (GLP-1, hyperglucagonemia, and raised concentrations of other counterregulatory hormones also contribute to insulin resistance, reduced insulin secretion, and hyperglycaemia in type 2 diabetes. Clinical-overt and experimental cortisol excess is associated with profound metabolic disturbances of intermediate metabolism resulting in abdominal obesity, insulin resistance, and low HDL-cholesterol levels, which can lead to diabetes. It was therefore suggested that subtle abnormalities in cortisol secretion and action are one of the missing links between insulin resistance and other features of the metabolic syndrome. The aim of this paper is to address the role of glucocorticoids on glucose homeostasis and to explain the relationship between hypercortisolism and type 2 diabetes.

  4. Metabolomics: Insulin Resistance and Type 2 Diabetes Mellitus

    Science.gov (United States)

    Type 2 diabetes mellitus (T2DM) develops over many years, providing an opportunity to consider early prognostic tools that guide interventions to thwart disease. Advancements in analytical chemistry enable quantitation of hundreds of metabolites in biofluids and tissues (metabolomics), providing in...

  5. ESTIMATION OF MICROALBUMIN IN TYPE2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Bharathi

    2014-01-01

    Full Text Available BACK GROUND: The objective of this study is to estimate microalbumin in type - 2 diabetes mellitus patients. METHODS: The sensitive marker for the detection of urine albumin excretion was done by estimation of morning urine sample by semi quantitative procedure by Bayerclinitek50 urine chemistry analyzer. For creatinine jaffes method , fasting blood sugar and post lunch blood sugar were estimated by glucometer and glycosylated hemoglobin ( HbA 1c was analyzed by Merck microlab 120 semi – automated analyzer. RESULTS: In the study significant increase in micro albumin was observed 193.50 ± 7 3.66 ( P<0.0001 in all the patients of type 2 diabetes mellitus which is the predictor of late development diabetic nephropathy. Para meters like fasting blood sugar , post lunch blood sugar , creatinine and glycosylated hemoglobin ( HbA 1c levels were increa sed above the normal range. CONCLUSION : In type 2 diabetes , microalbumin is the hallmark of subsequent diabetic nephropathy and a surrogate marker of cardiovascular diseases and increased cardiovascular mortality. In diabetic nephropathy patients , glomerular filtration rate is increased in early stage of the disease and glomerulopathy is an important renal structural change. Improving glycemic control in patients with type 2 diabetes may subsequently reduce the risk of complications

  6. Effective Nurse Communication With Type 2 Diabetes Patients : A Review

    NARCIS (Netherlands)

    Mulder, Bob C.; Lokhorst, Anne Marike; Rutten, Guy E H M; van Woerkum, Cees M J

    2015-01-01

    Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to nurse-pat

  7. Effective Nurse Communication With Type 2 Diabetes Patients

    NARCIS (Netherlands)

    Mulder, B.C.; Lokhorst, A.M.; Rutten, G.E.H.M.; Woerkum, van C.M.J.

    2015-01-01

    Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to nurse–pat

  8. Plasma follistatin is elevated in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Hansen, J; Rinnov, Anders Rasmussen; Krogh-Madsen, Rikke

    2013-01-01

    Plasma follistatin is elevated in patients with low-grade inflammation and insulin resistance as observed with polycystic ovary syndrome. In the present study, we evaluated plasma follistatin in patients with type 2 diabetes characterised by low-grade inflammation and assessed the acute effects o...

  9. Alcohol consumption and risk type 2 diabetes among older women

    NARCIS (Netherlands)

    Beulens, J.W.J.; Stolk, R.P.; Schouw, van der Y.T.; Grobbee, D.E.; Hendriks, H.F.J.; Bots, M.L.

    2005-01-01

    OBJECTIVE—This study aimed to investigate the relation between alcohol consumption and type 2 diabetes among older women. RESEARCH DESIGN AND METHODS—Between 1993 and 1997, 16,330 women aged 49–70 years and free from diabetes were enrolled in one of the Dutch Prospect-EPIC (European Prospective Stud

  10. Progression of nephropathy in type 2 diabetic patients

    DEFF Research Database (Denmark)

    Rossing, Kasper; Christensen, Per Klitgaard; Hovind, Peter

    2004-01-01

    BACKGROUND: Nephropathy in type 2 diabetes is the single most common cause of end-stage renal disease (ESRD), but the decline in kidney function varies considerably between individuals, and determinants of renal function loss, early in the course of renal disease, have not been clearly identified...

  11. Mitochondrial gene mutations and type 2 diabetes in Chinese families

    Institute of Scientific and Technical Information of China (English)

    LI Ming-zhen; YU De-min; YU Pei; LIU De-min; WANG Kun; TANG Xin-zhi

    2008-01-01

    Background Numerous mitochondrial DNA mutations are significantly correlated with development of diabetes. This study investigated mitochondrial gene, point mutations in patients with type 2 diabetes and their families. Methods Unrelated patients with type 2 diabetes(n=826)were randomly recruited; unrelated and nondiabetic subjects (n=637)served as controls. The clinical and biochemical data of the participants were collected. Total genome was extracted from peripheral leucocytes. Polymerase chain reaction, restriction fragment length polymorphism (PCR-RFLP)and clonig techniques were used to screen mitochondrial genes including np3316,np3394 and np3426 in the ND1 region and np3243 in the tRNALeu (UUR). Results In 39 diabetics with one or more mitochondrial gene point mutations, the prevalence(4.7%,39/826)of mtDNA mutations was higher than that(0.7%,5/637)in the controls. The identical mutation was found in 23 of 43 tested members from three pedigrees. Affected family members presented with variable clinical features ranging from normal glucose tolerance to impaired glucose tolerance (IGT)(n=2),impaired fasting glucose(IFG)(n=1)to type 2 diabetes (n=13)with 3 family members suffering from hearing loss. Conclusions Type 2 diabetes in China is associated with several mitochondrial gene mutations. Aged patients with diabetic family history had a higher prevalence of mutation and various clinical pictures. Mitochondrial gene mutation might be one of the genetic factors contributing to diabetic familial clustering.

  12. Prevalence of subclinical thyroid disorders in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Satvic C Manjunath

    2013-10-01

    Full Text Available Background: Subclinical thyroid disorders usually do not produce symptoms of thyroid disease until they turn into over thyroid disease. Thyroid disease is more common in people with diabetes mellitus than in the general population and it is important to detect thyroid disorder before its clinical manifestation. Subclinical hypothyroidism (SCH can produce dyslipidemia, obesity thus resulting increased predisposition to coronary artery disease. Subclinical hyperthyroidism can aggravate hyperglycemia and impair blood sugar control. Objectives: Our objective is to determine the prevalence of subclinical thyroid disorders in patients with type 2 diabetes mellitus (T2DM and to analyze the clinical and metabolic profile of patients with this dual endocrine disorder. Methods and Results: One hundred consecutive type 2 diabetic patients without clinical manifestations of thyroid disorders were screened for SCH and subclinical hyperthyroidism using serum free T 3 , free T 4 and thyroid stimulating hormone (TSH levels. Individuals of subclinical thyroid disease were further screened for thyroperoxidase (TPO antibodies. SCH was detected in 13% of type 2 diabetic patients and none had subclinical hyperthyroidism in our study. SCH was common among females with type 2 diabetes (84.6%. Elevated TPO antibody levels were present in 84.6% SCH patients. Diabetic retinopathy among SCH patients showed significant association with higher serum TSH levels. Left ventricular diastolic dysfunction was present in 30.8% of SCH patients. Conclusion: SCH is common among type 2 diabetic patients, especially in females. It is most commonly secondary to autoimmune thyroid disease. Microvascular complications are commonly observed in this group of patients with dual endocrinal disorder and treating physician should be aware of the impact and should routinely screen SCH to prevent complications.

  13. ASSESSMENT OF MAGNESIUM STATUS IN TYPE 2 DIABETES MELLITUS

    OpenAIRE

    Sangeeta,; Neetu; Seema,; Vivek; Vijay

    2016-01-01

    BACKGROUND Global burden of type 2 DM is raising. The condition is characterized by established decreased insulin secretion and insulin action. Many factors are responsible for this. Magnesium deficiency is commonly reported in type 2 DM. Decreased magnesium level may worsen insulin sensitivity and insulin action. Routinely, this biochemical alteration in type 2 diabetes is not addressed by the physicians. AIM OF THE STUDY To evaluate the levels of serum magnesium...

  14. Thyroid dysfunction among type 2 diabetic female Egyptian subjects

    Directory of Open Access Journals (Sweden)

    Elebrashy IN

    2016-11-01

    Full Text Available Ibrahim N Elebrashy,1 Amr El Meligi,1 Laila Rashed,2 Randa F Salam,1 Elham Youssef,1 Shaimaa A Fathy1 1Department of Internal Medicine, Diabetes, and Endocrinology, 2Department of Medical Biochemistry, Faculty of Medicine, Cairo University, Giza, Egypt Purpose: High prevalence of thyroid disorders is more common in type 1 diabetes compared to type 2 diabetes, due to associated autoimmunity. Hypothyroidism is the most common disorder. The objective was to assess the prevalence of thyroid dysfunction among type 2 diabetic Egyptian females and to find the correlation between metabolic syndrome components and autoimmune thyroid dysfunction. Materials and methods: The study included 62 type 2 diabetic Egyptian females and 27 sex- and age-matched controls. All patients in the study were subjected to anthropometric measures, including HbA1c, lipid profile, serum uric acid, thyroid-stimulating hormone (TSH, free triiodothyronine, free thyroxine, anti-thyroid peroxidase (TPO, antithyroglobulin (anti-Tg, and thyroid ultrasound. Results: Hypothyroidism was found in 45.2% of patients (5.49±3.37 µIU/mL versus 11.1% of controls (1.79±1.21 µIU/mL (P<0.001. Anti-TPO was found in 75.8% (347.15±244.87 IU/mL of patients versus 7.4% (32.89±33.26 IU/mL of controls (P<0.001. Anti-Tg was found in 61.3% (508.03±369.16 IU/mL of patients versus 0 (51.26±35.53 IU/mL controls (P<0.001. A significant positive correlation was found between TSH and antithyroid antibodies (anti-Tg, anti-TPO; P=0.002 and P=0.043, respectively and between TSH and thyroid-gland volume (P=0.002 in diabetic patients. No correlation was found between any components of metabolic syndrome and thyroid antibodies in diabetic patients. Conclusion: Autoimmune thyroid disease is more common in Egyptian women with type 2 diabetes than nondiabetic women, and thus points to a role of autoimmunity in the pathogenesis of type 2 diabetes. Keywords: autoimmune thyroid dysfunction, TSH, anti-TPO, anti

  15. Gene expression profile in obesity and type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Rao Allam A

    2007-12-01

    Full Text Available Abstract Obesity is an important component of metabolic syndrome X and predisposes to the development of type 2 diabetes mellitus. The incidence of obesity, type 2 diabetes mellitus and metabolic syndrome X is increasing, and the cause(s for this increasing incidence is not clear. Although genetics could play an important role in the higher prevalence of these diseases, it is not clear how genetic factors interact with environmental and dietary factors to increase their incidence. We performed gene expression profile in subjects with obesity and type 2 diabetes mellitus with and without family history of these diseases. It was noted that genes involved in carbohydrate, lipid and amino acid metabolism pathways, glycan of biosynthesis, metabolism of cofactors and vitamin pathways, ubiquitin mediated proteolysis, signal transduction pathways, neuroactive ligand-receptor interaction, nervous system pathways, neurodegenerative disorders pathways are upregulated in obesity compared to healthy subjects. In contrast genes involved in cell adhesion molecules, cytokine-cytokine receptor interaction, insulin signaling and immune system pathways are downregulated in obese. Genes involved in signal transduction, regulation of actin cytoskeleton, antigen processing and presentation, complement and coagulation cascades, axon guidance and neurodegenerative disorders pathways are upregulated in subjects with type 2 diabetes with family history of diabetes compared to those who are diabetic but with no family history. Genes involved in oxidative phosphorylation, immune, nervous system, and metabolic disorders pathways are upregulated in those with diabetes with family history of diabetes compared to those with diabetes but with no family history. In contrast, genes involved in lipid and amino acid pathways, ubiquitin mediated proteolysis, signal transduction, insulin signaling and PPAR signaling pathways are downregulated in subjects with diabetes with family

  16. Effect of diet on type 2 diabetes mellitus: a review.

    Science.gov (United States)

    Khazrai, Y M; Defeudis, G; Pozzilli, P

    2014-03-01

    Type 2 diabetes mellitus is one of the fastest growing diseases; the number of people affected by diabetes will soon reach 552 million worldwide, with associated increases in complications and healthcare expenditure. Lifestyle and medical nutrition therapy are considered the keystones of type 2 diabetes prevention and treatment, but there is no definite consensus on how to treat this disease with these therapies. The American Diabetes Association has made several recommendations regarding the medical nutrition therapy of diabetes; these emphasize the importance of minimizing macrovascular and microvascular complications in people with diabetes. Four types of diets were reviewed for their effects on diabetes: the Mediterranean diet, a low-carbohydrate/high-protein diet, a vegan diet and a vegetarian diet. Each of the four types of diet has been shown to improve metabolic conditions, but the degree of improvement varies from patient to patient. Therefore, it is necessary to evaluate a patient's pathophysiological characteristics in order to determine the diet that will achieve metabolic improvement in each individual. Many dietary regimens are available for patients with type 2 diabetes to choose from, according to personal taste and cultural tradition. It is important to provide a tailor-made diet wherever possible in order to maximize the efficacy of the diet on reducing diabetes symptoms and to encourage patient adherence. Additional randomized studies, both short term (to analyse physiological responses) and long term, could help reduce the multitude of diets currently recommended and focus on a shorter list of useful regimens.

  17. Mouse Models of Type 2 Diabetes Mellitus in Drug Discovery.

    Science.gov (United States)

    Baribault, Helene

    2016-01-01

    Type 2 diabetes is a fast-growing epidemic in industrialized countries, associated with obesity, lack of physical exercise, aging, family history, and ethnic background. Diagnostic criteria are elevated fasting or postprandial blood glucose levels, a consequence of insulin resistance. Early intervention can help patients to revert the progression of the disease together with lifestyle changes or monotherapy. Systemic glucose toxicity can have devastating effects leading to pancreatic beta cell failure, blindness, nephropathy, and neuropathy, progressing to limb ulceration or even amputation. Existing treatments have numerous side effects and demonstrate variability in individual patient responsiveness. However, several emerging areas of discovery research are showing promises with the development of novel classes of antidiabetic drugs.The mouse has proven to be a reliable model for discovering and validating new treatments for type 2 diabetes mellitus. We review here commonly used methods to measure endpoints relevant to glucose metabolism which show good translatability to the diagnostic of type 2 diabetes in humans: baseline fasting glucose and insulin, glucose tolerance test, insulin sensitivity index, and body type composition. Improvements on these clinical values are essential for the progression of a novel potential therapeutic molecule through a preclinical and clinical pipeline.

  18. Anakinra treatment in patients with gout and type 2 diabetes.

    Science.gov (United States)

    Vitale, Antonio; Cantarini, Luca; Rigante, Donato; Bardelli, Marco; Galeazzi, Mauro

    2015-05-01

    We report three Caucasian patients affected by gout and type 2 diabetes, who were treated with the recombinant nonglycosylated human interleukin-1 receptor antagonist anakinra (100 mg/day subcutaneously) after an unsatisfactory or incomplete response to urate-lowering therapy, colchicine, nonsteroidal anti-inflammatory drugs, and prednisone. The remarkable clinical improvement in joint symptoms within 24 h and in glycemic control during a 6-month period gives anakinra a potential therapeutic role in the management of gout and type 2 diabetes. When anakinra was discontinued, a gout attack occurred within 3-25 days in all three patients. The contribution of anakinra in the treatment of such syndromes is encouraging, but requires further studies to establish its long-term efficacy.

  19. Lixisenatide for the treatment of type 2 diabetes

    DEFF Research Database (Denmark)

    Petersen, A B; Knop, F K; Christensen, M

    2013-01-01

    Lixisenatide (trade name Lyxumia®), a short-acting glucagon-like peptide 1 receptor (GLP-1R) agonist, was approved for the treatment of type 2 diabetes by the European Medicines Agency in early 2013. In preclinical investigations, acceptable toxicity and carcinogenicity profiles were demonstrated...... in patients with type 2 diabetes, treatment with lixisenatide alone and in combination with insulin and various oral antidiabetics conferred significant reductions in HbA1c, fasting and postprandial plasma glucose. In direct comparison with the other GLP-1R agonists on the market (exenatide and liraglutide......, as well as pancreatic beta cell-preserving actions and favorable effects on glycemic control. Following subcutaneous administration in humans, lixisenatide displays linear pharmacokinetics and an absorption-dependent elimination half-life of 2-3 hours. In clinical trials of up to 1 year duration...

  20. Heterogeneity in limb fatty acid kinetics in type 2 diabetes

    DEFF Research Database (Denmark)

    Sacchetti, M; Olsen, D B; Saltin, B;

    2005-01-01

    control subjects (n=7) for 5 h under baseline conditions and during a 4-h hyperinsulinaemic-euglycaemic clamp. METHODS: Limb fatty acid kinetics was determined by means of continuous [U-(13)C]palmitate infusion and measurement of arteriovenous differences. RESULTS: The systemic palmitate rate......AIMS/HYPOTHESIS: In order to test the hypothesis that disturbances in skeletal muscle fatty acid metabolism with type 2 diabetes are not equally present in the upper and lower limbs, we studied fatty acid kinetics simultaneously across the arm and leg of type 2 diabetic patients (n=6) and matched...... of appearance was 3.6+/-0.4 and 2.7+/-0.3 micromol.kg lean body mass(-1).min(-1) and decreased during the clamp by 26% (p=0.04) and 43% (ppalmitate uptake across the arm was similar in the two groups, whereas leg palmitate...

  1. Canagliflozin: a novel treatment option for type 2 diabetes

    Science.gov (United States)

    Dietrich, Eric; Powell, Jason; Taylor, James R

    2013-01-01

    Type 2 diabetes continues to be a challenging disease to manage. The addition of new agents with a positive risk–benefit ratio could potentially assist clinicians and patients in achieving adequate diabetes control. Canagliflozin, the first sodium-glucose cotransporter 2 inhibitor presently available on the market, offers a unique mechanism of action: it inhibits renal reabsorption of glucose, thereby increasing urinary glucose excretion. It reduces hemoglobin A1c by approximately 0.37%–1.16%; it also reduces the patient’s weight and systolic blood pressure and has a low risk for hypoglycemia. Adverse effects include an increased risk of urinary tract infections and genital mycotic infections. In this manuscript we review canagliflozin and its potential role in management of type 2 diabetes mellitus. PMID:24285921

  2. Attenuated purinergic receptor function in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Thaning, Pia; Bune, Laurids T.; Hellsten, Ylva

    2010-01-01

    Objective: Extra cellular nucleotides and nucleosides are involved in regulation of skeletal muscle blood flow. Diabetes induces cardiovascular dysregulation but the extent to which the vasodilatatory capacity of nucleotides and nucleosides are affected in type 2 diabetes is unknown. The present......) was measured during intrafemoral artery infusion of ATP, UTP, and ADO eliciting a blood flow equal to knee-extensor exercise at 12 watts ( approximately 2.6 L/min). Results: The vasodilatatory effect of the purinergic system was 50 % lower in the diabetic group as exemplified by a LBF increase by 274+/-37 vs......-DM (1.5). The distribution and mRNA-expression of receptors were similar in the two groups. Conclusions: The vasodilatatory effect of the purinergic system is severely reduced in type 2 diabetic patients. The potency of nucleotides varies with the following rank order: UTP>ATP>>>ADO. This is not due...

  3. Mitochondrial dysfunction in type 2 diabetes and obesity

    DEFF Research Database (Denmark)

    Højlund, Kurt; Mogensen, Martin; Sahlin, Kent

    2008-01-01

    Insulin resistance in skeletal muscle is a major hallmark of type 2 diabetes mellitus (T2D) and obesity that is characterized by impaired insulin-mediated glucose transport and glycogen synthesis and by increased intramyocellular content of lipid metabolites. Several studies have provided evidence...... for mitochondrial dysfunction in skeletal muscle of type 2 diabetic and prediabetic subjects, primarily due to a lower content of mitochondria (mitochondrial biogenesis) and possibly to a reduced functional capacity per mitochondrion. This article discusses the latest advances in the understanding of the molecular...... mechanisms underlying insulin resistance in human skeletal muscle in T2D and obesity, with a focus on possible links between insulin resistance and mitochondrial dysfunction....

  4. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes

    DEFF Research Database (Denmark)

    Marso, Steven P; Bain, Stephen C; Consoli, Agostino

    2016-01-01

    cardiovascular causes were similar in the two groups. Rates of new or worsening nephropathy were lower in the semaglutide group, but rates of retinopathy complications (vitreous hemorrhage, blindness, or conditions requiring treatment with an intravitreal agent or photocoagulation) were significantly higher...... (hazard ratio, 1.76; 95% CI, 1.11 to 2.78; P=0.02). Fewer serious adverse events occurred in the semaglutide group, although more patients discontinued treatment because of adverse events, mainly gastrointestinal. Conclusions In patients with type 2 diabetes who were at high cardiovascular risk, the rate......Background Regulatory guidance specifies the need to establish cardiovascular safety of new diabetes therapies in patients with type 2 diabetes in order to rule out excess cardiovascular risk. The cardiovascular effects of semaglutide, a glucagon-like peptide 1 analogue with an extended half...

  5. Dark adaptation during transient hyperglycemia in type 2 diabetes

    DEFF Research Database (Denmark)

    Holfort, Stig Kraglund; Jackson, Gregory R; Larsen, Michael

    2010-01-01

    It was the purpose of the present study to examine dark adaptation in subjects with type 2 diabetes during transient hyperglycemia. Twenty-four subjects with type 2 diabetes and minimal diabetic retinopathy were randomized to undergo an oral glucose tolerance test (OGTT) or to remain fasting. Dark...... adaptometry was measured in one eye, chosen at random, using a computer-controlled dark adaptometer. Dark adaptation and capillary blood glucose were measured at baseline and 80 minutes into the OGTT/fasting test. Blood glucose remained stable throughout the examination in the 12 fasting subjects, whereas...... glycemia increased in the 12 OGTT subjects, from 8.6±2.1 at baseline to 21.1±3.6 mM after 80 min. In the OGTT group, four out of seven subjects with delayed dark adaptation at baseline reached normal values during hyperglycemia. All examined aspects of rod adaptation were accelerated by hyperglycemia (time...

  6. Weight Considerations in Pharmacotherapy for Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Vicky Cheng

    2011-01-01

    Full Text Available Obesity has been increasing in prevalence worldwide and the majority of patients with type 2 diabetes are either overweight or obese. Diabetes management in this population has been difficult since a number of antidiabetes agents are associated with weight gain. The effects of various antidiabetes agents and antiobesity agents on glycemic control and body weight will be reviewed. Briefly, sulfonylureas, thiazolidinediones, and insulin are associated with weight gain, whereas metformin and amylin analogs are weight neutral or associated with modest weight loss. Dipeptidyl-peptidase-4 inhibitors are weight neutral, whereas glucagon-like peptide-1 analogs are associated with weight loss. The effect of orlistat and sibutramine in type 2 diabetes is also evaluated. The treatment of diabetes should not only focus on glycemic control as its sole intention, but it should factor in the effect of these various agents on weight, as well, since obesity aggravates insulin resistance, beta cell failure, and cardiovascular risk.

  7. The changing world demography of type 2 diabetes.

    Science.gov (United States)

    Green, Anders; Christian Hirsch, Niels; Pramming, Stig Krøger

    2003-01-01

    In recent years it has been estimated that the current global prevalence of type 2 diabetes amounts to about 150 million patients. Projections suggest that by the year 2025 the number of prevalent patients in the world will reach approximately 300 million. It is assumed that the increase in the number of patients will be most pronounced in nations currently undergoing socio-economic development including increasing urbanization. The technique used to provide these estimates is based on results from available, contemporary survey results, combined with expected future trends in demographic indicators. We suggest that the currently available methods for the estimation of the future global burden of type 2 diabetes mellitus yield underestimates. Further modifications and validity tests of the modelling techniques are necessary in order to develop a reliable instrument to globally monitor the effects of the struggle against the diabetes problem.

  8. Vegetarian and vegan diets in type 2 diabetes management.

    Science.gov (United States)

    Barnard, Neal D; Katcher, Heather I; Jenkins, David J A; Cohen, Joshua; Turner-McGrievy, Gabrielle

    2009-05-01

    Vegetarian and vegan diets offer significant benefits for diabetes management. In observational studies, individuals following vegetarian diets are about half as likely to develop diabetes, compared with non-vegetarians. In clinical trials in individuals with type 2 diabetes, low-fat vegan diets improve glycemic control to a greater extent than conventional diabetes diets. Although this effect is primarily attributable to greater weight loss, evidence also suggests that reduced intake of saturated fats and high-glycemic-index foods, increased intake of dietary fiber and vegetable protein, reduced intramyocellular lipid concentrations, and decreased iron stores mediate the influence of plant-based diets on glycemia. Vegetarian and vegan diets also improve plasma lipid concentrations and have been shown to reverse atherosclerosis progression. In clinical studies, the reported acceptability of vegetarian and vegan diets is comparable to other therapeutic regimens. The presently available literature indicates that vegetarian and vegan diets present potential advantages for the management of type 2 diabetes.

  9. Sulfonylurea versus metformin monotherapy in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Hemmingsen, Bianca; Schroll, Jeppe B; Wetterslev, Jørn

    2014-01-01

    BACKGROUND: Guidelines recommend metformin as the first-line oral treatment for type 2 diabetes. We conducted a systematic review to assess whether the use of second- and third-generation sulfonylurea agents is associated with benefits and harms in terms of patient-important outcomes compared...... with metformin. METHODS: We searched several electronic databases and other sources for randomized clinical trials published to August 2011. We included trials that compared sulfonylurea versus metformin monotherapy among patients 18 years or older with type 2 diabetes and that had an intervention period...... of at least 24 weeks. We assessed risk of bias and extracted data related to interventions and outcomes. The risk of random errors was assessed by trial sequential analysis. RESULTS: We included 14 trials (4560 participants). All trials were judged to be at high risk of bias. Data on patient-important...

  10. Weight Considerations in Pharmacotherapy for Type 2 Diabetes

    OpenAIRE

    Vicky Cheng; Kashyap, Sangeeta R.

    2011-01-01

    Obesity has been increasing in prevalence worldwide and the majority of patients with type 2 diabetes are either overweight or obese. Diabetes management in this population has been difficult since a number of antidiabetes agents are associated with weight gain. The effects of various antidiabetes agents and antiobesity agents on glycemic control and body weight will be reviewed. Briefly, sulfonylureas, thiazolidinediones, and insulin are associated with weight gain, whereas metformin and amy...

  11. Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes

    OpenAIRE

    Foster, Gary D.; Sanders, Mark H.; Millman, Richard; Zammit,Gary; Borradaile, Kelley E.; Newman, Anne B.; Thomas A. Wadden; Kelley, David; Wing, Rena R.; Pi Sunyer, F. Xavier; Darcey, Valerie; Kuna, Samuel T.; ,

    2009-01-01

    OBJECTIVE To assess the risk factors for the presence and severity of obstructive sleep apnea (OSA) among obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Unattended polysomnography was performed in 306 participants. RESULTS Over 86% of participants had OSA with an apnea-hypopnea index (AHI) ≥5 events/h. The mean AHI was 20.5 ± 16.8 events/h. A total of 30.5% of the participants had moderate OSA (15 ≤ AHI

  12. Compromised Wound Healing in Ischemic Type 2 Diabetic Rats.

    Directory of Open Access Journals (Sweden)

    Peilang Yang

    Full Text Available Ischemia is one of the main epidemic factors and characteristics of diabetic chronic wounds, and exerts a profound effect on wound healing. To explore the mechanism of and the cure for diabetic impaired wound healing, we established a type 2 diabetic rat model. We used an 8 weeks high fat diet (HFD feeding regimen followed by multiple injections of streptozotocin (STZ at a dose of 10mg/kg to induce Wister rat to develop type 2 diabetes. Metabolic characteristics were assessed at the 5th week after the STZ injections to confirm the establishment of diabetes mellitus on the rodent model. A bipedicle flap, with length to width ratio 1.5, was performed on the back of the rat to make the flap area ischemic. Closure of excisional wounds on this bipedicle flap and related physiological and pathological changes were studied using histological, immunohistochemical, real time PCR and protein immunoblot approaches. Our results demonstrated that a combination of HFD feeding and a low dose of STZ is capable of inducing the rats to develop type 2 diabetes with noticeable insulin resistance, persistent hyperglycemia, moderate degree of insulinemia, as well as high serum cholesterol and high triglyceride levels. The excision wounds on the ischemic double pedicle flap showed deteriorative healing features comparing with non-ischemic diabetic wounds, including: delayed healing, exorbitant wound inflammatory response, excessive and prolonged ROS production and excessive production of MMPs. Our study suggested that HFD feeding combined with STZ injection could induce type 2 diabetes in rat. Our ischemic diabetic wound model is suitable for the investigation of human diabetic related wound repair; especically for diabetic chronic wounds.

  13. Incretin-based therapy and type 2 diabetes

    DEFF Research Database (Denmark)

    Hare, Kristine J; Knop, Filip Krag

    2010-01-01

    . Two new drug classes based on the actions of the incretin hormones have been approved for therapy of type 2 diabetes: injectable long-acting stable analogs of GLP-1, incretin mimetics, and orally available inhibitors of dipeptidyl peptidase 4 (DPP4; the enzyme responsible for the rapid degradation...... of incretin mimetics and incretin enhancers, review clinical experience gathered so far, and discuss future expectations for incretin-based therapy....

  14. Optimal Pharmacologic Treatment Strategies in Obesity and Type 2 Diabetes

    OpenAIRE

    Gayotri Goswami; Nataliya Shinkazh; Nichola Davis

    2014-01-01

    The prevalence of obesity has increased to pandemic levels worldwide and is related to increased risk of morbidity and mortality. Metabolic comorbidities are commonly associated with obesity and include metabolic syndrome, pre-diabetes, and type 2 diabetes. Even if the prevalence of obesity remains stable until 2030, the anticipated numbers of people with diabetes will more than double as a consequence of population aging and urbanization. Weight reduction is integral in the prevention of dia...

  15. Emerging treatments in type 2 diabetes: focus on canagliflozin

    OpenAIRE

    Rosiak M; Grzeszczak S; Kosior DA; Postuła M

    2014-01-01

    Marek Rosiak,1,2 Susanna Grzeszczak,2 Dariusz A Kosior,2,3 Marek Postuła1,2 1Department of Cardiology and Hypertension, Central Clinical Hospital, the Ministry of the Interior, Warsaw, Poland; 2Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland; 3Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland Abstract: Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder, which affects more than 300 million people globally...

  16. Canagliflozin Treatment in Patients with Type 2 Diabetes Mellitus

    OpenAIRE

    Curtis Triplitt; Susan Cornell

    2015-01-01

    Current guidelines for treatment of type 2 diabetes mellitus (T2DM) indicate a patient-centered approach that should go beyond glycemic control. Of the many antihyperglycemic agents available for treatment of T2DM, sodium-glucose cotransporter 2 (SGLT2) inhibitors offer the advantages of reduced glycated hemoglobin (A1C), body weight (BW), and systolic blood pressure (SBP) and are associated with a low risk of hypoglycemia when used either as monotherapy or with other agents not typically ass...

  17. Liraglutide in Type 2 Diabetes Mellitus: Clinical Pharmacokinetics and Pharmacodynamics

    OpenAIRE

    2015-01-01

    Liraglutide is an acylated glucagon-like peptide-1 analogue with 97 % amino acid homology with native glucagon-like peptide-1 and greatly protracted action. It is widely used for the treatment of type 2 diabetes mellitus, and administered by subcutaneous injection once daily. The pharmacokinetic properties of liraglutide enable 24-h exposure coverage, a requirement for 24-h glycaemic control with once-daily dosing. The mechanism of protraction relates to slowed release from the injection site...

  18. Type 2 Diabetes Mellitus and Increased Risk for Malaria Infection

    Centers for Disease Control (CDC) Podcasts

    2010-09-23

    This podcast describes research done in Ghana examining a correlation between type 2 diabetes and a possible increased risk for malaria infection in adults. Dr. Manoj Menon, a medical officer in the Division of Parasitic Diseases and Malaria in the Center for Global Health, discusses questions the study raises.  Created: 9/23/2010 by National Center for Emerging and Zoonotic Infectious Diseases; Center for Global Health.   Date Released: 9/23/2010.

  19. The oral microflora in obesity and type-2 diabetes

    OpenAIRE

    Shillitoe, Edward; Weinstock, Ruth; Kim, Taewan; Simon, Howard; Jessica, Planer; Noonan, Susan; Cooney, Robert

    2012-01-01

    Background: Type 2 diabetes mellitus (T2DM) is prevalent in people with obesity. It has been proposed that these conditions are related to specific features of the microflora of the mouth and lower gastrointestinal (GI) tract. Hyperglycemia often resolves quickly after Roux-en-Y gastric bypass (RYGB) but the role of the GI microflora cannot be examined easily because of reduced intestinal mobility. We propose that the study of microorganisms present in the mouth of patients undergoing RYGB wi...

  20. Oral manifestations in type-2 diabetes and related complications

    OpenAIRE

    Sarita Bajaj; Suresh Prasad; Arvind Gupta; Vijay Bahadur Singh

    2012-01-01

    Background: Knowledge of the wide spectrum of the oral markers of diabetes is imperative as one frequently encounters individuals with undetected, untreated or poorly controlled diabetes. Objectives: The objective was to study the oral manifestations in type 2 diabetes mellitus (DM) and to establish an association between oral manifestations and associated microvascular and macrovascular complications. Materials and Methods: 50 cases of DM were selected who had oral complications. The control...

  1. Epigenetic influences on type 2 diabetes and obesity

    OpenAIRE

    Yan,Jie

    2012-01-01

    Type 2 diabetes and obesity are multifactorial diseases involving interactions between genetic and environmental factors. A common feature shared between these two diseases is skeletal muscle insulin resistance. Insulin resistance refers to a state when the normal biological effect is not achieved by a normal amount of insulin. Complicated genetics alone is unlikely to explain the diversity of phenotypes in the general population. Epigenetics provides a mechanism which may explain the etiolog...

  2. ASSOCIATION OF ABO BLOOD GROUPS WITH TYPE 2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Sudheer

    2015-04-01

    Full Text Available There are no confirmatory studies have been available in In dia to know the Association of ABO blood groups with Type 2 Diabetes mellitus. We studied ABO blood groups association w ith Gender and age of onset of Type 2 Diabetes Mellitus. The study results showing that Blood Group O fallowed by B and A showing the posi tive association with Type2 Diabetes melllitus. In Males Blood group O (20% fallowed by B (16.9% and A and AB. In Females Blood group O (22.85% fallowed by A group (11.42% and B and AB having association with Type2 Diabetes mellitus. The association as per age of onset of Type 2 DM with ABO blood Groups showing that the age of onset of Type2 DM in 41 - 50 yrs (34.28%. It is commonly associated with Blood group O (18.09%, and in the age of onset of Type 2 DM in 30 - 40yrs (33.33% is commly assoc iated wit h blood group O and B (10.47% equally and in 51 - 60yrs (26.66% with with blood group O (11.42% and in the age of onset of DM above 60yrs (5.71% with blood group O (2.85%. PATIENTS AND METHODOLOGY: It was a prospective study conducted in 105 patients wi th Type 2 Diabetes mellitus. Prior consent taken from the study subjects to obtain the information about age of completed years, gender, age of onset of Diabetes and family history of known Diabetes. The age of onset of Diabetes above 30yrs were taken for study. Exclusion criteria were patients with Psychiatric illness, acute illness, age less than 30yrs old and history of diabetic ketoacidosis. Blood samples were collected from them with consent. The samples were tested for ABO blood groups. The Control sa mples are randomly selected. Patient recruitment lasted for 1 month from 1.1.2015 to 31.1.2015

  3. Anaemia and kidney dysfunction in Caribbean Type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Seales Dawn

    2008-08-01

    Full Text Available Abstract Background Anaemia has been shown in previous studies to be a risk factor for cardiovascular disease in diabetic patients with chronic kidney disorder. This study was aimed to assess the prevalence of anaemia and kidney dysfunction in Caribbean type 2 diabetic patients that have been previously shown to have a high prevalence of the metabolic syndrome. Methods 155 type 2 diabetic patients and 51 non-diabetic subjects of African origin were studied. Anthropometric parameters were measured and fasting blood samples were collected for glucose, creatinine, glycated hemoglobin and complete blood count. Anaemia was defined as haemoglobin 2. Comparisons for within- and between-gender, between diabetic and non-diabetic subjects were performed using Student's t-test while chi-square test was employed for categorical variables. Results The diabetic patients were older than the non-diabetic subjects. While male non-diabetic subjects had significantly higher red blood cell count (RBC, haemoglobin and hematocrit concentrations than non-diabetic female subjects (p 2, p Conclusion A high prevalence of anaemia was identified in this group of type 2 diabetic patients previously shown to have a high prevalence of the metabolic syndrome. It is therefore recommended that diagnostic laboratories in developing countries and elsewhere should include complete blood count in routine laboratory investigations in the management of diabetic patients.

  4. Optimal Pharmacologic Treatment Strategies in Obesity and Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Gayotri Goswami

    2014-06-01

    Full Text Available The prevalence of obesity has increased to pandemic levels worldwide and is related to increased risk of morbidity and mortality. Metabolic comorbidities are commonly associated with obesity and include metabolic syndrome, pre-diabetes, and type 2 diabetes. Even if the prevalence of obesity remains stable until 2030, the anticipated numbers of people with diabetes will more than double as a consequence of population aging and urbanization. Weight reduction is integral in the prevention of diabetes among obese adults with pre-diabetes. Lifestyle intervention and weight reduction are also key in the management of type 2 diabetes. Weight loss is challenging for most obese patients, but for those with diabetes, it can pose an even greater challenge due to the weight gain associated with many treatment regimens. This article will review optimal treatment strategies for patients with comorbid obesity and type 2 diabetes. The role of anti-obesity agents in diabetes will also be reviewed. This literature review will provide readers with current strategies for the pharmacologic treatment of obesity and diabetes with a focus on the weight outcomes related to diabetes treatments.

  5. Cannabinoid-1 receptor antagonists in type-2 diabetes.

    Science.gov (United States)

    Scheen, André J

    2007-12-01

    Type-2 diabetes is closely related to abdominal obesity and is generally associated with other cardiometabolic risk factors, resulting in a risk of major cardiovascular disease. Several animal and human observations suggest that the endocannabinoid system is over-active in the presence of abdominal obesity and/or diabetes. Both central and peripheral endocannabinoid actions, via the activation of CB1 receptors, promote weight gain and associated metabolic changes. Rimonabant, the first selective CB(1) receptor blocker in clinical use, has been shown to reduce body weight, waist circumference, triglycerides, blood pressure, insulin resistance index and C-reactive protein levels, and to increase high-density lipoprotein (HDL) cholesterol and adiponectin concentrations in both non-diabetic and diabetic overweight/obese patients. In addition, a 0.5-0.7% reduction in HbA1c levels was observed in metformin- or sulphonylurea-treated patients with type-2 diabetes and in drug-naïve diabetic patients. Almost half of the metabolic changes, including HbA1c reduction, could not be explained by weight loss, suggesting that there are direct peripheral effects. Rimonabant was generally well-tolerated, and the safety profile was similar in diabetic and non-diabetic patients, with a higher incidence of depressed mood disorders, nausea and dizziness. In conclusion, the potential role of rimonabant in overweight/obese patients with type-2 diabetes and at high risk of cardiovascular disease deserves much consideration.

  6. Effects of chromium picolinate supplementation in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Niladê Rosinski Rocha

    2014-10-01

    Full Text Available The effects of chromium picolinate in Type 2 diabetic patients are investigated.  Seventeen Type 2 diabetic patients were randomly divided into two groups. The experimental group received fiber-rich hypocaloric diet and chromium picolinate whereas the control group received fiber-rich hypocaloric diet and placebo. The chromium picolinate was offered twice a day at the dose of 100 μg. Anthropometric data such as blood pressure, fasting glycemia and glycated hemoglobin (HbA1c were measured and these parameters were evaluated again after 90 days. No difference was reported in rates of body weight, waist, hip, body mass index, blood pressure and fasting glycemia (Control vs. Experimental groups after treatment. However, a decrease (p = 0.0405 of HbA1c occurred in the experimental group when the pre- and post-treatment rates were compared. HbA1c data showed that chromium picolinate improved the glycemic control in Type 2 diabetes.

  7. Profile of Type 2 Diabetic Patients Referred to Electroneurography Laboratory

    Directory of Open Access Journals (Sweden)

    Ufuk Emre

    2010-05-01

    Full Text Available Objective: In this study, we aimed to assess the presence of minor complications in patients with type 2 diabetes mellitus (DM referred to electroneurography (ENG laboratory for evaluation of neuropathy. In addition, the relationship between duration of disease, electrophysiologic findings, neurological examination findings, plasma glycated hemoglobin A1C levels, glucose levels and microvascular complications were examined. Materials and Methods: One hundred seventy patients with type 2 diabetes were included. Age, gender, duration of disease, results of ophthalmological examinations, neuropathic complaints, electrophysiological examination results, neurological examination findings and laboratory examination results including blood glucose and A1C levels, presence of albuminuria were recorded retrospectively. Results: Abnormal ENG findings were found in one hundred forty patients (82.4%. In all patients, the rate of retinopathy was 34.1% and the rate of albuminuria was 19.4%. The rate of polyneuropathy (PNP( was 78.2% in patients with abnormal neurologic examination. Neuropathic complaints and PNP were found to be related with the presence of retinopathy. The rate of retinopathy was higher in patients with albuminuria. Significant relationship was found between disease duration and retinopathy, PNP and neuropathic complaints. Conclusions: This study emphasizes that detailed history, neurological and ophthalmological examinations are easy, cost-effective and reliable examinations in follow-up of type 2 diabetics. ENG examination, which needs time and money, should be done in asymptomatic cases or for differential diagnosis of neuropathies with clues not related with diabetic neuropathy. Turk Jem 2010; 14: 10-4

  8. Use of dicarboxylic acids in type 2 diabetes.

    Science.gov (United States)

    Mingrone, Geltrude; Castagneto-Gissey, Lidia; Macé, Katherine

    2013-03-01

    Even-number, medium-chain dicarboxylic acids (DAs), naturally occurring in higher plants, are a promising alternative energy substrate. Unlike the homologous fatty acids, DAs are soluble in water as salts. They are β-oxidized, providing acetyl-CoA and succinyl-CoA, the latter being an intermediate of the tricarboxylic acid cycle. Sebacic acid and dodecanedioic acid, DAs with 10 and 12 carbon atoms respectively, provide 6.6 and 7.2 kcal g⁻¹ each; therefore, their energy density is intermediate between glucose and fatty acids. Dicarboxylic acids have been proved to be safe in both experimental animals and humans, and their use has recently been proposed in diabetes. Studies in animals and humans with type 2 diabetes showed that oral administration of sebacic acid improved glycaemic control, probably by enhancing insulin sensitivity, and reduced hepatic gluconeogenesis and glucose output. Moreover, dodecanedioic acid intake reduced muscle fatigue during exercise in subjects with type 2 diabetes, suggesting an improvement of energy utilization and 'metabolic flexibility'. In this article, we review the natural sources of DAs, their fate in animals and humans and their effect in improving glucose metabolism in type 2 diabetes.

