[Show abstract][Hide abstract] ABSTRACT: This review presents an analysis of clinical and experimental studies related to post-transplantation diabetes mellitus (PTDM) - a specific complication after solid organ transplantation. A search of the databases eLibrary, PubMed and Scopus using the keywords ≪posttransplantation diabetes mellitus≫, ≪new onset diabetes after transplantation≫, ≪transplantation≫ and ≪immunosuppression≫ yielded in 523 results, including four from Russian literature (one original research manuscript). The analysis included original research, reviews, meta-analyses and monographs published not before 2005 in Russian and English. A total of 60 relevant original researches and reviews were included in this review. Diagnostic criteria, disease risk factors and potential pathogenic mechanisms were all considered. The mechanisms of the diabetogenic effect of modern immunosuppressive drugs were analysed. The principles of pre- and post-transplantation screening for PTDM and optimal management strategies for patients with PTDM are presented. The current controversial issues concerning the various aspects of PTDM are discussed.
[Show abstract][Hide abstract] ABSTRACT: During latest decade, as threat of acute complications of diabetes mellitus was surmounted, cardiovascular complications became leading cause of death. Clinical manifestation of coronary, brachiocephalic and renal atherosclerosis is quite dramatic in diabetes mellitus, which determines extent of dissemination and intensity of lesions. Combination of these mutually confounding conditions is a characteristic problem of patients with diabetes mellitus. Presence of 2+ risk factors (one of which is diabetes mellitus in itself) requires active examination in order to rule out coronary, brachiocephalic, peripheral and renal artery lesions. Aggressive care is necessary in order to control progression of disease and administer adequate conservative and endovascular treatment with account of high risk of combination of lesions.
[Show abstract][Hide abstract] ABSTRACT: The second isoform of the PPARgamma2 is specific for adipose tissue. In adipocytes, this isoform is involved in the regulation of adipogenesis and lipid storage, insulin and glucose metabolism. Pro12Ala, a missense mutation in exon 2 of PPARG, reduces transcriptional activity of PPARgamma2 and is shown to be associated with increased insulin sensitivity and protection from T2D. Previously, this polymorphism has never been assessed in a Russian population for its relationship to T2D, insulin resistance, and diabetes-related metabolic traits. In this study, we tested 588 Russian T2D patients and 597 normoglycaemic controls. Carriers of the Pro12 allele and subjects homozygous for Pro/Pro had significantly increased risk of developing T2D (OR 1.43 and 2.04, respectively). In Pro/Pro homozygotes, adjustment for potential confounding risk factors resulted in reducing the OR value from 2.04 to 1.69, but the association remained significant (p=0.046).The Pro/Pro genotype also showed association with increased levels of fasting insulin (p=0.019) in non-diabetic controls and elevated serum triglycerides (p=0.019) in T2D patients. Compared with other genotypes, non-diabetic and diabetic subjects homozygous for Pro/Pro had a significantly higher HOMA-IR score and reduced ISI value. This observation strongly supports the implication of the PPARG Pro12Ala in insulin resistance and T2D in a Russian population.
[Show abstract][Hide abstract] ABSTRACT: To determine risk factors, prognostic, value prevention of development of contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients with type 2 diabetes mellitus (T2DM).
We have retrospectively analyzed the incidence of CIN developed after PCI in 151 patients T2DM and 50 patients without diabetes. All patients were subjected to thorough clinical examination (including serum creatinine level before and 48 hours after intervention).
CIN developed more frequently after PCI in patients with T2DM than in patients of the same age without diabetes at the same baseline renal function, volume of contrast media and hydration status. The risk of developing CIN in patients with T2DM is associated with: heart failure, anemia, volume of contrast media, diuretics use in the peri-procedure period, multiple coronary artery disease, need of interventional procedures. TIDM patients with CIN had faster decline of renal function, more often developed cardiovascular diseases and had lower 24 month survival rate.
High risk of CIN development and its prognostic significance in patients with T2DM determine the necessity of individually evaluated risks for preventive measures during contrast media interventions.
Diabetes research and clinical practice 12/2009; 86 Suppl 1:S63-9. DOI:10.1016/S0168-8227(09)70012-9 · 2.54 Impact Factor