  9. Sleep disturbances and glucoregulation in patients with type 2 diabetes.

    Science.gov (United States)

    Cho, Eun-Hee; Lee, HeyJean; Ryu, Ohk Hyun; Choi, Moon Gi; Kim, Sang-Wook

    2014-02-01

    We investigated the frequency of sleep disturbances and the association between sleep disturbances and glucoregulation in type 2 diabetic patients. The frequency of sleep disturbances in 614 type 2 diabetic patients was investigated using validated sleep questionnaires. There were 381 male and 233 female patients. The mean age was 59.7 ± 11.1 yr; the mean body mass index was 24.9 ± 4.4 kg/m(2); the mean HbA1c was 7.8% ± 1.5%; and the mean duration of diabetes was 10.3 ± 8.4 yr. The questionnaires revealed insomnia in 48.2% of the patients while 8.5% reported excessive daytime sleepiness. A total of 49% of the patients was poor sleepers, while 28.5% had depression. Multivariate logistic regression analysis showed that there was no significant association between HbA1c and other sleep disturbances, such as poor sleep, insomnia, and short duration of sleep. Sleep disturbances were very common in patients with type 2 diabetes mellitus, whereas there was no association between poor or short sleep and glucoregulation. Awareness and identifying sleep complaints in such patients are necessary to improve their quality of daily life.

  10. 2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea

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    Seung-Hyun Ko

    2011-10-01

    Full Text Available As in other countries, type 2 diabetes is major health concern in Korea. A dramatic increase in the prevalence of type 2 diabetes and its chronic complications has led to an increase in health costs and economic burdens. Early detection of high risk individuals, hidden diabetic patients, and improvement in the quality of care for the disease are the first steps to mitigate the increase in prevalence. The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In the guidelines, the committee recommended active screening of high risk individuals for early detection and added the hemoglobin A1c level to the diagnostic criteria for type 2 diabetes based on clinical studies performed in Korea. Furthermore, the committee members emphasized that integrating patient education and self-management is an essential part of care. The drug treatment algorithm based on the degree of hyperglycemia and patient characteristics were also updated.

  11. Canagliflozin: a novel treatment option for type 2 diabetes

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    Dietrich E

    2013-11-01

    Full Text Available Eric Dietrich,1 Jason Powell,2 James R Taylor2 1University of Florida College of Medicine, Department of Community Health and Family Medicine, 2University of Florida College of Pharmacy, Department of Pharmacotherapy and Translational Research, Gainesville, FL, USA Abstract: Type 2 diabetes continues to be a challenging disease to manage. The addition of new agents with a positive risk–benefit ratio could potentially assist clinicians and patients in achieving adequate diabetes control. Canagliflozin, the first sodium-glucose cotransporter 2 inhibitor presently available on the market, offers a unique mechanism of action: it inhibits renal reabsorption of glucose, thereby increasing urinary glucose excretion. It reduces hemoglobin A1c by approximately 0.37%–1.16%; it also reduces the patient's weight and systolic blood pressure and has a low risk for hypoglycemia. Adverse effects include an increased risk of urinary tract infections and genital mycotic infections. In this manuscript we review canagliflozin and its potential role in management of type 2 diabetes mellitus. Keywords: canagliflozin, SGLT2 inhibitor, type 2 diabetes, oral hypoglycemic

  12. CHROMOGRANIN A DETECTION IN SALIVA OF TYPE 2 DIABETES PATIENTS

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    Martine Soell

    2010-02-01

    Full Text Available Chromogranin A is present in secretion granules of nerve, endocrine and immune cells and is a precursor of several peptides with antibacterial and antifungal properties at micromolar concentrations.Our aim in this prospective, double blind study, was to determine the expression of chromogranin A and its peptides at protein level in saliva of type 2 diabetic patients and thereby to obtain a new non-invasive diagnostic means for the future.Saliva was taken from 30 type 2 diabetic patients and 30 healthy individuals at the same time interval in the morning without any oral stimuli. Circadianic periodics in protein productions have been avoided. The presence of chromogranin A and its derived peptides was determined in whole saliva, after centrifugation at 40C for 12 min at 14 000 rpm, by SDS-PAGE electrophoresis and Immunoblotting (Western Blot. To ensure same protein concentrations Bradford protein quantification assay has been performed before.For the first time, we have determined an overexpression of chromogranin A in saliva of diabetic patients in 100% of the individuals.Chromogranin A, a circulating biomarker for epithelial tumours, is also overexpressed in saliva of type 2 diabetic patients. To confirm our results, more studies with a large amount of patients is necessary.

  13. Exercise for hepatic fat accumulation in type 2 diabetic subjects.

    Science.gov (United States)

    Bacchi, Elisabetta; Moghetti, Paolo

    2013-01-01

    Type 2 diabetes is characterized by frequent ectopic fat accumulation in several tissues and organs. In particular, a number of studies showed that these subjects frequently have hepatic fat accumulation, which may play a role in the metabolic abnormalities typical of diabetes and has been also linked to increased risk for cardiovascular disease. In the last decade, the effect of exercise on ectopic fat content of type 2 diabetic patients has raised growing interest. However, there are only a few small randomized controlled trials on this topic. Results from these intervention studies indicate that exercise training, independent of dietary modifications, may reduce hepatic fat content and serum transaminases in these patients, suggesting that exercise per se may be an effective strategy to be combined with the traditional dietary interventions. As regards the different training modalities, there is recent evidence that both aerobic and resistance exercise may equally reduce hepatic fat accumulation in type 2 diabetic subjects. However, information regarding the effect of exercise on liver histology and fat accumulation in other ectopic sites is still very limited.

  14. Mitochondrial dynamics in type 2 diabetes: Pathophysiological implications

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    Susana Rovira-Llopis

    2017-04-01

    Full Text Available Mitochondria play a key role in maintaining cellular metabolic homeostasis. These organelles have a high plasticity and are involved in dynamic processes such as mitochondrial fusion and fission, mitophagy and mitochondrial biogenesis. Type 2 diabetes is characterised by mitochondrial dysfunction, high production of reactive oxygen species (ROS and low levels of ATP. Mitochondrial fusion is modulated by different proteins, including mitofusin-1 (MFN1, mitofusin-2 (MFN2 and optic atrophy (OPA-1, while fission is controlled by mitochondrial fission 1 (FIS1, dynamin-related protein 1 (DRP1 and mitochondrial fission factor (MFF. PARKIN and (PTEN-induced putative kinase 1 (PINK1 participate in the process of mitophagy, for which mitochondrial fission is necessary. In this review, we discuss the molecular pathways of mitochondrial dynamics, their impairment under type 2 diabetes, and pharmaceutical approaches for targeting mitochondrial dynamics, such as mitochondrial division inhibitor-1 (mdivi-1, dynasore, P110 and 15-oxospiramilactone. Furthermore, we discuss the pathophysiological implications of impaired mitochondrial dynamics, especially in type 2 diabetes.

  15. Influence of Bisphenol A on Type 2 Diabetes Mellitus

    Science.gov (United States)

    Provvisiero, Donatella Paola; Pivonello, Claudia; Muscogiuri, Giovanna; Negri, Mariarosaria; de Angelis, Cristina; Simeoli, Chiara; Pivonello, Rosario; Colao, Annamaria

    2016-01-01

    Bisphenol A (BPA) is an organic synthetic compound employed to produce plastics and epoxy resins. It is used as a structural component in polycarbonate beverage bottles and as coating for metal surface in food containers and packaging. The adverse effects of BPA on human health are widely disputed. BPA has been recently associated with a wide variety of medical disorders and, in particular, it was identified as potential endocrine-disrupting compound with diabetogenic action. Most of the clinical observational studies in humans reveal a positive link between BPA exposure, evaluated by the measurement of urinary BPA levels, and the risk of developing type 2 diabetes mellitus. Clinical studies on humans and preclinical studies on in vivo, ex vivo, and in vitro models indicate that BPA, mostly at low doses, may have a role in increasing type 2 diabetes mellitus developmental risk, directly acting on pancreatic cells, in which BPA induces the impairment of insulin and glucagon secretion, triggers inhibition of cell growth and apoptosis, and acts on muscle, hepatic, and adipose cell function, triggering an insulin-resistant state. The current review summarizes the available evidences regarding the association between BPA and type 2 diabetes mellitus, focusing on both clinical and preclinical studies. PMID:27782064

  16. Markers of Antioxidant Defense in Patients with Type 2 Diabetes

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    K. Gawlik

    2016-01-01

    Full Text Available Aims. Diabetes is considered a state of increased oxidative stress. This study evaluates blood concentrations of selected markers of antioxidant defense in patients with type 2 diabetes. Methods. The study included 80 type 2 diabetes patients and 79 apparently healthy controls. Measured markers included ferric reducing ability of plasma (FRAP, reduced glutathione (GSH, glutathione peroxidase (GPx, glutathione reductase (GR, γ-glutamyltransferase (GGT and uric acid serum, and plasma and/or hemolysate levels. Results. FRAP, uric acid, CRP, and GGT levels were significantly higher in patients with diabetes. Plasma and hemolysate GR was significantly higher whereas GPx activity was significantly lower in patients with diabetes. There were no significant differences in antioxidant defense markers between patients with and without chronic diabetes complications. Fasting serum glucose correlated with plasma GPx, plasma and hemolysate GR, FRAP, and serum GGT, and HbA1c correlated with serum GGT. Only FRAP and serum uric acid were significantly higher in obese (BMI>30 kg/m2 patients with diabetes than in nonobese patients. Conclusions. Some components of antioxidant defense such as GR, uric acid, and GGT are increased in patients with type 2 diabetes. However, the whole system cannot compensate for an enhanced production of ROS as reflected by the trend toward decreased erythrocytes GSH.

  17. Influence of Bisphenol A on Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Donatella Paola Provvisiero

    2016-10-01

    Full Text Available Bisphenol A (BPA is an organic synthetic compound employed to produce plastics and epoxy resins. It is used as a structural component in polycarbonate beverage bottles and as coating for metal surface in food containers and packaging. The adverse effects of BPA on human health are widely disputed. BPA has been recently associated with a wide variety of medical disorders and, in particular, it was identified as potential endocrine-disrupting compound with diabetogenic action. Most of the clinical observational studies in humans reveal a positive link between BPA exposure, evaluated by the measurement of urinary BPA levels, and the risk of developing type 2 diabetes mellitus. Clinical studies on humans and preclinical studies on in vivo, ex vivo, and in vitro models indicate that BPA, mostly at low doses, may have a role in increasing type 2 diabetes mellitus developmental risk, directly acting on pancreatic cells, in which BPA induces the impairment of insulin and glucagon secretion, triggers inhibition of cell growth and apoptosis, and acts on muscle, hepatic, and adipose cell function, triggering an insulin-resistant state. The current review summarizes the available evidences regarding the association between BPA and type 2 diabetes mellitus, focusing on both clinical and preclinical studies.

  18. A case study of type 2 diabetes self-management

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    Wu Hsin-i

    2005-01-01

    Full Text Available Abstract Background It has been established that careful diabetes self-management is essential in avoiding chronic complications that compromise health. Disciplined diet control and regular exercise are the keys for the type 2 diabetes self-management. An ability to maintain one's blood glucose at a relatively flat level, not fluctuating wildly with meals and hypoglycemic medical intervention, would be the goal for self-management. Hemoglobin A1c (HbA1c or simply A1c is a measure of a long-term blood plasma glucose average, a reliable index to reflect one's diabetic condition. A simple regimen that could reduce the elevated A1c levels without altering much of type 2 diabetic patients' daily routine denotes a successful self-management strategy. Methods A relatively simple model that relates the food impact on blood glucose excursions for type 2 diabetes was studied. Meal is treated as a bolus injection of glucose. Medical intervention of hypoglycaemic drug or injection, if any, is lumped with secreted insulin as a damping factor. Lunch was used for test meals. The recovery period of a blood glucose excursion returning to the pre-prandial level, the maximal reach, and the area under the excursion curve were used to characterize one's ability to regulate glucose metabolism. A case study is presented here to illustrate the possibility of devising an individual-based self-management regimen. Results Results of the lunch study for a type 2 diabetic subject indicate that the recovery time of the post-prandial blood glucose level can be adjusted to 4 hours, which is comparable to the typical time interval for non-diabetics: 3 to 4 hours. A moderate lifestyle adjustment of light supper coupled with morning swimming of 20 laps in a 25 m pool for 40 minutes enabled the subject to reduce his A1c level from 6.7 to 6.0 in six months and to maintain this level for the subsequent six months. Conclusions The preliminary result of this case study is encouraging

  19. Population genetics in minority children with type 2 diabetes mellitus.

    Science.gov (United States)

    Wallerstein, Robert

    2002-04-01

    Non-insulin dependent (type 2) diabetes mellitus (DM) is a rapidly emerging health threat in minority populations in the United States, with the African-American, Hispanic, and Native American populations at greatest risk. Clearly, environmental factors play a role in this disorder, but the ethnic predilection suggests a significant genetic component. Type 2 DM is a condition not well understood on a genetic basis. Familial clustering and ethnic variation have been documented. The populations of Africans living in diverse environments provide a unique opportunity to study type 2 DM as the mechanism is becoming more clear.

  20. The association between paternal prostate cancer and type 2 diabetes

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    Zuern Christine

    2007-01-01

    Full Text Available Abstract Objective Increasing evidence indicates that type 2 diabetic patients are at elevated risk for developing different kinds of cancers. However, diabetes mellitus may be a protective factor for prostate cancer since both were found to be negatively associated. Based on the same genetic background, parents of diabetic patients might show similar risks concerning cancers. Research design and methods We conducted a case-control study, where familiy history of 794 type 2 diabetic cases and 775 non-diabetic controls was ascertained. Then, we expanded our study up to 801 type 2 diabetic cases and 1267 non-diabetic controls. Results Concerning the 794 type 2 diabetic patients and 775 controls, we observed that cancer of cervix uteri was elevated among mothers of controls (odds ratio (OR 0.19; 95% confidence interval (CI 0.02 to 0.88; p = 0.033. Mothers of diabetic patients showed an increased history of cancers of the liver and biliary tract (OR 5.23; 95% CI 1.87 to 19.9; p = 0.0009 and stomach (OR 3.84; 95% CI 1.47 to 12.4; p = 0.0049. Pancreatic cancers were found to be elevated in fathers of diabetic patients (OR 4.92; 95% CI 1.07 to 46.7; p = 0.039. Most notably, a lower number of prostate cancers was observed in fathers of diabetic patients (OR 0.47; 95% CI 0.22 to 0.94; p = 0.032. Since diabetic patients were 14.3 years older than the controls, higher levels of cancer history among parents of diabetic patients would have been expected. Thus, the observed lower level of history of prostate cancer can be regarded as highly reliable. The analysis of 801 type 2 diabetics and 1267 controls showed that cancer of stomach was elevated among mothers of controls (OR 2.67; p = 0.0106. In addition, stomach cancers were found to be elevated in fathers of diabetic patients (OR 2.10; p = 0.0141. In accordance with the previous investigation, we again obseved a lower number of prostate cancers in fathers of diabetic patients (OR 0.49; p = 0.0279. However

  1. Socioeconomic position, type 2 diabetes and long-term risk of death

    DEFF Research Database (Denmark)

    Dalsgaard, Else-Marie; Skriver, Mette Vinther; Sandbæk, Annelli;

    2015-01-01

    Det er velkendt, at personer med type 2-diabetes har højere dødelighed end personer uden, samt at der er overdødelighed blandt personer med lavere uddannelses- og indkomstniveau sammenlignet med personer med højere socioøkonomisk position. Formålet med dette studie var at undersøge sammenhængen...... diabetes i Diabetesregisteret i løbet af perioden. Vi fandt, at dødeligheden steg med faldende socioøkonomisk position både blandt personer med og uden diabetes. Både type 2-diabetes og socioøkonomisk position havde stor indflydelse på dødeligheden og den kombinerede effekt af de to faktorer på dødelighed...... mellem de tre faktorer: socioøkonomisk position, diabetes og død. I studiet indgik hele den danske befolkning i alderen 40-69 år i årene 2001-06 (N=2,330,206) uden diabetes ved studiestart. Populationen blev fulgt i op til 11 år, og personer overgik til diabetespopulation, hvis de blev registreret med...

  2. Progression of diabetic retinopathy during pregnancy in women with type 2 diabetes

    DEFF Research Database (Denmark)

    Rasmussen, K.L.; Laugesen, C.S.; Nielsen, Lene Ringholm;

    2010-01-01

    We studied the progression of diabetic retinopathy during pregnancy in women with type 2 diabetes.......We studied the progression of diabetic retinopathy during pregnancy in women with type 2 diabetes....

  3. Relationship between serum endothelial lipase and macrovascular complications in type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    陶利花

    2013-01-01

    Objective To explore the relationship of serum endothelial lipase and macrovascular complications in type 2 diabetes patients(T2DM). Methods 66 patients with type 2 diabetes were divided into macrovascular complication group and no macrovascular complication group.

  4. EFFICACY OF BARIATRIC SURGERY IN OBESE INDIAN WITH TYPE 2 DIABETES MELLITUS

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    Subodh

    2013-01-01

    Full Text Available ABSTRACT: CONTEXT: Individuals with morbid obesity and type 2 diabetes benefit from weight loss, as this allows better glycemic control and modifies the coexisting risk factors for coronary heart disease, namely hypertension, dyslipid emia, insulin resistance, sleep apnea, and other comorbidities that constitute the metabolic s yndrome. AIMS: The purpose of the present study was to investigate whether weight loss after bariatric surgery can correct glycemic control and reduces the need of anti-diabetic treat ment in morbidly obese patients with type 2 diabetes. SETTINGS AND DESIGN: This is a prospective cohort study performed in Sri Aurobindo Medical College & PG Institute, Indore. S ampling done was nonrandom and purposive. METHODS AND MATERIAL: Forty patients with body mass index (BMI > 35 and had known type 2 diabetes were enrolled in study, al l these patient undergone bariatric surgery. Their obesity status in terms of height, weight and BMI, Glycemic status in terms of fasting blood sugar (FBS, postprandial blood sugar (PPBS and glycosylated haemoglobin (HbA1c, and treatment status in terms of oral hypoglycemic a gents and insulin were noted in details preoperatively Statistical analysis used: Quantitative variables w ere tested using Chi square test and p values were calculated between two groups. p val ue of ≤ 0.05 was considered statistically significant. Averages were expressed between groups a s mean ± standard deviation or percentage. RESULTS: Our study shows good control of glycemic status af ter bariatric surgery with mean HbA1c within desired level after 6 months of bariatric surgery. CONCLUSIONS: In conclusion, our study shows that bariatric surgery is an effective option for morbidly obese patients with type 2 diabetes mellitus. Weight loss d ue to surgery is strongly associated with good glycemic control and improved treatment efficac y.

  5. Loss of inverse relationship between pulsatile insulin and glucagon secretion in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Menge, Björn A; Grüber, Lena; Jørgensen, Signe M;

    2011-01-01

    In patients with type 2 diabetes, glucagon levels are often increased. Furthermore, pulsatile secretion of insulin is disturbed in such patients. Whether pulsatile glucagon secretion is altered in type 2 diabetes is not known.......In patients with type 2 diabetes, glucagon levels are often increased. Furthermore, pulsatile secretion of insulin is disturbed in such patients. Whether pulsatile glucagon secretion is altered in type 2 diabetes is not known....

  6. Detection and significance of serum insulin-like growth factor-1 in patients with type 2 diabetes, osteoporosis and type 2 diabetic osteoporosis

    Institute of Scientific and Technical Information of China (English)

    Yan-Rong Kang; Pei-Li Gu

    2016-01-01

    Objective:To investigate the content of insulin-like growth factor-1 (IGF-1) in serum and the relationship with type 2 diabetes, osteoporosis and type 2 diabetic osteoporosis.Methods:A total of 86 cases of patients with type 2 diabetes, 82 cases of patients with osteoporosis, 79 cases of patients with type 2 diabetic osteoporosis and 86 cases of healthy person were selected, the levels of IGF-1, diabetes related factors (fasting plasma c-peptide, FIN, HbA1c, GLU) and osteoporosis related factors (BMP, osteocalcin,β-CTx, P1NP, lumbar vertebra BMD) were detected, the relationship between the above indicators were compared with those of the disease.Results: In each group, content change of IGF-1 was not statistically significant; content changes of IGF-1, BMP and osteocalcin were control group>type 2 diabetes group>osteoporosis group>type 2 diabetic osteoporosis group. Diabetic osteoporosis enhanced the decrease of IGF-1 content. The contents ofβ-CTx and P1NP in osteoporosis group and diabetic osteoporosis group were similar, which were significantly lower than that in control group and type 2 diabetes group. The level of lumbar vertebra BMD in osteoporosis group and diabetic osteoporosis group were the lowest. Fasting plasma c-peptide in diabetes group and diabetic osteoporosis group were significantly lower than that in control group and osteoporosis group, and the content of fasting plasma c-peptide in diabetic osteoporosis group was the lowest. The contents of FIN, HbA1c and GLU in type 2 diabetes group and type 2 diabetic osteoporosis group were significantly higher than that in control group and osteoporosis group.Conclusion:IGF-1 was related with type 2 diabetes, osteoporosis and type 2 diabetic osteoporosis, and could offer help for predicting type 2 diabetes and osteoporosis in the future.

  7. Clinical Guide for Family Physicians to Manage Type 2 Diabetes

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    Seyed Esmaeil Managheb

    2015-10-01

    Full Text Available Compiling clinical guidelines is one of the requirements of family physician plan and classification of health care services.1 The high prevalence of type 2 diabetes can easily be seen in general practice so that 2.5% of referrals to general practitioners are due to diabetes. More than half of the patients with Type 2 diabetes are left undiagnosed and most of them suffer from its complications at the time of diagnosis. For example, 6.2% of patients suffer from diabetic retinopathy at the time of diagnosis.2 Most patients diagnosed with diabetes take more than one type of medication to treat the complications; about 60% take only oral medications, and 14 percent take oral medications and insulin.3 Although the principles of care for people with Type 2 diabetes is well known, there is a gap between the quality of care in general practice and optimal care so that up to 50% of patients’ condition are weakly controlled.4 Chronic care model for patients with chronic diseases explains the necessary measures to improve the care of people with chronic diseases. These elements include supporting disease management by the patients themselves, patient care, and support teams. Consultation and training are often done in general practice while it is usually a brief consultation about weight, medication or exercise. There is little evidence that mere printed texts are effective in controlling the disease. Extensive training programs are designed to develop self-management skills for diabetes control.4 The implementation of clinical guidelines in medical practice is a challenging task. But, a number of evidences have been shown to accelerate effective clinical guideline implementation and care improvement.5 Management of diabetes mellitus type 2 is shown in Figure 1.

  8. Bodyweight changes associated with antihyperglycaemic agents in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hermansen, Kjeld; Mortensen, Lene S

    2007-01-01

    The majority of patients with type 2 diabetes mellitus are overweight or obese at the time of diagnosis, and obesity is a recognised risk factor for type 2 diabetes and coronary heart disease (CHD). Conversely, weight loss has been shown to improve glycaemic control in patients with type 2 diabetes...

  9. Predictive Value of Serum Sialic Acid in Type-2 Diabetes Mellitus and Its Complication (Nephropathy)

    OpenAIRE

    K, Prajna; Kumar J., Ashok; Rai, Srinidhi; Shetty, Shobith Kumar; Rai, Tirthal; Shrinidhi,; Begum, Mohamedi; MD, Shashikala

    2013-01-01

    Introduction: Sialic acid levels are increased in type-2 diabetes mellitus and its estimation helps in predicting the occurrence of microvascular complication such as diabetic nephropathy. The present study compared the levels of sialic acid, glycated haemoglobin, serum creatinine and urine microalbumin: in type-2 diabetics without any complications; in type-2 diabetics with nephropathy; and in age and sex matched healthy individual (controls).

  10. Brewer's Yeast Improves Blood Pressure in Type 2 Diabetes Mellitus

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    Payam Hosseinzadeh

    2013-06-01

    Full Text Available Background: This study was conducted to investigate the effects of Brewer's yeast supplementation on serum lipoproteins and blood pressure in patients with Type 2 diabetes mellitus.Methods: In a randomized double blind clinical trial, 90 adults with type 2 diabetes mellitus were recruited, and divided randomly into 2 groups, trial group received brewer's yeast (1800 mg/day and control group received placebo for 12 weeks. Weight, BMI, food consumption (based on 24 hour food recall, fasting serum lipoproteins (Cholesterol, Triglyceride, LDL-c, HDL-c, systolic and diastolic blood pressures were measured before and after the intervention. Data analyses were performed by Statistical Package for Social Sciences ver. 18.0, and the statistical tests included Independent t-test, Paired t-test, Kolmogorov-Smirnov and analysis of covariance. This trial was registered in Iranian Registry of Clinical Trials (IRCT, No.IRCT138807062513N1.Results: Eighty-four subjects (21 men and 63 women aged 46.3±6.1 years completed the study. After 12 weeks supplementation, systolic and diastolic blood pressures were decreased in the group receiving brewer's yeast (4.1±1.5, P=0.007 and 5.7±0.6, P=0.001 respectively. No-significant changes in LDL-c, HDL-c, Triglyceride and Cholesterol were shown.Conclusion: Supplementation with Brewer's yeast besides the usual treatment of type 2 diabetes mellitus can reduce systolic and diastolic blood pressures in diabetic patients.

  11. Heart Failure Considerations of Antihyperglycemic Medications for Type 2 Diabetes.

    Science.gov (United States)

    Standl, Eberhard; Schnell, Oliver; McGuire, Darren K

    2016-05-27

    Prevalent and incident heart failure (HF) is increased in people with type 2 diabetes mellitus, with risk directly associated with the severity of hyperglycemia. Furthermore, in patients with type 2 diabetes mellitus, mortality is increased ≈10-fold in patients with versus without HF. Reducing HF with antihyperglycemic therapies, however, has been unsuccessful until recently. In fact, HF as an important outcome in patients with type 2 diabetes mellitus seems to be heterogeneously modulated by antihyperglycemic medications, as evidenced by results from cardiovascular outcome trials (CVOTs) and large observational cohort studies. Appropriately powered and executed CVOTs are necessary to truly evaluate cardiovascular safety and efficacy of new antihyperglycemic medications, as reflected by the guidance of the US Food and Drug Administration and other regulatory agencies since 2008. In light of the best available evidence at present, metformin and the sodium-glucose-co-transporter 2-inhibitor empagliflozin seem to be especially advantageous with regard to HF effects, with their use associated with reduced HF events and improved mortality. Acarbose, the dipeptidyl-peptidase 4-inhibitor sitagliptin, the glucagon-like peptide 1-receptor agonist lixisenatide based on presently available CVOT results comprise reasonable additional options, as significant harm in terms of HF has been excluded for those drugs. Additions to this list are anticipated pending results of ongoing CVOTs. Although no HF harm was seen in CVOTs for insulin or sulfonylureas, they should be used only with caution in patients with HF, given their established high risk for hypoglycemia and some uncertainties on their safety in patients with HF derived from epidemiological observations. Pioglitazone is contraindicated in patients with HF>New York Heart Association I, despite some benefits suggested by CVOT subanalyses.

  12. Chronomedicine and type 2 diabetes: shining some light on melatonin.

    Science.gov (United States)

    Forrestel, Andrew C; Miedlich, Susanne U; Yurcheshen, Michael; Wittlin, Steven D; Sellix, Michael T

    2016-12-16

    In mammals, the circadian timing system drives rhythms of physiology and behaviour, including the daily rhythms of feeding and activity. The timing system coordinates temporal variation in the biochemical landscape with changes in nutrient intake in order to optimise energy balance and maintain metabolic homeostasis. Circadian disruption (e.g. as a result of shift work or jet lag) can disturb this continuity and increase the risk of cardiometabolic disease. Obesity and metabolic disease can also disturb the timing and amplitude of the clock in multiple organ systems, further exacerbating disease progression. As our understanding of the synergy between the timing system and metabolism has grown, an interest has emerged in the development of novel clock-targeting pharmaceuticals or nutraceuticals for the treatment of metabolic dysfunction. Recently, the pineal hormone melatonin has received some attention as a potential chronotherapeutic drug for metabolic disease. Melatonin is well known for its sleep-promoting effects and putative activity as a chronobiotic drug, stimulating coordination of biochemical oscillations through targeting the internal timing system. Melatonin affects the insulin secretory activity of the pancreatic beta cell, hepatic glucose metabolism and insulin sensitivity. Individuals with type 2 diabetes mellitus have lower night-time serum melatonin levels and increased risk of comorbid sleep disturbances compared with healthy individuals. Further, reduced melatonin levels, and mutations and/or genetic polymorphisms of the melatonin receptors are associated with an increased risk of developing type 2 diabetes. Herein we review our understanding of molecular clock control of glucose homeostasis, detail the influence of circadian disruption on glucose metabolism in critical peripheral tissues, explore the contribution of melatonin signalling to the aetiology of type 2 diabetes, and discuss the pros and cons of melatonin chronopharmacotherapy in

  13. Vitamin D levels and microvascular complications in type 2 diabetes

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    Sarita Bajaj

    2014-01-01

    Full Text Available Background: Vitamin D has important actions on glucose metabolism. These include improved insulin exocytosis, direct stimulation of insulin receptor, improved uptake of glucose by peripheral tissues, improving insulin resistance. It has got various pleiotropic effects like suppression of cell mediated immunity, regulation of cell proliferation, stimulation of neurotropic factors such as nerve growth factor, Glial cell line-derived neurotrophic factor, neurotropin, suppression of RAAS, reduction of albuminuria, immunomodulatory effects, and anti-inflammatory effects. Thus, vitamin D is implicated in many ways in the pathogenesis of retinopathy, neuropathy and nephropathy. Objectives: To study the correlation of vitamin D levels with microvascular complications in type 2 diabetes. Materials and Methods: Cross-sectional case-control study of 18 patients (18-70 years, who met the American Diabetes Association 2011 criteria for type 2 diabetes, was conducted. Age and sex matched healthy controls were taken. Subjects were evaluated for the presence of microvascular complications by clinical evaluation, urine examination, fundus examination, nerve conduction studies, and various biochemical tests. 25-OH cholecalciferol levels were done for each. Cut off level for vitamin D deficiency was 20 ng/ml. Results: Mean vitamin D was lower in type 2 diabetics than healthy subjects (19.046 vs. 27.186 ng/ml. Prevalence of vitamin D deficiency and insufficiency was found to significantly higher in diabetics when compared to healthy subjects (P = 0.0001. Vitamin D deficiency was found to be significantly associated with neuropathy (χ2 = 5.39, df = 1, P = 0.020, retinopathy, (χ2 = 6.6, df = 1, P = 0.010 and nephropathy (χ2 = 10. 52, df = 1, P = 0.001. Lower levels of vitamin D were found to be associated with increasing prevalence of combinations of microvascular complications namely neuropathy with retinopathy (P = 0.036, neuropathy with nephropathy (P = 0

  14. Sexual Dysfunction in Women with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Forouzan Elyasi

    2015-05-01

    Full Text Available Background: Sexual dysfunction (SD is one of the important problems in diabetic patients. The present study aimed to determine the prevalence of sexual problems in Iranian women with type 2 diabetes mellitus. Methods: A cross-sectional study was conducted among type 2 diabetic women who visited two outpatient endocrine clinics, namely Imam Hospital and Tuba clinic (Sari, Iran in 2012. Patients were asked to complete two validated questionnaires: Female Sexual Function Index (FSFI and The Hospital Anxiety and Depression Scale (HADS as well as a demographic questionnaire. Analysis was performed using descriptive and analytical tests. P<0.05 was considered to be significant. Results: One hundred and fifty women with type 2 diabetes were investigated. Most of the cases aged 40-44 years old. The mean of the total score of the FSFI questionnaire was 22. The prevalence of sexual dysfunction was 78.7% (CI: 71.4-84.4; among these, 58% (CI: 50.0-65.6 reported problems in lubrication, 50% (CI: 42.1-57.9 complained of decreased sexual desire, 50% (CI: 42.1-57.9 had problems with arousal, 47.3% (CI: 39.5-55.3 had dyspareunia, 32.7% (CI: 25.7-40.5 complained of orgasmic dysfunction and 42.7% (CI: 35.0-50.7 reported problems in sexual satisfaction. With regard to the results of the HADS questionnaire, 58.7% (CI: 50.7-66.2 of the patients had depression and 96.7% (CI: 92.4-98.6 had anxiety. Conclusion: This study showed the high prevalence of sexual dysfunction in diabetic women, especially among those complaining of depression. Health care professionals dealing with diabetic patients should be aware of possible presence of sexual dysfunction in female patients.

  15. Fruit and Glycemic Control in Type 2 Diabetes

    DEFF Research Database (Denmark)

    Christensen, Allan Stubbe; Viggers, Lone; Gregersen, Søren

    2015-01-01

    Health professionals often advise subjects with type 2 diabetes (T2D) to restrict fruit intake. We show here that there is no supportive scientific evidence for this. At least 19 studies have tested intake of fruit on postprandial glucose in T2D. Only two long-term intervention studies have...... investigated the impact of fruit intake on glycemic control in T2D. The studies show that fruit has neutral or positive glycemic effects. By restraining fruit intake, T2D subjects add an additional risk of disease and premature death. Further, there is no evidence to support that fructose contained in fruit...

  16. [Coma in type 2 diabete mellitus on metformin treatment].

    Science.gov (United States)

    Renard, C; Tellal, S; Fevre, G; Ragot, C; Vest, P; Foissaud, V; Renaudeau, C

    2003-01-01

    Non traumatic coma in diabete mellitus has two origins : hypo- or hyperglycemia. Coma with hyperglycemia can be due to ketoacidosis, hyperosmolar state or lactic acidosis. The present observation reports on a type 2 diabete mellitus patient presenting with a coma while the patient was on metformin and glibenclamide treatment. On admission, biologicals tests showed major acidosis, hyperglycemia and hyperosmolarity. No metformine accumulation was demonstrated by analytical measure. In this case, the association of hyperosmolar state and metabolic acidosis prove the difficulty of the differential diagnosis.

  17. Depression in type 2 diabetes mellitus--a brief review.

    Science.gov (United States)

    Siddiqui, Samreen

    2014-01-01

    Diabetes mellitus is a chronic disease which has been associated with depression. Depression is more common in adults with type 2 diabetes mellitus (T2DM) as compared to those without. Both micro- and macro vascular diabetic complications are associated with depression and have shown to increase the risk of mood disorder. Further, poor glycemic control in T2DM patients could lead to more complications of diabetes and such patients are more likely to develop depression. More research is needed in this area to determine the exact relationship between depression and T2DM and to unfold the mystery of mechanism behind this.

  18. Management of Pediatric and Adolescent Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    M. Constantine Samaan

    2013-01-01

    Full Text Available Type 2 diabetes (T2D was an adult disease until recently, but the rising rates of obesity around the world have resulted in a younger age at presentation. Children who have T2D have several comorbidities and complications reminiscent of adult diabetes, but these are appearing in teens instead of midlife. In this review, we discuss the clinical presentation and management options for youth with T2D. We discuss the elements of lifestyle intervention programs and allude to pharmacotherapeutic options used in the treatment of T2D youth. We also discuss comorbidities and complications seen in T2D in children and adolescents.

  19. Incretin-based therapy of type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Knop, Filip K; Vilsbøll, Tina; Holst, Jens J

    2009-01-01

    This review article focuses on the therapeutic potential of the incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), in treating type 2 diabetes mellitus (T2DM). T2DM is characterized by insulin resistance, impaired glucose-induced insulin...... secretion and inappropriately regulated glucagon secretion which in combination eventually result in hyperglycemia and in the longer term microvascular and macrovascular diabetic complications. Traditional treatment modalities--even multidrug approaches--for T2DM are often unsatisfactory at getting patients...

  20. Sulfonylureas and cardiovascular complications of type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    L V Nedosugova

    2013-06-01

    Full Text Available This article addresses possible mechanisms for development of cardiovascular events (CVE in type 2 diabetes mellitus (T2DM patients treated with sulfonylurea derivatives (SU. Several problems are highlighted in this review, including molecular aspects of pancreatic and extrapancreatic action of these drugs, their comparative potential to induce hypoglycemic events (as predictors of acute CVE and impairment of ischemic preconditioning, as well as antiarrhythmic activity of certain SU agents. Finally, efficacy and cardiovascular safety of glimepiride in T2DM patients is substantiated based on a survey of current literature.

  1. Osteoprotegerin and biomarkers of vascular inflammation in type 2 diabetes.

    LENUS (Irish Health Repository)

    O'Sullivan, Eoin P

    2010-09-01

    Osteoprotegerin (OPG), receptor activator for nuclear factor kappa beta ligand (RANKL) and tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) are newly discovered members of the tumour necrosis factor-alpha receptor superfamily. While their role in bone metabolism is well described, their function within the vasculature is poorly understood. OPG inhibits vascular calcification in vitro and high serum levels have been demonstrated in type 2 diabetes, but serum RANKL and TRAIL and their potential correlation with well-established biomarkers of subclinical vascular inflammation such as high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) have not been described.

  2. [Mobile applications for management of Type 2 diabetes].

    Science.gov (United States)

    Vitger, Tobias; Hempler, Nana Folmann

    2016-08-15

    This literature review describes Type 2 diabetes applications with regard to purpose, effect, preferences and possibilities. Diabetes apps might have a positive effect on the health of a person with diabetes. Some studies have found improve-ments in HbA1c, body weight and health behaviour. Important is to personalise diabetes apps to the target group and involve the group actively in the development and testing of the app. More research on how diabetes apps can be implemented in the healthcare system is crucial. Current research is characterised by methodological challenges.

  3. The origin of circulating CD36 in type 2 diabetes

    OpenAIRE

    2013-01-01

    Objective: Elevated plasma levels of the fatty acid transporter, CD36, have been shown to constitute a novel biomarker for type 2 diabetes mellitus (T2DM). We recently reported such circulating CD36 to be entirely associated with cellular microparticles (MPs) and aim here to determine the absolute levels and cellular origin(s) of these CD36+MPs in persons with T2DM. Design: An ex vivo case-control study was conducted using plasma samples from 33 obese individuals with T2DM (body mass index (B...

  4. The endocannabinoid system in obesity and type 2 diabetes.

    Science.gov (United States)

    Di Marzo, V

    2008-08-01

    Endocannabinoids (ECs) are defined as endogenous agonists of cannabinoid receptors type 1 and 2 (CB1 and CB2). ECs, EC anabolic and catabolic enzymes and cannabinoid receptors constitute the EC signalling system. This system participates in the control of lipid and glucose metabolism at several levels, with the possible endpoint of the accumulation of energy as fat. Following unbalanced energy intake, however, the EC system becomes dysregulated, and in most cases overactive, in several organs participating in energy homeostasis, particularly, in intra-abdominal adipose tissue. This dysregulation might contribute to excessive visceral fat accumulation and reduced adiponectin release from this tissue, and to the onset of several cardiometabolic risk factors that are associated with obesity and type 2 diabetes. This phenomenon might form the basis of the mechanism of action of CB1 antagonists/inverse agonists, recently developed by several pharmaceutical companies as adjuvants to lifestyle modification for weight reduction, glycaemic control and dyslipidaemia in obese and type 2 diabetes patients. It also helps to explain why some of the beneficial actions of these new therapeutics appear to be partly independent from weight loss.

  5. A study on body mass index and its correlation with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Subhash Chand Jain

    2014-08-01

    Full Text Available Obesity and increases in body weight are among the most important risk factors for type 2 diabetes mellitus. Obesity contributes to the development of type 2 diabetes mellitus. Body mass index is also known as obesity index. Body mass index is a strong and independent risk factor for being diagnosed in cases of type 2 diabetes mellitus. There is a high risk of type 2 diabetes in those who have a higher body mass index. The present study has been done with the objective of finding correlation between BMI and type 2 diabetes. [Int J Res Med Sci 2014; 2(4.000: 1638-1641

  6. Youth with Type 2 Diabetes Develop Complications More Often Than Type 1 Peers

    Science.gov (United States)

    ... February 28, 2017 Youth with type 2 diabetes develop complications more often than type 1 peers NIH, ... funded study finds many in both groups quickly develop kidney, nerve, eye diseases. Percentage of young adults ...

  7. Diabetic Nephropathy and Microalbuminuria in Pregnant Women With Type 1 and Type 2 Diabetes

    DEFF Research Database (Denmark)

    Damm, Julie Agner; Asbjörnsdóttir, Björg; Callesen, Nicoline Foged

    2013-01-01

    To evaluate the prevalence of diabetic nephropathy and microalbuminuria in pregnant women with type 2 diabetes in comparison with type 1 diabetes and to describe pregnancy outcomes in these women following the same antihypertensive protocol.......To evaluate the prevalence of diabetic nephropathy and microalbuminuria in pregnant women with type 2 diabetes in comparison with type 1 diabetes and to describe pregnancy outcomes in these women following the same antihypertensive protocol....

  8. Estimation of Cardiovascular Risk in Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Belkis Vicente Sánchez

    2015-09-01

    Full Text Available Background: diabetes mellitus accelerates atherosclerotic changes throughout the vascular tree and consequently increases the risk of developing fatal acute events. Objective: to estimate the global cardiovascular risk in patients with type 2 diabetes mellitus. Method: a cross-sectional study of a series of type 2 diabetic patients from the People's Council of Constancia, Abreus municipality, Cienfuegos province was conducted from July to December 2012. The universe comprised the 180 people with diabetes in the area. Variables studied were: age, sex, body mass index, nutritional assessment, blood pressure, toxic habits, associated chronic diseases, blood levels of glucose, lipids (total cholesterol and triglycerides and microalbuminuria. World Health Organization/International Society of Hypertension prediction charts specific to the region of the Americas, in which Cuba is included, were used to estimate the cardiovascular risk. Results: mean age was 61.63 years and females predominated. Relevant risk factors were hypertension followed by obesity, smoking and dyslipidemia. Mean body mass index was 27.66kg/m2; waist circumference was 94.45 cm in women and 96.86 cm in men. Thirty point six percent had more than two uncontrolled risk factors and 28.3 % of the total presented a high to very high cardiovascular risk. Conclusions: cardiovascular risk prediction charts are helpful tools for making clinical decisions, but their interpretation must be flexible and allow the intervention of clinical reasoning.

  9. Dulaglutide (LY-2189265) for the treatment of type 2 diabetes.

    Science.gov (United States)

    Scheen, André J

    2016-01-01

    Dulaglutide is a new once-weekly glucagon-like peptide-1 receptor agonist for the management of hyperglycemia in adult patients with type 2 diabetes. It stimulates dose-dependent insulin secretion and reduces glucagon secretion, both in a glucose-dependent manner. Efficacy on blood glucose control and safety were demonstrated in the large AWARD program in type 2 diabetic patients treated with diet, metformin, dual oral therapy or insulin lispro with or without metformin, confirming findings of pilot studies in Caucasian patients and data in Japanese patients. Dulaglutide 1.5 mg once weekly was superior to metformin, sitagliptin, insulin glargine and exenatide twice daily, and non-inferior to liraglutide 1.8 mg once daily regarding the reduction in glycated hemoglobin. A modest but significant weight loss was consistently observed. Most frequent adverse events were transient and generally mild gastrointestinal disturbances. Clinical outcomes of dulaglutide will not be known until the large prospective cardiovascular outcome trial REWIND is complete.

  10. Understanding type 2 diabetes: including the family member's perspective.

    LENUS (Irish Health Repository)

    White, Patricia

    2012-02-01

    PURPOSE: The purpose of this study was to examine the relationship between psychological and social factors and diabetes outcomes in people with type 2 diabetes and their family members. METHODS: A total of 153 patients with type 2 diabetes were assessed at a diabetes outpatient clinic and postal questionnaires were sent to nominated family members. The measures examined were diabetes knowledge, social support, well-being, and illness perceptions. RESULTS: When compared with those with diabetes, family members reported lower positive well-being and lower levels of satisfaction with support. They also perceived diabetes as a more cyclical illness, which was controlled more by treatment than by the individual. Family members also reported that the person with diabetes was more emotionally distressed and knew more about diabetes than the patient had actually reported himself or herself. There were no differences between the family members of those in good or poor glycaemic control. CONCLUSIONS: This study reinforces the importance of understanding social context and illness beliefs in diabetes management. It also highlights the potential for including family members in discussions and education about diabetes management.

  11. Type 2 diabetes mellitus affects eradication rate of Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Mehmet Sargyn; Oya Uygur-Bayramicli; Haluk Sargyn; Ekrem Orbay; Dilek Yavuzer; Ali Yayla

    2003-01-01

    AIM: To study the eradication rate of Helicobacter pylori (Hp) in a group of type 2 diabetes and compared it with an age and sex matched non-diabetic group.METHODS: 40 diabetic patients (21 females, 19 males;56±7 years) and 40 non-diabetic dyspeptic patients (20females, 20 males; 54±9 years) were evaluated. Diabetic patients with dyspeptic complaints were referred for upper gastrointestinal endoscopies; 2 corpus and 2 antral gastric biopsy specimens were performed on each patient. Patients with positive Hp results on histopathological examination comprised the study group. Non-diabetic dyspeptic patients seen at the Gastroenterology Outpatient Clinic and with the same biopsy and treatment protocol formed the control group.A triple therapy with amoxycillin (1 g b.i.d), clarithromycin (500 mg b.i.d) and omeprazole (20 mg b.i.d.) was given to both groups for 10 days. Cure was defined as the absence of Hp infection assessed by corpus and antrum biopsies in control upper gastrointestinal endoscopies performed 6weeks after completing the antimicrobial therapy.RESULTS: The eradication rate was 50 % in the diabetic group versus 85 % in the non-diabetic control group (P<0.001).CONCLUSION: Type 2 diabetic patients showed a significantly lower eradication rate than controls which may be due to changes in microvasculature of the stomach and to frequent antibiotic usage because of recurrent bacterial infections with the development of resistant strains.

  12. Lipoprotein(a) and risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Mora, Samia; Kamstrup, Pia R; Rifai, Nader;

    2010-01-01

    (a) concentrations and incident type 2 diabetes (n = 1670) for a follow-up period of 13 years. We confirmed our findings in 9652 Danish men and women with prevalent diabetes (n = 419). Analyses were adjusted for risk factors that included age, race, smoking, hormone use, family history, blood pressure, body mass......BACKGROUND: Previous studies have demonstrated that cardiovascular risk is higher with increased lipoprotein (a) [Lp(a)]. Whether Lp(a) concentration is related to type 2 diabetes is unclear. METHODS: In 26 746 healthy US women (mean age 54.6 years), we prospectively examined baseline Lp...... index, hemoglobin A(1c) (Hb A(1c)), C-reactive protein, and lipids. RESULTS: Lp(a) was inversely associated with incident diabetes, with fully adjusted hazard ratios (HRs) and 95% CIs for quintiles 2-5 vs quintile 1 of 0.87 (0.75-1.01), 0.80 (0.68-0.93), 0.88 (0.76-1.02), and 0.78 (0.67-0.91); P...

  13. Type 2 diabetes in Brazil: epidemiology and management

    Directory of Open Access Journals (Sweden)

    Almeida-Pititto B

    2015-01-01

    Full Text Available Bianca de Almeida-Pititto,1 Monike Lourenço Dias,2 Ana Carolina Franco de Moraes,3 Sandra RG Ferreira,3 Denise Reis Franco,4 Freddy Goldberg Eliaschewitz4,5 1Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil; 2Department of Endocrinology, Federal University of Goiás, Goiânia, Goiás, Brazil; 3Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil; 4CPClin Clinical Research Center, 5Albert Einstein Hospital, São Paulo, Brazil Abstract: Type 2 diabetes mellitus (T2DM is one of the most important epidemic diseases in the world this century, and accounts for 90% of cases of diabetes globally. Brazil is one of the most important examples of the alarming picture of T2DM in emergent societies, being the country with the fourth largest number of people with diabetes. The aim of this paper is to review the literature on diabetes in Brazil, specifically looking at the epidemiology and management of T2DM. A literature search was conducted using PubMed and LILACS to identify articles containing information on diabetes in Brazil. Official documents from the Brazilian government, World Health Organization, and International Diabetes Federation were also reviewed. Keywords: type 2 diabetes, Brazil, epidemiology, management

  14. Adipose tissue angiogenesis: impact on obesity and type-2 diabetes.

    Science.gov (United States)

    Corvera, Silvia; Gealekman, Olga

    2014-03-01

    The growth and function of tissues are critically dependent on their vascularization. Adipose tissue is capable of expanding many-fold during adulthood, therefore requiring the formation of new vasculature to supply growing and proliferating adipocytes. The expansion of the vasculature in adipose tissue occurs through angiogenesis, where new blood vessels develop from those pre-existing within the tissue. Inappropriate angiogenesis may underlie adipose tissue dysfunction in obesity, which in turn increases type-2 diabetes risk. In addition, genetic and developmental factors involved in vascular patterning may define the size and expandability of diverse adipose tissue depots, which are also associated with type-2 diabetes risk. Moreover, the adipose tissue vasculature appears to be the niche for pre-adipocyte precursors, and factors that affect angiogenesis may directly impact the generation of new adipocytes. Here we review recent advances on the basic mechanisms of angiogenesis, and on the role of angiogenesis in adipose tissue development and obesity. A substantial amount of data points to a deficit in adipose tissue angiogenesis as a contributing factor to insulin resistance and metabolic disease in obesity. These emerging findings support the concept of the adipose tissue vasculature as a source of new targets for metabolic disease therapies. This article is part of a Special Issue entitled: Modulation of Adipose Tissue in Health and Disease.

  15. Lipoprotein(a) and risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Mora, S.; Kamstrup, Pia R; Rifai, N.;

    2010-01-01

    BACKGROUND: Previous studies have demonstrated that cardiovascular risk is higher with increased lipoprotein (a) [Lp(a)]. Whether Lp(a) concentration is related to type 2 diabetes is unclear. METHODS: In 26 746 healthy US women (mean age 54.6 years), we prospectively examined baseline Lp......(a) concentrations and incident type 2 diabetes (n = 1670) for a follow-up period of 13 years. We confirmed our findings in 9652 Danish men and women with prevalent diabetes (n = 419). Analyses were adjusted for risk factors that included age, race, smoking, hormone use, family history, blood pressure, body mass...... index, hemoglobin A(1c) (Hb A(1c)), C-reactive protein, and lipids. RESULTS: Lp(a) was inversely associated with incident diabetes, with fully adjusted hazard ratios (HRs) and 95% CIs for quintiles 2-5 vs quintile 1 of 0.87 (0.75-1.01), 0.80 (0.68-0.93), 0.88 (0.76-1.02), and 0.78 (0.67-0.91); P...

  16. Renal histopathology of a baboon model with type 2 diabetes.

    Science.gov (United States)

    Rincon-Choles, Hernan; Abboud, Hanna E; Lee, Shuko; Shade, Robert E; Rice, Karen S; Carey, K Dee; Comuzzie, Anthony G; Barnes, Jeffrey L

    2012-10-01

    Naturally occurring type 2 diabetes has been found in a colony of baboons. Ongoing characterization of the baboon colony maintained at the Southwest National Primate Research Center has revealed a significant range of glucose sensitivity with some animals clearly diabetic.   Seven baboons, four with diabetes and three without diabetes, underwent histopathological investigation. Three diabetic animals were diagnosed using fasting blood glucose, hemoglobin A1C, and intravenous glucose tolerance test, and a fourth one was known to have hyperglycemia. One control baboon and three baboons with diabetes had microalbuminuria. On kidney biopsy, diabetic baboons had thickening of the glomerular basement membrane and mesangial matrix expansion compared to controls. Immunohistochemistry showed the diabetic animals had increased mesangial expression of cellular fibronectin ED-A. Two diabetic animals with microalbuminuria had evidence of mesangiolysis with the formation of an early nodule. One diabetic animal had a Kimmestiel-Wilson nodule. We conclude that the baboon represents a useful primate model of diabetes and nephropathy that resembles the nephropathy associated with type 2 diabetes in humans.

  17. Gene expression profile analysis of type 2 diabetic mouse liver.

    Directory of Open Access Journals (Sweden)

    Fang Zhang

    Full Text Available Liver plays a key role in glucose metabolism and homeostasis, and impaired hepatic glucose metabolism contributes to the development of type 2 diabetes. However, the precise gene expression profile of diabetic liver and its association with diabetes and related diseases are yet to be further elucidated. In this study, we detected the gene expression profile by high-throughput sequencing in 9-week-old normal and type 2 diabetic db/db mouse liver. Totally 12132 genes were detected, and 2627 genes were significantly changed in diabetic mouse liver. Biological process analysis showed that the upregulated genes in diabetic mouse liver were mainly enriched in metabolic processes. Surprisingly, the downregulated genes in diabetic mouse liver were mainly enriched in immune-related processes, although all the altered genes were still mainly enriched in metabolic processes. Similarly, KEGG pathway analysis showed that metabolic pathways were the major pathways altered in diabetic mouse liver, and downregulated genes were enriched in immune and cancer pathways. Analysis of the key enzyme genes in fatty acid and glucose metabolism showed that some key enzyme genes were significantly increased and none of the detected key enzyme genes were decreased. In addition, FunDo analysis showed that liver cancer and hepatitis were most likely to be associated with diabetes. Taken together, this study provides the digital gene expression profile of diabetic mouse liver, and demonstrates the main diabetes-associated hepatic biological processes, pathways, key enzyme genes in fatty acid and glucose metabolism and potential hepatic diseases.

  18. Atorvastatin prevents type 2 diabetes mellitus--an experimental study.

    Science.gov (United States)

    Madhu, Sri Venkata; Aslam, Mohammad; Galav, Vikas; Bhattacharya, Swapan Kumar; Jafri, Aiman Abbas

    2014-04-01

    Recent reports of increased diabetes risk have raised concerns regarding the use of statins. The present study was therefore planned to clarify whether atorvastatin can prevent diabetes development in a rat model of type 2 diabetes mellitus. Eight week old male Wistar rats were randomized into three groups (n = 12 each group). Group A was given standard chow diet, while group B and group C were offered high sucrose diet. In addition to high sucrose diet, group C was given atorvastatin (20mg/kg/day) from beginning of study till 26th week. After 26 weeks, a low dose of streptozotocin (15 mg/kg, i.p.) was given to all 3 groups and further followed for 4 weeks. Oral glucose tolerance tests were done at week 4, 26 and week 30. Development of impaired glucose tolerance at week 26 (16.66% vs 100%, P = diabetes at week 30 (16.66% vs 81.81%, P = 0.002) was significantly lower in rats pretreated with atorvastatin along with high sucrose diet viz group C compared to group B rats who received high sucrose diet only respectively. Also, metabolic indices like body weight, hypertriglyceridemia, glucose area under the curve (Gl-AUC) were significantly lower in group C compared to group B (P = diabetes mellitus that atorvastatin prevents development of type 2 diabetes.

  19. Preterm Birth—A Risk Factor for Type 2 Diabetes?

    Science.gov (United States)

    Kajantie, Eero; Osmond, Clive; Barker, David J.P.; Eriksson, Johan G.

    2010-01-01

    OBJECTIVE The association between low birth weight and type 2 diabetes is well established. We studied whether preterm birth carries a similar risk. RESEARCH DESIGN AND METHODS The Helsinki Birth Cohort includes 13,345 men and women born between 1934 and 1944. Of them, 12,813 had adequate data on length of gestation, which we linked with data on special reimbursement for diabetes medication. RESULTS Of the subjects, 5.1% had received special reimbursement after age 40. In subjects born before 35 weeks of gestation, the odds ratio for diabetes was 1.68 (95% CI 1.06–2.65) compared with that in those born at term. After adjustment for birth weight relative to length of gestation, the odds ratio was 1.59 (1.00–2.52). CONCLUSIONS Preterm birth before 35 weeks of gestation is associated with an increased risk of type 2 diabetes in adult life. The risk is independent of that associated with slow fetal growth. PMID:20823347

  20. Daily physical activity and type 2 diabetes: A review

    Institute of Scientific and Technical Information of China (English)

    Hidetaka; Hamasaki

    2016-01-01

    Physical activity improves glycemic control and reduces the risk of cardiovascular disease(CVD) and mortality in patients with type 2 diabetes(T2D). Moderate to vigorous physical activity is recommended to manage T2D; however, patients with T2D can be physically weak, making it difficult to engage in the recommended levels of physical activity. Daily physical activity includes various activities performed during both occupational and leisure time such as walking, gardening, and housework that type 2 diabetic patients should be able to perform without considerable physical burden. This review focuses on the association between daily physical activity and T2D. Walking was the most common form of daily physical activity, with numerous studies demonstrating its beneficial effects on reducing the risk of T2D, CVD, and mortality. Walking for at least 30 min per day was shown to reduce the risk of T2D by approximately 50%. Additionally, walking was associated with a reduction in mortality. In contrast, evidence was extremely limited regarding other daily physical activities such as gardening and housework in patients with T2D. Recent studies have suggested daily physical activity, including non-exercise activity thermogenesis, to be favorably associated with metabolic risks and mortality. However, well-designed longitudinal studies are warranted to elucidate its effects on overall health.

  1. Management of type 2 diabetes mellitus in youth.

    Science.gov (United States)

    Giampatzis, Vassilios; Tziomalos, Konstantinos

    2012-12-15

    The rising rates of obesity in youth have concurrently led to an increase in the rates of type 2 diabetes mellitus (T2DM) in this age group. However, there are limited data on the efficacy of different antidiabetic agents in youth. In this context, the Treatment Options for Type 2 Diabetes in Adolescents and Youth trial recently reported that the majority of obese children and adolescents 10-17-years old with newly diagnosed T2DM (T2DM duration less than 2 years) could not achieve HbA1c levels 1 year with metformin monotherapy, metformin plus rosiglitazone combination, or metformin and lifestyle changes. These findings suggest that, in the majority of youth with T2DM, tight long-term glycemic control with oral agents is an elusive goal and that most patients will require treatment with insulin within a few years of diagnosis to achieve HbA1c targets and reduce the risk of macro- and microvascular complications. Therefore, reducing the incidence of T2DM by preventing pediatric obesity through the implementation of lifestyle changes in the community should be the primary objective of healthcare systems.

  2. Glycemic control and implant stabilization in type 2 diabetes mellitus.

    Science.gov (United States)

    Oates, T W; Dowell, S; Robinson, M; McMahan, C A

    2009-04-01

    Diabetes mellitus is considered a relative contra-indication for implant therapy. However, the effect of glycemic level on implant integration in persons with diabetes remains poorly understood. The hypothesis of this research was that poor glycemic control is directly related to short-term-impairment implant stabilization. This prospective clinical study evaluated 10 non-diabetic individuals (12 implants) and 20 persons with type 2 diabetes (30 implants). Glycated hemoglobin (HbA1c) levels ranged from 4.7-12.6%. Implant stability was assessed by resonance frequency analysis over 4 months following placement. Minimum stability levels were observed 2-6 weeks following placement for all 42 implants. Persons with HbA1c > or = 8.1% had a greater maximum decrease in stability from baseline and required a longer time for healing, as indicated by return of stability level to baseline. This study demonstrates alterations in implant stability consistent with impaired implant integration for persons with type 2 diabetes mellitus in direct relation to hyperglycemic conditions.

  3. The effects of bariatric surgeries on type 2 diabetes mellitus

    Science.gov (United States)

    Lerd Ng, Jia; Ortiz, Roberto; Hughes, Tyler; Abou Ghantous, Michel; Bouhali, Othmane; Arredouani, Abdelilah; Allen, Roland

    2012-10-01

    We consider a scientific mystery which is of central importance in treating the most rapidly emerging national and global health threat: type 2 diabetes mellitus. The mystery involves a surprising effect of certain bariatric surgeries, and specifically Roux-en-Y gastric bypass (RYGB), a procedure which bypasses most of the stomach and upper intestine. An unanticipated result is that RYGB is usually found to contribute within only a few days to glucose homeostasis. This means the surgery can immediately cure patients even before they start losing weight. We are investigating this wondrous biochemical response with a quantitative model which includes the most important mechanisms. One of the major contributors is glucagon-like peptide 1 (GLP-1), an incretin whose concentration is found to increase by a large amount right after the RYGB surgical procedure. However, our results, in conjunction with the experimental and medical data, indicate that other substances must also contribute. If these substances can be definitively identified, it may be possible to replace the surgery with pharmaceuticals as the preferred treatment for type 2 diabetes.

  4. Attitudes and beliefs among Mexican Americans about type 2 diabetes.

    Science.gov (United States)

    Coronado, Gloria D; Thompson, Beti; Tejeda, Silvia; Godina, Ruby

    2004-11-01

    Hispanics in the United States have a disproportionately high risk for non-insulin-dependent diabetes mellitus (type 2 diabetes) compared with non-Hispanic whites. Little is known of the attitudes and beliefs about diabetes in this group. Using data from six focus groups of 42 Mexican Americans (14 men and 28 women), we characterized perceptions about the causes of and treatments for type 2 diabetes. Many participants believed diabetes is caused by having a family history of the disease, eating a diet high in fat or sugar, and engaging in minimal exercise. Experiencing strong emotions such as fright (susto), intense anger (coraje), or sadness and depression (tristeza) was also thought to precipitate diabetes. Nearly all participants expressed the belief that it is important to follow doctors' recommendations for diet and exercise, oral medication or insulin; many also cited herbal therapies, such as prickly pear cactus (nopal) and aloe vera (savila) as effective treatments. These findings may be useful in designing interventions to reduce the burden of diabetes in Hispanic populations.

  5. Association of Advanced Glycation End Products with coronary Artery Calcification in Japanese Subjects with Type 2 Diabetes as Assessed by Skin Autofluorescence

    OpenAIRE

    Hangai, Mari; Takebe, Noriko; Honma, Hiroyuki; Sasaki, Atsumi; Chida, Ai; Nakano, Rieko; Togashi, Hirobumi; Nakagawa, Riyuki; Oda, Tomoyasu; Matsui, Mizue; Yashiro, Satoshi; Nagasawa, Kan; Kajiwara, Takashi; Takahashi, Kazuma; Takahashi, Yoshihiko

    2016-01-01

    Aim: Advanced glycation end products (AGE) are considered to be among the critical pathogenic factors involved in the progression of diabetic complications. Skin autofluorescence (AF), a noninvasive measurement of AGE accumulation, has been recognized as a useful and convenient marker for diabetic vascular diseases in Caucasians. This study aimed to evaluate the association of tissue AGE, assessed using skin AF, with coronary artery calcification in Japanese subjects with type 2 diabetes. Met...

  6. Megatrials in type 2 diabetes. From excitement to frustration?

    Science.gov (United States)

    Del Prato, S

    2009-07-01

    Whether glycaemic control may result in a reduction of cardiovascular (CV) risk has been a matter of continuous discussion and investigation. Epidemiological analyses have extensively suggested a relationship between glycaemic control and CV events; however, the results of intervention trials have been less conclusive. The UKPDS reported a 16% reduction in the risk of myocardial infarction, but this reduction was not statistically significant. The results of the Kumamoto and PROactive studies could not allow any firm conclusions to be drawn either, because of limited size and the defined primary endpoint, respectively. The results of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) and Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trials and the Veteran Administration Diabetes Trial (VADT) were published in rapid succession over the second half of 2008 and at the beginning of 2009. A total number of almost 25,000 type 2 diabetic patients were recruited in these three trials, which assessed the effect of intensive glycaemic control vs conventional treatment on well-defined CV endpoints. In spite of the achievement and maintenance of strict glycaemic control (HbA(1c) therapy was apparent in any of the studies. At the same time these results were presented, the results of an analysis of the 10 year follow-up of the UKPDS also became available and provided a more optimistic view of the potential benefit of achieving good glycaemic control. The relative risk reductions for myocardial infarction and all-cause mortality were significantly lower in the patients who initially received the intensive treatment compared with those in the conventional treatment arm. Moreover, the initial benefit in terms of microvascular complications observed at the end of the intervention trial remained unaltered at follow-up. Once again the debate on the importance of glycaemic control in preventing

  7. Type 2 Diabetes Mellitus: A Review of Current Trends

    Directory of Open Access Journals (Sweden)

    Abdulfatai B. Olokoba

    2012-07-01

    Full Text Available Type 2 diabetes mellitus (DM is a chronic metabolic disorder in which prevalence has been increasing steadily all over the world. As a result of this trend, it is fast becoming an epidemic in some countries of the world with the number of people affected expected to double in the next decade due to increase in ageing population, thereby adding to the already existing burden for healthcare providers, especially in poorly developed countries. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include type 2 diabetes mellitus, prevalence, current diagnosis, and current treatment. Only articles in English were included. Screening and diagnosis is still based on World Health Organization (WHO and American Diabetes Association (ADA criteria which include both clinical and laboratory parameters. No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycemic agents, and insulin sensitizers like metformin, a biguanide that reduces insulin resistance, is still the recommended first line medication especially for obese patients. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin. Recent research into the pathophysiology of type 2 DM has led to the introduction of new medications like glucagon-like peptide 1 analogoues: dipeptidyl peptidase-IV inhibitors, inhibitors of the sodium-glucose cotransporter 2 and 11ß-hydroxysteroid dehydrogenase 1, insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, metabolic inhibitors of hepatic glucose output and quick-release bromocriptine. Inhaled insulin was licensed for use in 2006 but has been withdrawn from the market because of low patronage.

  8. Dopaminergic drugs in type 2 diabetes and glucose homeostasis.

    Science.gov (United States)

    Lopez Vicchi, Felicitas; Luque, Guillermina Maria; Brie, Belen; Nogueira, Juan Patricio; Garcia Tornadu, Isabel; Becu-Villalobos, Damasia

    2016-07-01

    The importance of dopamine in central nervous system function is well known, but its effects on glucose homeostasis and pancreatic β cell function are beginning to be unraveled. Mutant mice lacking dopamine type 2 receptors (D2R) are glucose intolerant and have abnormal insulin secretion. In humans, administration of neuroleptic drugs, which block dopamine receptors, may cause hyperinsulinemia, increased weight gain and glucose intolerance. Conversely, treatment with the dopamine precursor l-DOPA in patients with Parkinson's disease reduces insulin secretion upon oral glucose tolerance test, and bromocriptine improves glycemic control and glucose tolerance in obese type 2 diabetic patients as well as in non diabetic obese animals and humans. The actions of dopamine on glucose homeostasis and food intake impact both the autonomic nervous system and the endocrine system. Different central actions of the dopamine system may mediate its metabolic effects such as: (i) regulation of hypothalamic noradrenaline output, (ii) participation in appetite control, and (iii) maintenance of the biological clock in the suprachiasmatic nucleus. On the other hand, dopamine inhibits prolactin, which has metabolic functions; and, at the pancreatic beta cell dopamine D2 receptors inhibit insulin secretion. We review the evidence obtained in animal models and clinical studies that posited dopamine receptors as key elements in glucose homeostasis and ultimately led to the FDA approval of bromocriptine in adults with type 2 diabetes to improve glycemic control. Furthermore, we discuss the metabolic consequences of treatment with neuroleptics which target the D2R, that should be monitored in psychiatric patients to prevent the development in diabetes, weight gain, and hypertriglyceridemia.

  9. Influence of Bariatric Surgery on Remission of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Paweł Nalepa

    2011-12-01

    Full Text Available The plague of obesity afflicts an increasing group of people. Moreover type 2 diabetes, which is the most serious illness accompanying excessive weight, is becoming more and more common. Traditional methods of obesity treatment, such as diet and physical exercise, fail. This applies especially to people with class III obesity. The only successful way of treating obesity in their case is bariatric surgery. There are three types of bariatric surgery: restrictive procedures (reducing stomach volume, malabsorptive procedures, and mixed procedures, which combine both methods. In spite of the risk connected with the surgery and complications after it, bariatric procedures are advised to patients with class III obesity and class II with an accompanying illness which increases the probability of death. It has been proved that bariatric surgery not only eliminates obesity but also very frequently (in 90�0of cases leads to the remission of type 2 diabetes. Moreover, the remission occurs very fast – it takes place a long time before the patients reduce their weight, even within a few days after surgery. Detailed studies have shown that the remission of diabetes is caused mostly by the change of the gastro-intestinal hormones’ profile, resulting from the surgery. These hormones include GLP-1, GIP, peptide YY, ghrelin and oxyntomodulin. Additionally, the change of the amount of adipose tissue after the surgery influences the level of adipokines, i.e. the hormones of the adipose tissue, among which the most important are leptin, adiponectin and resistin. Thus, bariatric surgery not only changes the shape of the gastrointestinal tract but it also modulates the hormonal activity. Bariatric surgery is considered as therapy not only for the obese but also for diabetic patients.

  10. Patient beliefs and behaviors about genomic risk for type 2 diabetes: implications for prevention.

    Science.gov (United States)

    Gallagher, Patrick; King, Heather A; Haga, Susanne B; Orlando, Lori A; Joy, Scott V; Trujillo, Gloria M; Scott, William Michael; Bembe, Marylou; Creighton, Dana L; Cho, Alex H; Ginsburg, Geoffrey S; Vorderstrasse, Allison

    2015-01-01

    Type 2 diabetes is a major health burden in the United States, and population trends suggest this burden will increase. High interest in, and increased availability of, testing for genetic risk of type 2 diabetes presents a new opportunity for reducing type 2 diabetes risk for many patients; however, to date, there is little evidence that genetic testing positively affects type 2 diabetes prevention. Genetic information may not fit patients' illness representations, which may reduce the chances of risk-reducing behavior changes. The present study aimed to examine illness representations in a clinical sample who are at risk for type 2 diabetes and interested in genetic testing. The authors used the Common Sense Model to analyze survey responses of 409 patients with type 2 diabetes risk factors. Patients were interested in genetic testing for type 2 diabetes risk and believed in its importance. Most patients believed that genetic factors are important to developing type 2 diabetes (67%), that diet and exercise are effective in preventing type 2 diabetes (95%), and that lifestyle changes are more effective than drugs (86%). Belief in genetic causality was not related to poorer self-reported health behaviors. These results suggest that patients' interest in genetic testing for type 2 diabetes might produce a teachable moment that clinicians can use to counsel behavior change.

  11. Osteoprotegerin and mortality in type 2 diabetic patients

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Lajer, Maria Stenkil; Gall, Mari-Anne;

    2010-01-01

    OBJECTIVE Plasma osteoprotegerin (OPG) is an emerging strong and independent predictor of cardiovascular disease (CVD) in high-risk populations. OPG is a bone-related glycopeptide produced by vascular smooth muscle cells, and increased plasma OPG levels may reflect arterial vascular damage. We...... filtration rate, and conventional risk factors); hazard ratio (HR) 1.81 [95% CI 1.21-2.69]. The all-cause predictive effect of OPG was independent of NH(2)-terminal pro-brain natriuretic peptide (NT-proBNP) and was also useful within groups divided according to level of UAER. In total, 103 (73%) patients...... predictor of all-cause mortality in type 2 diabetic patients. The effect of OPG on all-cause mortality was independent of conventional cardiovascular risk factors, UAER, and NT-proBNP levels....

  12. Effective Nurse Communication With Type 2 Diabetes Patients: A Review.

    Science.gov (United States)

    Mulder, Bob C; Lokhorst, Anne Marike; Rutten, Guy E H M; van Woerkum, Cees M J

    2015-08-01

    Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to nurse-patient communication and to review potentially effective communication methods. Important communication barriers are lack of skills and self-efficacy, possibly because nurses work in a context where they have to perform biomedical examinations and then perform patient-centered counseling from a biopsychosocial approach. Training in patient-centered counseling does not seem helpful in overcoming this paradox. Rather, patient-centeredness should be regarded as a basic condition for counseling, whereby nurses and patients seek to cooperate and share responsibility based on trust. Nurses may be more successful when incorporating behavior change counseling based on psychological principles of self-regulation, for example, goal setting, incremental performance accomplishments, and action planning.

  13. Fractal analysis of circulating platelets in type 2 diabetic patients.

    Science.gov (United States)

    Bianciardi, G; Tanganelli, I

    2015-01-01

    This paper investigates the use of computerized fractal analysis for objective characterization by means of transmission electron microscopy of the complexity of circulating platelets collected from healthy individuals and from type 2 diabetic patients, a pathologic condition in which platelet hyperreactivity has been described. Platelet boundaries were extracted by means of automatically image analysis. Local fractal dimension by box counting (measure of geometric complexity) was automatically calculated. The results showed that the platelet boundary observed by electron microscopy is fractal and that the shape of the circulating platelets is significantly more complex in the diabetic patients in comparison to healthy subjects (p fractal analysis of platelet shape by transmission electron microscopy can provide accurate, quantitative, data to study platelet activation in diabetes mellitus.

  14. Different Pathophysiological Phenotypes among Newly Diagnosed Type 2 Diabetes Patients

    DEFF Research Database (Denmark)

    Stidsen, Jacob

    2013-01-01

    Type 2 diabetes (T2D) can be considered a syndrome with several different pathophysiological mechanisms leading to hyperglycemia. Nonetheless, T2D is treated according to algorithms as if it was one disease entity. Methods: We investigated the prevalence of different pathophysiological phenotypes...... among newly diagnosed T2D patients in Denmark. Based on baseline data from a Danish national cohort study we investigated 1048 incident diagnosed T2D patients. The diagnosis T2D was made by general practitioners based on clinical judgement. Phenotypes were classified in the following groups: latent...... autoimmune diabetes (LADA) (GAD antibody titer >= 20 IE/ml and not T1D), secondary diabetes (recent history of pancreatitis, pancreatectomy or pancreas amylase > 65U/l, and GAD negativity), steroid-induced diabetes (oral glucocorticoid-treated subjects), insulinopenic (f-P-C-peptide

  15. Renal outcomes with aliskiren in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Heerspink, Hiddo J L; Persson, Frederik; Brenner, Barry M;

    2016-01-01

    diabetes and chronic kidney disease or cardiovascular disease. We did a prespecified analysis of the ALTITUDE trial to analyse the effects of aliskiren on surrogate renal outcomes in all patients and on primary renal outcomes in subgroups of patients. METHODS: In the double-blind, randomised, controlled...... ALTITUDE trial, 8561 patients with type 2 diabetes and chronic kidney disease or cardiovascular disease were randomly assigned (1:1) to receive aliskiren 300 mg per day or placebo as an adjunct to ACE inhibitors or ARBs. Randomisation was stratified on the basis of baseline urinary albumin......-to-creatinine ratio and presence of cardiovascular disease history, and treatment assignments were masked to all patients and study staff. Patients were followed up for a median of 2·6 years (IQR 2·0-3·2). In our secondary analysis, we investigated prespecified intermediate renal outcomes of transitions...

  16. Galectin-3 In Obesity And Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Pejnovic Nada

    2015-12-01

    Full Text Available Galectin-3 is an important regulator of inflammation and acts as a receptor for advanced-glycation (AGE and lipoxidation end-products (ALE. Evidence indicates a significant upregulation in circulating levels and visceral adipose tissue production of Galectin-3 in obesity and type 2 diabetes. Recent studies demonstrate development of obesity and dysregulation of glucose metabolism in Galectin-3 “knockout” (KO mice, which also develop accelerated and more severe pathology in models of atherosclerosis and metabolically-induced kidney damage. Thus, evidence that Galectin-3 is an important player in metabolic disease is accumulating. This review discusses current evidence on the connection between Galectin-3 and metabolic disease, focusing on mechanisms by which this galectin modulates adiposity, glucose metabolism and obesity-associated inflammatory responses.

  17. Incretin-based therapy of type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Knop, Filip K; Vilsbøll, Tina; Holst, Jens Juul

    2009-01-01

    This review article focuses on the therapeutic potential of the incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), in treating type 2 diabetes mellitus (T2DM). T2DM is characterized by insulin resistance, impaired glucose-induced insulin...... secretion and inappropriately regulated glucagon secretion which in combination eventually result in hyperglycemia and in the longer term microvascular and macrovascular diabetic complications. Traditional treatment modalities--even multidrug approaches--for T2DM are often unsatisfactory at getting patients...... on the actions of the incretin hormones have recently been approved for therapy of T2DM; injectable long-acting stable analogues of GLP-1, incretin mimetics, and orally available inhibitors of dipeptidyl peptidase 4 (DPP4; the enzyme responsible for the rapid degradation of GLP-1 and GIP), the so-called incretin...

  18. The link between type 2 diabetes and neurodegenerative disorders

    Institute of Scientific and Technical Information of China (English)

    Changqing Liu; Jake Hoekstra; Kangping Xiong; Jing Zhang

    2014-01-01

    Various age-associated diseases are becoming more prominent as a greater percentage of the population reaches old age.Neurodegenerative disorders,e.g.Alzheimer's disease (AD)and Parkinson's disease (PD),and diabetes,in particular type 2 diabetes mellitus (T2DM),are the diseases that represent a large proportion of diagnoses amongst this group.These dis-eases have long been regarded as separate and each has distinct pathologies,symptoms,and treatments.Recent studies in epide-miology and pathology,however,have shown that T2DM may share a common mechanism of disease with AD and PD, which could allow for a therapeutic intervention capable of managing each disease.This review will discuss evidence implicating connections between these diseases,potential shared mechanisms,and possible treatments.

  19. MicroRNAs and Type 2 Diabetes/Obesity

    Institute of Scientific and Technical Information of China (English)

    Mustafa Abdo Saif Dehwah; Aimin Xu; Qingyang Huang

    2012-01-01

    MicroRNAs belong to a newly identified class of small non-coding RNAs that have been widely implicated in the fine-tuning of many physiological processes such as the pathogenesis of type 2 diabetes (T2D) and obesity.Microarray studies have highlighted an altered profile of miRNA expression in insulin target tissues in diabetic and obese models.Emerging evidences suggest that miRNAs play significant roles in insulin production,secretion and actions,as well as in diverse aspects of glucose homeostasis and adipocyte differentiation.The identification of tissue-specific miRNAs implicated in T2D and obesity might be useful for the future development of effective strategies for early diagnosis and therapeutic intervention of obesity-related medical complications.

  20. MicroRNAs and type 2 diabetes/obesity.

    Science.gov (United States)

    Dehwah, Mustafa Abdo Saif; Xu, Aimin; Huang, Qingyang

    2012-01-01

    MicroRNAs belong to a newly identified class of small non-coding RNAs that have been widely implicated in the fine-tuning of many physiological processes such as the pathogenesis of type 2 diabetes (T2D) and obesity. Microarray studies have highlighted an altered profile of miRNA expression in insulin target tissues in diabetic and obese models. Emerging evidences suggest that miRNAs play significant roles in insulin production, secretion and actions, as well as in diverse aspects of glucose homeostasis and adipocyte differentiation. The identification of tissue-specific miRNAs implicated in T2D and obesity might be useful for the future development of effective strategies for early diagnosis and therapeutic intervention of obesity-related medical complications.

  1. Type 2 diabetes mellitus in children and youth.

    Science.gov (United States)

    Ramkumar, S; Tandon, Nikhil

    2013-03-01

    Type 2 diabetes mellitus (T2DM) which used to be a disease of adults is now seen commonly at an early age in children and adolescents. T2DM is now an important diagnostic consideration in children who present with signs and symptoms of diabetes. The emerging epidemic of obesity in children throughout the world and the resultant insulin resistance contributes to the increasing prevalence of T2DM in this population. The recommended treatment options include metformin and insulin. Optimal glycemic control is essential considering the lifelong nature of the disease and therefore, the increased risk of long term complications - both microvascular and macrovascular. This review article summarizes the classification, diagnosis, pathogenesis, management, complications and screening of T2DM in children, incorporating and contextualizing guidelines from various professional associations.

  2. Beyond gut microbiota: understanding obesity and type 2 diabetes.

    Science.gov (United States)

    Lau, Eva; Carvalho, Davide; Pina-Vaz, Cidália; Barbosa, José-Adelino; Freitas, Paula

    2015-01-01

    Obesity and type 2 diabetes are metabolic diseases that have reached epidemic proportions worldwide. Although their etiology is complex, both result from interplay between behaviour, environment and genetic factors. Within ambient determinants, human overall gut bacteria have been identified as a crucial mediator of obesity and its consequences. Gut microbiota plays a crucial role in gastro-intestinal mucosa permeability and regulates the fermentation and absorption of dietary polyssacharides, which may explain its importance in the regulation of fat accumulation and the resultant development of obesity-related diseases. The main objective of this review is to address the pathogenic association between gut microbiota and obesity and to explore related innovative therapeutic targets. New insights into the role of the small bowel and gut microbiota in diabetes and obesity may make possible the development of integrated strategies to prevent and treat these metabolic disorders.

  3. Type 2 diabetes in children and adolescents on atypical antipsychotics.

    Science.gov (United States)

    Pramyothin, Pornpoj; Khaodhiar, Lalita

    2015-08-01

    Youth receiving treatment with antipsychotics are particularly susceptible to weight gain, type 2 diabetes (T2D), and associated metabolic disorders, which is directly associated with excess morbidity and mortality in this vulnerable population. The risk of T2D is 2- to 3-fold that of the general population, starts early in the course of treatment, and reflects the effects of weight gain in conjunction with direct effects of antipsychotics on the hypothalamus, pancreatic beta cells, and insulin-sensitive peripheral tissues. Close monitoring with early intervention through lifestyle intervention, switching away from antipsychotics with deleterious metabolic effects, and adjunctive treatment with metformin are modalities available to mitigate weight gain and improve cardiometabolic health in these patients. Despite rapidly advancing knowledge in the field, patient's access to metabolic screening and quality care remains limited. Efforts must be made to broaden reach of early cardiometabolic intervention among these patients in order to avert serious cardiovascular disease burden in the future.

  4. Canagliflozin Treatment in Patients with Type 2 Diabetes Mellitus

    Science.gov (United States)

    Triplitt, Curtis; Cornell, Susan

    2015-01-01

    Current guidelines for treatment of type 2 diabetes mellitus (T2DM) indicate a patient-centered approach that should go beyond glycemic control. Of the many antihyperglycemic agents available for treatment of T2DM, sodium-glucose cotransporter 2 (SGLT2) inhibitors offer the advantages of reduced glycated hemoglobin (A1C), body weight (BW), and systolic blood pressure (SBP) and are associated with a low risk of hypoglycemia when used either as monotherapy or with other agents not typically associated with increased risk of hypoglycemia. Collaborative, multidisciplinary teams are best suited to provide care to patients with diabetes, and clinical pharmacists can enhance the care provided by these teams. This review aims to provide insight into the mode of action, pharmacology, potential drug–drug interactions, clinical benefits, and safety considerations associated with use of the SGLT2 inhibitor canagliflozin in patients with T2DM and to provide information to enhance clinical pharmacists’ understanding of canagliflozin. PMID:26523120

  5. Glycosylated Hemoglobin: The Importance in Management of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Abbas Yavari

    2011-12-01

    Full Text Available Type 2 diabetes is a major public health problem with high and increasing prevalence, morbidity and mortality. The association between diabetes and microvascular and macrovascular complications is well known besides, tight glycemic control is a necessity. HbA1C has clinically been used since 1980s as a gold standard for monitoring glycemic control and predicting of diabetic complications. The present review article was prepared by computerized sources of literature searches 2000 - 2009.The history of Hemoglobin A1C, its assay techniques, optimal A1C targets, its reliability in control of diabetic complications, limitations of test results and its importance in control of diabetes patients and their complications are discussed.

  6. Effect of periodontal treatment on adipokines in type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    Hiroshi; Ogawa; Teerasak; Damrongrungruang; Sayaka; Hori; Kaname; Nouno; Kumiko; Minagawa; Misuzu; Sato; Hideo; Miyazaki

    2014-01-01

    The association between adipokines and inflammatory periodontal diseases has been studied over the last two decades. This review was intended to explore the observation that periodontal therapy may lead to an improvement of adipokines in diabetic patients. In summary, substantial evidence suggests that diabetes is associated with increased prevalence, extent and severity of periodontitis. Numerous mechanisms have been elucidated to explain the impact of diabetes on the periodontium. However, current knowledge concerning the role of major adipokines indicates only some of their associations with the pathogenesis of periodontitis in type 2 diabetes. Conversely, treatment of periodontal disease and reduction of oral inflammation may have positive effects on the diabetic condition, although evidence for this remains somewhat equivocal.

  7. Current view from Alzheimer disease to type 2 diabetes mellitus.

    Science.gov (United States)

    Rasool, Mahmood; Malik, Arif; Qazi, Aamer M; Sheikh, Ishfaq A; Manan, Abdul; Shaheen, Sumaira; Qazi, Mahmood H; Chaudhary, Adeel G; Abuzenadah, Adel M; Asif, Muhammad; Alqahtani, Mohammed H; Iqbal, Zafar; Shaik, Munvar M; Gan, Siew H; Kamal, Mohammad A

    2014-04-01

    Alzheimer's disease (AD) is a neurodegenerative disorder that leads to memory problems. It has been associated with type 2 diabetes mellitus at both the molecular and biochemical level. Pancreatic cells have molecular similarities to the brain at the transcriptomic and proteomic levels. Several genes have been reported to be responsible for both AD and diabetes. Currently, no proper treatment is available but various therapeutic approaches are utilized worldwide for the management of these disorders and may be nanoparticles and herbal treatment of Bacopa monnieri will make promise for the treatment of AD in future. The formation of amyloids in neurons and the formation of amylin in pancreatic cells are potential links between these two disorders, which can be silent killers.

  8. Incretin response in Asian type 2 diabetes: Are Indians different?

    Directory of Open Access Journals (Sweden)

    Awadhesh Kumar Singh

    2015-01-01

    Full Text Available Incretin-based therapy has clearly emerged as one of the most sought out strategy in managing type 2 diabetes, primarily because they generally do not causes hypoglycemia and possess weight-neutral or weight losing properties. Efficacy-wise too, these agents, are more or less similar to commonly used drugs metformin and sulfonylureas. Interestingly, some studies recently suggested that glycemic response to these incretin-based therapies could also differ ethnicity-wise. Subsequently, meta-analysis from these studies also suggested that Asians may have better response to these incretin-based therapies. This review will be an attempt to critically analyze those studies available in literature and to address as to why East-Asians and South-Asians may have different incretin response compared to non-Asians.

  9. Oxidative stress, insulin resistance, dyslipidemia and type 2diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Surapon Tangvarasittichai

    2015-01-01

    Oxidative stress is increased in metabolic syndromeand type 2 diabetes mellitus (T2DM) and this appearsto underlie the development of cardiovascular disease,T2DM and diabetic complications. Increased oxidativestress appears to be a deleterious factor leading to insulin resistance, dyslipidemia, β-cell dysfunction, impaired glucose tolerance and ultimately leading to T2DM. Chronic oxidative stress, hyperglycemia and dyslipidemia are particularly dangerous for β-cells from lowest levels of antioxidant, have high oxidative energy requirements, decrease the gene expression of key β-cell genes and induce cell death. If β-cell functioning is impaired, it results in an under production of insulin, impairs glucose stimulated insulin secretion, fasting hyperglycemia and eventually the development of T2DM.

  10. novel treatment approaches in hypertensive type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Yaniel; Castro; Torres; Richard; E; Katholi

    2014-01-01

    Type 2 diabetes mellitus(T2DM)and hypertension represent two common conditions worldwide.Their frequent association with cardiovascular diseases makes management of hypertensive patients with T2DM an important clinical priority.Carvedilol and renal denervation are two promising choices to reduce plasma glucose levels and blood pressure in hypertensive patients with T2DM to reduce future complications and improve clinical outcomes and prognosis.Pathophysiological mechanisms of both options are under investigation,but one of the most accepted is an attenuation in sympathetic nervous system activity which lowers blood pressure and improves insulin sensitivity.Choice of these therapeutic approaches should be individualized based on specific characteristics of each patient.Further investigations are needed to determine when to consider their use in clinical practice.

  11. Vitamin D and type 2 diabetes mellitus (D2).

    Science.gov (United States)

    Xuan, Yan; Zhao, Hong-yan; Liu, Jian-Min

    2013-09-01

    Based on increasing evidence from animal and human studies, vitamin D deficiency is now regarded as a potential risk factor for Type 2 diabetes mellitus (T2DM). Vitamin D is involved in the pathogenesis of pancreatic β-cell dysfunction, insulin resistance, and systemic inflammation, conditions that contribute to the development of T2DM. Vitamin D can affect the progress of this disease directly through the activation of its own receptor, and indirectly via the regulation of calcium homeostasis. Observational studies have revealed the association between vitamin D deficiency and incident T2DM. More double-blind randomized control studies that investigate the effects of vitamin D supplementation on insulin sensitivity, insulin secretion, and the occurrence of T2DM are needed.

  12. Insulin initiation in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Vaag, Allan; Lund, Søren

    2012-01-01

    This review addresses the apparent disconnect between international guideline recommendations, real-life clinical practice and the results of clinical trials, with regard to the initiation of insulin using basal (long-acting) or premixed insulin analogues in patients with type 2 diabetes (T2D......). English language guidelines vary considerably with respect to recommended glycaemic targets, the selection of human vs analogue insulin, and choice of insulin regimen. Randomised trials directly comparing insulin initiation between basal and premixed analogues are scarce, and hard endpoint outcome data...... are inadequate. The evidence presented suggests that a major component of the HbA1c not being attained in every day clinical practice may be a result of factors that are not adequately addressed in forced titration trials of highly motivated patients, including failure to comply with complex treatment...

  13. Efficacy of teneligliptin in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Riyaz Mohammed

    2016-10-01

    Conclusions: In conclusion, the addition of teneligliptin to metformin treatment was effective and well tolerated in patients with type 2 diabetes. Teneligliptin has long half-life of 26.9 hours along with it also has a unique pharmacokinetic advantage which allows convenient once daily administration irrespective of food, superadded it has a dual mode of elimination via renal and hepatic, and hence can be administered safely in renal impairment patients. In mild to moderate hepatic impairment no dosage adjustment is required. The appropriate approach towards managing diabetes should be not only glycemic control but also preservation of islet cell function early and to delay progression of a disease. Teneligliptin add-on to Metformin during the early course of treatment helps in delaying the exhaustion of pancreatic islet function. [Int J Res Med Sci 2016; 4(10.000: 4607-4610

  14. Type 2 diabetes mellitus and CA 19-9 levels

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To prospectively investigate serum CA 19-9 levels in type 2 diabetic patients in comparison with age- and gender-matched control subjects. METHODS: We recorded duration of diabetes and examined fasting glucose levels, HbA1c levels and serum CA 19-9 levels in 76 type 2 diabetic patients and 76 controls. Abdominal CT was performed in order to eliminate abdominal malignancy in the diabetic and control groups. RESULTS: The average CA 19-9 level was 46.0 ± 22.4 U/mL for diabetic patients whereas it was 9.97 ± 7.1 U/mL for the control group (P < 0.001 ). Regression analysis showed a positive correlation between diabetes and CA 19-9 independent from age, gender, glucose level and HbA1c level (t = 8.8, P < 001 ). Two of the diabetic patients were excluded from the study because of abdominal malignancy shown by CT at the initial evaluation. For all patients, abdominal CT showed no pancreatic abnormalities. CONCLUSION: CA 19-9 is a tumor-associated antigen, which is elevated in pancreatic, upper gastrointestinal tract, ovarian hepatocellular, and colorectal cancers, as well as in inflammatory conditions of the hepatobiliary system, biliary obstruction and in thyroid diseases. Diabetes has been claimed to be a risk factor for pancreatic cancer, which is increasing its incidence and has one of the lowest survival rates of all cancers. CA 19-9 is used in the diagnosis of pancreatic cancer but is also a marker of pancreatic tissue damage that might be caused by diabetes. We propose that a higher cutoff value of CA 19-9 should be used in diabetics to differentiate benign and malignant pancreatic disease, and subtle elevations of CA 19-9 in diabetics should be considered as the indication of exocrine pancreatic dysfunction.

  15. Dodecanedioic acid overcomes metabolic inflexibility in type 2 diabetic subjects.

    Science.gov (United States)

    Salinari, Serenella; Bertuzzi, Alessandro; Gandolfi, Alberto; Greco, Aldo V; Scarfone, Antonino; Manco, Melania; Mingrone, Geltrude

    2006-11-01

    Metabolically healthy skeletal muscle possesses the ability to switch easily between glucose and fat oxidation in response to homeostatic signals. In type 2 diabetes mellitus and obesity, the skeletal muscle shows a great reduction in this metabolic flexibility. A substrate like dodecanedioic acid (C-12), able to increase skeletal muscle glycogen stores via succinyl-CoA formation, might both postpone the fatigue and increase fatty acid utilization, since it does not affect insulin secretion. In healthy volunteers and in type 2 diabetic subjects, the effect of an oral C-12 load was compared with a glucose or water load during prolonged, moderate-intensity, physical exercise. C-12 metabolism was analyzed by a mathematical model. After C-12, diabetics were able to complete the 2 h of exercise. Nonesterified fatty acids increased both during and after the exercise in the C-12 session. C-12 oxidation provided 14% of total energy expenditure, and the sum of C-12 plus lipids oxidized after the C-12 meal was significantly greater than lipids oxidized after the glucose meal (P < 0.025). The fraction of C-12 that entered the central compartment was 47% of that ingested. During the first phase of the exercise ( approximately 60 min), the mean C-12 clearance from the central compartment toward tissues was 2.57 and 1.30 l/min during the second phase of the exercise. In conclusion, C-12 seems to be a suitable energy substrate during exercise, since it reduces muscle fatigue, is rapidly oxidized, and does not stimulate insulin secretion, which implies that lipolysis is not inhibited as reported after glucose ingestion.

  16. New treatments for patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Wolffenbuttel, B H; Graal, M B

    1996-11-01

    In subjects with type 2 diabetes, both defects of insulin secretion and insulin resistance contribute to the development of hyperglycaemia. The major goals of treatment are to optimise blood glucose control, and normalise the associated lipid disturbances and elevated blood pressure. Pharmacologic treatment is often necessary. This paper discusses new forms of oral treatment for subjects with type 2 diabetes. These include a new sulphonylurea compound glimepiride (Amaryl), which binds to a different protein of the putative sulphonylurea receptor than glibenclamide, and seems to have a lower risk of hypoglycaemia. A new class of drugs with insulin secretory capacity, of which repaglinide (NovoNorm) is the leading compound, is now in phase III clinical trials. Alpha-glucosidase inhibitors reversibly inhibit alpha-glucosidase enzymes in the small intestine, which delays cleavage of oligo- and disaccharides to monosaccharides. This leads to a delayed and reduced blood glucose rise after a meal. Two compounds are in development or have been marketed, ie, miglitol and acarbose (Glucobay). Another new class of drugs is the thiazolidine-diones, which seem to work by enhancing insulin action. The 'insulin sensitising' effects of the leading compounds, troglitazone and BRL 49653C, do not involve any effect on insulin secretion. These drugs also seem to beneficially influence serum cholesterol and triglyceride levels. Oral antihyperglycaemic agents can be used only during a limited period of time in most patients, after which the diabetic state 'worsens' and insulin therapy has to be started. In this light, two new forms of treatment which require subcutaneous injections are also discussed: the synthetic human amylin analogue AC137 (pramlintide) and glucagon-like peptide-1 (7-36)-amide, a strong glucose-dependent stimulator of insulin secretion. It remains to be seen whether these compounds can be developed further for clinical use in patients with diabetes.

  17. Mitochondrial apoptosis of lymphocyte is induced in type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    Xu Hui; Chen Yanbo; Li Yanxiang; Xia Fangzhen; Han Bing; Zhang Huixin; Zhai Hualing

    2014-01-01

    Background Lymphocyte function and homeostasis is associated with immune defence to infection.Apoptosis of lymphocytes might be a considerably important component which has an impact on immunity to infections in people with hyperglycemia.The aim of this study was to explore the mitochondrial apoptosis pathway of lymphocyte in diabetic patients.Methods Sixty patients with type 2 diabetes mellitus and fifty healthy volunteers were included in this study.Annexin V and propidiumiodide (Pl) were joined in the isolated lymphocytes and the rate of lymphocyte apoptosis was calculated with flow cytometry.Observation of the lymphocytes was done using transmission electron microscopy; mitochondria had been extracted and then mitochondrial membrane potential (MMP) was detected to assess mitochondrial function; the mRNA level of Bcl-2,cytochrome c (Cyt-C),caspase-9 and caspase-3 were analyzed by real-time reverse transcriptionpolymerase chain reaction (RT-PCR).Results Apoptosis rate of lymphocyte was significantly higher in diabetic group than that in normal control group (P <0.05).Transmission electron microscopy showed lymphocyte shrinkage and breakage,chromatin condensation and less mitochondria; a fall in MMP levels was also evident; Bcl-2 concentration was reduced and the expressions of caspase-9,caspase-3 and Cyt-C were elevated (P <0.05) in diabetic patients.Conclusions The rate of lymphocyte apoptosis was significantly higher in type 2 diabetic patients than that in normal population.Mitochondrial apoptosis pathway may play a very important role in decreasing function of lymphocyte in diabetes.

  18. Liraglutide in Type 2 Diabetes Mellitus: Clinical Pharmacokinetics and Pharmacodynamics.

    Science.gov (United States)

    Jacobsen, Lisbeth V; Flint, Anne; Olsen, Anette K; Ingwersen, Steen H

    2016-06-01

    Liraglutide is an acylated glucagon-like peptide-1 analogue with 97 % amino acid homology with native glucagon-like peptide-1 and greatly protracted action. It is widely used for the treatment of type 2 diabetes mellitus, and administered by subcutaneous injection once daily. The pharmacokinetic properties of liraglutide enable 24-h exposure coverage, a requirement for 24-h glycaemic control with once-daily dosing. The mechanism of protraction relates to slowed release from the injection site, and a reduced elimination rate owing to metabolic stabilisation and reduced renal filtration. Drug exposure is largely independent of injection site, as well as age, race and ethnicity. Increasing body weight and male sex are associated with reduced concentrations, but there is substantial overlap between subgroups; therefore, dose escalation should be based on individual treatment outcome. Exposure is reduced with mild, moderate or severe renal or hepatic impairment. There are no clinically relevant changes in overall concentrations of various drugs (e.g. paracetamol, atorvastatin, griseofulvin, digoxin, lisinopril and oral combination contraceptives) when co-administered with liraglutide. Pharmacodynamic studies show multiple beneficial actions with liraglutide, including improved fasting and postprandial glycaemic control (mediated by increased insulin and reduced glucagon levels and minor delays in gastric emptying), reduced appetite and energy intake, and effects on postprandial lipid profiles. The counter-regulatory hormone response to hypoglycaemia is largely unaltered. The effects of liraglutide on insulin and glucagon secretion are glucose dependent, and hence the risk of hypoglycaemia is low. The pharmacokinetic and pharmacodynamic properties of liraglutide make it an important treatment option for many patients with type 2 diabetes.

  19. Macrovascular complication phenotypes in type 2 diabetic patients

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    Papa Giuseppe

    2013-01-01

    Full Text Available Abstract Background Macrovascular diseases (MVD in type 2 diabetes mellitus (T2DM are often considered all together, without discriminating the areas involved. The aim of our study was to analyse MVD prevalence in a large population of T2DM patients by dividing the cases into subgroups according to MVD sites (NMVD, no MVD; NSCS, non-significant carotid stenosis; CBVD, cerebrovascular disease; CAD, coronary artery disease; PAD, peripheral artery disease; PVD, polyvascular disease and studying the anthropometric, clinical and laboratory parameters in each group. Methods A diabetic outpatient cohort (n = 1199 was retrospectively studied. Demographic, clinical and laboratory parameters were included in analyses. A thorough cardiovascular history as documented by previous medical records (including medical and hospital records and vascular laboratory studies (including standardised electrocardiogram, echocardiogram, provocative tests for cardiac ischaemia, ankle/brachial index, duplex ultrasonography of the carotid and lower limbs and, in selected cases, computed tomography angiography, carotid and peripheral arteriography and evaluation of transcutaneous oxygen pressure, was collected for all of the patients. Standardised procedures were used to assess microvascular complications as well as metabolic syndrome (Mets. Results The unadjusted MVD prevalence was 46.4% among the participants. The majority of patients with MVD were in the PVD group. In the multivariate analysis, age, male sex and diabetes duration were independent risk factors for PAD and PVD (P Conclusion Phenotypic heterogeneity is associated with different macrovascular complications in T2DM patients. These findings might have clinical implications for developing diagnostic and therapeutic strategies targeting type 2 diabetes.

  20. Seroprevalence of hepatitis C infection in type 2 diabetes mellitus

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    Demitrost Laloo

    2015-01-01

    Full Text Available Introduction: Hepatitis C is an emerging disease with different studies showing varying prevalence rates across India. In several studies, prevalence of hepatitis C infection was found to be higher in diabetics than nondiabetics. However, none has been reported from India. Objectives: The aim was to determine the sero-prevalence of hepatitis C infection in type 2 diabetes mellitus (T2DM. Settings and Design: Cross-sectional study of all T2DM patients attending endocrine clinic in Regional Institute of Medical Sciences, Imphal from October 2011 to September 2013. Subjects and Methods: All T2DM patients included and exclusion criteria are patients with other forms of diabetes, liver failure, renal failure, malignancy or other chronic illness. Patient′s age, sex, height, weight, body mass index, history of risk factors, etc., collected and investigated for blood glucose fasting and prandial levels, transaminases levels, hepatitis C virus (HCV screening, etc., Statistical Analysis: Statistical analysis was performed using  Statistical Package for the Social Sciences version 20; appropriate test used where applicable. Results: Out of the 192 T2DM patients screened, prevalence rate of HCV sero-positivity is found to be 5.7% (11/192, higher in males. History of jaundice in the past was the only significant history among sero-positive patients. Transaminases levels are significantly higher in sero-postive cases. They had higher fasting and postprandial blood glucose, fasting glucose levels being significantly higher. Conclusion: Our study shows a slightly higher prevalence of hepatitis C infection in type 2 diabetics.

  1. Management of nephropathy in patients with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Purpose To review evidence-based management of nephropathy in patients with type 2 diabetes. Data sources A literature search (MEDLINE 1966 to 2000) was performed using the key word “diabetic nephropathy". Relevant book chapters were also reviewed. Study selection Well-controlled, prospective landmark studies and expert review articles on diabetic nephropathy were selected. Data extraction Data and conclusions from the selected articles that provide solid evidence to the optimal management of diabetic nephropathy were extracted and interpreted in light of our clinical research experience with many thousands of Hong Kong Chinese patients. Results Hypertension, long diabetes duration, poor glycaemic control and central obesity are the most important risk factors. Microalbuminuria is a practical marker to predict overt nephropathy in type 2 diabetic patients. Risk factor modification, renal function monitoring and combined therapies are the current integrated approaches to manage patients with diabetic kidney disease. Optimal glycaemic control is the mainstay of treatment but effective antihypertensive therapy is also key to delaying the progression of diabetic nephropathy. Angiotensin-converting enzyme inhibitors and angiotensin Ⅱ receptor antagonists have important renoprotective actions independent of their blood pressure lowering actions. Conclusions Diabetic nephropathy is the leading cause of end-stage renal disease worldwide. Monitoring renal function and screening for microalbuminuria will allow the identification of patients with nephropathy at a very early stage for intervention. Tight glycaemic control and aggressive antihypertensive treatment as well as the use of renin-angiotensin system inhibitors should substantially delay the progression of nephropathy.

  2. Quantification of intrapancreatic fat in type 2 diabetes by MRI

    Science.gov (United States)

    Hollingsworth, Kieren G.; Steven, Sarah; Tiniakos, Dina; Taylor, Roy

    2017-01-01

    Objectives Accumulation of intrapancreatic fat may be important in type 2 diabetes, but widely varying data have been reported. The standard quantification by MRI in vivo is time consuming and dependent upon a high level of experience. We aimed to develop a new method which would minimise inter-observer variation and to compare this against previously published datasets. Methods A technique of ‘biopsying’ the image to minimise inclusion of non-parenchymal tissues was developed. Additionally, thresholding was applied to exclude both pancreatic ducts and intrusions of visceral fat, with pixels of fat values of 20% being excluded. The new MR image ‘biopsy’ (MR-opsy) was compared to the standard method by 6 independent observers with wide experience of image analysis but no experience of pancreas imaging. The effect of the new method was examined on datasets from two studies of weight loss in type 2 diabetes. Results At low levels of intrapancreatic fat neither the result nor the inter-observer CV was changed by MR-opsy, thresholding or a combination of the methods. However, at higher levels the conventional method exhibited poor inter-observer agreement (coefficient of variation 26.9%) and the new combined method improved the CV to 4.3% (p<0.03). Using either MR-opsy alone or with thresholding, the new methods indicated a closer relationship between decrease in intrapancreatic fat and fall in blood glucose. Conclusion The inter-observer variation for quantifying intrapancreatic fat was substantially improved by the new method when pancreas fat levels were moderately high. The method will improve comparability of pancreas fat measurement between research groups. PMID:28369092

  3. AMPK activation: a therapeutic target for type 2 diabetes?

    Directory of Open Access Journals (Sweden)

    Coughlan KA

    2014-06-01

    Full Text Available Kimberly A Coughlan, Rudy J Valentine, Neil B Ruderman, Asish K Saha Endocrinology and Diabetes, Department of Medicine, Boston University Medical Center, Boston, MA, USA Abstract: Type 2 diabetes (T2D is a metabolic disease characterized by insulin resistance, β-cell dysfunction, and elevated hepatic glucose output. Over 350 million people worldwide have T2D, and the International Diabetes Federation projects that this number will increase to nearly 600 million by 2035. There is a great need for more effective treatments for maintaining glucose homeostasis and improving insulin sensitivity. AMP-activated protein kinase (AMPK is an evolutionarily conserved serine/threonine kinase whose activation elicits insulin-sensitizing effects, making it an ideal therapeutic target for T2D. AMPK is an energy-sensing enzyme that is activated when cellular energy levels are low, and it signals to stimulate glucose uptake in skeletal muscles, fatty acid oxidation in adipose (and other tissues, and reduces hepatic glucose production. There is substantial evidence suggesting that AMPK is dysregulated in animals and humans with metabolic syndrome or T2D, and that AMPK activation (physiological or pharmacological can improve insulin sensitivity and metabolic health. Numerous pharmacological agents, natural compounds, and hormones are known to activate AMPK, either directly or indirectly – some of which (for example, metformin and thiazolidinediones are currently used to treat T2D. This paper will review the regulation of the AMPK pathway and its role in T2D, some of the known AMPK activators and their mechanisms of action, and the potential for future improvements in targeting AMPK for the treatment of T2D. Keywords: adenosine monophosphate-activated protein kinase, type 2 diabetes, insulin resistance, drug therapy

  4. Thyroid dysfunction in type 2 diabetes mellitus: A retrospective study

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    Laloo Demitrost

    2012-01-01

    Full Text Available Introduction: Type 2 diabetes mellitus (DM is a growing problem in our country and we have observed that many patients are associated with thyroid dysfunction later in their life. However, the prevalence of thyroid dysfunction in these patients has not been investigated. Aims and Objectives: To find the prevalence of thyroid dysfunction in type 2 DM in Manipur, India. Materials and Methods: In this retrospective study, data of 202 Type 2 DM patients who attended the diabetic clinic of the Regional Institute of Medical Sciences, Imphal from January 2011 to July 2012, and whose thyroid stimulating hormone (TSH level was investigated were included. The inclusion criteria are known cases of type 2 DM. Exclusion criteria are patients with previous history of hypothyroidism and those on drugs affecting the thyroid profile. Results: Out the 202 type 2 DM patients for the study of which 61 are males and 141 are females, 139 (68.8% are euthyroid, 33 (16.3% have subclinical hypothyroidism (10 males and 23 females, 23 (11.4% have hypothyroidism (6 males and 17 females, 4 (2% have subclinical hyperthyroidism and 3 (1.5% are hyperthyroidism cases. Maximum cases were of hypothyroidism (subclinical and clinical seen in the age group of 45-64 years. Patients with BMI > 25 were at increased risk of having hypothyroidism (P < 0.016. Conclusion: Prevalence of hypothyroidism is quite high in type 2 DM patients above 45 years and more so if their BMI is over 25.

  5. Maternal and Neonatal Outcomes in Korean Women with Type 1 and Type 2 Diabetes

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    Hee-Sook Kim

    2015-08-01

    Full Text Available BackgroundThe purpose of this study was to evaluate maternal and neonatal outcomes in Korean women with type 1 diabetes and type 2 diabetes.MethodsWe performed a retrospective survey of 163 pregnancies in women with type 1 diabetes (n=13 and type 2 diabetes (n=150 treated from 2003 to 2010 at Cheil General Hospital & Women's Healthcare Center, Korea. We compared maternal characteristics as well as maternal and neonatal outcomes between groups.ResultsDifferences in glycosylated hemoglobin between type 1 and type 2 diabetes were not significant. Birth weight (3,501±689.6 g vs. 3,366±531.4 g and rate of major congenital malformations (7.7% vs. 5.6% were not significantly different. However, women with type 1 diabetes had higher rates of preeclampsia (38.5% vs. 8.2%, P=0.006, large for gestational age (LGA; 46.2% vs. 20.4%, P=0.004, macrosomia (38.5% vs. 13.4%, P=0.032, and admission for neonatal care (41.7% vs. 14.8%, P=0.03 than women with type 2 diabetes.ConclusionMaternal and neonatal outcomes for women with type 1 diabetes were poorer than for women with type 2 diabetes, especially preeclampsia, LGA, macrosomia and admission to the neonatal intensive care unit.

  6. Role of T Cells in Type 2 Diabetic Nephropathy

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    Chia-Chao Wu

    2011-01-01

    Full Text Available Type 2 diabetic nephropathy (DN is the most common cause of end-stage renal disease and is increasingly considered as an inflammatory disease characterized by leukocyte infiltration at every stage of renal involvement. Inflammation and activation of the immune system are closely involved in the pathogenesis of diabetes and its microvascular complications. Macrophage has been well recognized to play an important role in type 2 DN, leukocyte infiltration, and participated in process of DN, as was proposed recently. Th1, Th2, Th17, T reg, and cytotoxic T cells are involved in the development and progression of DN. The purpose of this review is to assemble current information concerning the role of T cells in the development and progression of type 2 DN. Specific emphasis is placed on the potential interaction and contribution of the T cells to renal damage. The therapeutic strategies involving T cells in the treatment of type 2 DN are also reviewed. Improving knowledge of the recognition of T cells as significant pathogenic mediators in DN reinforces the possibility of new potential therapeutic targets translated into future clinical treatments.

  7. Common type 2 diabetes risk gene variants associate with gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Grarup, Niels; Damm, Peter;

    2009-01-01

    OBJECTIVE: We aimed to examine the association between gestational diabetes mellitus (GDM) and 11 recently identified type 2 diabetes susceptibility loci. RESEARCH DESIGN AND METHODS: Type 2 diabetes risk variants in TCF7L2, CDKAL1, SLC30A8, HHEX/IDE, CDKN2A/2B, IGF2BP2, FTO, TCF2, PPARG, KCNJ11......, and WFS1 loci were genotyped in a cohort of women with a history of GDM (n = 283) and glucose-tolerant women of the population-based Inter99 cohort (n = 2446). RESULTS: All the risk alleles in the 11 examined type 2 diabetes risk variants showed an odds ratio (OR) greater than 1 for the GDM group compared....... CONCLUSIONS: The prevalence in a prior GDM group of several previously proven type 2 diabetes risk alleles equals the findings from association studies on type 2 diabetes. This supports the hypothesis that GDM and type 2 diabetes are two of the same entity....

  8. A review of the treatment of type 2 diabetes in children.

    Science.gov (United States)

    Onge, Erin St; Miller, Shannon A; Motycka, Carol; DeBerry, Adrienne

    2015-01-01

    The incidence of type 2 diabetes and obesity in children and adolescents has risen at staggering rates. Studies have shown that treating type 2 diabetes with oral medications in children may be more difficult than treating in adults. Compounding this problem is the fact that most of the medications available for treating type 2 diabetes have not been studied in children. Recently, the American Diabetes Association and the Pediatric Endocrine Society have collaborated to create a guideline for the treatment of type 2 diabetes in children. Similar to the treatment of adults with type 2 diabetes, metformin remains the mainstay of therapy along with diet and exercise. Adjunctive therapy should be based on the limited clinical evidence available as well as on patient preference. In order to avoid detrimental microvascular and macrovascular complications, patients, clinicians, and family members should work together to ensure adequate treatment of type 2 diabetes in children.

  9. Gene expression in skeletal muscle biopsies from people with type 2 diabetes and relatives

    DEFF Research Database (Denmark)

    Palsgaard, Jane; Brøns, Charlotte; Friedrichsen, Martin

    2009-01-01

    BACKGROUND: Gene expression alterations have previously been associated with type 2 diabetes, however whether these changes are primary causes or secondary effects of type 2 diabetes is not known. As healthy first degree relatives of people with type 2 diabetes have an increased risk of developing...... type 2 diabetes, they provide a good model in the search for primary causes of the disease. METHODS/PRINCIPAL FINDINGS: We determined gene expression profiles in skeletal muscle biopsies from Caucasian males with type 2 diabetes, healthy first degree relatives, and healthy controls. Gene expression...... downregulated in people with type 2 diabetes. On the individual gene level, 11 genes showed altered expression levels in first degree relatives compared to controls, among others KIF1B and GDF8 (myostatin). LDHB was found to have a decreased expression in both groups compared to controls. CONCLUSIONS...

  10. Association of Psoriasis With the Risk for Type 2 Diabetes Mellitus and Obesity

    DEFF Research Database (Denmark)

    Lønnberg, Ann Sophie; Skov, Lone; Skytthe, Axel;

    2016-01-01

    and Relevance: This study determines the contribution of genetic and environmental factors to the interaction between obesity, type 2 diabetes mellitus, and psoriasis. Psoriasis, type 2 diabetes mellitus, and obesity are also strongly associated in adults after taking key confounding factors, such as sex, age......Importance: Psoriasis has been shown to be associated with overweight and type 2 diabetes mellitus. The genetic association is unclear. Objective: To examine the association among psoriasis, type 2 diabetes mellitus, and body mass index (BMI) (calculated as weight in kilograms divided by height...... diagnoses of type 2 diabetes mellitus and self-reported BMI. Data were collected in the spring of 2002. Data were analyzed from January 1 to October 31, 2014. Main Outcomes and Measures: Crude and adjusted odds ratios (ORs) were calculated for psoriasis in relation to type 2 diabetes mellitus, increasing...

  11. Analog insulin detemir for patients with type 1 and type 2 diabetes: a review

    Directory of Open Access Journals (Sweden)

    Gregory E Peterson

    2009-05-01

    Full Text Available Gregory E PetersonDepartment of Internal Medicine, Des Moines University, USAObjective: To review insulin detemir for clinical use to better manage patients with type 1 and type 2 diabetes.Methods: A MEDLINE search, in English, from June 30, 2006 to December 1, 2008, using the terms “insulin analogs,” “insulin detemir” and “long-acting insulin analog.”Results: Insulin detemir improves glycemic control, based on HbA1C reduction and fasting glucose levels, without increasing the risk of hypoglycemia and weight gain. Insulin detemir has lower glycemic variability, with less intra-subject variability in blood glucose levels in patients with type 1 and type 2 diabetes, without increasing the risk of hypoglycemia. When added to oral anti-diabetes agents (OADs in type 2 diabetes, insulin detemir demonstrates superiority to other basal insulin options.Conclusion: Insulin detemir appears to provide better glycemic control with a lower risk of hypoglycemia and less weight gain in the treatment of patients with type 1 and type 2 diabetes.Keywords: type 1 diabetes, type 2 diabetes, insulin analogs, insulin detemir

  12. Biphasic Insulin Analogues in Type 2 Diabetes: Expert Panel Recommendations

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    Sema Akalın

    2011-09-01

    Full Text Available Recently, the prevalence of type 2 diabetes has reached pandemic levels all over the world, and the problem is still growing. Type 2 diabetes is a progressive disease, in which insulin resistance and decrease in beta cell function accompany obesity. Early disorder, which ensues in clinical progression of the disease, is the defect of early phase insulin secretion. Patients have already lost approximately half of their beta cell reserve at the time of diagnosis. Aims of type 2 diabetes treatment are to eliminate hyperglycemia caused by insufficient insulin secretion and/or insulin resistance, to slow down beta cell destruction/depletion, to improve concomitant metabolic problems and to prevent complications. In treatment algorithms, insulin is evaluated as a replacement therapy at the following stage after life style changes (medical nutrition therapy, exercise and oral anti-diabetic drugs (OADs options. Since beta cell depletion is present at initial stages of the disease, it transforms insulin therapy into an earlier approach in treatment stages. Premixed insulin forms are one of the proposed treatment options in patients with hyperglycemia that is not controlled by OADs. These types of insulins are developed to meet both basal and postprandial insulin requirements of patients. Currently, premixed human insulin forms are replaced by analogue insulin forms, which can mimic the physiological secretion in more acceptable manner. Biphasic analogue insulin is one of the readily available pre-mixed analogue insulin forms, an example of this, Biphasic Insulin aspart 30 which is the one of the premixed analoge insulin forms, contains 30% insulin aspart and 70% protaminated insulin aspart. Consensus recommending the individualized approach in insulin therapy implies that physicians should have more detailed information about the use of different insulin forms. Although a global consensus report about initiation, titration and intensification and the use

  13. The Efficacy of Red Ginseng in Type 1 and Type 2 Diabetes in Animals

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    Bin Na Hong

    2013-01-01

    Full Text Available Diabetes mellitus (DM is one of the most modern chronic metabolic diseases in the world. Moreover, DM is one of the major causes of modern neurological diseases. In the present study, the therapeutic actions of Korean red ginseng were evaluated in type 1 and type 2 diabetic mouse models using auditory electrophysiological measurement. The comprehensive results from auditory brainstem response (ABR, auditory middle latency response (AMLR, and transient evoked otoacoustic emission (TEOAE demonstrate auditory functional damage caused by type 1 or 2 DM. Korean red ginseng improved the hearing threshold shift, delayed latencies and signal intensity decrease in type 2 diabetic mice. Type 1 diabetic mice showed a partial improvement in decreasing amplitude and signal intensity, not significantly. We suggest that the Korean red ginseng has a more potent efficacy in hearing loss in insulin resistance type 2 diabetes than in type 1 diabetes.

  14. Suicidal ideation reported by adults with Type 1 or Type 2 diabetes

    DEFF Research Database (Denmark)

    Handley, T E; Ventura, A D; Browne, Jessica L

    2016-01-01

    or Type 2 diabetes not using insulin (14 and 12%, respectively). After controlling for depression, there was little difference in the prevalence of SI between diabetes types/treatments, but higher diabetes-specific distress significantly increased the odds of SI. CONCLUSIONS: As SI is a significant risk......AIMS: To examine the prevalence and correlates of suicidal ideation (SI) in a community-based sample of adults with Type 1 or Type 2 diabetes. METHODS: Participants were 3338 adults aged 18-70 years with Type 1 diabetes (n = 1376) or Type 2 diabetes (non-insulin: n = 1238; insulin: n = 724) from...... a national survey administered to a random sample registered with the National Diabetes Services Scheme. Depression and SI were assessed using the Patient Health Questionnaire, and diabetes-specific distress with the Problem Areas In Diabetes scale. Separate logistic regression analyses by diabetes type...

  15. Effects of Probiotic Yogurt Consumption on Cardiovascular Disease Risk Factors in Subjects with Type 2 Diabetes

    OpenAIRE

    Mohammadi, F; M Veissi; F Haidari; Shahbazian, H.; M mohammad shahi

    2015-01-01

    Introduction: Cardiovascular disease is more prevalent in patients with type 2 diabetes. Regarding the role of probiotics in control of inflammation and modulating the lipid profile, this study assess the effect of probiotic and conventional yogurt on inflammatory markers and lipid profile in type 2 diabetic patients. Methods: Forty- four subjects with type 2 diabetes were randomly assigned to two intervention and control groups. The intervention group consumed 300 g/d probiotic yogurt (e...

  16. Type 2 diabetes genes – Present status and data from Norwegian studies

    OpenAIRE

    Jens K. Hertel Hertel; Stefan Johansson; Kristian Midthjell; Ottar Nygård; Njølstad, Pål R.; Anders Molven

    2013-01-01

    The worldwide rise in prevalence of type 2 diabetes has led to an intense search for the genetic risk factors of this disease. In type 2 diabetes and other complex disorders, multiple genetic and environmental factors, as well as the interaction between these factors, determine the phenotype. In this review, we summarize present knowledge, generated by more than two decades of efforts to dissect the genetic architecture of type 2 diabetes. Initial studies were either based on a candidate gene...

  17. Cultural and Family Challenges to Managing Type 2 Diabetes in Immigrant Chinese Americans

    OpenAIRE

    2009-01-01

    OBJECTIVE Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. RESEARCH DESIGN AND METHODS This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple ...

  18. Comparison between repaglinide and glipizide in Type 2 diabetes mellitus: a 1-year multicentre study

    DEFF Research Database (Denmark)

    Madsbad, Sten; Kilhovd, B; Lager, I;

    2001-01-01

    AIMS: To evaluate the long-term effectiveness and safety of repaglinide, a novel prandial glucose regulator, in comparison with glipizide in the treatment of patients with Type 2 diabetes. METHODS: Diet or tablet-treated patients with Type 2 diabetes (n = 256; age 40-75 years, body mass index (BMI...... with Type 2 diabetes, and is better than glipizide in controlling HbA1c and FBG levels, overall, and in OHA-naive patients....

  19. An innovative approach to providing lifestyle education and behaviour change to prevent type 2 diabetes

    OpenAIRE

    Katherine Grady; Linda Savas

    2012-01-01

    Introduction Diabetes is one of the major health challenges of our time. Diabetes UK recently estimated 10% of the total NHS budget is spent on diabetes care. NICE guidance “Prevention of type 2 diabetes in adults” (2011) and “Prevention of type 2 diabetes in high-risk groups” (currently consultation phase) emphasises the importance of prevention. Impaired glucose tolerance (IGT) is a precursor for the development of type 2 diabetes and is additionally associated with increased cardiovascular...

  20. Serum Levels of Progranulin Are Closely Associated with Microvascular Complication in Type 2 Diabetes

    OpenAIRE

    Lin Xu; Bo Zhou; Huixia Li; Jiali Liu; Junhui Du; Weijin Zang; Shufang Wu; Hongzhi Sun

    2015-01-01

    Objective. Progranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the correlation between PGRN and type 2 diabetics with microvascular complications. Methods. PGRN serum levels and glucose metabolism related substance were measured in 84 type 2 diabetic patients with or without microangiopathies and 12 health persons. Further analys...

  1. A Systematic Review of the Direct Economic Burden of Type 2 Diabetes in China

    OpenAIRE

    2015-01-01

    Background Type 2 diabetes is associated with acute and chronic complications and poses a large economic, social, and medical burden on patients and their families as well as society. Objective This study aims to evaluate the direct economic burden of type 2 diabetes in China. Data source: systematic review on cost of illness, health care costs, direct service costs, drug costs, and health expenditures in relation to type 2 diabetes was conducted up to 2014 using databases such as Pubmed; EBS...

  2. Retinal Capillary Rarefaction in Patients with Type 2 Diabetes Mellitus

    Science.gov (United States)

    Jumar, Agnes; Harazny, Joanna M.; Ott, Christian; Friedrich, Stefanie; Kistner, Iris; Striepe, Kristina

    2016-01-01

    Purpose In diabetes mellitus type 2, capillary rarefaction plays a pivotal role in the pathogenesis of end-organ damage. We investigated retinal capillary density in patients with early disease. Methods This cross-sectional study compares retinal capillary rarefaction determined by intercapillary distance (ICD) and capillary area (CapA), measured non-invasively and in vivo by scanning laser Doppler flowmetry, in 73 patients with type 2 diabetes, 55 healthy controls and 134 individuals with hypertension stage 1 or 2. Results In diabetic patients, ICD was greater (23.2±5.5 vs 20.2±4.2, p = 0.013) and CapA smaller (1592±595 vs 1821±652, p = 0.019) than in healthy controls after adjustment for differences in cardiovascular risk factors between the groups. Compared to hypertensive patients, diabetic individuals showed no difference in ICD (23.1±5.8, p = 0.781) and CapA (1556±649, p = 0.768). Conclusion In the early stage of diabetes type 2, patients showed capillary rarefaction compared to healthy individuals. PMID:27935938

  3. Risk Factors for and Barriers to Control Type-2 Diabetes among Saudi Population

    Science.gov (United States)

    Alneami, Yahya Mari; Coleman, Christopher L.

    2016-01-01

    Background: The prevalence of Type-2 Diabetes is dramatically increasing in urban areas within Saudi Arabia. Hence, Type-2 Diabetes has now become the most common public health problem. Understanding the major risk factors for and barriers to control Type-2 Diabetes may lead to strategies to prevent, control, and reduce in the burden of disease cases. Objective: To describe risk factors for and barriers to control Type- 2 Diabetes in Saudi Arabia. Methods: The literature search was conducted on risk factors for and barriers to control Type- 2 Diabetes in Saudi Arabia using the databases PubMed, MEDLINE, and Google Scholar (2007-2015). The literature search yielded 80 articles, of which 70 articles were included in this review after excluding non-relevant articles. Results: The literature review revealed that obesity, physical inactivity, unhealthy diet, smoking, and aging are the major risk factors for Type-2 Diabetes in Saudi Arabia. Further, the review allocated a complex set of barriers including, lack of education, social support, and healthy environment. These barriers may hinder Saudis with Type-2 Diabetes from controlling their disease. Conclusion: The prevalence of Type-2 Diabetes is high among the Saudi population and represents a major public health problem. Effective research programs are needed to address the modifiable risk factors for and barriers to control Type-2 Diabetes among Saudi population. PMID:27157156

  4. Subjective sleep impairment in adults with type 1 or type 2 diabetes

    DEFF Research Database (Denmark)

    Nefs, Giesje; Donga, Esther; van Someren, Eus

    2015-01-01

    AIMS: Despite growing recognition of the impact of sleep on diabetes, a clear profile of people with diabetes regarding subjective sleep impairment has yet to be established. This study examines: (1) subjective sleep characteristics in adults with type 1 and type 2 diabetes; (2) the relationship...... of poor subjective sleep quality with glycaemic control, self-care and daytime functioning; (3) possible risk markers for poor sleep quality. METHODS: In a cross-sectional study, Dutch adults with type 1 (n=267) or type 2 diabetes (n=361) completed an online survey, including the Pittsburgh Sleep Quality...... Index (PSQI), socio-demographic, clinical, self-care and psychological measures. RESULTS: Poor sleep quality (PSQI-score >5) was reported by 31% of adults with type 1 and 42% of adults with type 2 diabetes. Participants with good and poor sleep quality did not differ in self-reported HbA1c...

  5. Non-diabetic renal disease (NDRD) in patients with type 2 diabetes mellitus (type 2 DM).

    Science.gov (United States)

    Prakash, Jai

    2013-03-01

    In contrast to Type 1 diabetes mellitus (DM), the incidence of non-diabetic renal disease (NDRD) is very high in Type 2 diabetic patients. A wide spectrum of non-diabetic nephropathy (NDN) including both glomerular and tubulointerstitial lesions are reported in patients with Type 2 DM and their precise diagnosis requires histological examination of kidney tissue. Renal biopsy studies suggest that 25-50% of patients with Type 2 diabetes had glomerular lesions unrelated to or in addition to diabetic nephropathy. Histological studies confirm that NDRD can occur in isolated form without diabetic nephropathy or superimposed on diabetic nephropathy. Diabetic nephropathy can occur in absence of retinopathy and chance of getting diabetic and non-diabetic renal lesions are nearly equal in Type 2 diabetic patient in absence of diabetic retinopathy (RP). The presence of RP suggests the concurrence of DN, but does not exclude non-diabetic nephropathy. Clearly, renal biopsy is indicated in proteinuric Type 2 diabetic patients for precise diagnosis of diabetic vs non-diabetic renal disease. Appropriate treatment of NDRD is associated with good clinical outcome. Thus, it is gratifying to treat NDRD in selected patients. Besides, 40 to 60% of ESRD in Type 2 diabetic patients is not caused by diabetic nephropathy.

  6. Risk factors of diabetic retinopathy in type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    CAI Xiao-ling; WANG Fang; JI Li-nong

    2006-01-01

    Background Advances in treatment have greatly reduced the risk of blindness from this disease, but because diabetes is so common, diabetic retinopathy remains an important problem. The purpose of this study is to investigate the risk factors of diabetic retinopathy (DR) in Chinese type 2 diabetic patients.Methods Totally 746 type 2 diabetic patients were selected for biochemical and clinical characteristics test and examined by the retina-camera for diabetic retinopathy and the average age was 55.9 years old.Results A total of 526 patients was classified as non-DR, 159 patients as non-proliferative-DR and 61 patients as proliferative-DR. Duration of diabetes [(66.09±72.51) months vs (143.71 ±93.27) months vs (174.30±81.91)months, P=0.00], systolic blood pressure [(131.95±47.20) mmHg vs (138.71 ±21.36) mmHg vs (147.58±24.10)mmHg, P=0.01], urine albumin [(32.79± 122.29) mg/L vs (190.96±455.65) mg/L vs (362.00±552.51) mg/L,P=0.00], glycated hemoglobin (HbA1c) [(8.68 ± 2.26)% vs (9.42±1.84)% vs (9.42±1.96)%, P=0.04],C-reactive protein (CRP) [(3.19±7.37) mg/L vs (6.36± 23.59) mg/L vs (3.02±4.34) mg/L, P=0.03],high-density lipoprotein cholesterol (HDL-C) [(1.23±0.37) mmol/L vs (1.33±0.35) mmol/L vs (1.24±0.33)mmol/L, P=0.01], uric acid (UA) [(288.51 ±90.85) mmol/L vs (300.29±101.98) mmol/L vs (337.57±115.09)mmol/L, P=0.00], creatinine (CREA) [(84.22±16.31) μmol/L vs (89.35±27.45) μmol/L vs (103.28±48.64)μmol/L, P=0.00], blood urine nitrogen (BUN) [(5.62± 1.62) mmol/L vs (6.55±2.74) mmol/L vs (8.11±3.60)mmol/L, P=0.00] were statistically different among the three groups. Logistic regression analysis showed that diabetic duration and urine albumin were two independent risk factors of DR (the OR values were 1.010 and 1.003 respectively).Conclusions Diabetic duration and urine albumin are two independent risk factors of diabetic retinopathy in elderly type 2 diabetic patients.

  7. STUDY ON EVOKED POTENTIALS IN TYPE 2 DIABETIC PATIENTS

    Institute of Scientific and Technical Information of China (English)

    陈薇; 陈慎仁; 陈璇; 吴静珊; 刘兴材

    2003-01-01

    The aim of this study is to explore the changes of visual evoked potentiaK VEP), brainstem auditory evoked potential (BAEP), Somatosensory e-voked potential (SEP), event-related potential(ERP) of patients with type 2 diabetes mellitus(DM).Methods VEP, BAEP, SEP, ERP were measured in 30 cases with type 2 DM (DM group) and in 30 age- and sex-matched healthy volunteers (Control group) by using Nicolet Viking Ⅳ EMG/EP instrument. The numerical values of VEP, BAEP, SEP and ERP were recorded and analyzed by SPSS.Results Abnormalities were found as follows: VEP in 20(66.7%), BAEP in 18(60%), MNSEP in 20(66.7%),PTNSEP in 22(73.3%), and ERP in 11 (36.67%) diabetic patients, including the disappearance of wave, prolonged wave latency and decreased wave amplitude. Compared with control group, the P100 latency of VEP, the latencies of wave Ⅰ and Ⅴ, amplitude of wave Ⅴ, the interpeak latencies (IPL) of each wave in BAEP, the latencies and wave amplitudes in N9 to P20 of MNSEP and in N9 to P38 of PTNSEP, as well a

  8. Dapagliflozin in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Filippatos, Theodosios D; Liberopoulos, Evangelos N; Elisaf, Moses S

    2015-02-01

    Dapagliflozin is a selective and reversible inhibitor of sodium-glucose linked transporter type 2 (SGLT2), which mediates approximately 90% of active renal glucose reabsorption in the early proximal tubule of the kidney. Dapagliflozin significantly reduces glucose reabsorption and decreases serum glucose concentration in an insulin-independent manner. The decrease of glucose reabsorption by dapagliflozin has also been associated with a reduction in body weight. Furthermore, the drug modestly reduces blood pressure levels through weight loss and its action as osmotic diuretic. Dapagliflozin has been approved as monotherapy in patients with type 2 diabetes mellitus (T2DM) who cannot tolerate metformin or in combination with other antidiabetic drugs, with the exception of pioglitazone due to the theoretical increased risk of bladder cancer. The drug should not be prescribed in patients with moderate or severe renal impairment or in patients at risk for developing volume depletion. Dapagliflozin is associated with increased incidence of genital and lower urinary tract infections, but these infections are usually mild to moderate and respond to standard antimicrobial treatment. Based on current evidence, dapagliflozin is a useful drug for patients with T2DM with a favorable safety profile. However, further research regarding the effects of dapagliflozin on cardiovascular outcomes is needed.

  9. Update on the treatment of type 2 diabetes mellitus

    Science.gov (United States)

    Marín-Peñalver, Juan José; Martín-Timón, Iciar; Sevillano-Collantes, Cristina; del Cañizo-Gómez, Francisco Javier

    2016-01-01

    To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2DM, with an emphasis on agents introduced within the last decade. PMID:27660695

  10. Type 2 diabetes mellitus and Alzheimer’s disease

    Institute of Scientific and Technical Information of China (English)

    Mario; Barbagallo; Ligia; J; Dominguez

    2014-01-01

    Epidemiological and biological evidences support a link between type 2 diabetes mellitus(DM2) and Alzheimer’s disease(AD). Persons with diabetes have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. Cognitive deficits in persons with diabetes mainly affect the areas of psychomotor efficiency, attention, learning and memory, mental flexibility and speed, and executive function. The strong epidemiological association has suggested the existence of a physiopathological link. The determinants of the accelerated cognitive decline in DM2, however, are less clear. Increased cortical and subcortical atrophy have been evidenced after controlling for diabetic vascular disease and inadequate cerebral circulation. Most recent studies have focused on the role of insulin and insulin resistance as possible links between diabetes and AD. Disturbances in brain insulin signaling mechanisms may contribute to the molecular, biochemical, and histopathological lesions in AD. Hyperglycemia itself is a risk factor for cognitive dysfunction and dementia. Hypoglycemia may also have deleterious effects on cognitive function. Recurrent symptomatic and asymptomatic hypoglycemic episodes have been suggested to cause sub-clinical brain damage, and permanent cognitive impairment. Futuretrials are required to clarify the mechanistic link, to address the question whether cognitive decline may be prevented by an adequate metabolic control, and to elucidate the role of drugs that may cause hypoglycemic episodes.

  11. Human cerebral neuropathology of Type 2 diabetes mellitus.

    Science.gov (United States)

    Nelson, Peter T; Smith, Charles D; Abner, Erin A; Schmitt, Frederick A; Scheff, Stephen W; Davis, Gregory J; Keller, Jeffrey N; Jicha, Gregory A; Davis, Daron; Wang-Xia, Wang; Hartman, Adria; Katz, Douglas G; Markesbery, William R

    2009-05-01

    The cerebral neuropathology of Type 2 diabetes (CNDM2) has not been positively defined. This review includes a description of CNDM2 research from before the 'Pubmed Era'. Recent neuroimaging studies have focused on cerebrovascular and white matter pathology. These and prior studies about cerebrovascular histopathology in diabetes are reviewed. Evidence is also described for and against the link between CNDM2 and Alzheimer's disease pathogenesis. To study this matter directly, we evaluated data from University of Kentucky Alzheimer's Disease Center (UK ADC) patients recruited while non-demented and followed longitudinally. Of patients who had come to autopsy (N = 234), 139 met inclusion criteria. These patients provided the basis for comparing the prevalence of pathological and clinical indices between well-characterized cases with (N = 50) or without (N = 89) the premortem diagnosis of diabetes. In diabetics, cerebrovascular pathology was more frequent and Alzheimer-type pathology was less frequent than in non-diabetics. Finally, a series of photomicrographs demonstrates histopathological features (including clinical-radiographical correlation) observed in brains of persons that died after a history of diabetes. These preliminary, correlative, and descriptive studies may help develop new hypotheses about CNDM2. We conclude that more work should be performed on human material in the context of CNDM2.

  12. Type 2 diabetes in children: Clinical aspects and risk factors.

    Science.gov (United States)

    Rao, P V

    2015-04-01

    A strong link between obesity, insulin resistance, and metabolic syndrome has been reported with development of a new paradigm to type 2 diabetes mellitus (T2DM), with some evidence suggesting that beta-cell dysfunction is present before the onset of impaired glucose tolerance. Differentiating type 1 diabetes mellitus (T1DM) from T2DM is actually not very easy and there exists a number of overlapping characteristics. The autoantibody frequencies of seven antigens in T1DM patients may turn out to be actually having T2DM patients (pre-T2DM). T2DM patients generally have increased C-peptide levels (may be normal at time of diagnosis), usually no auto-antibodies, strong family history of diabetes, obese and show signs of insulin resistance (hypertension, acanthosis, PCOS). The American Academy of Paediatrics recommends lifestyle modifications ± metformin when blood glucose is 126-200 mg/dL and hemoglobin A1c (HbA1c) 200 mg/dL and HbA1c >8.5, with or without ketosis. Metformin is not recommended if the patient is ketotic, because this increases the risk of lactic acidosis. Metformin is currently the only oral hypoglycemic that has been approved for use in children. Knowing these subtle differences in mechanism, and knowing how to test patients for which mechanism (s) are causing their diabetes mellitus, may help us eventually tailor treatment programs on an individual basis.

  13. Type 2 diabetes in children: Clinical aspects and risk factors

    Directory of Open Access Journals (Sweden)

    P V Rao

    2015-01-01

    Full Text Available A strong link between obesity, insulin resistance, and metabolic syndrome has been reported with development of a new paradigm to type 2 diabetes mellitus (T2DM, with some evidence suggesting that beta-cell dysfunction is present before the onset of impaired glucose tolerance. Differentiating type 1 diabetes mellitus (T1DM from T2DM is actually not very easy and there exists a number of overlapping characteristics. The autoantibody frequencies of seven antigens in T1DM patients may turn out to be actually having T2DM patients (pre-T2DM. T2DM patients generally have increased C-peptide levels (may be normal at time of diagnosis, usually no auto-antibodies, strong family history of diabetes, obese and show signs of insulin resistance (hypertension, acanthosis, PCOS. The American Academy of Paediatrics recommends lifestyle modifications ± metformin when blood glucose is 126-200 mg/dL and hemoglobin A1c (HbA1c 200 mg/dL and HbA1c >8.5, with or without ketosis. Metformin is not recommended if the patient is ketotic, because this increases the risk of lactic acidosis. Metformin is currently the only oral hypoglycemic that has been approved for use in children. Knowing these subtle differences in mechanism, and knowing how to test patients for which mechanism (s are causing their diabetes mellitus, may help us eventually tailor treatment programs on an individual basis.

  14. Serum leptin concentration in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Malecha-Jedraszek Arleta

    2015-12-01

    Full Text Available With the increasing importance of early type 2 diabetes (DM2 and obesity detection, it is useful to reevaluate leptin role in these conditions. Our study aimed at investigating circulating leptin concentrations in a group of patients with DM2, and at assessing in detail whether leptin concentrations correlate with selected biochemical, clinical parameters and markers of systemic inflammation in patients with DM2 and in healthy volunteers. In our work, we analysed samples and data drawn from 71 patients aged 61.4 ± 11.7 years, who have been diagnosed with type 2 diabetes, as well as from a healthy control group (HC consisting of 51 healthy subjects with a mean age of 57.8 ± 13.7 years. Therein, the concentration of leptin in the DM2 patients was significantly higher than in the HC (p < 0.01, with median value of 16.59 (IQR 8.58-33.39 ng/ml in the DM2, vs median value of 6.66 (IQR 4.52-21.40 ng/ml in the HC. In the analysis of variance, higher leptin concentrations were revealed in the DM2 group as compared to the HC, and this figure remained significant after adjusting for gender and age (p < 0.001. Moreover, it was independent of HOMA-IR (p = 0.003. However, the differences in leptin levels between the groups disappeared when additional adjustments for anthropometric parameters (BMI, waist circumference were applied (p = 0.088. Beyond the aforementioned, significant positive correlations were found in the DM 2 group between leptin level and CRP (r=0.256; p < 0.05 and IL-6 (r = 0.345; p < 0.01. Among the selected variables, only gender and BMI were included in the predictive model explaining the variability of leptin, and, in total, were responsible for 72.6% of the original variation of the studied adipocytokine. The results of this study have led to conclusion that leptin may participate in the complex pathogenesis of DM2 and be a predictor of the development of this disease. As higher concentrations of leptin coexist with obesity, and this

  15. Metformin in Patients With Type 2 Diabetes and Kidney Disease

    Science.gov (United States)

    Inzucchi, Silvio E.; Lipska, Kasia J.; Mayo, Helen; Bailey, Clifford J.; McGuire, Darren K.

    2015-01-01

    IMPORTANCE Metformin is widely viewed as the best initial pharmacological option to lower glucose concentrations in patients with type 2 diabetes mellitus. However, the drug is contraindicated in many individuals with impaired kidney function because of concerns of lactic acidosis. OBJECTIVE To assess the risk of lactic acidosis associated with metformin use in individuals with impaired kidney function. EVIDENCE ACQUISITION In July 2014, we searched the MEDLINE and Cochrane databases for English-language articles pertaining to metformin, kidney disease, and lactic acidosis in humans between 1950 and June 2014. We excluded reviews, letters, editorials, case reports, small case series, and manuscripts that did not directly pertain to the topic area or that met other exclusion criteria. Of an original 818 articles, 65 were included in this review, including pharmacokinetic/metabolic studies, large case series, retrospective studies, meta-analyses, and a clinical trial. RESULTS Although metformin is renally cleared, drug levels generally remain within the therapeutic range and lactate concentrations are not substantially increased when used in patients with mild to moderate chronic kidney disease (estimated glomerular filtration rates, 30-60 mL/min per 1.73 m2). The overall incidence of lactic acidosis in metformin users varies across studies from approximately 3 per 100 000 person-years to 10 per 100 000 person-years and is generally indistinguishable from the background rate in the overall population with diabetes. Data suggesting an increased risk of lactic acidosis in metformin-treated patients with chronic kidney disease are limited, and no randomized controlled trials have been conducted to test the safety of metformin in patients with significantly impaired kidney function. Population-based studies demonstrate that metformin may be prescribed counter to prevailing guidelines suggesting a renal risk in up to 1 in 4 patients with type 2 diabetes mellitus

  16. Red cell distribution width in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Nada AM

    2015-10-01

    Full Text Available Aml Mohamed Nada Department of Internal Medicine, Unit of Endocrinology, Diabetes and Metabolism, Faculty of Medicine, Mansoura University, Mansoura, Egypt Objective: To study the indices of some elements of the complete blood count, in type 2 diabetic patients, in comparison with nondiabetic healthy controls; and to find out the effects of glycemic control and different medications on these indices. To the best of our knowledge, this study is novel in our environment and will serve as a foundation for other researchers in this field. Methods: This retrospective study included 260 type 2 diabetic patients on treatment and 44 healthy control subjects. Sex, age, weight, height, blood pressure, complete blood count, fasting plasma glucose, hemoglobin A1c (HbA1c, and lipid profile data, were available for all of the study population. For diabetic patients, data on duration of diabetes and all medications were also available. Results: Red cell distribution width (RDW was significantly higher in diabetic patients than in control subjects (P=0.008. It was also higher in patients with uncontrolled glycemia (HbA1c >7% than those with good control (HbA1c ≤7%; P=0.035. Mean platelet volume (MPV was comparable in both diabetic patients and healthy controls (P=0.238. RDW and MPV did not significantly correlate with fasting plasma glucose, HbA1c, or duration of diabetes. Both aspirin and clopidogrel did not show a significant effect on MPV. Both insulin and oral hypoglycemic agents did not show a significant effect on RDW, mean corpuscular volume, MPV, platelet count, or white blood cell count. Diabetic patients treated with indapamide or the combined thiazides and angiotensin receptor blockers showed no significant difference in RDW when compared with the control subjects. Conclusion: RDW, which is recently considered as an inflammatory marker with a significant predictive value of mortality in diseased and healthy populations, is significantly higher in

  17. Budget impact of rosiglitazone in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Orietta Zaniolo

    2007-03-01

    Full Text Available BACKGROUND: in type 2 diabetes, the maintenance of non-diabetic glycaemic levels has been shown to decrease the onset of long term complications and consequently their high management costs. In order to achieve and maintain normal blood glucose levels, lifestyle interventions are highly cost/effective, but require good compliance, strong motivation and efforts by the patients. For this reason, a majority of patients needs to start pharmacological therapy shortly after diagnosis. Rosiglitazone, an insulin-sensitising drug, is indicated for subjects with inadequate glycaemic control both as monotherapy, in those contraindicated to metformin, especially if overweight, and as combination therapy with metformin, sulphanilureas or both. OBJECTIVES: rosiglitazone offers clinical advantages over the alternatives, decreasing and/or postponing the need for insulin treatment. Its high acquisition cost may therefore be totally or partially offset by the reduction in future health care resources consumption, and by short-term practical advantages, such as the decrease in the need for blood glucose monitoring and of adverse events. Aim of this study was to investigate the impact of the use of rosiglitazone in eligible diabetic patients on the National Health System budget. METHODS: for this scope an analytic model was implemented, which pathway may be summarized as follows: a estimate of the number type 2 diabetes patients living in Italy, grouped according to current therapeutic classes; b estimate of the number of patients with inadequate glycaemic control for each subgroup; c identification of patients eligible to rosiglitazone treatment; d identification of the comparator strategy for each patient sub-group; e comparison of costs for each couple of alternative options; f calculation of budget impact. RESULTS: use of rosiglitazone monotherapy instead of sulphanilurea monotherapy induces a mild costs increase. Combination treatment with rosiglitazone added

  18. Metformin Treatment in Type 2 Diabetes in Pregnancy: An Active Controlled, Parallel-Group, Randomized, Open Label Study in Patients with Type 2 Diabetes in Pregnancy

    OpenAIRE

    2015-01-01

    Aims. To assess the effect of metformin and to compare it with insulin treatment in patients with type 2 diabetes in pregnancy in terms of perinatal outcome, maternal complications, additional insulin requirement, and treatment acceptability. Methods. In this randomized, open label study, 206 patients with type 2 diabetes in pregnancy who met the eligibility criteria were selected from the antenatal clinics. Insulin was added to metformin treatment when required, to maintain the target glycem...

  19. Pathomechanism of Renal Damage in Type 2 Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Yuliana Sambara

    2013-12-01

    Full Text Available BACKGROUND: Hyperglycemia in diabetic patients cause both chronic inflammation and extracellular matrix accumulation that can lead to progressive renal damage. Albumin, Gammaglutamytransferase (GGT and clusterin in urine are markers to detect damage in glomerulus, cell of the tubules and proximal tubules, respectively. METHODS: This study aimed to evaluate the pathomechanism of haemoglobin A1c (HbA1c, albumin, GGT, clusterin, type IV collagen in urine, and high sensitivity C-reactive protein (hsCRP in type 2 diabetes mellitus (DM patients. The study was a cross sectional study involving 82 subjects consisting of 36 males and 46 females, 35-65 years old, divided into 3 groups: uncontrolled DM, controlled DM and non DM. Data were obtained from interviews, physical examinations (weight, height, blood pressure and laboratory examinations (HbA1c, serum glutamic oxaloacetic (SGOT, serum glutamic pyruvic (SGPT, creatinine, hsCRP, urinary albumin, urinary GGT, urinary clusterin, and urinary type IV collagen. Statistical analysis was performed for correlation, difference and cross tabulation tests. RESULTS: The study results showed there were significant differences (p<0.05 between uncontrolled DM group compared with controlled DM and non DM groups in HbA1c, ratio of urinary type IV collagen and ratio of urinary albumin. However, there were no significant differences between controlled DM and non DM groups. There were positive significant correlations between HbA1c with hsCRP (r=0.223, p<0.05, HbA1c with ratio of urinary type IV collagen/creatinine (r=0.563, p<0.001, HbA1c with ratio of urinary albumin/creatinine (r=0.263, p<0.05, and ratio of urinary type IV collagen/creatinine with ratio urinary albumin/creatinine (r=0.613, p<0.001. CONCLUSIONS: Results of this study indicated that albumin and type IV collagen in urine play a role in renal damage caused by uncontrolled glucose level in subjects with type 2 DM. The increased concentration of both HbA1c

  20. Mitochondrial respiration is decreased in skeletal muscle of patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Hey-Mogensen, Martin; Sahlin, Kent; Fernström, Maria

    2007-01-01

    We tested the hypothesis of a lower respiratory capacity per mitochondrion in skeletal muscle of type 2 diabetic patients compared with obese subjects. Muscle biopsies obtained from 10 obese type 2 diabetic and 8 obese nondiabetic male subjects were used for assessment of 3-hydroxy....... Maximal ADP-stimulated respiration (state 3) with pyruvate plus malate and respiration through the electron transport chain (ETC) were reduced in type 2 diabetic patients, and the proportion of type 2X fibers were higher in type 2 diabetic patients compared with obese subjects (all P ..., and the proportion of type 2X fibers correlated with markers of insulin resistance (P type 2X fibers in muscle of type 2 diabetic patients. These alterations may contribute to the development...

  1. Subclinical hyperthyroidism in patients with type 2 diabetes.

    Science.gov (United States)

    Díez, Juan J; Iglesias, Pedro

    2012-08-01

    Both subclinical hyperthyroidism and type 2 diabetes (T2D) have been associated with an increase in cardiovascular disease risk and mortality. We aimed to assess the prevalence of newly diagnosed subclinical hyperthyroidism in a cohort of patients with T2D, and also to analyse the relationships between diabetes-related characteristics and the presence of subclinical hyperthyroidism. 933 diabetic patients without previous history of thyroid disease (45.4% females, mean age 66.3 years, median duration of diabetes 10 years) were evaluated. A sample of 911 non-diabetic subjects without known thyroid dysfunction was studied as control group. Serum concentrations of thyrotropin were measured in all subjects. Subclinical hyperthyroidism was present in 4.3% of female and 3.5% of male diabetic patients. Relative risk was significant only for the female gender (OR 3.69, 95% CI 1.56-8.71). In comparison with diabetic patients without thyroid hyperfunction, patients with subclinical hyperthyroidism were older, had longer duration of diabetes, showed lower fasting glucose levels, had greater proportion of goitre and diet therapy, and had lower proportion of treatment with oral agents. Logistic regression analysis showed that age and the presence of goitre were significantly related to subclinical hyperthyroidism in patients with T2D. The risk for subclinical hyperthyroidism is increased in women with T2D. Advanced age and the presence of goitre are significantly and independently related with the presence of subclinical hyperthyroidism in diabetic population.

  2. Meat Consumption as a Risk Factor for Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Neal Barnard

    2014-02-01

    Full Text Available Disease risk factors identified in epidemiological studies serve as important public health tools, helping clinicians identify individuals who may benefit from more aggressive screening or risk-modification procedures, allowing policymakers to prioritize intervention programs, and encouraging at-risk individuals to modify behavior and improve their health. These factors have been based primarily on evidence from cross-sectional and prospective studies, as most do not lend themselves to randomized trials. While some risk factors are not modifiable, eating habits are subject to change through both individual action and broader policy initiatives. Meat consumption has been frequently investigated as a variable associated with diabetes risk, but it has not yet been described as a diabetes risk factor. In this article, we evaluate the evidence supporting the use of meat consumption as a clinically useful risk factor for type 2 diabetes, based on studies evaluating the risks associated with meat consumption as a categorical dietary characteristic (i.e., meat consumption versus no meat consumption, as a scalar variable (i.e., gradations of meat consumption, or as part of a broader dietary pattern.

  3. Gene-Lifestyle Interaction and Type 2 Diabetes

    DEFF Research Database (Denmark)

    Langenberg, Claudia; Sharp, Stephen J; Franks, Paul W

    2014-01-01

    (p for interaction  = 1.20×10-4). Relative genetic risk (per standard deviation [4.4 risk alleles]) was also larger in participants who were leaner, both in terms of body mass index (p for interaction  = 1.50×10-3) and waist circumference (p for interaction  = 7.49×10-9). Examination of absolute......BACKGROUND: Understanding of the genetic basis of type 2 diabetes (T2D) has progressed rapidly, but the interactions between common genetic variants and lifestyle risk factors have not been systematically investigated in studies with adequate statistical power. Therefore, we aimed to quantify...... the combined effects of genetic and lifestyle factors on risk of T2D in order to inform strategies for prevention. METHODS AND FINDINGS: The InterAct study includes 12,403 incident T2D cases and a representative sub-cohort of 16,154 individuals from a cohort of 340,234 European participants with 3.99 million...

  4. Sialolithiasis and Poorly Controlled Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Agoeng Tjahjani Sarwono

    2015-10-01

    Full Text Available Sialolithiasis is a common disease of the submandibular glands or its duct but rare in parotids of patients, especially in male adults. The accessory of salivary glands are small, unsheathed masses with a small canaliculi. The irritant factors might be due to inflammation of the inner layer of the canaliculi, that often concomitant to saliva stasis. This process leads to development of calculus that it is related to secretive specificity of the submandibular gland. The essential factor for its calcification is the stagnation of secretory matieral rich in calcium. The accumulation of this material would cause swelling, further obstruction and atrophy until there is widespread inflammation that has been termed sialadenitis. Diabetes mellitus is one of the medically compromised diseases. Although there are many assocaiations between diabetes mellitus and oral health, lack of investigation in this area has been done to study salivary gland alterations. Many diabetic patient complained xerostomia, a decreasing salivary flow and enlargement of the parotid gland due to a compensatory mechanism to xerostomia that has been termed sialadenosis. This review article summarized that there is no relationship between sialolithiasis and poorly controlled type 2 diabetes mellitus.

  5. Update on type 2 diabetes-related osteoporosis

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    It was previously understood that body weight gainand obesity observed in type 2 diabetes mellitus (T2DM)could be beneficial since body weight increase elevatedbone mineral density and thus helped maintain theskeletal framework. However, a number of recentfindings in humans and rodents have revealed thatT2DM is not only associated with trabecular defectsbut also increases cortical porosity, and compromisedbone cell function and bone mechanical properties.Hyperglycemia and insulin resistance in T2DM mayfurther induce osteoblast apoptosis and uncouplingbone turnover. Prolonged accumulation of advancedglycation end products and diminished activity of lysyloxidase, an essential enzyme for collagen cross-link,can lead to structural abnormalities of bone collagenfibrils, brittle matrix, and fragility fractures. Our studiesin T2DM rats showed that dyslipidemia, which oftenoccurs in T2DM, could obscure the T2DM-associatedchanges in bone microstructure and osteopenia. Longitudinalbone growth regulated by the growth platechondrocytes is also impaired by T2DM since differentiationof growth plate chondrocytes is arrested andretained in the resting state while only a small numberof cells undergo hypertrophic differentiation. Such adelayed chondrocyte differentiation may have alsoresulted from premature apoptosis of the growth platechondrocytes. Nevertheless, the underlying cellularand molecular mechanisms of insulin resistance inosteoblasts, osteoclasts, osteocytes, and growth platechondrocytes remain to be investigated.

  6. Pharmacogenetic studies update in type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Shalini; Singh; Kauser; Usman; Monisha; Banerjee

    2016-01-01

    Type 2 diabetes mellitus(T2DM) is a silent progressive polygenic metabolic disorder resulting from ineffective insulin cascading in the body. World-wide, about 415 million people are suffering from T2DM with a projected rise to 642 million in 2040. T2DM is treated with several classes of oral antidiabetic drugs(OADs) viz. biguanides, sulfonylureas, thiazolidinediones, meglitinides, etc. Treatment strategies for T2DM are to minimize long-term micro and macro vascular complications by achieving an optimized glycemic control. Genetic variations in the human genome not only disclose the risk of T2DM development but also predict the personalized response to drug therapy. Inter-individual variability in response to OADs is due to polymorphisms in genes encoding drug receptors, transporters, and metabolizing enzymes for example, genetic variants in solute carrier transporters(SLC22A1, SLC22A2, SLC22A3, SLC47A1 and SLC47A2) are actively involved in glycemic/HbA1c management of metformin. In addition, CYP gene encoding Cytochrome P450 enzymes also play a crucial role with respect to metabolism of drugs. Pharmacogenetic studies provide insights on the relationship between individual genetic variants and variable therapeutic outcomes of various OADs. Clinical utility of pharmacogenetic study is to predict the therapeutic dose of various OADs on individual basis. Pharmacogenetics therefore, is a step towards personalized medicine which will greatly improve the efficacy of diabetes treatment.

  7. Type 2 diabetes among Asian Americans: Prevalence andprevention

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Type 2 diabetes mellitus (T2DM) is a growing problemamong Asian Americans. Based on the Centers forDisease Control, the age-adjusted prevalence of T2DMfor Asian Americans is 9%, placing them at "moderaterisk". However differential patterns of disease burdenemerge when examining disaggregated data acrossAsian American ethnic groups; with Filipino, PacificIslander, Japanese, and South Asian groups consistentlydescribed as having the highest prevalence of T2DM.Disentangling and strengthening prevalence data is vitalfor on-going prevention efforts. The strongest evidencecurrently available to guide the prevention of T2DMin the United States comes from a large multicenterrandomized clinical control trial called the DiabetesPrevention Program, which targets individual lifestylebehavior changes. It has been translated and adoptedfor some Asian American groups, and shows promise.However stronger study designs and attention toseveral key methodological considerations will improvethe science. Increased attention has also been directedtoward population level downstream prevention efforts.Building an infrastructure that includes both individualand population approaches is needed to prevent T2DMamong Asian American populations, and is essential forreducing health disparities.

  8. Renal AA Amyloidosis in Patients with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Ramón Díez

    2014-07-01

    Full Text Available Background: Type 2 diabetes mellitus (T2DM is the leading cause of chronic kidney disease and a major cause of cardiovascular disease (CVD mortality. Inflammation is closely involved in the pathogenesis of T2DM, and reactive amyloidosis occurs in the presence of chronic inflammation. We hypothesized that patients with T2DM may have a higher prevalence of renal AA amyloidosis (RAAA and that this could contribute to worse atherosclerosis and CVD. Materials and Methods: We analyzed 330 autopsy kidneys from patients with a previous T2DM diagnosis. The kidney tissue was evaluated in order to determine the presence of diabetic nephropathy and RAAA, and systemic vessels were evaluated for the presence of atherosclerosis. Results: RAAA was detected in 9% of our study population and was associated with an increased risk for nodular sclerosis [OR (95% CI] [11 (2.04-59.16], for chronic ischemic cardiomyopathy [4.59 (2.02-10.42], for myocardial infarction [3.41 (1.52-7.64] as well as for aortic [4.75 (1.09-20.69], coronary [3.22 (1.47-7.04], and intrarenal atherosclerosis [3.84 (1.46-10.09]. Conclusions: RAAA is prevalent in T2DM and is associated with worse CVD and renal disease, likely because RAAA is a marker of severe chronic inflammation.

  9. Glyoxylate, a New Marker Metabolite of Type 2 Diabetes

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    Victoria J. Nikiforova

    2014-01-01

    Full Text Available Type 2 diabetes (T2D is characterized by a variety of metabolic impairments that are closely linked to nonenzymatic glycation reactions of proteins and peptides resulting in advanced glycation end-products (AGEs. Reactive aldehydes derived from sugars play an important role in the generation of AGEs. Using metabolite profiling to characterize human plasma from diabetic versus nondiabetic subjects we observed in a recent study that the reactive aldehyde glyoxylate was increased before high levels of plasma glucose, typical for a diabetic condition, could be measured. Following this observation, we explored the relevance of increased glyoxylate in diabetic subjects and in diabetic C57BLKS/J-Leprdb/db-/- mice in the pathophysiology of diabetes. A retrospective study using samples of long-term blood donors revealed that glyoxylate levels unlike glucose levels became significantly elevated up to 3 years prior to diabetes diagnosis (difference to control P=0.034. Elevated glyoxylate levels impact on newly identified mechanisms linking hyperglycemia and AGE production with diabetes-associated complications such as diabetic nephropathy. Glyoxylate in its metabolic network may serve as an early marker in diabetes diagnosis with predictive qualities for associated complications and as potential to guide the development of new antidiabetic therapies.

  10. Osteoarthritis and type 2 diabetes mellitus: What are the links?

    Science.gov (United States)

    Courties, Alice; Sellam, Jérémie

    2016-12-01

    Osteoarthritis (OA) is the most frequent joint disorder and one of the leading cause of disability. During a long time, it was considered as the consequence of aging and mechanical stress on cartilage. Recent advances in the knowledge of OA have highlighted that it is a whole joint disease with early modifications of synovium and subchondral bone but also that it is associated with obesity and metabolic syndrome through systemic mechanisms. In the past year, type 2 diabetes has been described in two meta-analyzes as an independent risk factor for OA. In vivo models of diabetes corroborated epidemiological studies. Indeed, diabetic rodents display a spontaneous and a more severe experimental OA than their non-diabetic counterparts, which can be partially prevented by diabetes treatment (insulin, pioglitazone). The negative impact of diabetes on joints could be explain by the induction of oxidative stress and pro-inflammatory cytokines but also by advanced age products accumulation in joint tissues exposed to chronic high glucose concentration. Insulin resistance might also impair joint tissue because of a local insulin resistance of diabetic synovial membrane but also by the systemic low grade inflammation state related to obesity and insulin resistant state.

  11. Type 2 diabetes mellitus: Role of melatonin and oxidative stress.

    Science.gov (United States)

    Zephy, Doddigarla; Ahmad, Jamal

    2015-01-01

    Type 2 diabetes mellitus caused by transfer of susceptible immortal gene from parent to progeny in individuals prone, and/or in contribution of factors such as obesity and physical inactivity results in chronic extracellular hyperglycemia due to insulin resistance or impaired glucose tolerance. Hyperglycemia leads to increased production of superoxide radical in mitochondrial electron transport chain, consequently, inhibit glyceraldehyde-3-phosphate dehydrogenase activity, increase the flux of substrates that direct the expression of genes responsible for activation of polyol, hexosamine, advanced glycation end products and protein kinase-C pathways enzymes. Simultaneously, these pathways add-up free radicals in the body, hamper cell redox state, alter genes of insulin sensitivity and are responsible for the diabetic complications like retinopathy, atherosclerosis, cardiovascular diseases, nephropathy and neuropathy. Experimental evidence suggests that the indoleamine hormone melatonin is capable of influencing in development of diabetic complications by neutralizing the unnecessary production of ROS, protection of beta cells, as they possess low antioxidant potential and normalize redox state in the cell. However, studies reported the beneficial effects of pharmacological supplementation of melatonin in humans but it has not been extensively studied in a multicountric, multicentric which should include all ethnic population.

  12. Oxytocin and Psychological Factors Affecting Type 2 Diabetes Mellitus

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    K. Kontoangelos

    2012-01-01

    Full Text Available Background. The aim of this study was to investigate the association of oxytocin with trait and state psychological factors in type 2 diabetic patients. Methods. OXT and psychological variables were analyzed from 86 controlled diabetic patients (glycosylated haemoglobin A1c (HbA1c < 7% from 45 uncontrolled diabetic patients (HbA1c ≥ 7. Psychological characteristics were assessed with the Eysenck Personality Questionnaire (EPQ, while state psychological characteristics were measured with the Symptom Checklist 90-R (SCL 90-R. Blood samples were taken for measuring oxytocin in both subgroups during the initial phase of the study. One year later, the uncontrolled diabetic patients were reevaluated with the use of the same psychometric instruments. Results. During the first evaluation of the uncontrolled diabetic patients, a statistically significant positive relationship between the levels of OXT and psychoticism in EPQ rating scale (P<0.013 was observed. For controlled diabetic patients, a statistically significant negative relationship between oxytocin and somatization (P<0.030, as well as obsessive-compulsive scores (P<0.047 in SCL-90 rating scale, was observed. During the second assessment, the values of OXT decreased when the patients managed to control their metabolic profile. Conclusions. The OXT is in association with psychoticism, somatization, and obsessionality may be implicated in T2DM.

  13. Depression in type 2 diabetes mellitus: prevalence, impact, and treatment.

    Science.gov (United States)

    Semenkovich, Katherine; Brown, Miriam E; Svrakic, Dragan M; Lustman, Patrick J

    2015-04-01

    Clinically significant depression is present in one of every four people with type 2 diabetes mellitus (T2DM). Depression increases the risk of the development of T2DM and the subsequent risks of hyperglycemia, insulin resistance, and micro- and macrovascular complications. Conversely, a diagnosis of T2DM increases the risk of incident depression and can contribute to a more severe course of depression. This linkage reflects a shared etiology consisting of complex bidirectional interactions among multiple variables, a process that may include autonomic and neurohormonal dysregulation, weight gain, inflammation, and hippocampal structural alterations. Two recent meta-analyses of randomized controlled depression treatment trials in patients with T2DM concluded that psychotherapy and antidepressant medication (ADM) were each moderately effective for depression and that cognitive behavior therapy (CBT) had beneficial effects on glycemic control. However, the number of studies (and patients exposed to randomized treatment) included in these analyses is extremely small and limits the certainty of conclusions that can be drawn from the data. Ultimately, there is no escaping the paucity of the evidence base and the need for additional controlled trials that specifically address depression management in T2DM. Future trials should determine both the effects of treatment and the change in depression during treatment on measures of mood, glycemic control, and medical outcome.

  14. Brainstem auditory evoked potential abnormalities in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Sharat Gupta

    2013-01-01

    Full Text Available Background: Diabetes mellitus represents a syndrome complex in which multiple organ systems, including the central nervous system, are affected. Aim: The study was conducted to determine the changes in the brainstem auditory evoked potentials in type 2 diabetes mellitus. Materials and Methods: A cross sectional study was conducted on 126 diabetic males, aged 35-50 years, and 106 age-matched, healthy male volunteers. Brainstem auditory evoked potentials were recorded and the results were analyzed statistically using student′s unpaired t-test. The data consisted of wave latencies I, II, III, IV, V and interpeak latencies I-III, III-V and I-V, separately for both ears. Results: The latency of wave IV was significantly delayed only in the right ear, while the latency of waves III, V and interpeak latencies III-V, I-V showed a significant delay bilaterally in diabetic males. However, no significant difference was found between diabetic and control subjects as regards to the latency of wave IV unilaterally in the left ear and the latencies of waves I, II and interpeak latency I-III bilaterally. Conclusion: Diabetes patients have an early involvement of central auditory pathway, which can be detected with fair accuracy with auditory evoked potential studies.

  15. Exenatide Use in the Management of Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Angelos Kyriacou

    2010-08-01

    Full Text Available Exenatide is a GLP-1 (glucagon-like peptide-1 agonist that has been approved in the UK for use in the management of Type 2 Diabetes Mellitus (T2DM since 2006. It acts by increasing glucose-induced insulin release and by reducing glucagon secretion postprandially. It therefore increases insulin secretion and reduces glucose levels, especially postprandially. It also reduces gastric emptying and acts centrally to promote satiety. In clinical practice it reduces HbA1c (range; -0.4% to -1.3%, fasting and postprandial blood glucose levels and is the only antidiabetic agent (together with liraglutide; a human GLP-1 analogue to promote weight loss (range; -1.5 kg to -5.5 kg. It can be used as monotherapy or in combination with metformin and/or sulphonylureas (SU and/or thiazolinediones (TZD. When compared with insulin it causes similar reductions in HbA1c and glucose levels, but unlike insulin it has the advantage of inducing weight loss. Its main side effect is gastrointestinal (GI disturbances; nausea is the commonest GI adverse effect, albeit usually mild and transient. Hypoglycaemia is uncommon, especially when used as monotherapy or in combination with metformin. In this review article we scrutinize the currently available evidence for use of exenatide in the management of T2DM.

  16. Obesity and type 2 diabetes in children: epidemiology and treatment.

    Science.gov (United States)

    Pulgaron, Elizabeth R; Delamater, Alan M

    2014-08-01

    The incidence of overweight and obesity among children has increased dramatically in recent decades, with about one-third of children in the U.S. currently being either overweight or obese. Being overweight in early childhood increases risk for later obesity. There is evidence for the efficacy of family-based behavioral treatment to control weight and improve health outcomes. Obesity-related health risks have been documented, including metabolic syndrome. There is also increasing incidence of type 2 diabetes (T2D) among youth in recent years, with obesity and family history of T2D generally present. Lower income and ethnic minority status are associated with both obesity and T2D in youth. Most youth with T2D do not achieve optimal glycemic control, and are at high risk for later health complications. Obesity and T2D represent significant public health issues with potentially great personal and societal cost. Research addressing the prevention of obesity and T2D among youth is urgently needed.

  17. Pharmacogenomics in type 2 diabetes: oral antidiabetic drugs.

    Science.gov (United States)

    Daniels, M A; Kan, C; Willmes, D M; Ismail, K; Pistrosch, F; Hopkins, D; Mingrone, G; Bornstein, S R; Birkenfeld, A L

    2016-10-01

    Type 2 diabetes mellitus (T2DM) is a fast progressing disease reaching pandemic proportions. T2DM is specifically harmful because of its severe secondary complications. In the course of the disease, most patients require treatment with oral antidiabetic drugs (OADs), for which a relatively large number of different options are available. The growing number of individuals affected by T2DM as well as marked interindividual differences in the response to treatment call for individualized therapeutic regimens that can maximize treatment efficacy and thus reduce side effects and costs. A large number of genetic polymorphisms have been described affecting the response to treatment with OADs; in this review, we summarize the most recent advances in this area of research. Extensive evidence exists for polymorphisms affecting pharmacokinetics and pharmacodynamics of biguanides and sulfonylureas. Data on incretin-based medications as well as the new class of sodium/glucose cotransporter 2 (SGLT2) inhibitors are just starting to emerge. With diabetes being a known comorbidity of several psychiatric disorders, we also review genetic polymorphisms possibly responsible for a common treatment response in both conditions. For all drug classes reviewed here, large prospective trials are necessary in order to consolidate the existing evidence and derive treatment schemes based on individual genetic traits.

  18. Pharmacogenetic studies update in type 2 diabetes mellitus

    Science.gov (United States)

    Singh, Shalini; Usman, Kauser; Banerjee, Monisha

    2016-01-01

    Type 2 diabetes mellitus (T2DM) is a silent progressive polygenic metabolic disorder resulting from ineffective insulin cascading in the body. World-wide, about 415 million people are suffering from T2DM with a projected rise to 642 million in 2040. T2DM is treated with several classes of oral antidiabetic drugs (OADs) viz. biguanides, sulfonylureas, thiazolidinediones, meglitinides, etc. Treatment strategies for T2DM are to minimize long-term micro and macro vascular complications by achieving an optimized glycemic control. Genetic variations in the human genome not only disclose the risk of T2DM development but also predict the personalized response to drug therapy. Inter-individual variability in response to OADs is due to polymorphisms in genes encoding drug receptors, transporters, and metabolizing enzymes for example, genetic variants in solute carrier transporters (SLC22A1, SLC22A2, SLC22A3, SLC47A1 and SLC47A2) are actively involved in glycemic/HbA1c management of metformin. In addition, CYP gene encoding Cytochrome P450 enzymes also play a crucial role with respect to metabolism of drugs. Pharmacogenetic studies provide insights on the relationship between individual genetic variants and variable therapeutic outcomes of various OADs. Clinical utility of pharmacogenetic study is to predict the therapeutic dose of various OADs on individual basis. Pharmacogenetics therefore, is a step towards personalized medicine which will greatly improve the efficacy of diabetes treatment. PMID:27555891

  19. Persistent organic pollutants as risk factors for type 2 diabetes.

    Science.gov (United States)

    Ngwa, Elvis Ndonwi; Kengne, Andre-Pascal; Tiedeu-Atogho, Barbara; Mofo-Mato, Edith-Pascale; Sobngwi, Eugene

    2015-01-01

    Type 2 diabetes mellitus (T2DM) is a major and fast growing public health problem. Although obesity is considered to be the main driver of the pandemic of T2DM, a possible contribution of some environmental contaminants, of which persistent organic pollutants (POPs) form a particular class, has been suggested. POPs are organic compounds that are resistant to environmental degradation through chemical, biological, and photolytic processes which enable them to persist in the environment, to be capable of long-range transport, bio accumulate in human and animal tissue, bio accumulate in food chains, and to have potential significant impacts on human health and the environment. Several epidemiological studies have reported an association between persistent organic pollutants and diabetes risk. These findings have been replicated in experimental studies both in human (in-vitro) and animals (in-vivo and in-vitro), and patho-physiological derangements through which these pollutants exercise their harmful effect on diabetes risk postulated. This review summarizes available studies, emphasises on limitations so as to enable subsequent studies to be centralized on possible pathways and bring out clearly the role of POPs on diabetes risk.

  20. Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy.

    Science.gov (United States)

    Sung, Jia-Ying; Tani, Jowy; Chang, Tsui-San; Lin, Cindy Shin-Yi

    2017-01-01

    This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using the total neuropathy score-reduced (TNSr). Patients in the G0 group were asymptomatic and had a TNSr score of 0. Sensory and motor nerve excitability data from diabetic patients were compared with data from 33 healthy controls. Clinical assessment, nerve conduction studies, and sensory and motor nerve excitability testing data were analyzed to determine axonal dysfunction in diabetic neuropathy. In the G0 group, sensory excitability testing revealed increased stimulus for the 50% sensory nerve action potential (Pmotor excitability only had significantly increased stimulus for the 50% compound motor nerve action potential (Pdevelopment of axonal dysfunction in sensory axons occurred prior to and in a different fashion from motor axons. Additionally, sensory nerve excitability tests can detect axonal dysfunction even in asymptomatic patients. These insights further our understanding of diabetic neuropathy and enable the early detection of sensory axonal abnormalities, which may provide a basis for neuroprotective therapeutic approaches.

  1. Early Life Factors and Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Xinli Jiang

    2013-01-01

    Full Text Available Type 2 diabetes mellitus (T2DM is a multifactorial disease, and its aetiology involves a complex interplay between genetic, epigenetic, and environmental factors. In recent years, evidences from both human and animal experiments have correlated early life factors with programming diabetes risk in adult life. Fetal and neonatal period is crucial for organ development. Many maternal factors during pregnancy may increase the risk of diabetes of offsprings in later life, which include malnutrition, healthy (hyperglycemia and obesity, behavior (smoking, drinking, and junk food diet, hormone administration, and even stress. In neonates, catch-up growth, lactation, glucocorticoids administration, and stress have all been found to increase the risk of insulin resistance or T2DM. Unfavorable environments (socioeconomic situation and famine or obesity also has long-term negative effects on children by causing increased susceptibility to T2DM in adults. We also address the potential mechanisms that may underlie the developmental programming of T2DM. Therefore, it might be possible to prevent or delay the risk for T2DM by improving pre- and/or postnatal factors.

  2. Scleredema Diabeticorum in a Patient with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    C. Martín

    2011-01-01

    Full Text Available Background. Scleredema adultorum, a connective tissue disorder of unknown aetiology, is characterized by a thickening of the reticular dermis in the upper back of the body that may decrease the mobility of the affected tissues. It has been reported in diabetic patients with poor metabolic control. Therapeutic options are limited with generally poor results. Case Report. 53-year-old white male with type 2 diabetes mellitus was referred to our department for evaluation of incipient nephropathy and retinopathy. On examination, he presented erythematous, indurated, painless and ill-defined plaque on the skin of the upper back with limited movement of shoulders. A biopsy was done revealing scleredema. PUVA treatment and physiotherapy were started with the amelioration of mobility and acquiring some elasticity of the upper back. Discussion. The development of scleredema in diabetic patients has been related to prolonged exposure to chronic hyperglycaemia. Our patient has had diabetes for 20 years with an acceptable glucose control, however he developed the scleredema 10 years ago. Conclusions. Scleredema is a rare connective disorder that seems to appear most frequently in diabetic subjects. Good metabolic control seems not to preclude its development. PUVA treatment and physiotherapy are therapeutic options that seem to be of some help.

  3. Nicotinamide Riboside Opposes Type 2 Diabetes and Neuropathy in Mice.

    Science.gov (United States)

    Trammell, Samuel A J; Weidemann, Benjamin J; Chadda, Ankita; Yorek, Matthew S; Holmes, Amey; Coppey, Lawrence J; Obrosov, Alexander; Kardon, Randy H; Yorek, Mark A; Brenner, Charles

    2016-05-27

    Male C57BL/6J mice raised on high fat diet (HFD) become prediabetic and develop insulin resistance and sensory neuropathy. The same mice given low doses of streptozotocin are a model of type 2 diabetes (T2D), developing hyperglycemia, severe insulin resistance and diabetic peripheral neuropathy involving sensory and motor neurons. Because of suggestions that increased NAD(+) metabolism might address glycemic control and be neuroprotective, we treated prediabetic and T2D mice with nicotinamide riboside (NR) added to HFD. NR improved glucose tolerance, reduced weight gain, liver damage and the development of hepatic steatosis in prediabetic mice while protecting against sensory neuropathy. In T2D mice, NR greatly reduced non-fasting and fasting blood glucose, weight gain and hepatic steatosis while protecting against diabetic neuropathy. The neuroprotective effect of NR could not be explained by glycemic control alone. Corneal confocal microscopy was the most sensitive measure of neurodegeneration. This assay allowed detection of the protective effect of NR on small nerve structures in living mice. Quantitative metabolomics established that hepatic NADP(+) and NADPH levels were significantly degraded in prediabetes and T2D but were largely protected when mice were supplemented with NR. The data justify testing of NR in human models of obesity, T2D and associated neuropathies.

  4. Team care of type 2 diabetes mellitus in Taiwan.

    Science.gov (United States)

    Wang, Chih-Yuan; Yu, Neng-Chun; Sheu, Wayne Huey-Herng; Tsai, Shih-Tzer; Tai, Tong-Yuan

    2014-12-01

    Type 2 diabetes mellitus (T2DM) is a global health-care and national policy issue. As fluctuating glycemic control in diabetes often results in serious complications, we must encourage the diabetes educators' efforts at long-term follow-up among patients with T2DM. Therefore, certified diabetes educators (CDEs) play the most pivotal roles as life-long protectors for patients with T2DM. In the past 15 years, more than 4,000 CDEs have been trained and qualified, including health professionals such as physicians, nurses, dieticians, and pharmacists. The most important initiation of diabetes share care in Taiwan was originated in I-Lan County. Initiated to provide regional diabetes care, the name of this program is the Lan-Yang Diabetes Shared Care System. In 2006, the Taiwanese Association of Diabetes Educators (TADE) carried out a nationwide survey to evaluate the status of diabetes control in Taiwan, focusing on the "ABC" goal (A: HbA1c Five years later, in 2011, TADE compared two nationwide surveys and found total ABC attainment rates of 4.1% and 8.6%, respectively. The team-care approach to T2DM has been underway for over 20 years in Taiwan. Future interventions and treatment algorithms with team-based education should aim at preventing acute and chronic complications, which remains a long-term challenge in Taiwan.

  5. DNA methylation in obesity and type 2 diabetes.

    Science.gov (United States)

    de Mello, Vanessa Derenji Ferreira; Pulkkinen, Leena; Lalli, Marianne; Kolehmainen, Marjukka; Pihlajamäki, Jussi; Uusitupa, Matti

    2014-05-01

    To elucidate the mechanisms related to the development of type 2 diabetes (T2D) and other degenerative diseases at a molecular level, a better understanding of the changes in the chromatin structure and the corresponding functional changes in molecular pathways is still needed. For example, persons with low birth weight are at a high risk for development of T2D later in life, suggesting that the intrauterine environment contributes to the disease. One of the hypotheses is that epigenetic regulation, including changes in DNA methylation leading to modifications in chromatin structure, are behind metabolic alterations, e.g. leading to the phenomenon termed metabolic memory. Altered DNA methylation has been shown to affect healthy aging and also to promote age-related health problems. There is suggestive evidence that lifestyle changes including weight loss can have an impact on DNA methylation and consequently gene expression. In this review we provide an overview of human studies investigating DNA methylation in obesity and T2D and associated risk factors behind these diseases.

  6. Job Strain as a Risk Factor for Type 2 Diabetes

    DEFF Research Database (Denmark)

    Nyberg, Solja T; Fransson, Eleonor I; Heikkilä, Katriina

    2014-01-01

    at work, defined as "job strain," is associated with incident type 2 diabetes independent of lifestyle factors. RESEARCH DESIGN AND METHODS: We extracted individual-level data for 124,808 diabetes-free adults from 13 European cohort studies participating in the IPD-Work Consortium. We measured job strain...... of incident diabetes during a mean follow-up of 10.3 years. After adjustment for age, sex, and socioeconomic status (SES), the hazard ratio (HR) for job strain compared with no job strain was 1.15 (95% CI 1.06-1.25) with no difference between men and women (1.19 [1.06-1.34] and 1.13 [1.00-1.28], respectively......). In stratified analyses, job strain was associated with an increased risk of diabetes among those with healthy and unhealthy lifestyle habits. In a multivariable model adjusted for age, sex, SES, and lifestyle habits, the HR was 1.11 (1.00-1.23). CONCLUSIONS: Findings from a large pan-European dataset suggest...

  7. Association between type 2 diabetes loci and measures of fatness.

    Directory of Open Access Journals (Sweden)

    Slavica Pecioska

    Full Text Available BACKGROUND: Type 2 diabetes (T2D is a metabolic disorder characterized by disturbances of carbohydrate, fat and protein metabolism and insulin resistance. The majority of T2D patients are obese and obesity by itself may be a cause of insulin resistance. Our aim was to evaluate whether the recently identified T2D risk alleles are associated with human measures of fatness as characterized with Dual Energy X-ray Absorptiometry (DEXA. METHODOLOGY/PRINCIPAL FINDINGS: Genotypes and phenotypes of approximately 3,000 participants from cross-sectional ERF study were analyzed. Nine single nucleotide polymorphisms (SNPs in CDKN2AB, CDKAL1, FTO, HHEX, IGF2BP2, KCNJ11, PPARG, SLC30A8 and TCF7L2 were genotyped. We used linear regression to study association between individual SNPs and the combined allelic risk score with body mass index (BMI, fat mass index (FMI, fat percentage (FAT, waist circumference (WC and waist to hip ratio (WHR. Significant association was observed between rs8050136 (FTO and BMI (p = 0.003, FMI (p = 0.007 and WC (p = 0.03; fat percentage was borderline significant (p = 0.053. No other SNPs alone or combined in a risk score demonstrated significant association to the measures of fatness. CONCLUSIONS/SIGNIFICANCE: From the recently identified T2D risk variants only the risk variant of the FTO gene (rs8050136 showed statistically significant association with BMI, FMI, and WC.

  8. Association between Type 2 Diabetes Loci and Measures of Fatness

    Science.gov (United States)

    Pecioska, Slavica; Zillikens, M. Carola; Henneman, Peter; Snijders, Pieter J.; Oostra, Ben A.; van Duijn, Cornelia M.; Aulchenko, Yurii S.

    2010-01-01

    Background Type 2 diabetes (T2D) is a metabolic disorder characterized by disturbances of carbohydrate, fat and protein metabolism and insulin resistance. The majority of T2D patients are obese and obesity by itself may be a cause of insulin resistance. Our aim was to evaluate whether the recently identified T2D risk alleles are associated with human measures of fatness as characterized with Dual Energy X-ray Absorptiometry (DEXA). Methodology/Principal Findings Genotypes and phenotypes of approximately 3,000 participants from cross-sectional ERF study were analyzed. Nine single nucleotide polymorphisms (SNPs) in CDKN2AB, CDKAL1, FTO, HHEX, IGF2BP2, KCNJ11, PPARG, SLC30A8 and TCF7L2 were genotyped. We used linear regression to study association between individual SNPs and the combined allelic risk score with body mass index (BMI), fat mass index (FMI), fat percentage (FAT), waist circumference (WC) and waist to hip ratio (WHR). Significant association was observed between rs8050136 (FTO) and BMI (p = 0.003), FMI (p = 0.007) and WC (p = 0.03); fat percentage was borderline significant (p = 0.053). No other SNPs alone or combined in a risk score demonstrated significant association to the measures of fatness. Conclusions/Significance From the recently identified T2D risk variants only the risk variant of the FTO gene (rs8050136) showed statistically significant association with BMI, FMI, and WC. PMID:20049090

  9. Coffee: A Dietary Intervention on Type 2 Diabetes?

    Science.gov (United States)

    Rebelo, Irene; Casal, Susana

    2017-01-01

    Coffee beverages, prepared in a multitude of ways around the world, are increasingly part of our daily lives. Although considered an unhealthy beverage for decades, coffee is increasingly the headline of medical journals in association with a reduced risk for several diseases. What if this beverage could give us pleasure, while modulating mood and lowering the risk for several diseases of the modern society, including type 2 diabetes (T2D)? Based on the most recent epidemiological and research data, long-term consumption of coffee beverages is associated with a lower risk of developing T2D in healthy individuals, probably involving multiple mechanisms, with interventions on glucose homeostasis, antioxidant activity, and inflammatory biomarkers. Several coffee constituents potentially responsible for these effects are described, as well as the factors that make their presence highly variable, with interesting effects associated with chlorogenic acids, trigonelline and norharman. Due to the high number of compounds contained in coffee, we explore the potential synergic effect within the coffee matrix. Moreover, acute coffee consumption shows different health effects from those achieved on a long-term daily consumption, and not all coffee beverages are similar. Still, despite the huge amount or work developed in the last decade, the substances and mechanisms behind these protective effects on T2D are still to be fully elucidated, being therefore soon for dietary interventions based on coffee.

  10. AMPK activation: a therapeutic target for type 2 diabetes?

    Science.gov (United States)

    Coughlan, Kimberly A; Valentine, Rudy J; Ruderman, Neil B; Saha, Asish K

    2014-01-01

    Type 2 diabetes (T2D) is a metabolic disease characterized by insulin resistance, β-cell dysfunction, and elevated hepatic glucose output. Over 350 million people worldwide have T2D, and the International Diabetes Federation projects that this number will increase to nearly 600 million by 2035. There is a great need for more effective treatments for maintaining glucose homeostasis and improving insulin sensitivity. AMP-activated protein kinase (AMPK) is an evolutionarily conserved serine/threonine kinase whose activation elicits insulin-sensitizing effects, making it an ideal therapeutic target for T2D. AMPK is an energy-sensing enzyme that is activated when cellular energy levels are low, and it signals to stimulate glucose uptake in skeletal muscles, fatty acid oxidation in adipose (and other) tissues, and reduces hepatic glucose production. There is substantial evidence suggesting that AMPK is dysregulated in animals and humans with metabolic syndrome or T2D, and that AMPK activation (physiological or pharmacological) can improve insulin sensitivity and metabolic health. Numerous pharmacological agents, natural compounds, and hormones are known to activate AMPK, either directly or indirectly - some of which (for example, metformin and thiazolidinediones) are currently used to treat T2D. This paper will review the regulation of the AMPK pathway and its role in T2D, some of the known AMPK activators and their mechanisms of action, and the potential for future improvements in targeting AMPK for the treatment of T2D.

  11. Targeting nocturnal hypertension in type 2 diabetes mellitus.

    Science.gov (United States)

    Rossen, Niklas Blach; Knudsen, Søren Tang; Fleischer, Jesper; Hvas, Anne-Mette; Ebbehøj, Eva; Poulsen, Per Løgstrup; Hansen, Klavs Würgler

    2014-11-01

    Several studies in different populations have suggested that nighttime blood pressure (BP) is a stronger predictor of cardiovascular events than daytime BP. Consequently, treatment strategies to target nighttime BP have come into focus. The aim of the present study was to investigate the effect of change of administration time of antihypertensive drugs. We included 41 patients with type 2 diabetes mellitus and nocturnal hypertension (nighttime systolic BP >120 mm Hg) in an open-label, crossover study. Patients were randomized to 8 weeks of either morning or bedtime administration of all of the individual's once-daily antihypertensive drugs, followed by 8 weeks of switched dosing regimen. Bedtime administration of antihypertensive drugs resulted in a significant reduction in nighttime (7.5 mm Hg; Phypertension, administration of once-daily antihypertensive drugs at bedtime may be favorable. The increased nocturnal natriuresis may reflect increased effect of bedtime-administered thiazides and renin-angiotensin system inhibitors, suggesting a potential mechanism of the observed effects on BP with chronotherapeutic intervention.

  12. Structured exercise interventions for type 2 diabetes mellitus: Strength of current evidence

    Directory of Open Access Journals (Sweden)

    Mohammed Ejas Hussain

    2011-07-01

    Full Text Available Exercise, along with medical nutrition therapy and pharmacological interventions, is an important component in the clinical management of type 2 diabetes mellitus (T2D. Current clinical guidelines on type 2 diabetes provide no detailed information on the modalities of effective exercise intervention in the treatment of type 2 diabetes. Both endurance and resistance types of exercise seem to be equally effective in improving metabolic control in patients with type 2 diabetes. Determining the best method of providing exercise is clinically relevant to this population. This paper reviews the epidemiology of diabetes and problems of physical function associated with type 2 diabetes and discuss the benefits of exercise therapy on the parameters of glycemic control and function in type 2 diabetes patients, with special reference to Asian Indians. Based on the currently available literature, it is concluded that type 2 diabetes patients should be encouraged to participate in specifically designed exercise intervention programs. Attention should be paid to the avoidance of cardiovascular and musculoskeletal deconditioning. More clinical research is warranted to establish the efficacy of different dosages of exercise intervention in a holistic approach for type 2 diabetes subpopulations within different stages of the disease and various levels of co-morbidity.

  13. No evidence of seasonality of birth in adult type 2 diabetes in Denmark

    DEFF Research Database (Denmark)

    Jensen, Camilla Bjørn; Zimmermann, Esther; Gamborg, Michael;

    2015-01-01

    AIMS/HYPOTHESIS: The season of birth might influence prenatal circumstances, which may influence the risk of developing type 2 diabetes. The aim of this study was to determine whether the diagnosis of type 2 diabetes in Denmark changed with the season of birth. METHODS: This study used data from...... on the risk of type 2 diabetes was assessed using Cox regression, with month or season of birth as the predictor. The underlying time variable was age, and follow-up started in 1977 or at age 30 years. RESULTS: The study population consisted of 223,099 people, of whom 12,486 developed adult type 2 diabetes....... Using January as the reference month, the risk of type 2 diabetes by month of birth was not statistically different for any of the 11 comparative birth months. Grouping month of birth into seasons (spring was the reference) gave essentially similar results, showing no difference in the risk of type 2...

  14. Nepalese patients’ perceptions of treatment modalities for type 2 diabetes

    Science.gov (United States)

    Sapkota, Sujata; Brien, Jo-anne E; Aslani, Parisa

    2016-01-01

    Background Perceptions and beliefs about treatment can influence patients’ adherence to treatment regimens. Perceptions, in turn, are often shaped by patients’ sociocultural context. Nepal and the Nepalese have unique sociocultural traditions and beliefs, and their perceptions of diabetes treatment remain largely unexplored. This study explored Nepalese participants’ perceptions of diabetes treatment, and whether perceptions differed between the Nepalese living in Australia and Nepal. Methods Face-to-face qualitative interviews (n=48) were conducted with Nepalese participants with type 2 diabetes in Sydney and Kathmandu. All interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Results Perceptions of diabetes treatment were similar among Nepalese participants in Australia and Nepal. There was a general reluctance to start oral antidiabetic medications and an even greater reluctance to commence parenteral (insulin) therapy. Participants preferred to try lifestyle modifications and alternative treatments such as herbs and “traditional” medicines, particularly as a first step. Unwillingness to take medications was primarily associated with the belief that, once started, these medications needed to be taken for life, and perceptions of long-term harms caused by such medications. Even when commenced on medication, participants were averse to any type of therapy escalation, for example, moving to insulin therapy. Insulin was perceived as the “last option” available for diabetes treatment. Most participants, however, did not find medication taking challenging once they had commenced treatment. Conclusion Antidiabetic medications were perceived to be harmful and unstoppable once initiated. These perceptions significantly impacted participants’ willingness to commence antidiabetic medications and therefore have the potential to adversely affect their medication-taking behavior. This study therefore highlights the need to explore

  15. Emerging links between type 2 diabetes and Alzheimer'sdisease

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Type 2 diabetes mellitus and Alzheimer's disease areboth associated with increasing age, and each increasesthe risk of development of the other. Epidemiological,clinical, biochemical and imaging studies have shownthat elevated glucose levels and diabetes are associatedwith cognitive dysfunction, the most prevalent causeof which is Alzheimer's disease. Cross sectional studieshave clearly shown such an association, whereaslongitudinal studies are equivocal, reflecting the manycomplex ways in which the two interact. Despitethe dichotomy, common risk and etiological factors(obesity, dyslipidemia, insulin resistance, and sedentaryhabits) are recognized; correction of these by lifestylechanges and pharmacological agents can be expectedto prevent or retard the progression of both diseases.Common pathogenic factors in both conditions span abroad sweep including chronic hyperglycemia per se ,hyperinsulinemia, insulin resistance, acute hypoglycemicepisodes, especially in the elderly, microvascular disease,fibrillar deposits (in brain in Alzheimer's disease and inpancreas in type 2 diabetes), altered insulin processing,inflammation, obesity, dyslipidemia, altered levels ofinsulin like growth factor and occurrence of variant formsof the protein butyrylcholinesterase. Of interest not onlydo lifestyle measures have a protective effect against thedevelopment of cognitive impairment due to Alzheimer'sdisease, but so do some of the pharmacological agentsused in the treatment of diabetes such as insulin(especially when delivered intranasally), metformin,peroxisome proliferator-activated receptors γ agonists,glucagon-like peptide-1 receptor agonists and dipeptidylpeptidase-4 inhibitors. Diabetes must be recognized asa risk for development of Alzheimer's disease; cliniciansmust ensure preventive care be given to control andpostpone both conditions, and to identify cognitiveimpairment early to manage it appropriately.

  16. Effects of Probiotic Yogurt Consumption on Cardiovascular Disease Risk Factors in Subjects with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    F mohammadi

    2015-02-01

    Conclusion: Consumption of probiotic yogurt improved lipid profile and some inflammatory biomarkers in patients with type 2 diabetes. Also, probiotic yogurt caused significant decrease in HbA1c. It is suggested that probiotic yogurt may be used as an adjunct therapy to reduce the cardiovascular disease risk factors in type 2 diabetes mellitus patients

  17. Urinary proteome analysis enables assessment of renoprotective treatment in type 2 diabetic patients with microalbuminuria

    DEFF Research Database (Denmark)

    Andersen, Sten Peder; Mischak, Harald; Zürbig, Petra;

    2010-01-01

    Previously the angiotensin II receptor blocker Irbesartan has been demonstrated to reduce the risk for progression from microalbuminuria to macroalbuminuria in type 2 diabetic patients. The purpose of this study was to evaluate the effect of treatment with Irbesartan in type 2 diabetic patients w...

  18. Magnesium in type 2 diabetes mellitus and its correlation with glycemic control

    Directory of Open Access Journals (Sweden)

    Nehal Hamdy El-said

    2015-08-01

    Conclusion: hypomagnesaemia is closely linked to type 2 diabetes mellitus and it is strongly correlated to glycemic control. We recommend to measure serum Mg in type 2 diabetes and patients who need supplementation should be considered. [Int J Res Med Sci 2015; 3(8.000: 1958-1963

  19. Insulin-degrading enzyme inhibition, a novel therapy for type 2 diabetes?

    Science.gov (United States)

    Costes, Safia; Butler, Peter C

    2014-08-01

    The insulin-degrading enzyme (IDE) has been identified as a type 2 diabetes and Alzheimer's disease susceptibility gene, though its physiological function remains unclear. Maianti et al. (2014) now propose that an IDE inhibitor may be a promising therapeutic strategy for type 2 diabetes.

  20. Type 2 diabetes in children in the Netherlands: The need for diagnostic protocols

    NARCIS (Netherlands)

    Rotteveel, J.; Belksma, E.J.; Renders, C.M.; Hirasing, R.A.; Delemarre-Van de Waal, H.A.

    2007-01-01

    Objective: The worldwide trend towards obesity in childhood is also observed in the Netherlands and one of the consequences may be type 2 diabetes. In this study, we assessed the number of children with type 2 diabetes, diagnosed by paediatricians, in the Netherlands. Methods: In 2003 and 2004 the D

  1. Combined effect of alcohol consumption and lifestyle behaviors on risk of type 2 diabetes

    NARCIS (Netherlands)

    Joosten, M.M.; Grobbee, D.E.; Verschuren, W.M.M.; Hendriks, H.F.J.; Beulens, J.W.J.

    2010-01-01

    Background: It has been suggested that the inverse association between alcohol and type 2 diabetes could be explained by moderate drinkers' healthier lifestyles. Objective: We studied whether moderate alcohol consumption is associated with a lower risk of type 2 diabetes in adults with combined low-

  2. Prognostic factors for successful insulin therapy in subjects with type 2 diabetes

    NARCIS (Netherlands)

    Wolffenbuttel, B H; Sels, J P; Rondas-Colbers, G J; Menheere, P P

    1999-01-01

    OBJECTIVE: To assess which factors influence or predict the efficacy of insulin therapy in subjects with type 2 diabetes, who were poorly controlled despite maximal doses of oral glucose lowering agents. RESEARCH DESIGN AND METHODS: Seventy-five patients with type 2 diabetes participated (mean age (

  3. Metabolic dysregulation and interventions in type 2 diabetes mellitus and HIV-lipodystrophy

    NARCIS (Netherlands)

    Wijk, J.P.H. van

    2005-01-01

    The focus of this thesis is on two aspects of metabolic dysregulation, type 2 diabetes mellitus and HIV-lipodystrophy, and the effects of insulin-sensitizing agents. Thiazolidinediones (TZDs) have received increasing attenttion for the treatment of hyperglycemia in type 2 diabetes. Currently, ther

  4. Sedentary behavior and physical activity in youth with recent onset of type 2 diabetes

    Science.gov (United States)

    With the rise of type 2 diabetes in youth, it is critical to investigate factors such as physical activity (PA) and time spent sedentary that may be contributing to this public health problem. This article describes PA and sedentary time in a large cohort of youth with type 2 diabetes and compares t...

  5. Exercise and Type 2 Diabetes: Molecular Mechanisms Regulating Glucose Uptake in Skeletal Muscle

    Science.gov (United States)

    Stanford, Kristin I.; Goodyear, Laurie J.

    2014-01-01

    Exercise is a well-established tool to prevent and combat type 2 diabetes. Exercise improves whole body metabolic health in people with type 2 diabetes, and adaptations to skeletal muscle are essential for this improvement. An acute bout of exercise increases skeletal muscle glucose uptake, while chronic exercise training improves mitochondrial…

  6. Comparison of metformin and insulin versus insulin alone for type 2 diabetes

    DEFF Research Database (Denmark)

    Hemmingsen, Bianca; Christensen, Louise Lundby; Wetterslev, Jørn;

    2012-01-01

    To compare the benefits and harms of metformin and insulin versus insulin alone as reported in randomised clinical trials of patients with type 2 diabetes.......To compare the benefits and harms of metformin and insulin versus insulin alone as reported in randomised clinical trials of patients with type 2 diabetes....

  7. Medicine on demand, medication patterns and glycemic control in patients with type 2 diabetes

    NARCIS (Netherlands)

    Lamberts, E.J.F.

    2013-01-01

    Diabetes mellitus is a metabolic disease that currently affects approximately 5% of the general population in Western countries. Type 2 diabetes mellitus accounts for 90-95% of all diabetes cases. In the last decades, the prevalence of type 2 diabetes has increased steeply due to a combination of ag

  8. Impact of Common Variation in Bone-Related Genes on Type 2 Diabetes and Related Traits

    NARCIS (Netherlands)

    Billings, Liana K.; Hsu, Yi-Hsiang; Ackerman, Rachel J.; Dupuis, Josee; Voight, Benjamin F.; Rasmussen-Torvik, Laura J.; Hercberg, Serge; Lathrop, Mark; Barnes, Daniel; Langenberg, Claudia; Hui, Jennie; Fu, Mao; Bouatia-Naji, Nabila; Lecoeur, Cecile; An, Ping; Magnusson, Patrik K.; Surakkaza, Ida; Ripatti, Samuli; Christiansen, Lene; Dalgard, Christine; Folkersen, Lasse; Grundberg, Elin; Eriksson, Per; Kaprio, Jaakko; Kyvik, Kirsten Ohm; Pedersen, Nancy L.; Borecki, Ingrid B.; Province, Michael A.; Balkau, Beverley; Froguel, Philippe; Shuldiner, Alan R.; Palmer, Lyle J.; Wareham, Nick; Meneton, Pierre; Johnson, Toby; Pankow, James S.; Karasik, David; Meigs, James B.; Kiel, Douglas P.; Florez, Jose C.

    2012-01-01

    Exploring genetic pleiotropy can provide clues to a mechanism underlying the observed epidemiological association between type 2 diabetes and heightened fracture risk. We examined genetic variants associated with bone mineral density (BMD) for association with type 2 diabetes and glycemic traits in

  9. Pregnancy outcomes in youth with type 2 diabetes: The TODAY Study experience

    Science.gov (United States)

    We evaluated pregnancy outcomes, maternal and fetal/neonatal, during the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study. The TODAY study was a randomized controlled trial comparing three treatment options for youth with type 2 diabetes. Informed consent included the req...

  10. Prediction of mortality in type 2 diabetes from health-related quality of life (ZODIAC-4)

    NARCIS (Netherlands)

    Kleefstra, N.; Houweling, S.T.; Ubink-Veltmaat, L.J.; Logtenberg, S.J.J.; Meyboom-de Jong, B.; Coyne, J.C.; Groenier, K.H.; Bilo, H.J.G.; Landman, G.

    2008-01-01

    OBJECTIVE - To investigate the relationship between health-related quality of life (HRQOL) and mortality in type 2 diabetes. RESEARCH DESIGN AND METHODS - In 1998,1,143 primary care patients with type 2 diabetes participated in the Zwolle Outpatient Diabetes project Integrating Available Care (ZODIA

  11. Low-Frequency Variants in HMGA1 Are Not Associated With Type 2 Diabetes Risk

    NARCIS (Netherlands)

    Marquez, Marcel; Huyvaert, Marlene; Perry, John R. B.; Pearson, Richard D.; Falchi, Mario; Morris, Andrew P.; Vivequin, Sidonie; Lobbens, Stephane; Yengo, Loic; Gaget, Stefan; Pattou, Francois; Poulain-Godefroy, Odile; Charpentier, Guillaume; Carlsson, Lena M. S.; Jacobson, Peter; Sjostrom, Lars; Lantieri, Olivier; Heude, Barbara; Walley, Andrew; Balkau, Beverley; Marre, Michel; Froguel, Philippe; Cauchi, Stephane

    2012-01-01

    It has recently been suggested that the low-frequency c.136-14_136-13insC variant in high-mobility group Al (HMGA1) may strongly contribute to insulin resistance and type 2 diabetes risk. In our study, we attempted to confirm that HMGA1 is a novel type 2 diabetes locus in French Caucasians. The gene

  12. Urinary proteome analysis enables assessment of renoprotective treatment in type 2 diabetic patients with microalbuminuria

    DEFF Research Database (Denmark)

    Andersen, Sten Peder; Mischak, Harald; Zürbig, Petra;

    2010-01-01

    Previously the angiotensin II receptor blocker Irbesartan has been demonstrated to reduce the risk for progression from microalbuminuria to macroalbuminuria in type 2 diabetic patients. The purpose of this study was to evaluate the effect of treatment with Irbesartan in type 2 diabetic patients...... with microalbuminuria on the urinary proteome....

  13. Efficacy and safety of sitagliptin when added to insulin therapy in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Vilsbøll, Tina; Rosenstock, J; Yki-Järvinen, H;

    2010-01-01

    To evaluate the efficacy and tolerability of sitagliptin when added to insulin therapy alone or in combination with metformin in patients with type 2 diabetes.......To evaluate the efficacy and tolerability of sitagliptin when added to insulin therapy alone or in combination with metformin in patients with type 2 diabetes....

  14. Diminished performance on response-selection tasks in type-2 diabetes

    NARCIS (Netherlands)

    Groot, P.C.; Borghouts, L.B.; Adam, J.J.; Keizer, H.A.

    2003-01-01

    Comparisons of visual perception, response-selection, and response-execution performance were made between Type 2 diabetes mellitus patients and a matched nondiabetic control group. 10 well-controlled male patients with Type 2 diabetes without diabetic complications (M age 58 yr.) and an age and IQ-

  15. The onset of type 2 diabetes: Proposal for a multi-scale model

    NARCIS (Netherlands)

    Castiglione, F.; Tieri, P.; Graaf, A. de; Franceschi, C.; Liò, P.; Ommen, B. van; Mazzà, C.; Tuchel, A.; Bernaschi, M.; Samson, C.; Colombo, T.; Castellani, G.C.; Capri, M.; Garagnani, P.; Salvioli, S.; Nguyen, V.A.; Bobeldijk-Pastorova, I.; Krishnan, S.; Cappozzo, A.; Sacchetti, M.; Morettini, M.; Ernst, M.

    2013-01-01

    Background: Type 2 diabetes mellitus (T2D) is a common age-related disease, and is a major health concern, particularly in developed countries where the population is aging, including Europe. The multi-scale immune system simulator for the onset of type 2 diabetes (MISSION-T2D) is a European Union-f

  16. The Effectiveness of Different Diet Strategies to Reduce Type 2 Diabetes Risk in Youth

    Science.gov (United States)

    Gow, Megan L.; Garnett, Sarah P.; Baur, Louise A.; Lister, Natalie B.

    2016-01-01

    Type 2 diabetes in children and adolescents has become a prominent clinical issue in recent decades. Increasing numbers of young people have risk factors for type 2 diabetes, particularly obesity, indicating the need for effective type 2 diabetes prevention strategies. The aim of this review was to identify specific dietary strategies that optimize improvements in risk factors for type 2 diabetes in youth and hence reduce the risk of type 2 diabetes development. Our review of the current literature indicates that dietary interventions lead to weight loss when intervention adherence is high. However, in addition to weight loss, a diet that is reduced in carbohydrates may optimize improvements in other type 2 diabetes risk factors, including insulin resistance and hyperglycemia. While further research is needed to confirm this finding, reduced carbohydrate diets may include a very low-carbohydrate diet, a very low-energy diet, a lower-glycemic-index diet, and/or an intermittent fasting diet. This array of dietary strategies provides a suite of intervention options for clinicians to recommend to young people at risk of type 2 diabetes. However, these findings are in contrast to current guidelines for the prevention of type 2 diabetes in adults which recommends a low-fat, high-carbohydrate diet. PMID:27517953

  17. Multifactorial treatment increases endothelial progenitor cells in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Reinhard, H; Jacobsen, P Karl; Lajer, Marianne

    2010-01-01

    Endothelial progenitor cells (EPC) augment vascular repair and neovascularisation. Patients with type 2 diabetes have reduced EPC and increased risk of cardiovascular disease (CVD), which is reduced by multifactorial intervention. Our aim, therefore, was to evaluate in type 2 diabetic patients...

  18. Metabolic Effects of High Altitude Trekking in Patients With Type 2 Diabetes

    NARCIS (Netherlands)

    de Mol, Pieter; Fokkert, Marion J.; de Vries, Suzanna T.; de Koning, Eelco J. P.; Dikkeschei, Bert D.; Gans, Rijnold O. B.; Tack, Cees J.; Bilo, Henk J. G.

    2012-01-01

    OBJECTIVE-Limited information is available regarding the metabolic effects of high altitude trekking in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS-Thirteen individuals with type 2 diabetes took part, in a 12-day expedition to the summit of Mount Toubkal (altitude, 4,167 m), Morocco,

  19. Metabolic effects of high altitude trekking in patients with type 2 diabetes

    NARCIS (Netherlands)

    Mol, P. de; Fokkert, M.J.; Vries, S.T. de; Koning, E.J. de; Dikkeschei, B.D.; Gans, R.O.; Tack, C.J.J.; Bilo, H.J.

    2012-01-01

    OBJECTIVE Limited information is available regarding the metabolic effects of high altitude trekking in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Thirteen individuals with type 2 diabetes took part in a 12-day expedition to the summit of Mount Toubkal (altitude, 4,167 m), Morocco, a

  20. Hydrogen peroxide production is not primarily increased in human myotubes established from type 2 diabetic subjects

    DEFF Research Database (Denmark)

    Minet, A D; Gaster, M

    2011-01-01

    Increased oxidative stress and mitochondrial dysfunction have been implicated in the development of insulin resistance in type 2 diabetes. To date, it is unknown whether increased mitochondrial reactive oxygen species (ROS) production in skeletal muscle from patients with type 2 diabetes is prima...

  1. Impact of type 2 diabetes susceptibility variants on quantitative glycemic traits reveals mechanistic heterogeneity

    DEFF Research Database (Denmark)

    Dimas, Antigone S; Lagou, Vasiliki; Barker, Adam

    2013-01-01

    Patients with established type 2 diabetes display both beta-cell dysfunction and insulin resistance. To define fundamental processes leading to the diabetic state, we examined the relationship between type 2 diabetes risk variants at 37 established susceptibility loci and indices of proinsulin pr...

  2. Type 2 diabetes mellitus impairs bone healing of dental implants in GK rats.

    Science.gov (United States)

    Wang, Feng; Song, Ying-liang; Li, De-hua; Li, Cui-xia; Wang, Yao; Zhang, Ning; Wang, Bao-gang

    2010-04-01

    Type 2 diabetes is an increasingly prevalent disease with oral health manifestations. In this study, titanium implants were placed in the femora of 10 type 2 diabetic and 10 age-matched normal rats. We compared the results of bone histomorphometry around the dental implants at 4 and 8 weeks postsurgery.

  3. Tubular markers are associated with decline in kidney function in proteinuric type 2 diabetic patients

    DEFF Research Database (Denmark)

    Nielsen, Stine; Reinhard, Henrik; Zdunek, Dietmar

    2012-01-01

    Our aim was to investigate u-NGAL, u-KIM1 and p-FGF23 and prediction of decline in kidney function in type 2 diabetic patients with proteinuria.......Our aim was to investigate u-NGAL, u-KIM1 and p-FGF23 and prediction of decline in kidney function in type 2 diabetic patients with proteinuria....

  4. The Effectiveness of Different Diet Strategies to Reduce Type 2 Diabetes Risk in Youth.

    Science.gov (United States)

    Gow, Megan L; Garnett, Sarah P; Baur, Louise A; Lister, Natalie B

    2016-08-09

    Type 2 diabetes in children and adolescents has become a prominent clinical issue in recent decades. Increasing numbers of young people have risk factors for type 2 diabetes, particularly obesity, indicating the need for effective type 2 diabetes prevention strategies. The aim of this review was to identify specific dietary strategies that optimize improvements in risk factors for type 2 diabetes in youth and hence reduce the risk of type 2 diabetes development. Our review of the current literature indicates that dietary interventions lead to weight loss when intervention adherence is high. However, in addition to weight loss, a diet that is reduced in carbohydrates may optimize improvements in other type 2 diabetes risk factors, including insulin resistance and hyperglycemia. While further research is needed to confirm this finding, reduced carbohydrate diets may include a very low-carbohydrate diet, a very low-energy diet, a lower-glycemic-index diet, and/or an intermittent fasting diet. This array of dietary strategies provides a suite of intervention options for clinicians to recommend to young people at risk of type 2 diabetes. However, these findings are in contrast to current guidelines for the prevention of type 2 diabetes in adults which recommends a low-fat, high-carbohydrate diet.

  5. Reduced lung function is independently associated with increased risk of type 2 diabetes in Korean men

    Directory of Open Access Journals (Sweden)

    Kwon Chang-Hee

    2012-04-01

    Full Text Available Abstract Background Reduced lung function is associated with incident insulin resistance and diabetes. The aim of this study was to assess the relationship between lung function and incident type 2 diabetes in Korean men. Methods This study included 9,220 men (mean age: 41.4 years without type 2 diabetes at baseline who were followed for five years. Subjects were divided into four groups according to baseline forced vital capacity (FVC (% predicted and forced expiratory volume in one second (FEV1 (% predicted quartiles. The incidence of type 2 diabetes at follow-up was compared according to FVC and FEV1 quartiles. Results The overall incidence of type 2 diabetes was 2.2%. Reduced lung function was significantly associated with the incidence of type 2 diabetes after adjusting for age, BMI, education, smoking, exercise, alcohol, and HOMA-IR. Both FVC and FEV1 were negatively associated with type 2 diabetes (P 1 had a significantly higher odds ratio for type 2 diabetes compared with the highest quartile after adjusting for age and BMI (2.15 [95% CI 1.02-4.57] and 2.19 [95% CI 1.09-4.42]. Conclusions Reduced lung function is independently associated with the incidence of type 2 diabetes in Korean men.

  6. Characteristics of dysfunction of islet β-cell in newly diagnosed type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    李延兵

    2006-01-01

    Objective To investigate the characteristics of the dysfunction of isletβ-cell in newly diagnosed type 2 diabetic patients. Methods Intravenous glucose tolerance test (IVGTT) was carried out on 352 newly diagnosed type 2 diabetic patients and 48 subjects with normal glucose tolerance (NGT) and then blood samples were collected 1, 2, 4, 6, and 10 minutes later to measure the

  7. Plasma osteoprotegerin concentrations in peripheral sensory neuropathy in Type 1 and Type 2 diabetic patients

    DEFF Research Database (Denmark)

    Nybo, M; Poulsen, M K; Grauslund, J

    2010-01-01

    Osteoprotegerin (OPG) has been linked to different diabetes complications, including cardiovascular disease, and new findings have indicated a specific role in diabetic peripheral neuropathy, but the exact mechanism is unknown. To investigate a possible association between OPG and diabetic...... peripheral sensory neuropathy, we therefore analysed plasma OPG in Type 1 and Type 2 diabetic patients with and without peripheral neuropathy....

  8. Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus

    NARCIS (Netherlands)

    Muller, L M A J; Gorter, K J; Hak, E; Goudzwaard, W L; Schellevis, F G; Hoepelman, A I M; Rutten, G E H M

    2005-01-01

    BACKGROUND: Clinical data on the association of diabetes mellitus with common infections are virtually lacking, not conclusive, and often biased. We intended to determine the relative risks of common infections in patients with type 1 and type 2 diabetes mellitus (DM1 and DM2, respectively). METHODS

  9. Ceramide content is higher in type I compared to type II fibers in obesity and type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Kristensen, Ditte Bech; Prats Gavalda, Clara; Ara, Ignacio;

    2012-01-01

    This study investigated fiber-type-specific muscle ceramide content in obese subjects and type 2 diabetes patients. Two substudies, one which compared type 2 diabetes patients to both lean- and obese BMI-matched subjects and the other study which compared lean body-matched post-obese, obese...... index was higher in lean compared to type 2 diabetes patients and obese controls. Also in control and post-obese subjects, a higher insulin sensitivity was observed compared to obese subjects. Ceramide content was consistently higher in type I than in type II muscle fibers and higher in deltoideus than...... vastus lateralis across all groups. No significant differences between groups were observed in ceramide content in either of the two substudies. In human skeletal muscle, ceramide content was higher in type I than in type II fibers in patients with type 2 diabetes and in obese subjects, but overall...

  10. Severe vulvovaginitis as a presenting problem of type 2 diabetes in adolescent girls: a case series.

    Science.gov (United States)

    Curran, Jacqueline; Hayward, Jenette; Sellers, Elizabeth; Dean, Heather

    2011-04-01

    This article describes the presentation of 4 adolescent girls who sought medical attention for severe vulvovaginitis and were subsequently found to have type 2 diabetes. Symptomatic vulvovaginitis is rare in adolescent girls, and its presence should alert health care providers to test for underlying hyperglycemia. These 4 girls represent 8.5% of the females with new-onset type 2 diabetes during a 3-year period (2007-2009). The 4 cases fulfilled the current Canadian Diabetes Association screening criteria for type 2 diabetes in youth, yet none of these girls had been screened. These cases highlight the need for better awareness of screening criteria for type 2 diabetes in adolescents. Consideration should be given in clinical practice guidelines to including the presence of unusual or severe infections as a risk factor for type 2 diabetes in youth.

  11. Intravascular ultrasound assessment of remodelling and reference segment plaque burden in type-2 diabetic patients

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Mintz, Gary S;

    2007-01-01

    with type-2 diabetes mellitus. METHODS AND RESULTS: We used pre-intervention IVUS to study 62 de novo lesions in 43 patients with type-2 diabetes mellitus. The lesion site was the image slice with the smallest lumen cross-sectional area (CSA). The proximal and distal reference segments were the most normal...... size [slope = -0.12 (95% CI -0.17 to -0.07); P type-2 diabetes mellitus. CONCLUSION: Lesions in type-2 diabetic patients are different from previous reports in non-diabetics. Lesions in type-2 diabetics are characterized by a large reference segment plaque burden......AIMS: Intravascular ultrasound (IVUS) assesses arterial remodelling by comparing the lesion external elastic membrane (EEM) with the reference segments; however, reference segments are rarely disease-free. The aim was to assess lesion and reference segment remodelling and plaque burden in patients...

  12. Patient perspectives on type 2 diabetes and medicine use during Ramadan among Pakistanis in Denmark

    DEFF Research Database (Denmark)

    Mygind, Anna; Kristiansen, Maria; Wittrup, Inge

    2013-01-01

    (six interviewers). Results All interviewees pointed out that Islam allows ill people to refrain from fasting during Ramadan. However, all had fasted during Ramadan despite being diagnosed with type 2 diabetes. While fasting, they adapted their use of medicines in different ways, e.g. by changing...... on whether or not to fast. Instead, friends and relatives, especially those with type 2 diabetes, were considered important to the decision-making process. Conclusion For people with Muslim background and a chronic condition, fasting during Ramadan may mean changes in medicine use that are not always......Background Type 2 diabetes is highly prevalent among people of Pakistani background. Studies show that adherence to medicines is complicated for people with type 2 diabetes in general. Also, studies indicate that many people with type 2 diabetes and Muslim background fast during the month...

  13. Diabetic ketoacidosis in type 1 and type 2 diabetes mellitus – clinical and biochemical differences

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    N. Krdžalić

    2007-02-01

    Full Text Available The goal of this retrospective study was to establish differences in clinical picture, biochemical parametres and precipitating factors in patiens with diabetic ketoacidosis in type 1 and type 2 diabetes. A total number of 25 patients was hospitalised in the Intensive Case Unit of the Department for Internal Diseases of the Cantonal Hospital in Zenica in the period of 14 months. Most patients had type 1 diabetes whose ketoacidosis showed symptoms of vomiting, stomachache and it was most often caused by a discontinued application of insulin or an infection. In patients with type 2 diabetes an inadequate regulation of glycemia had been noticed before hospitalisation and diabetic ketoacidosis was manifested by polyuria, polyphagia, polydipsia and weight loss. Precipitating factor in most patients with type 2 diabetes was an infection. In addition, a significant number of patients were newly discovered diabetics whose precipitating factor in most cases could not be found and the symptoms of the disease correspond to insulin dependent patients. The observed biochemical parameters did not show statistically significant differences between the groups of patients suffering from different types of diabetes. This study has shown that diabetic ketoacidosis can occur in type 2 diabetes. DKA can be prevented by education of patients, improvement of health care as well as improved communication between patients and doctors of family medicine.

  14. Management of Type 2 Diabetes Mellitus through Telemedicine.

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    Claudio Carallo

    Full Text Available Type 2 diabetes mellitus T2DM has a huge and growing burden on public health, whereas new care models are not implemented into clinical practice; in fact the purpose of this study was to test the effectiveness of a program of integrated care for T2DM, compared with ordinary diligence."Progetto Diabete Calabria" is a new organizational model for the management of patients with diabetes mellitus, based on General Practitioners (GPs empowerment and the use of a web-based electronic health record, shared in remote consultations among GPs and Hospital Consultants. One-year change in glucose and main cardiovascular risk factors control in 104 patients (Cases following this integrated care program has been evaluated and compared with that of 208 control patients (Controls matched for age, gender, and cardiometabolic profile, and followed in an ordinary outpatient medical management by the Consultants only. Both patient groups had Day Hospitals before and after the study period.The mean number of accesses to the Consultants during the study was 0.6 ± 0.9 for Cases, and 1.3 ± 1.5 for Controls (p<0.0001. At follow-up, glycated hemoglobin (HbA1c significantly decreased from 58 ± 6 to 54 ± 8 mmol/mol in Cases only (p=0.01; LDL cholesterol decreased in both groups; body mass index decreased in Cases only, from 31.0 ± 4.8 to 30.5 ± 4.6 kg/m(2 (p=0.03.The present study demonstrates that a health care program based on GPs empowerment and taking care plus remote consultation with Consultants is at least as effective as standard outpatient management, in order to improve the control of T2DM.

  15. Teneligliptin in management of type 2 diabetes mellitus.

    Science.gov (United States)

    Sharma, Surendra Kumar; Panneerselvam, A; Singh, K P; Parmar, Girish; Gadge, Pradeep; Swami, Onkar C

    2016-01-01

    Teneligliptin is a recently developed oral dipeptidyl peptidase 4 inhibitor indicated for the management of type 2 diabetes mellitus (T2DM) in adults along with diet and exercise. Teneligliptin has been recently available in Japan (Teneria(®)), Argentina (Teneglucon(®)), and India (Tenepure; Teneza) at relatively affordable price. This is a positive step toward the management of T2DM in developing countries, where the cost of medicine is out-of-pocket expenditure and is a limiting factor for health care. This review evaluates the efficacy and safety of teneligliptin in the management of T2DM. Teneligliptin has been systematically evaluated in T2DM as monotherapy with diet and exercise and in combination with metformin, glimepiride, pioglitazone, and insulin in short-term (12 weeks) and long-term (52 weeks) studies. These studies have reported a reduction in HbA1c of 0.8%-0.9% within 12 weeks of therapy. Two 52-week studies reported sustained improvement in glycemic control with teneligliptin. Teneligliptin has been found to be well tolerated, and the safety profile is similar to other dipeptidyl peptidase 4 inhibitors. Hypoglycemia and constipation are the main adverse events. Teneligliptin can be administered safely to patients with mild, moderate, or severe renal impairment or end-stage renal disease without dose adjustment. Similarly, it can be used in patients with mild-to-moderate hepatic impairment. Teneligliptin is effective and well tolerated and may have an important role in the management of T2DM.

  16. Myocardial dysfunction and cardiovascular disease in type 2 diabetes.

    Science.gov (United States)

    Ofstad, Anne Pernille

    2016-07-01

    Type 2 diabetes mellitus (T2DM) is strongly associated with increased risk of myocardial dysfunction and cardiovascular disease (CVD), two separate conditions which often co-exist and influence each other's course. The prevalence of myocardial dysfunction may be as high as 75% in T2DM populations but is often overlooked due to the initial asymptomatic nature of the disease, complicating co-morbidities such as coronary artery disease (CAD) and obesity, and the lack of consensus on diagnostic criteria. More sensitive echocardiographic applications are furthermore needed to improve detection of early subclinical changes in myocardial function which do not affect conventional echocardiographic parameters. The pathophysiology of the diabetic myocardial dysfunction is not fully elucidated, but involves hyperglycemia and high levels of free fatty acids. It evolves over several years and increases the risk of developing overt HF, and is suggested to at least in part account for the worse outcome seen in T2DM individuals after cardiac events. CAD and stroke are the most frequent CV manifestations among T2DM patients and relate to a large degree to the accelerated atherosclerosis driven by inflammation. Diagnosing CAD is challenging due to the lower sensitivity inherent in the diagnostic tests and there is thus a need for new biomarkers to improve prediction and detection of CAD. It seems that a multi-factorial approach (i.e. targeting several CV risk factors simultaneously) is superior to a strict glucose lowering strategy in reducing risk for macrovascular events, and recent research may even support an effect also on HF outcomes.

  17. Direct medical cost of type 2 diabetes in singapore.

    Directory of Open Access Journals (Sweden)

    Charmaine Shuyu Ng

    Full Text Available Due to the chronic nature of diabetes along with their complications, they have been recognised as a major health issue, which results in significant economic burden. This study aims to estimate the direct medical cost associated with type 2 diabetes mellitus (T2DM in Singapore in 2010 and to examine both the relationship between demographic and clinical state variables with the total estimated expenditure. The National Healthcare Group (NHG Chronic Disease Management System (CDMS database was used to identify patients with T2DM in the year 2010. DM-attributable costs estimated included hospitalisations, accident and emergency (A&E room visits, outpatient physician visits, medications, laboratory tests and allied health services. All charges and unit costs were provided by the NHG. A total of 500 patients with DM were identified for the analyses. The mean annual direct medical cost was found to be $2,034, of which 61% was accounted for by inpatient services, 35% by outpatient services, and 4% by A&E services. Independent determinants of total costs were DM treatments such as the use of insulin only (p<0.001 and the combination of both oral medications and insulin (p=0.047 as well as having complications such as cerebrovascular disease (p<0.001, cardiovascular disease (p=0.002, peripheral vascular disease (p=0.001, and nephropathy (p=0.041. In this study, the cost of DM treatments and DM-related complications were found to be strong determinants of costs. This finding suggests an imperative need to address the economic burden associated with diabetes with urgency and to reorganise resources required to improve healthcare costs.

  18. Epigenetic mechanisms of endothelial dysfunction in type 2 diabetes.

    Science.gov (United States)

    Prattichizzo, Francesco; Giuliani, Angelica; Ceka, Artan; Rippo, Maria Rita; Bonfigli, Anna Rita; Testa, Roberto; Procopio, Antonio Domenico; Olivieri, Fabiola

    2015-01-01

    The development of type-2 diabetes mellitus (T2DM) and its complications is largely due to the complex interaction between genetic factors and environmental influences, mainly dietary habits and lifestyle, which can either accelerate or slow down disease progression. Recent findings suggest the potential involvement of epigenetic mechanisms as a crucial interface between the effects of genetic predisposition and environmental factors. The common denominator of environmental factors promoting T2DM development and progression is that they trigger an inflammatory response, promoting inflammation-mediated insulin resistance and endothelial dysfunction. Proinflammatory stimuli, including hyperglycemia, oxidative stress, and other inflammatory mediators, can affect epigenetic mechanisms, altering the expression of specific genes in target cells without changes in underlying DNA sequences. DNA methylation and post-translational histone modifications (PTHMs) are the most extensively investigated epigenetic mechanisms. Over the past few years, non-coding RNA, including microRNAs (miRNAs), have also emerged as key players in gene expression modulation. MiRNAs can be actively released or shed by cells in the bloodstream and taken up in active form by receiving cells, acting as efficient systemic communication tools. The miRNAs involved in modulation of inflammatory pathways (inflammamiRs), such as miR-146a, and those highly expressed in endothelial lineages and hematopoietic progenitor cells (angiomiRs), such as miR-126, are the most extensively studied circulating miRNAs in T2DM. However, data on circulating miRNA signatures associated with specific diabetic complications are still lacking. Since immune cells and endothelial cells are primarily involved in the vascular complications of T2DM, their relative contribution to circulating miRNA signatures needs to be elucidated. An integrated approach encompassing different epigenetic mechanisms would have the potential to

  19. Emerging treatments in type 2 diabetes: focus on canagliflozin

    Science.gov (United States)

    Rosiak, Marek; Grzeszczak, Susanna; Kosior, Dariusz A; Postuła, Marek

    2014-01-01

    Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder, which affects more than 300 million people globally. The common effect of uncontrolled diabetes is the state of hyperglycemia, which results from beta-cell dysfunction as well as insulin resistance, which is accompanied with microvascular and macrovascular complications. As hyperglycemia defines diabetes, glycemic control is fundamental to the management of diabetes. Sodium glucose co-transporter 2 inhibitors (SGLT2) are a new group of oral antidiabetic medications that act by blocking the reabsorption of glucose, causing it to be excreted in the urine. Canagliflozin was the first SGLT2 inhibitor to be approved in the US by the Food and Drug Administration for the treatment and control of T2DM and on September 19, 2013, the Committee for Medicinal Products for Human Use of the European Medicines Agency adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Invokana®. Canagliflozin is a SGLT2 inhibitor, which acts upon the proximal tubules of the kidneys and reduces the renal threshold for glucose. It is highly selective, binding 250 times more potently to SGLT2 than sodium glucose co-transporter 1 inhibitor. This action allows a higher amount of glucose to be excreted within the urine, causing the patient’s plasma glucose level to be decreased and indirectly causing weight loss. Among the most common adverse events are hypoglycemia, headache, nausea, female genital and urinary tract infections, nasopharyngitis, and transient postural dizziness. Given its high efficacy in reducing hyperglycemia and good safety profile as either monotherapy or an add-on treatment to metformin, sulfonylureas, or insulin, canagliflozin seems to be a promising antihyperglycemic drug. Nevertheless, further large-scale and long-term studies should be conducted to evaluate the impact of canagliflozin on cardiovascular risk in T2DM patients. PMID:25187722

  20. Cytokine profile and lymphocyte subsets in type 2 diabetes

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    C.O. Francisco

    2016-01-01

    Full Text Available Type 2 diabetes mellitus (T2D is a metabolic disease with inflammation as an important pathogenic background. However, the pattern of immune cell subsets and the cytokine profile associated with development of T2D are unclear. The objective of this study was to evaluate different components of the immune system in T2D patients' peripheral blood by quantifying the frequency of lymphocyte subsets and intracellular pro- and anti-inflammatory cytokine production by T cells. Clinical data and blood samples were collected from 22 men (51.6±6.3 years old with T2D and 20 nonsmoking men (49.4±7.6 years old who were matched for age and sex as control subjects. Glycated hemoglobin, high-sensitivity C-reactive protein concentrations, and the lipid profile were measured by a commercially available automated system. Frequencies of lymphocyte subsets in peripheral blood and intracellular production of interleukin (IL-4, IL-10, IL-17, tumor necrosis factor-α, and interferon-γ cytokines by CD3+ T cells were assessed by flow cytometry. No differences were observed in the frequency of CD19+ B cells, CD3+CD8+ and CD3+CD4+ T cells, CD16+56+ NK cells, and CD4+CD25+Foxp3+ T regulatory cells in patients with T2D compared with controls. The numbers of IL-10- and IL-17-producing CD3+ T cells were significantly higher in patients with T2D than in controls (P<0.05. The frequency of interferon-γ-producing CD3+ T cells was positively correlated with body mass index (r=0.59; P=0.01. In conclusion, this study shows increased numbers of circulating IL-10- and IL-17-producing CD3+ T cells in patients with T2D, suggesting that these cytokines are involved in the immune pathology of this disease.

  1. The oral microflora in obesity and type-2 diabetes

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    Edward Shillitoe

    2012-10-01

    Full Text Available Background: Type 2 diabetes mellitus (T2DM is prevalent in people with obesity. It has been proposed that these conditions are related to specific features of the microflora of the mouth and lower gastrointestinal (GI tract. Hyperglycemia often resolves quickly after Roux-en-Y gastric bypass (RYGB but the role of the GI microflora cannot be examined easily because of reduced intestinal mobility. We propose that the study of microorganisms present in the mouth of patients undergoing RYGB will contribute to our understanding of the role of bacteria in the pathogenesis of T2DM. Objective: To conduct a feasibility study to examine differences in oral microbes in obese patients with and without T2DM and to determine whether it is feasible to measure changes after gastric bypass surgery. Methods: Individuals with morbid obesity (n=29, of whom 13 had T2DM, were studied. Oral rinses, stool samples, and blood samples were obtained before RYGB, and oral rinses and blood samples were obtained at 2 and 12 weeks postsurgery. Results: Prior to surgery, participants with T2DM had slightly higher total levels of oral bacteria than those without diabetes. Those with HbA1c > 6.5% had rather lower levels of Bifidobacteria in the mouth and stool. At 2 weeks post-RYGB, patients with T2DM were able to reduce or discontinue their hypoglycemic medications. Stool samples could not be obtained but oral rinses were readily available. The levels of oral Bifidobacteria had increased tenfold and levels of circulating endotoxin and tumor necrosis factor-alpha had decreased. Conclusions: The study of oral bacteria before and after RYGB is feasible and should be tested in larger patient populations to increase our understanding of the role of microorganisms in the pathogenesis of obesity and T2DM.

  2. Type 2 Diabetes Mellitus and Thoracic Aortic Aneurysm and Dissection

    Science.gov (United States)

    Jiménez-Trujillo, Isabel; González-Pascual, Montserrat; Jiménez-García, Rodrigo; Hernández-Barrera, Valentín; de Miguel-Yanes, José Mª; Méndez-Bailón, Manuel; de Miguel-Diez, Javier; Salinero-Fort, Miguel Ángel; Perez-Farinos, Napoleón; Carrasco-Garrido, Pilar; López-de-Andrés, Ana

    2016-01-01

    Abstract To describe trends in the rates of discharge due to thoracic aortic aneurysm and dissection (TAAD) among patients with and without type 2 diabetes in Spain (2001–2012). We used national hospital discharge data to select all of the patients who were discharged from the hospital after TAAD. We focused our analysis on patients with TAAD in the primary diagnosis field. Discharges were grouped by diabetes status (diabetic or nondiabetic). Incidence was calculated overall and stratified by diabetes status. We divided the study period into 4 periods of 3 years each. We analyzed diagnostic and surgical procedures, length of stay, and in-hospital mortality. We identified 48,746 patients who were discharged with TAAD. The rates of discharge due to TAAD increased significantly in both diabetic patients (12.65 cases per 100,000 in 2001/2003 to 23.92 cases per 100,000 in 2010/2012) and nondiabetic patients (17.39 to 21.75, respectively). The incidence was higher among nondiabetic patients than diabetic patients in 3 of the 4 time periods. The percentage of patients who underwent thoracic endovascular aortic repair increased in both groups, whereas the percentage of patients who underwent open repair decreased. The frequency of hospitalization increased at a higher rate among diabetic patients (incidence rate ratio 1.14, 95% confidence interval [CI] 1.07–1.20) than among nondiabetic patients (incidence rate ratio 1.08, 95% CI 1.07–1.11). The in-hospital mortality was lower in diabetic patients than in nondiabetic patients (odds ratio 0.83, 95% CI 0.69–0.99). The incidence rates were higher in nondiabetic patients. Hospitalizations seemed to increase at a higher rate among diabetic patients. Diabetic patients had a significantly lower mortality, possibly because of earlier diagnoses, and improved and more readily available treatments. PMID:27149499

  3. Uncovering sensory axonal dysfunction in asymptomatic type 2 diabetic neuropathy

    Science.gov (United States)

    Sung, Jia-Ying; Tani, Jowy; Chang, Tsui-San; Lin, Cindy Shin-Yi

    2017-01-01

    This study investigated sensory and motor nerve excitability properties to elucidate the development of diabetic neuropathy. A total of 109 type 2 diabetes patients were recruited, and 106 were analyzed. According to neuropathy severity, patients were categorized into G0, G1, and G2+3 groups using the total neuropathy score-reduced (TNSr). Patients in the G0 group were asymptomatic and had a TNSr score of 0. Sensory and motor nerve excitability data from diabetic patients were compared with data from 33 healthy controls. Clinical assessment, nerve conduction studies, and sensory and motor nerve excitability testing data were analyzed to determine axonal dysfunction in diabetic neuropathy. In the G0 group, sensory excitability testing revealed increased stimulus for the 50% sensory nerve action potential (P<0.05), shortened strength-duration time constant (P<0.01), increased superexcitability (P<0.01), decreased subexcitability (P<0.05), decreased accommodation to depolarizing current (P<0.01), and a trend of decreased accommodation to hyperpolarizing current in threshold electrotonus. All the changes progressed into G1 (TNSr 1–8) and G2+3 (TNSr 9–24) groups. In contrast, motor excitability only had significantly increased stimulus for the 50% compound motor nerve action potential (P<0.01) in the G0 group. This study revealed that the development of axonal dysfunction in sensory axons occurred prior to and in a different fashion from motor axons. Additionally, sensory nerve excitability tests can detect axonal dysfunction even in asymptomatic patients. These insights further our understanding of diabetic neuropathy and enable the early detection of sensory axonal abnormalities, which may provide a basis for neuroprotective therapeutic approaches. PMID:28182728

  4. Arterial Stiffness in Nonhypertensive Type 2 Diabetes Patients in Ghana

    Science.gov (United States)

    Antwi, Daniel A.; Gyan, Ben

    2016-01-01

    Background. Increased arterial stiffness is an independent cardiovascular risk factor in diabetes patients and general population. However, the contribution of diabetes to arterial stiffness is often masked by coexistent obesity and hypertension. In this study, we assessed arterial stiffness in nonhypertensive, nonobese type 2 diabetes (T2DM) patients in Ghana. Methods. In case-control design, 166 nonhypertensive, nonobese participants, comprising 96 T2DM patients and 70 nondiabetes controls, were recruited. Peripheral and central blood pressure (BP) indices were measured, and arterial stiffness was assessed as aortic pulse wave velocity (PWVao), augmentation index (AIx), cardioankle vascular index (CAVI), and heart-ankle pulse wave velocity (haPWV). Results. With similar peripheral and central BP indices, T2DM patients had higher PWVao (8.3 ± 1 versus 7.8 ± 1.3, p = 0.044) and CAVI (7.9 ± 1.2 versus 6.9 ± 0.7, p = 0.021) than nondiabetic control. AIx and haPWV were similar between T2DM and nondiabetic controls. Multiple regression models showed that, in the entire study participants, the major determinants of PWVao were diabetes status, age, gender, systolic BP, and previous smoking status (β = 0.22, 0.36, 0.48, 0.21, and 0.25, resp.; all p < 0.05); the determinants of CAVI were diabetes status, age, BMI, heart rate, HbA1c, total cholesterol, HDL cholesterol, and previous smoking status (β = 0.21, 0.38, 0.2, 0.18, 0.24. 0.2, −0.19, and 0.2, resp.; all p < 0.05). Conclusion. Our findings suggest that nonhypertensive, nonobese T2DM patients have increased arterial stiffness without appreciable increase in peripheral and central pressure indices.

  5. Radiation-modified albumin in type 2 diabetic patients

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    Galina Gorbenko

    2013-02-01

    Full Text Available Objectives: Diabetes mellitus has been one of the most crippling diseases that man has seen, and its prevalence has risen dramatically over the past two decades. Currently, there are over 150 million diabetics worldwide and this number is likely to increase to 300 million or more by the year 2025. Diabetes mellitus increases the risk of many disorders including cardiovascular diseases. Understanding the molecular properties of diabetic progression is a big challenge in the system biology era. The aim of this study is to determine association in albumin modifications between Chernobyl clean-up workers with and without type 2 diabetes mellitus. Methods: ABM (3-aminobenzanthrone derivative developed in Daugavpils University, Latvia has been previously shown as a potential biomarker for determination of the immune state of patients with different pathologies. In this study several aspects of plasma albumin alterations in the group of Chernobyl clean-up workers with diabetes mellitus in relation to the group of workers without diabetes mellitus and people having no professional contact with radioactivity were determined. The following parameters were examined: (1 spectral characteristics of ABM in blood plasma; (2 effective and total albumin concentration in blood plasma; and (3 quantitative parameters of albumin auto-fluorescence. Results: Screening of individuals with diabetes mellitus 25-26 years after their work in Chernobyl revealed two groups of patients differing in structural and functional properties of membrane. The revealed structural modifications of membrane are dependent on radiation-induced factors. Concomitant diseases (diabetes mellitus, cardiovascular diseases reinforce radiation-induced effects. Conclusion: ABM is a sensitive probe of albumin alterations; it can be used to elucidate the changes in protein systems. Significant differences in albumin dynamics exist between the control group (donors and that of diabetics and non

  6. Lipid profile of type 2 diabetic and hypertensive patients in the Jamaican population

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    Lorenzo Gordon

    2010-01-01

    Full Text Available Aims : Previous studies have shown that diabetes mellitus (DM increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods : The study included 107 type 2 diabetic patients (41 males and 66 females, and 122 hypertensive type 2 diabetic patients (39 males and 83 females, aged 15 years and older. Total cholesterol (TC, triglycerides (TG, low density lipoprotein-cholesterol (LDL-C, very low density lipoprotein-cholesterol (VLDL-C and high density lipoprotein-cholesterol (HDL-C concentrations were assayed for each group using standard biochemical methods. Results : The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05. Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L than hypertensive non-diabetic males (5.76±1.57 mmol/L; P 0.05. Conclusion : This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males.

  7. Recent developments and emerging therapies for type 2 diabetes mellitus.

    Science.gov (United States)

    Evans, A J; Krentz, A J

    1999-08-01

    Most patients with type 2 (non-insulin-dependent) diabetes mellitus require pharmacotherapy, initially as monotherapy and subsequently in combination, as adjuncts to diet and exercise. Exogenous insulin is ultimately required in a substantial proportion, reflecting the progressive natural history of the disease. Sulphonylureas and biguanides have been employed for over 4 decades as oral antidiabetic agents, but they have a limited capacity to provide long term glycaemic control and can cause serious adverse effects. Thus, more efficacious and tolerable antidiabetic agents are required. Recent years have witnessed the introduction of agents with novel modes of action, that is, the alpha-glucosidase inhibitors acarbose and miglitol (which reduce postprandial hyperglycaemia) and the first of the thiazolidinedione insulinsensitising drugs--troglitazone and rosiglitazone. Although the former has been withdrawn in some countries due to adverse effects, another 'glitazone' pioglitazone is expected to be approved in the near future. Other recently introduced drugs include glimepiride and the meglitinide insulin secretagogue, repaglinide. Attention is also focusing increasingly on combination therapy using insulin together with sulphonylureas, metformin or troglitazone. Rapid-acting insulin analogues are now being used as alternatives to conventional insulins; their role in the management of type 2 diabetes mellitus is presently uncertain but reports of a reduced frequency of hypoglycaemia are encouraging. The development of new drugs aims to counter the principal metabolic defects of the disorder, respectively, relative insulin deficiency and insulin resistance. Novel classes of rapid-acting secretagogues under evaluation include the morphilinoguanide BTS 67582 and the meglitinides mitiglinide (KAD 1229) and senaglinide (A-4166). Succinate ester derivatives represent a potential novel approach to improving beta-cell function through enhancement of insulin biosynthesis and

  8. WJD 5th Anniversary Special Issues(2): Type 2 diabetes Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?

    Institute of Scientific and Technical Information of China (English)

    Iciar; Martín-Timón; Cristina; Sevillano-Collantes; Amparo; Segura-Galindo; Francisco; Javier; del; Caizo-Gómez

    2014-01-01

    Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin.Compared with individuals without diabetes,patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality,and are disproportionately affected by cardiovascular disease.Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension,dyslipidaemia and obesity in these patients.However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors.Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus.Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events.Many of these risk factors could be common history for both di-abetes mellitus and cardiovascular disease,reinforcing the postulate that both disorders come independently from"common soil".The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients.

  9. Teneligliptin in management of type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Sharma SK

    2016-08-01

    Full Text Available Surendra Kumar Sharma,1 A Panneerselvam,2 KP Singh,3 Girish Parmar,4 Pradeep Gadge,5 Onkar C Swami6 1Diabetes, Thyroid and Endocrine Centre, Galaxy Speciality Centre, Jaipur, 2Aruna Diabetes Centre, Chennai, 3Fortis Hospital, Sector 62, Phase VIII, Mohali, 4Kokilaben Dhirubhai Ambani Hospital, Andheri (W, Mumbai, 5Dr Gadge’s Diabetes Care Centre, Mumbai, 6Unichem Laboratories Ltd, Jogeshwari (W, Mumbai, India Abstract: Teneligliptin is a recently developed oral dipeptidyl peptidase 4 inhibitor indicated for the management of type 2 diabetes mellitus (T2DM in adults along with diet and exercise. Teneligliptin has been recently available in Japan (Teneria®, Argentina (Teneglucon®, and India (Tenepure; Teneza at relatively affordable price. This is a positive step toward the management of T2DM in developing countries, where the cost of medicine is out-of-pocket expenditure and is a limiting factor for health care. This review evaluates the efficacy and safety of teneligliptin in the management of T2DM. Teneligliptin has been systematically evaluated in T2DM as monotherapy with diet and exercise and in combination with metformin, glimepiride, pioglitazone, and insulin in short-term (12 weeks and long-term (52 weeks studies. These studies have reported a reduction in HbA1c of 0.8%–0.9% within 12 weeks of therapy. Two 52-week studies reported sustained improvement in glycemic control with teneligliptin. Teneligliptin has been found to be well tolerated, and the safety profile is similar to other dipeptidyl peptidase 4 inhibitors. Hypoglycemia and constipation are the main adverse events. Teneligliptin can be administered safely to patients with mild, moderate, or severe renal impairment or end-stage renal disease without dose adjustment. Similarly, it can be used in patients with mild-to-moderate hepatic impairment. Teneligliptin is effective and well tolerated and may have an important role in the management of T2DM. Keywords: diabetes

  10. The role of hormonal treatment in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Imam SK

    2015-02-01

    Full Text Available Syed Khalid ImamLiaquat National Hospital and Medical College, Karachi, Pakistan; Al-Mouwasat Hospital, Jubail Industrial City, Kingdom of Saudi ArabiaAbstract: Diabetes mellitus (DM is a disorder of abnormal glucose metabolism resulting primarily from insulin resistance and relative insulin deficiency and characterized by hyperglycemia causing significant short- and long-term complications. Type 2 diabetes mellitus (T2DM contributes to more than 90% of cases of diabetes. Obesity, sedentary lifestyles, and consumption of very high-caloric meals are thought to be the primary triggering factors causing T2DM in genetically predisposed individuals. Although treatment of hyperglycemia plays a key role in the management, therapies directed at other comorbid conditions, such as dyslipidemia, hypertension, hypercoagulability, obesity, and insulin resistance, have also been a major focus of research and therapy. DM is rising to an epidemic proportion globally, and it is, indeed, one of the most challenging public health problems in the 21st century. According to 2011 statistics, there were approximately 366 million diabetes cases worldwide, and this figure would probably increase to 552 million by 2030. Long-term complications from high blood sugar include coronary artery disease, cerebrovascular events, peripheral arterial diseases leading to amputation, retinopathy, nephropathy leading to end-stage renal disease requiring hemodialysis and transplantation, and neuropathy. The acute complication of T2DM includes drug-induced hypoglycemia, hyperosmolar hyperglycemic state, and although uncommon, ketoacidosis. Diabetes care requires a comprehensive and multidisciplinary approach to delay the progression to acute as well as chronic and debilitating long-term complications. This approach requires the thorough understanding of the pathophysiology of hyperglycemia and impact of various risk factors and comorbidities, careful selection of antihyperglycemic

  11. Emerging treatments in type 2 diabetes: focus on canagliflozin

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    Rosiak M

    2014-08-01

    Full Text Available Marek Rosiak,1,2 Susanna Grzeszczak,2 Dariusz A Kosior,2,3 Marek Postuła1,2 1Department of Cardiology and Hypertension, Central Clinical Hospital, the Ministry of the Interior, Warsaw, Poland; 2Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland; 3Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland Abstract: Type 2 diabetes mellitus (T2DM is a prevalent metabolic disorder, which affects more than 300 million people globally. The common effect of uncontrolled diabetes is the state of hyperglycemia, which results from beta-cell dysfunction as well as insulin resistance, which is accompanied with microvascular and macrovascular complications. As hyperglycemia defines diabetes, glycemic control is fundamental to the management of diabetes. Sodium glucose co-transporter 2 inhibitors (SGLT2 are a new group of oral antidiabetic medications that act by blocking the reabsorption of glucose, causing it to be excreted in the urine. Canagliflozin was the first SGLT2 inhibitor to be approved in the US by the Food and Drug Administration for the treatment and control of T2DM and on September 19, 2013, the Committee for Medicinal Products for Human Use of the European Medicines Agency adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Invokana®. Canagliflozin is a SGLT2 inhibitor, which acts upon the proximal tubules of the kidneys and reduces the renal threshold for glucose. It is highly selective, binding 250 times more potently to SGLT2 than sodium glucose co-transporter 1 inhibitor. This action allows a higher amount of glucose to be excreted within the urine, causing the patient's plasma glucose level to be decreased and indirectly causing weight loss. Among the most common adverse events are hypoglycemia, headache, nausea, female genital and urinary tract infections, nasopharyngitis, and transient postural dizziness. Given its

  12. Differential hexosamine biosynthetic pathway gene expression with type 2 diabetes

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    Megan Coomer

    2014-01-01

    Full Text Available The hexosamine biosynthetic pathway (HBP culminates in the attachment of O-linked β-N-acetylglucosamine (O-GlcNAc onto serine/threonine residues of target proteins. The HBP is regulated by several modulators, i.e. O-linked β-N-acetylglucosaminyl transferase (OGT and β-N-acetylglucosaminidase (OGA catalyze the addition and removal of O-GlcNAc moieties, respectively; while flux is controlled by the rate-limiting enzyme glutamine:fructose-6-phosphate amidotransferase (GFPT, transcribed by two genes, GFPT1 and GFPT2. Since increased HBP flux is glucose-responsive and linked to insulin resistance/type 2 diabetes onset, we hypothesized that diabetic individuals exhibit differential expression of HBP regulatory genes. Volunteers (n = 60; n = 20 Mixed Ancestry, n = 40 Caucasian were recruited from Stellenbosch and Paarl (Western Cape, South Africa and classified as control, pre- or diabetic according to fasting plasma glucose and HbA1c levels, respectively. RNA was purified from leukocytes isolated from collected blood samples and OGT, OGA, GFPT1 and GFPT2 expressions determined by quantitative real-time PCR. The data reveal lower OGA expression in diabetic individuals (P < 0.01, while pre- and diabetic subjects displayed attenuated OGT expression vs. controls (P < 0.01 and P < 0.001, respectively. Moreover, GFPT2 expression decreased in pre- and diabetic Caucasians vs. controls (P < 0.05 and P < 0.01, respectively. We also found ethnic differences, i.e. Mixed Ancestry individuals exhibited a 2.4-fold increase in GFPT2 expression vs. Caucasians, despite diagnosis (P < 0.01. Gene expression of HBP regulators differs between diabetic and non-diabetic individuals, together with distinct ethnic-specific gene profiles. Thus differential HBP gene regulation may offer diagnostic utility and provide candidate susceptibility genes for different ethnic groupings.

  13. Type-2 diabetes mellitus and auditory brainstem response

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    Sheelu S Siddiqi

    2013-01-01

    % had diabetic neuropathy, of which 12 (92% showed abnormal BERA. In nonneuropathic [12 (48%] only 6 (50% showed abnormal BERA. Conclusion: Delay in absolute latencies and interpeak latencies by BERA demonstrates defect at level of brainstem and midbrain in long standing Type-2 diabetes subjects, which is more pronounced in those with neuropathy.

  14. Behavioral economics survey of patients with type 1 and type 2 diabetes

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    Emoto N

    2015-05-01

    Full Text Available Naoya Emoto,1 Fumitaka Okajima,1 Hitoshi Sugihara,2 Rei Goto3,4 1Division of Endocrinology, Department of Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, 2Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, Tokyo, 3Hakubi Center of Advanced Research, Kyoto University, Kyoto, 4Graduate School of Economics, Kyoto University, Kyoto, Japan Background: Adherence to treatment and the metabolic control of diabetes are challenging in many patients with diabetes. The theory of neuroeconomics can provide important clues for understanding unreasonable human behavior concerning decisions between outcomes occurring at different time points.  Objective: We investigated patients with type 1 and type 2 diabetes to determine whether patients who are at a risk of developing complications are less risk averse. We also examined whether patients with type 1 and type 2 diabetes have different behavioral traits in decision making under risk.  Methods: We conducted a behavioral economics survey of 219 outpatients, 66 with type 1 diabetes and 153 with type 2 diabetes. All patients had been referred by general practitioners or other departments in the hospital. At the time of the survey, levels of hemoglobin A1c were not significantly different between patients with type 1 and type 2 diabetes.  Results: Patients with type 2 diabetes showed a lower response rate to the survey compared with patients with type 1 diabetes (71.9% vs 87.9%, P<0.01. Logistic regression analysis indicated that diabetic retinopathy was negatively associated with risk averse in pricing of hypothetical lotteries, myopic time preference, willingness to pay for preventive medicine, and levels of satisfaction with life. Diabetic nephropathy was also negatively associated with risk averse in pricing of hypothetical lotteries. Detailed analysis revealed that a lower proportion of patients with type 2 diabetes (22.7% were categorized

  15. Management of obesity, insulin resistance and type 2 diabetes in children: consensus and controversy

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    Amy Fleischman

    2009-11-01

    Full Text Available Amy Fleischman, Erinn T RhodesDivision of Endocrinology, Children’s Hospital Boston, Boston, MA, United StatesAbstract: Childhood obesity has become a national and international epidemic. The prevalence and incidence of type 2 diabetes in youth have been increasing, and type 2 diabetes is one of the most challenging complications of obesity in childhood. Comprehensive lifestyle interventions that include attention to dietary change, increased physical activity and behavior change appear to be required for the successful treatment of pediatric obesity. In particular, aspects of behavioral interventions that have been identified as contributing to effectiveness have included intensity, parent/family participation, addressing healthy dietary change, promoting physical activity, and involving behavioral management principles such as goal setting. A multidisciplinary team approach is required for successful management of type 2 diabetes in youth as well. As with many therapies in pediatrics, clinical trials and support for treatments of obesity and type 2 diabetes in youth lag behind adult data. Pediatric recommendations may be extrapolated from adult data and are often based on consensus guidelines. Type 2 diabetes in children is most commonly managed with lifestyle modification and medications, metformin and/or insulin, the only medications currently approved for use in children. However, many opportunities exist for ongoing research to clarify optimal management for obesity and type 2 diabetes in youth.Keywords: children, obesity, type 2 diabetes, metformin, insulin, bariatric surgery

  16. Plasma lipid profiling shows similar associations with prediabetes and type 2 diabetes.

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    Peter J Meikle

    Full Text Available The relationship between lipid metabolism with prediabetes (impaired fasting glucose and impaired glucose tolerance and type 2 diabetes mellitus is poorly defined. We hypothesized that a lipidomic analysis of plasma lipids might improve the understanding of this relationship. We performed lipidomic analysis measuring 259 individual lipid species, including sphingolipids, phospholipids, glycerolipids and cholesterol esters, on fasting plasma from 117 type 2 diabetes, 64 prediabetes and 170 normal glucose tolerant participants in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab then validated our findings on 1076 individuals from the San Antonio Family Heart Study (SAFHS. Logistic regression analysis of identified associations with type 2 diabetes (135 lipids and prediabetes (134 lipids, after adjusting for multiple covariates. In addition to the expected associations with diacylglycerol, triacylglycerol and cholesterol esters, type 2 diabetes and prediabetes were positively associated with ceramide, and its precursor dihydroceramide, along with phosphatidylethanolamine, phosphatidylglycerol and phosphatidylinositol. Significant negative associations were observed with the ether-linked phospholipids alkylphosphatidylcholine and alkenylphosphatidylcholine. Most of the significant associations in the AusDiab cohort (90% were subsequently validated in the SAFHS cohort. The aberration of the plasma lipidome associated with type 2 diabetes is clearly present in prediabetes, prior to the onset of type 2 diabetes. Lipid classes and species associated with type 2 diabetes provide support for a number of existing paradigms of dyslipidemia and suggest new avenues of investigation.

  17. Positive Correlation of PTH-Related Peptide with Glucose in Type 2 Diabetes

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    Ioannis Legakis

    2009-01-01

    Full Text Available Type 2 diabetes is characterized by hyperglycemia resulting from insulin resistance in the setting of inadequate beta-cell compensation. Recent studies indicate that for attaining a well-functioning ß-cell mass, parathyroid hormone-related protein (PTHrP is a very promising candidate among several insulinotropic peptides. In order to elucidate its role, we determine the levels of PTHrP, insulin and c-peptide in type 2 diabetics and in normal subjects in the fasting state. We enrolled 28 patients (16 men and 12 postmenopausal women with type 2 diabetes and twenty eight aged-matched healthy individuals as control subjects (15 men and 13 women. PTHrP was statistically significant correlated with glucose in type 2 diabetes and in normal subjects in the fasting state. Additionally, PTHrP serum levels exhibited a significant increase in type 2 diabetes compared to control subjects. Interestingly, PTHrP showed a positive correlation with insulin levels only among healthy individuals presumably due to defective glucose stimulated insulin secretion known to occur in type 2 diabetics. In conclusion ,the strong positive relation of PTHrP with glucose in the fasting state in patients with type 2 diabetes mellitus raises several questions for further experimentation concerning its exact role and physiological significance.

  18. GLUT4 is reduced in slow muscle fibers of type 2 diabetic patients: is insulin resistance in type 2 diabetes a slow, type 1 fiber disease?

    DEFF Research Database (Denmark)

    Gaster, M; Staehr, P; Beck-Nielsen, H

    2001-01-01

    To gain further insight into the mechanisms underlying muscle insulin resistance, the influence of obesity and type 2 diabetes on GLUT4 immunoreactivity in slow and fast skeletal muscle fibers was studied. Through a newly developed, very sensitive method using immunohistochemistry combined...... with morphometry, GLUT4 density was found to be significantly higher in slow compared with fast fibers in biopsy specimens from lean and obese subjects. In contrast, in type 2 diabetic subjects, GLUT4 density was significantly lower in slow compared with fast fibers. GLUT4 density in slow fibers from diabetic...... patients was reduced by 9% compared with the weight-matched obese subjects and by 18% compared with the lean control group. The slow-fiber fraction was reduced to 86% in the obese subjects and to 75% in the diabetic subjects compared with the control group. Estimated GLUT4 contribution from slow fibers...

  19. Parental History of Type 2 Diabetes in Patients with Nonaffective Psychosis

    Science.gov (United States)

    Fernandez-Egea, Emilio; Miller, Brian; Bernardo, Miguel; Donner, Thomas; Kirkpatrick, Brian

    2009-01-01

    Introduction We attempted to replicate two previous studies which found an increased risk of diabetes in the relatives of schizophrenia probands. Methods N=34 patients with newly-diagnosed nonaffective psychosis and N=52 non-psychiatric controls were interviewed for parental history of Type 2 diabetes. Results In a logistic regression model that included multiple potential confounders, psychosis was a significant predictor of Type 2 diabetes in either parent (p<0.04). Discussion We found an increased prevalence of Type 2 diabetes in the parents of nonaffective psychosis subjects. This association may be due to shared environmental or genetic risk factors, or both. PMID:18031995

  20. Role of PUFAs, the precursors of endocannabinoids, in human obesity and type 2 diabetes.

    Science.gov (United States)

    Dain, Alejandro; Repossi, Gaston; Das, Undurti N; Eynard, Aldo Renato

    2010-06-01

    Polyunsaturated fatty acids (PUFAs) serve as precursors of the endocannabinoids (ECs) that are bioactive lipids molecules. Recent studies revealed that ECs participate in several physiological and pathological processes including obesity and type 2 diabetes mellitus. Here we review the experimental and clinical aspects of the role of endocannabinoids in obesity and type 2 diabetes mellitus and the modification of the endocannabinoids by exogenously administered PUFAs. Based on these evidences, we propose that the endocannabinoid system (ECS) can be modulated by exogenous manipulation of PUFAs that could help in the prevention and management of human diseases such as obesity, metabolic syndrome and type 2 diabetes mellitus.

  1. Medical therapy versus bariatric surgery of obese patients with Type 2 diabetes

    DEFF Research Database (Denmark)

    Svane, Maria Saur; Bojsen-Møller, Kirstine Nyvold; Madsbad, Sten

    2016-01-01

    Bariatric surgery induces large and sustainable weight loss in obese patients and improves glycaemic control in patients with Type 2 diabetes. Eleven randomized controlled trials have shown superior glycaemic outcomes after bariatric procedures vs. medical therapy/intensive lifestyle interventions...... in obese patients with Type 2 diabetes. Furthermore, many patients experience remission of Type 2 diabetes after surgery but relapse may occur during follow-up. Data from observational studies show reduced incidence of micro- and macrovascular complications in addition to reduced cardiovascular and total...

  2. Abnormal echocardiography in patients with type 2 diabetes and relation to symptoms and clinical characteristics

    DEFF Research Database (Denmark)

    Jørgensen, Peter Godsk; Jensen, Magnus T; Mogelvang, Rasmus;

    2016-01-01

    OBJECTIVES: We aimed to determine the prevalence of echocardiographic abnormalities and their relation to clinical characteristics and cardiac symptoms in a large, contemporary cohort of patients with type 2 diabetes. RESULTS: A total of 1030 patients with type 2 diabetes participated...... with abnormal echocardiography along with dyspnoea and characteristic chest pain (p characteristics had sufficient sensitivity and specificity to accurately identify patients with abnormal echocardiography. CONCLUSION: Echocardiographic abnormalities...... are very common in outpatients with type 2 diabetes, but neither cardiac symptoms nor clinical characteristics are effective to identify patients with echocardiographic abnormalities....

  3. Sustained effects of interleukin-1 receptor antagonist treatment in type 2 diabetes

    DEFF Research Database (Denmark)

    Larsen, Claus M; Faulenbach, Mirjam; Vaag, Allan

    2009-01-01

    OBJECTIVE: Interleukin (IL)-1 impairs insulin secretion and induces beta-cell apoptosis. Pancreatic beta-cell IL-1 expression is increased and interleukin-1 receptor antagonist (IL-1Ra) expression reduced in patients with type 2 diabetes. Treatment with recombinant IL-1Ra improves glycemia and beta......-cell function and reduces inflammatory markers in patients with type 2 diabetes. Here we investigated the durability of these responses. RESEARCH DESIGN AND METHODS: Among 70 ambulatory patients who had type 2 diabetes, A1C >7.5%, and BMI >27 kg/m(2) and were randomly assigned to receive 13 weeks of anakinra...

  4. The alpha-cell as target for type 2 diabetes therapy

    DEFF Research Database (Denmark)

    Christensen, Mikkel; Bagger, Jonatan I; Vilsboll, Tina;

    2011-01-01

    for type 2 diabetes. Several lines of preclinical evidence have paved the way for the development of drugs, which suppress glucagon secretion or antagonize the glucagon receptor. In this review, the physiological actions of glucagon and the role of glucagon in type 2 diabetic pathophysiology are outlined....... Furthermore, potential advantages and limitations of antagonizing the glucagon receptor or suppressing glucagon secretion in the treatment of type 2 diabetes are discussed with a focus on already marketed drugs and drugs in clinical development. It is concluded that the development of novel glucagon receptor...

  5. Reduced incretin effect in type 2 diabetes: cause or consequence of the diabetic state?

    DEFF Research Database (Denmark)

    Knop, Filip K; Vilsbøll, Tina; Højberg, Patricia V;

    2007-01-01

    We aimed to investigate whether the reduced incretin effect observed in patients with type 2 diabetes is a primary event in the pathogenesis of type 2 diabetes or a consequence of the diabetic state. Eight patients with chronic pancreatitis and secondary diabetes (A1C mean [range] of 6.9% [6...... patients with NGT and in healthy subjects, respectively. These results suggest that the reduced incretin effect is not a primary event in the development of type 2 diabetes, but rather a consequence of the diabetic state....

  6. Physical activity in prevention and management of obesity and type-2 diabetes.

    Science.gov (United States)

    Hill, James O; Stuht, Jennifer; Wyatt, Holly R; Regensteiner, Judith G

    2006-01-01

    Obesity and type-2 diabetes can be considered diseases of physical inactivity. Physically activity protects against type-2 diabetes through its positive effects on weight management and on the metabolic pathways involved in glycemic control that are not weight-dependent. Increasing physical activity is one of the most effective strategies both for preventing type-2 diabetes and for managing it once it is present. However, we still face an enormous challenge in getting people to achieve sustainable increases in physical activity. A promising strategy is to get people walking more, starting small and increasing gradually over time.

  7. Screening for microalbuminuria in patients with type 2 diabetes is incomplete in general practice

    DEFF Research Database (Denmark)

    Knudsen, Soren Tang; Mosbech, Thomas Hammershaimb; Hansen, Birtha

    2012-01-01

    ,057 patients with type 2 diabetes were randomly selected from 64 general practitioners (GPs) from different geographical areas of Denmark. Clinical and laboratory data on the individual patients were collected through the GPs' electronic medical patient records; particular emphasis was given to annual...... patients by plasma-creatinine measurements. The importance of diagnosing microalbuminuria in patients with type 2 diabetes needs to be emphasised.......INTRODUCTION: National Danish guidelines recommend screening for microalbuminuria with assessment of urinary albumin/creatinine ratio at least annually in patients with type 2 diabetes. To which extent such screening is actually performed is not known. MATERIAL AND METHODS: A total of 2...

  8. Minimal change disease associated with type 1 and type 2 diabetes mellitus.

    Science.gov (United States)

    Moyses Neto, Miguel; Silva, Gyl Eanes Barros; Costa, Roberto S; Romão, Elen A; Vieira Neto, Osvaldo Merege; Dantas, Marcio

    2012-07-01

    A 19-year-old female with type 1 diabetes for four years, and a 73-year-old female with type 2 diabetes for twenty years developed sudden-onset nephrotic syndrome. Examination by light microscopy, immunofluorescence, and electron microscopy (in one case) identified minimal change disease (MCD) in both cases. There was a potential causative drug (meloxicam) for the 73-year-old patient. Both patients were treated with prednisone and responded with complete remission. The patient with type 1 diabetes showed complete remission without relapse, and the patient with type 2 diabetes had two relapses; complete remission was sustained after associated treatment with cyclophosphamide and prednisone. Both patients had two years of follow-up evaluation after remission. We discuss the outcomes of both patients and emphasize the role of kidney biopsy in diabetic patients with an atypical proteinuric clinical course, because patients with MCD clearly respond to corticotherapy alone or in conjunction with other immunosuppressive agents.

  9. Web-based depression treatment for type 1 and type 2 diabetic patients

    DEFF Research Database (Denmark)

    van Bastelaar, Kim M P; Pouwer, Francois; Cuijpers, Pim

    2011-01-01

    OBJECTIVE: Comorbid depression is common in patients with type 1 and type 2 diabetes, adversely affecting quality of life, diabetes outcomes, and mortality. Depression can be effectively treated with cognitive behavior therapy (CBT). The Internet is a new and attractive method for delivering CBT...... in reducing depressive symptoms by intention-to-treat analyses (P = 0.04, d = 0.29; clinical improvement 41% vs. 24% P protocol analyses (P

  10. Genome-wide analysis of DNA methylation differences in muscle and fat from monozygotic twins discordant for type 2 diabetes

    DEFF Research Database (Denmark)

    Ribel-Madsen, Rasmus; Fraga, Mario F; Jacobsen, Stine

    2012-01-01

    Monozygotic twins discordant for type 2 diabetes constitute an ideal model to study environmental contributions to type 2 diabetic traits. We aimed to examine whether global DNA methylation differences exist in major glucose metabolic tissues from these twins.......Monozygotic twins discordant for type 2 diabetes constitute an ideal model to study environmental contributions to type 2 diabetic traits. We aimed to examine whether global DNA methylation differences exist in major glucose metabolic tissues from these twins....

  11. Vitamin D levels and asymptomatic coronary artery disease in type 2 diabetic patients with elevated urinary albumin excretion rate

    DEFF Research Database (Denmark)

    Joergensen, Christel; Reinhard, Henrik; Schmedes, Anne;

    2012-01-01

    Coronary artery disease (CAD) is the major cause of morbidity and mortality in type 2 diabetic patients. Severe vitamin D deficiency has been shown to predict cardiovascular mortality in type 2 diabetic patients.......Coronary artery disease (CAD) is the major cause of morbidity and mortality in type 2 diabetic patients. Severe vitamin D deficiency has been shown to predict cardiovascular mortality in type 2 diabetic patients....

  12. Potential new approaches to modifying intestinal GLP-1 secretion in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Holst, Jens Juul; McGill, Maria A

    2012-01-01

    Type 2 diabetes mellitus is associated with a progressive decline in insulin-producing pancreatic ß-cells, an increase in hepatic glucose production, and a decrease in insulin sensitivity. The incretin hormones glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1......) stimulate glucose-induced insulin secretion; however, in patients with type 2 diabetes, the incretin system is impaired by loss of the insulinotropic effects of GIP as well as a possible reduction in secretion of GLP-1. Agents that modify GLP-1 secretion may have a role in the management of type 2 diabetes....... The currently available incretin-based therapies, GLP-1 receptor agonists (incretin mimetics) and dipeptidyl peptidase-4 (DPP-4) inhibitors (CD26 antigen inhibitors) [incretin enhancers], are safe and effective in the treatment of type 2 diabetes. However, they may be unable to halt the progression of type 2...

  13. The Association of Binge Eating Disorder with Glycemic Control in Patients with Type 2 Diabetes

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    Fatih Canan

    2011-06-01

    Full Text Available Objective: Our aim was to assess the prevalence of binge eating disorder (BED in individuals with type 2 diabetes and to investigate whether a comorbidity with BED would affect glycemic control in these patients. Materials and Methods: Eighty-two type 2 diabetic patients were enrolled. The participants were assessed for eating disorders by a psychiatrist. Blood samples were drawn and HbA1c and other biochemical parameters were measured. Results: Of the 82 subjects, 27 (34.1% met the criteria for BED. No other types of eating disorders were detected. HbA1c was significantly higher in individuals with BED (p<0.05. Conclusion: Our findings reveal that BED is highly prevalent among type 2 diabetic patients and it impairs glycemic control. Thus, patients with type 2 diabetes should be assessed carefully for eating disorders. Turk Jem 2011; 15: 26-7

  14. The role of insulin pump therapy for type 2 diabetes mellitus.

    Science.gov (United States)

    Landau, Zohar; Raz, Itamar; Wainstein, Julio; Bar-Dayan, Yosefa; Cahn, Avivit

    2017-01-01

    Many patients with type 2 diabetes fail to achieve adequate glucose control despite escalation of treatment and combinations of multiple therapies including insulin. Patients with long-standing type 2 diabetes often suffer from the combination of severe insulin deficiency in addition to insulin resistance, thereby requiring high doses of insulin delivered in multiple injections to attain adequate glycemic control. Insulin-pump therapy was first introduced in the 1970s as an approach to mimic physiological insulin delivery and attain normal glucose in patients with type 1 diabetes. The recent years have seen an increase in the use of this technology for patients with type 2 diabetes. This article summarizes the clinical studies evaluating insulin pump use in patients with type 2 diabetes and discusses the benefits and shortcomings of pump therapy in this population. Copyright © 2016 John Wiley & Sons, Ltd.

  15. A variant in the KCNQ1 gene predicts future type 2 diabetes and mediates impaired insulin secretion

    DEFF Research Database (Denmark)

    Jonsson, Anna Elisabet; Isomaa, Bo; Tuomi, Tiinamaija;

    2009-01-01

    Two independent genome-wide association studies for type 2 diabetes in Japanese subjects have recently identified common variants in the KCNQ1 gene that are strongly associated with type 2 diabetes. Here we studied whether a common variant in KCNQ1 would influence BMI as well as insulin secretion...... and action and predict future type 2 diabetes in subjects from Sweden and Finland....

  16. Safety and Efficacy of Liraglutide in Patients With Type 2 Diabetes and End-Stage Renal Disease

    DEFF Research Database (Denmark)

    Idorn, Thomas; Knop, Filip K; Jørgensen, Morten B;

    2016-01-01

    OBJECTIVE: To evaluate parameters related to safety and efficacy of liraglutide in patients with type 2 diabetes and dialysis-dependent end-stage renal disease (ESRD). RESEARCH DESIGN AND METHODS: Twenty-four patients with type 2 diabetes and ESRD and 23 control subjects with type 2 diabetes...

  17. Coffee intake and risk of obesity, metabolic syndrome and type 2 diabetes

    DEFF Research Database (Denmark)

    Nordestgaard, Ask Tybjærg; Thomsen, Mette; Nordestgaard, Børge Grønne

    2015-01-01

    to 78,021 additional individuals from the DIAGRAM consortium. RESULTS: Observationally, high coffee intake was associated with low risk of obesity, metabolic syndrome and type 2 diabetes. Further, high coffee intake was associated with high body mass index, waist circumference, weight, height, systolic...... convincingly with obesity, metabolic syndrome, type 2 diabetes, body mass index, waist circumference, weight, height, systolic/diastolic blood pressure, triglycerides, total cholesterol, high-density lipoprotein cholesterol or glucose levels. Per-allele meta-analysed odds ratios for type 2 diabetes were 1......BACKGROUND: Coffee is one of the most widely consumed beverages. We tested the hypothesis that genetically high coffee intake is associated with low risk of obesity, metabolic syndrome and type 2 diabetes, and with related components thereof. METHODS: We included 93,179 individuals from two large...

  18. Variation in Macro and Trace Elements in Progression of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Khalid Siddiqui

    2014-01-01

    Full Text Available Macro elements are the minerals of which the body needs more amounts and are more important than any other elements. Trace elements constitute a minute part of the living tissues and have various metabolic characteristics and functions. Trace elements participate in tissue and cellular and subcellular functions; these include immune regulation by humoral and cellular mechanisms, nerve conduction, muscle contractions, membrane potential regulations, and mitochondrial activity and enzyme reactions. The status of micronutrients such as iron and vanadium is higher in type 2 diabetes. The calcium, magnesium, sodium, chromium, cobalt, iodine, iron, selenium, manganese, and zinc seem to be low in type 2 diabetes while elements such as potassium and copper have no effect. In this review, we emphasized the status of macro and trace elements in type 2 diabetes and its advantages or disadvantages; this helps to understand the mechanism, progression, and prevention of type 2 diabetes due to the lack and deficiency of different macro and trace elements.

  19. Effect of Sitagliptin therapy on postprandial lipoprotein levels in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Tremblay, AJ; Lamarche, B; Deacon, Carolyn F.;

    2011-01-01

    Aim: Recent studies indicate that type 2 diabetes is associated with an increased secretion of both hepatic and intestinal lipoproteins, leading to the accumulation of atherogenic triglyceride (TG)-rich lipoproteins. Sitagliptin is a selective inhibitor of dipeptidyl peptidase-4 that has been shown...... to reduce fasting and postprandial glucose levels in patients with type 2 diabetes presumably through incretin hormone-mediated improvements in islet function. The objective of the present study is to examine the effects of treatment with sitagliptin on postprandial lipid and incretin hormone levels as well...... as glucose homeostasis in patients with type 2 diabetes. Methods: Thirty-six subjects with type 2 diabetes (30 men/6 postmenopausal women with a mean age of 58.1 ± 6.4 years and a body mass index of 30.7 ± 4.9 kg/m2) were recruited in this double-blind cross-over study using sitagliptin 100 mg/day or placebo...

  20. Increased VLDL-TG fatty acid storage in skeletal muscle in men with type 2 diabetes

    DEFF Research Database (Denmark)

    Andersen, Iben R; Søndergaard, Esben; Sørensen, Lars P

    2016-01-01

    -TG storage rate and LPL activity or other storage factors in muscle or adipose tissue. However, LPL activity correlated with fractional VLDL-TG storage in abdominal fat (p=0.04). CONCLUSIONS: Men with type 2 diabetes have increased VLDL-TG storage in muscle tissue, potentially contributing to increased......CONTEXT: Lipoprotein lipase (LPL) activity is considered the rate-limiting step of very-low-density-lipoprotein triglycerides (VLDL-TG) tissue storage, and has been suggested to relate to the development of obesity as well as insulin resistance and type 2 diabetes. OBJECTIVE: The objective...... of the study was to assess the relationship between the quantitative storage of VLDL-TG fatty acids and LPL activity and other storage factors in muscle and adipose tissue. In addition, we examine whether such relations were influenced by type 2 diabetes. DESIGN: 23 men (12 with type 2 diabetes, 11 non...

  1. Some Pathological Knowledge Discovered in Large Database of Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    LUO Sen-lin; GAO Juan; JIA Hong-bo; WANG Heng; ZHANG Tie-mei; HAN Yi-wen

    2007-01-01

    Taking the advantage of the nearly 14000 items of multi-source, multi-dimension practical dataset of type 2 diabetes, and a series of data mining experiments are designed to seek for important type 2 diabetes risk factors and their relationships with blood glucose. The valuable pathological knowledge includes, the decision tree is almost identical with the list of clinical diabetic risk factors; 9 items important risk factors of type 2 diabetes were found, and the relationship between the main risk factors and the blood glucose, and the feature of critical value of the risk factors were given too in this paper. These valuable results are good to the cure and macro-control type 2 diabetes.

  2. Secretion of glucagon-like peptide-1 (GLP-1) in type 2 diabetes

    DEFF Research Database (Denmark)

    Nauck, M A; Vardarli, I; Deacon, C F;

    2011-01-01

    The incretin hormones gastric inhibitory polypeptide and especially glucagon-like peptide (GLP) have an important physiological function in augmenting postprandial insulin secretion. Since GLP-1 may play a role in the pathophysiology and treatment of type 2 diabetes, assessment of meal-related GLP......-1 secretory responses in type 2 diabetic patients vs healthy individuals is of great interest. A common view states that GLP-1 secretion in patients with type 2 diabetes is deficient and that this applies to a lesser degree in individuals with impaired glucose tolerance. Such a deficiency...... with and without diabetes after oral glucose and mixed meals. Our analysis does not support the contention of a generalised defect in nutrient-related GLP-1 secretory responses in type 2 diabetes patients. Rather, factors are identified that may determine individual incretin secretory responses and explain some...

  3. The Genetics of Type 2 Diabetes: A Realistic Appraisal in 2008

    OpenAIRE

    Florez, Jose C.

    2008-01-01

    Context: Over the last few months, genome-wide association studies have contributed significantly to our understanding of the genetic architecture of type 2 diabetes. If and how this information will impact clinical practice is not yet clear.

  4. Relationship between daily dietary fructose intake, body composition and biochemical parameters patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Sabriye Arslan

    2016-05-01

    Conclusion: Further studies are needed to develop more specific suggestions regarding fructose intake and to better understand the relationship between fructose intakes, body composition and biochemical parameters in individuals with type 2 diabetes.

  5. Differences in social relations between persons with type 2 diabetes and the general population

    DEFF Research Database (Denmark)

    Hempler, Nana Folmann; Ekholm, Ola; Willaing, Ingrid

    2013-01-01

    Aims: Poor social support and lack of social network are well-established risk factors for morbidity and mortality in general populations. Good social relations, such as social support and network contacts, are associated with better self-management and fewer psychosocial problems in persons...... with type 2 diabetes. The aim of this study was to investigate whether persons with type 2 diabetes have poorer social relations than the general population. Methods: We conducted a cross-sectional survey in three settings: a specialist diabetes clinic (SDC) (n = 1084), a web panel (WP) consisting...... of persons with type 2 diabetes (n = 1491) and a sample from the 2010 Danish Health and Morbidity Survey, representative of the general population (n = 15,165). We compared social relations using multivariate logistic regression. Results: Compared to the general population, persons with type 2 diabetes more...

  6. Correlation of serum angiogenin level with various vascular complications in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Nagwa F. Ahmed

    2012-01-01

    As angiogenin is one of most powerful angiogenic factors, we recommend further studies to evaluate the diagnostic, prognostic, and therapeutic value of angiogenin in various microangiopathic and cardiovascular complications of type 2 diabetes.

  7. The Effect of an Inhaled Corticosteroid on Glucose Control in Type 2 Diabetes

    OpenAIRE

    2009-01-01

    Objective: To determine the effect of inhaled corticosteroid (ICS) therapy on glucose control in adults with type 2 diabetes mellitus and coexisting asthma or chronic obstructive pulmonary disease (COPD).

  8. Dysregulation of muscle glycogen synthase in recovery from exercise in type 2 diabetes

    DEFF Research Database (Denmark)

    Pedersen, Andreas J T; Hingst, Janne Rasmuss; Friedrichsen, Martin

    2015-01-01

    obese controls. CONCLUSIONS/INTERPRETATION: Exercise-induced activation of muscle GS in obesity and type 2 diabetes involves dephosphorylation of GS at sites 3a + 3b and 2 + 2a and enhanced substrate affinity, which is likely to facilitate glucose partitioning towards storage. Lower GS activity...... and increased phosphorylation at sites 2 + 2a in type 2 diabetes in the recovery period imply an impaired response to exercise....... and substrate affinity in obesity and type 2 diabetes. METHODS: Obese men with type 2 diabetes (n = 13) and weight-matched controls (n = 14) underwent euglycaemic-hyperinsulinaemic clamps in the rested state and 3 h after 60 min of cycling (70% maximal pulmonary oxygen uptake [[Formula: see text

  9. Effects of exercise training on mitochondrial function in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Larsen, Steen; Skaaby, Stinna; Helge, Jørn Wulff

    2014-01-01

    Type 2 diabetes is characterized by a decreased ability of insulin to facilitate glucose uptake into insulin sensitive tissue, i.e., skeletal muscle. The mechanism behind this is at the moment unresolved. It has been suggested that increased amount of lipids inside the skeletal muscle...... intensity training) improves insulin sensitivity in healthy humans and in patients with type 2 diabetes. Whether patients with type 2 diabetes have the same beneficial effects (same improvement) as control subjects, when it comes to regular physical activity in regard to mitochondrial function......, is not established in the literature. This review will focus only on the effect of physical activity on skeletal muscle (mitochondrial function) in patients with type 2 diabetes....

  10. Structured primary care for type 2 diabetes has positive effects on clinical outcomes

    NARCIS (Netherlands)

    Fokkens, Andrea S.; Wiegersma, P. Auke; Beltman, Frank W.; Reijneveld, Sijmen A.

    2011-01-01

    Background Patients with type 2 diabetes have an increased risk of developing microvascular and macrovascular complications. In routine diabetes care an adequate reduction of risk factors for these complications is often not achieved.

  11. No Influence of Type 2 Diabetes on Chronic Inflammation and Oxidative Stress in Obese Patients

    Directory of Open Access Journals (Sweden)

    Adriana Florinela CĂTOI

    2014-03-01

    Full Text Available Obesity per se carries the features of chronic inflammation and oxidative stress that interrelate in a complex network and exert an important role in the onset of several complications such as type 2 diabetes, atherosclerosis and cardiovascular events. On the other hand, it seems that hyperglycemia per se as well as insulin resistance (independent of hyperglycemia, both induce increased oxidative stress. The aim of our study was to analyze proinflammatory and oxidative stress markers in obese patients with and without type 2 diabetes and to verify the hypothesis that type 2 diabetes associated with obesity would promote a higher chronic inflammation and oxidative stress state as compared to obesity alone. We found no differences between the two groups of patients regarding chronic inflammation and oxidative stress markers. Therefore we may conclude that there is no influence of type 2 diabetes on chronic inflammation and oxidative stress in obese patients.

  12. Relationship of food security with Type 2 diabetes and its risk factors in Tehranian adults

    Directory of Open Access Journals (Sweden)

    Majid Hasan-Ghomi

    2015-01-01

    Conclusions: There were no significant differences in food security levels of diabetic and non-diabetic groups. However, some risk factors of type 2 diabetes including sex, marital status, educational level, and obesity were associated with food insecurity.

  13. Cardiorenal end points in a trial of aliskiren for type 2 diabetes

    DEFF Research Database (Denmark)

    Parving, Hans-Henrik; Brenner, Barry M; McMurray, John J V;

    2012-01-01

    This study was undertaken to determine whether use of the direct renin inhibitor aliskiren would reduce cardiovascular and renal events in patients with type 2 diabetes and chronic kidney disease, cardiovascular disease, or both....

  14. Low dose spironolactone reduces blood pressure in patients with resistant hypertension and type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Stolzenburg Oxlund, Christina; Henriksen, J. E.; Tarnow, L.

    2013-01-01

    Background:The increased risk of cardiovascular morbidity and mortality associated with arterial hypertension is particularly pronounced in patients with type 2 diabetes mellitus. Blood pressure control is, therefore, decisively important but often not sufficiently achieved.Objective:The primary...

  15. Pharmacokinetics and pharmacodynamics of vildagliptin in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    He, Yan-Ling; Serra, Denise; Wang, Yibin;

    2007-01-01

    BACKGROUND: Vildagliptin is a dipeptidyl peptidase IV (DPP-4) inhibitor currently under development for the treatment of type 2 diabetes mellitus. OBJECTIVES: To assess the pharmacokinetic and pharmacodynamic characteristics and tolerability of vildagliptin at doses of 10 mg, 25 mg and 100 mg twice...... daily following oral administration in patients with type 2 diabetes. METHODS: Thirteen patients with type 2 diabetes were enrolled in this randomised, double-blind, double-dummy, placebo-controlled, four-period, crossover study. Patients received vildagliptin 10 mg, 25 mg and 100 mg as well as placebo...... regimen, corresponding to a 10% and 19% reduction, respectively. Vildagliptin was generally well tolerated. CONCLUSION: Vildagliptin is likely to be a useful therapy for patients with type 2 diabetes based on the inhibition of DPP-4 and the subsequent increase in incretin hormones, GLP-1 and GIP...

  16. Vascular effects of ultrafine particles in persons with type 2 diabetes

    Science.gov (United States)

    BACKGROUND: Diabetes confers an increased risk for cardiovascular effects of airborne particles. OBJECTIVE: We hypothesized that inhalation of elemental carbon ultrafine particles (UFP) would activate blood platelets and vascular endothelium in people with type 2 diabetes. ...

  17. Acute hyperinsulinemia decreases plasma osteoprotegerin with diminished effect in type 2 diabetes and obesity

    DEFF Research Database (Denmark)

    Jørgensen, Gitte Maria; Vind, Birgitte; Nybo, Mads;

    2009-01-01

    the acute effects of insulin on plasma OPG concentrations in individuals with type 2 diabetes and obese individuals compared with lean controls. DESIGN: The study population consisted of ten type 2 diabetic, ten obese subjects, and ten lean subjects with no family history of diabetes. METHODS: All subjects...... infusion decreased plasma OPG concentrations in all groups (Pobese and type 2 diabetic individuals (P=0.007). Baseline OPG correlated with fasting insulin, baseline lactate, and low density lipoprotein cholesterol in the diabetic group, and with baseline FFA...... in the lean group. The relative change of OPG in response to insulin correlated inversely with HbA1c and baseline FFA in the lean group. CONCLUSIONS: Acute hyperinsulinemia decreases plasma OPG, but with diminished effect in individuals with type 2 diabetes and obesity. Increased levels of OPG in arteries...

  18. High Prevalence of Arcobacter Carriage in Older Subjects with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Maria Teresa Fera

    2010-01-01

    Our study demonstrated a high prevalence of arcobacters colonization in type 2 diabetic and older subjects. The clinical significance and the potential health risk associated with these emerging species remain to be determined.

  19. Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives

    OpenAIRE

    Mathew John; Deepa Gopinath; Rejitha Jagesh

    2016-01-01

    The treatment of type 2 diabetes is a challenging problem. Most subjects with type 2 diabetes have progression of beta cell failure necessitating the addition of multiple antidiabetic agents and eventually use of insulin. Intensification of insulin leads to weight gain and increased risk of hypoglycemia. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of antihyperglycemic agents which act by blocking the SGLT2 in the proximal tubule of the kidney. They have potential benefits in...

  20. Diabetes Remission after Nonsurgical Intensive Lifestyle Intervention in Obese Patients with Type 2 Diabetes

    OpenAIRE

    Adham Mottalib; Mahmoud Sakr; Mohamed Shehabeldin; Osama Hamdy

    2015-01-01

    Partial or complete remission from type 2 diabetes was recently observed after bariatric surgeries. Limited data is available about the possibility of inducing diabetes remission through intensive weight reduction. We retrospectively evaluated diabetes remissions after one year of the Weight Achievement and Intensive Treatment (Why WAIT) program, a 12-week intensive program for diabetes weight management in real-world clinical practice. Among 120 obese patients with type 2 diabetes who comple...

  1. Comments to: «Type 2 diabetes mellitus – time to change the concept»

    OpenAIRE

    Oleg Viktorovich Udovichenko

    2014-01-01

    Authors of the paper “Diabetes mellitus – time to change the concept” (Diabetes Mellitus, 2013; №1: 91) address weight-reduction treatment modalities (including bariatric surgery) as the pivotal approach to type 2 diabetes management. While acknowledging the importance of weight loss in patients with type 2 diabetes mellitus (T2DM), this short letter aims to advise the endocrinology community against viewing bariatric surgery as the ultimate solution of all challenges of T2DM.

  2. Podocyte detachment and reduced glomerular capillary endothelial fenestration promote kidney disease in type 2 diabetic nephropathy

    OpenAIRE

    Weil, E. Jennifer; Lemley, Kevin V; Mason, Clinton C; Yee, Berne; Jones, Lois I.; Blouch, Kristina; Lovato, Tracy; Richardson, Meghan; Myers, Bryan D.; Nelson, Robert G.

    2012-01-01

    Podocyte detachment and reduced endothelial cell fenestration and relationships between these features and the classic structural changes of diabetic nephropathy have not been described in patients with type 2 diabetes. Here we studied these relationships in 37 Pima Indians with type 2 diabetes of whom 11 had normal albuminuria, 16 had microalbuminuria, and 10 had macroalbuminuria. Biopsies from ten kidney donors (not Americans Indians) showed almost undetectable (0.03%) podocyte detachment a...

  3. Magnesium in type 2 diabetes mellitus and its correlation with glycemic control

    OpenAIRE

    Nehal Hamdy El-said; Noha Adly Sadik; Nagwa Abd EL-Ghaffar Mohammed

    2015-01-01

    Background: Hypomagnesaemia may have negative impact on glucose homeostasis and insulin sensitivity. This study was done to compare serum Mg levels in type 2 diabetic patients with non diabetic healthy control subjects and to assess the correlation between serum Mg levels and glycemic control in Egyptian patients. Methods: 60 type 2 diabetic patients attending the outpatient clinic of diabetes at Kasr Al Aini hospital faculty of medicine Cairo University and 30 healthy age matched control ...

  4. Clinical risk factors, DNA variants, and the development of type 2 diabetes

    DEFF Research Database (Denmark)

    Lyssenko, Valeriya; Jonsson, Anna Elisabet; Almgren, Peter;

    2008-01-01

    Type 2 diabetes mellitus is thought to develop from an interaction between environmental and genetic factors. We examined whether clinical or genetic factors or both could predict progression to diabetes in two prospective cohorts.......Type 2 diabetes mellitus is thought to develop from an interaction between environmental and genetic factors. We examined whether clinical or genetic factors or both could predict progression to diabetes in two prospective cohorts....

  5. The study of correlative factors to resistin and its regression equation in type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective To study the changes of resistin and the relationship between resistin and other indexes in patients with type 2 diabetes mellitus.Methods Seventy patients with type 2 diabetics were chosen and divided into three groups according to weight index and 15 healthy persons were chosen as controls.ELISA was adopted to determine resistin concentration.Oxydase method was adopted to measure blood sugar.Radio immunoassay was used to measure insulin level.Results Resistin concentration of patient groups [(23...

  6. Effects of passive static stretching on blood glucose levels in patients with type 2 diabetes mellitus

    OpenAIRE

    Park, Seong Hoon

    2015-01-01

    [Purpose] This study determined the effects of passive static stretching on blood glucose levels in patients with type 2 diabetes. [Subjects] Fifteen patients (8 males and 7 females) with type 2 diabetes were recruited and randomly assigned to the control group or passive static stretching group. [Methods] Glycated hemoglobin was measured before and after the 8-week training period. [Results] Glycated hemoglobin levels decreased significantly in the passive static stretching group, and there ...

  7. The Architecture of Risk for Type 2 Diabetes: Understanding Asia in the Context of Global Findings

    OpenAIRE

    Noraidatulakma Abdullah; John Attia; Christopher Oldmeadow; Scott, Rodney J; Elizabeth G. Holliday

    2014-01-01

    The prevalence of Type 2 diabetes is rising rapidly in both developed and developing countries. Asia is developing as the epicentre of the escalating pandemic, reflecting rapid transitions in demography, migration, diet, and lifestyle patterns. The effective management of Type 2 diabetes in Asia may be complicated by differences in prevalence, risk factor profiles, genetic risk allele frequencies, and gene-environment interactions between different Asian countries, and between Asian and other...

  8. Benchmarking Is Associated With Improved Quality of Care in Type 2 Diabetes

    OpenAIRE

    Hermans, Michel; Elisaf, Moses; Michel, Georges; Muls, Erik; Nobels, Frank; Vandenberghe, Hans; Brotons, Carlos; OPTIMISE (OPtimal Type 2 dIabetes Management Including benchmarking and Standard trEatment) International Steering Committee.

    2013-01-01

    OBJECTIVE: To assess prospectively the effect of benchmarking on quality of primary care for patients with type 2 diabetes by using three major modifiable cardiovascular risk factors as critical quality indicators. RESEARCH DESIGN AND METHODS: Primary care physicians treating patients with type 2 diabetes in six European countries were randomized to give standard care (control group) or standard care with feedback benchmarked against other centers in each country (benchmarking group). In both...

  9. Trends for type 2 diabetes and other cardiovascular risk factors in Mexico from 1993-2006

    OpenAIRE

    Salvador Villalpando; Teresa Shamah-Levy; Rosalba Rojas; Aguilar-Salinas, Carlos A.

    2010-01-01

    OBJECTIVE: To describe the trends in the prevalence of type 2 diabetes (T2D), and other cardiovascular risk factors in three national health surveys (1993, 2000 and 2006). MATERIALS AND METHODS: The databases of three surveys: ENEC 1993, ENSA 2000 and ENSANUT 2006 were gathered. Calculations of published data were reprocessed to do appropriate adjustments to assure comparability among surveys. RESULTS: From 1993 to 2006 the prevalence of type 2 diabetes (6.7-14.4%), metabolic syndrome (26.6-3...

  10. Depression and Type 2 Diabetes in Low and Middle Income Countries: A Systematic Review

    OpenAIRE

    Mendenhall, Emily; Norris, Shane A; Shidhaye, Rahul; Prabhakaran, Dorairaj

    2014-01-01

    Eighty percent of people with type 2 diabetes reside in low and middle-income countries (LMICs). Yet much of the research around depression among people with diabetes has been conducted in high-income countries (HICs). In this systematic review we searched Ovid Medline, PubMed, and PsychINFO for studies that assessed depression among people with type 2 diabetes in LMICs. Our focus on quantitative studies provided a prevalence of co-morbid depression among those with diabetes...

  11. Thyroid disease in insulin-treated patients with type 2 diabetes: a retrospective study

    OpenAIRE

    Witting, Valerie; Bergis, Dominik; Sadet, Dilek; Badenhoop, Klaus

    2014-01-01

    Background: Diabetes mellitus and thyroid diseases frequently coexist. In order to evaluate how thyroid disorders interfere with glycemic control, we analysed insulin-treated type 2 diabetes patients with thyroid disease. Methods: Diabetes patients (n = 1.957) were retrospectively investigated. We focused on type 2 diabetes patients who had been admitted for insulin-treatment and diagnosed thyroid diseases (n = 328). Patients were divided into three groups according to thyroid disease mani...

  12. Incretin mimetics: a novel therapeutic option for patients with type 2 diabetes - a review

    DEFF Research Database (Denmark)

    Hansen, Katrine Bilberg; Vilsbøll, Tina; Knop, Filip K

    2010-01-01

    Type 2 diabetes mellitus is a metabolic disease associated with low quality of life and early death. The goal in diabetes treatment is to prevent these outcomes by tight glycemic control and minimizing vascular risk factors. So far, even intensified combination regimen with the traditional......Med and Medline search for publications with the key words GLP-1 receptor agonist, exenatide, liraglutide and type 2 diabetes mellitus up to January 2009....

  13. Type 2 diabetes genes – Present status and data from Norwegian studies

    Directory of Open Access Journals (Sweden)

    Jens K. Hertel Hertel

    2013-06-01

    Full Text Available The worldwide rise in prevalence of type 2 diabetes has led to an intense search for the genetic risk factors of this disease. In type 2 diabetes and other complex disorders, multiple genetic and environmental factors, as well as the interaction between these factors, determine the phenotype. In this review, we summarize present knowledge, generated by more than two decades of efforts to dissect the genetic architecture of type 2 diabetes. Initial studies were either based on a candidate gene approach or attempted to fine-map signals generated from linkage analysis. Despite the detection of multiple genomic regions proposed to be linked to type 2 diabetes, subsequent positional fine-mapping of candidates were mostly inconclusive. However, the introduction of genome-wide association studies (GWAS, applied on thousands of patients and controls, completely changed the field. To date, more than 50 susceptibility loci for type 2 diabetes have been detected through the establishment of large research consortia, the application of GWAS on intermediary diabetes phenotypes and the use of study samples of different ethnicities. Still, the common variants identified in the GWAS era only explain some of the heritability seen for type 2 diabetes. Thus, focus is now shifting towards searching also for rare variants using new high-throughput sequencing technologies. For genes involved in the genetic predisposition to type 2 diabetes the emerging picture is that there are hundreds of different gene variants working in a complex interplay influencing pancreatic beta cell function/mass and, only to a lesser extent, insulin action. Several Norwegian studies have contributed to the field, extending our understanding of genetic risk factors in type 2 diabetes and in diabetes-related phenotypes like obesity and cardiovascular disease.

  14. Type 2 diabetes, obesity, and sex difference affect the fate of glucose in the human heart

    OpenAIRE

    Peterson, Linda R.; Herrero, Pilar; Coggan, Andrew R.; Kisrieva-Ware, Zulia; Saeed, Ibrahim; Dence, Carmen; Koudelis, Deborah; McGill, Janet B.; Lyons, Matthew R.; Novak, Eric; Dávila-Román, Víctor G.; Waggoner, Alan D.; Gropler, Robert J.

    2015-01-01

    Type 2 diabetes, obesity, and sex difference affect myocardial glucose uptake and utilization. However, their effect on the intramyocellular fate of glucose in humans has been unknown. How the heart uses glucose is important, because it affects energy production and oxygen efficiency, which in turn affect heart function and adaptability. We hypothesized that type 2 diabetes, sex difference, and obesity affect myocardial glucose oxidation, glycolysis, and glycogen production. In a first-in-hum...

  15. Screening for microalbuminuria in patients with type 2 diabetes is incomplete in general practice

    DEFF Research Database (Denmark)

    Knudsen, Søren Tang; Mosbech, Thomas Hammershaimb; Hansen, Birtha Petrea;

    2012-01-01

    National Danish guidelines recommend screening for microalbuminuria with assessment of urinary albumin/creatinine ratio at least annually in patients with type 2 diabetes. To which extent such screening is actually performed is not known.......National Danish guidelines recommend screening for microalbuminuria with assessment of urinary albumin/creatinine ratio at least annually in patients with type 2 diabetes. To which extent such screening is actually performed is not known....

  16. Insulin resistance, lipotoxicity, type 2 diabetes and atherosclerosis: the missing links. The Claude Bernard Lecture 2009

    OpenAIRE

    2010-01-01

    Insulin resistance is a hallmark of type 2 diabetes mellitus and is associated with a metabolic and cardiovascular cluster of disorders (dyslipidaemia, hypertension, obesity [especially visceral], glucose intolerance, endothelial dysfunction), each of which is an independent risk factor for cardiovascular disease (CVD). Multiple prospective studies have documented an association between insulin resistance and accelerated CVD in patients with type 2 diabetes, as well as in non-diabetic individ...

  17. Exercise Strategies to Optimize Glycemic Control in Type 2 Diabetes: A Continuing Glucose Monitoring Perspective

    OpenAIRE

    van Dijk, Jan-Willem; van Loon, Luc J. C.

    2015-01-01

    IN BRIEF The introduction of continuous glucose monitoring (CGM) several years ago enabled researchers to investigate the impact of exercise strategies on 24-hour glycemic control. Such unique information on the glucoregulatory properties of exercise will ultimately lead to more effective exercise programs to prevent and treat type 2 diabetes. This article reviews the role of exercise and physical activity in the treatment of type 2 diabetes, complemented by recent data obtained by CGM.

  18. Liraglutide: a once-daily GLP-1 analogue for the treatment of type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Vilsbøll, Tina

    2007-01-01

    properties that are suitable for once-daily dosing. Liraglutide has demonstrated lasting improvement of HbA(1c )levels, weight reduction and improved beta-cell function in patients with Type 2 diabetes mellitus. Liraglutide is well tolerated; the adverse events that are most frequently reported being...... transient nausea and diarrhoea. This article reviews the mechanisms of action and efficacy of liraglutide for the treatment of Type 2 diabetes mellitus. This agent is presently in Phase III clinical development....

  19. Type 2 diabetes in rural Uganda : prevalence, risk factors, perceptions and implications for the health system

    OpenAIRE

    Mayega, Roy William

    2014-01-01

    Background: Between 2010 and 2030, a 69% increase in type-2 diabetes is expected in low-income countries compared to a 20% increase in high income countries. Yet health system responsiveness to non-communicable diseases has been slow in sub-Saharan Africa. Data on the prevalence of type 2 diabetes and its associated factors in mainly rural settings is lacking, yet such data can guide planning for diabetes control. Objective: The aim of these studies was to assess the preval...

  20. Effect of glycemic control on periodontitis in type 2 diabetic patients with periodontal disease

    OpenAIRE

    2013-01-01

    Abstract Aims/Introduction Diabetes mellitus and periodontitis are closely related. A huge number of reports has addressed the effect of periodontal intervention therapy on glycemic control, but no reports have addressed the effect of glycemic intervention therapy on periodontal disease in type 2 diabetic patients. The aim of this study was to examine the effect of improved glycemic control by glycemic intervention therapy on periodontitis in type 2 diabetic patients. Materials and Methods A ...