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Prevalence of lipid abnormalities, awareness, and treatment in U.S. adults with diabetes
... Ninety-seven percent of patients with diabetes are dyslipidaemic, with a characteristic pattern of increased plasma triglycerides and decreased high density lipoprotein (HDL) cholesterol. In a large clinical study with an average follow-up period of 3.9 years, low density lipoprotein (LDL) cholesterol, non-HDL cholesterol, apolipoprotein B, triglyceride, and homocysteine levels all increased over time, with most participants also having low HDL levels [6]. The downregulation of the enzyme lipoprotein lipase due to low insulin levels may be the cause of the dyslipidaemic profiles noted in diabetic individuals [7]. ...
... Thus, a chronic hyperlipidaemic state may impair the host resistance to bacterial infection. Cardiovascular disease is a major complication of type 2 DM and lipid abnormalities seen in diabetics are a serious contributor to this complication [6]. Glycaemic control via maintaining adequate levels of HbA1c is considered as an essential way to lower patients' risk of having diabetic complications and each 1% drop in HbA1c levels is associated with a risk reduction of 21% for diabetes-related deaths, 14% for myocardial infarction, and 37% for microvascular complications [24]. ...
Periodontitis is a chronic inflammatory disorder often seen in patients with diabetes mellitus (DM). Individuals with diabetes are at a greater risk of developing cardiovascular complications and this may be related, in part, to lipid abnormalities observed in these individuals. The objective of this systematic review is to compile the current scientific evidence of the effects of periodontal treatment on lipid profiles in patients with type 2 diabetes mellitus. Through a systematic search using MEDLINE, EMBASE, PubMed, and Web of Science, 313 articles were identified. Of these, seven clinical trials which met all inclusion criteria were chosen for analysis. Between baseline and 3-month follow-up, there was a statistically significant reduction in the levels of total cholesterol (mean differences (MD) −0.47 mmol/L (95% confidence interval (CI), −0.75, −0.18, p = 0.001)), triglycerides (MD −0.20 mmol/L (95% CI −0.24, −0.16, p < 0.00001)) favouring the intervention arm, and a statistically significant reduction in levels of high density lipoprotein (HDL) (MD 0.06 mmol/L (95% CI 0.03, 0.08, p < 0.00001)) favouring the control arm. No significant differences were observed between baseline and 6-month follow-up levels for any lipid analysed. The heterogeneity between studies was high. This review foreshadows a potential benefit of periodontal therapy for lipid profiles in patients suffering from type 2 DM, however, well designed clinical trials using lipid profiles as primary outcome measures are warranted.
... Aİ orta göstəriciləri qadın və kişi qruplarında yüksək səviyyədədir, kişilərdə qadınlara nisbətən yüksəkdir, bu o deməkdir ki, tədqiqata daxil edilən xəstələrin böyük əksəriyyətində qan zərdabında nisbi aterogenlik yüksəlmişdir. Belə bir fikir mövcuddur ki, qadınlarda gender xüsusiyyətləri ilə əlaqədar kişilərlə müqayisədə ÜDX-dən müdafiə olunmuşdur [15]. Diabetli xəstələrin plazmasında yüksək triqliserid səviyyəsi və azalmış YSLP səviyyəsinin səciyyəvi mənzərəsinə əlavə olaraq qeyd etmək lazımdır ki, pozğunluqlar lipoprotein hissəciklərinin quruluşunda da görünür. ...
Tədqiqatın məqsədi AH və II tip ŞD xəstələrində lipid mübadiləsinin xüsusiyyətləri və intima-media kompleksinin qalınlığı ilə qarşılıqlı əlaqəsinin tədqiqidir. Hər iki cinsin nümayəndələrindən 63 xəstə 27-78 yaş arasında müayinə edilmişdir. Xəstələrin qan zərdabında lipid spektrinin göstəriciləri müayinə edilmişdir: ümumi xolesterin səviyyəsi (ÜXS), yüksək sıxlıqlı lipoproteinlər (YSLP), aşağı sıxlıqlı lipoptoteinlər (ASLP), triqliseridlər (TQ) və aterogenlik indeksi (Aİ). Bunlarla yanaşı, qan zərdabında qlükoza və protrombin indeksi təyin edilmişdir. Ultrasəs doppleroqrafik müayinə vasitəsilə xəstələrdə yuxu arteriyaları müayinə aparılmış, ümumi yuxu arteriyasında intima-media kompleksinin qalınlığı (İMKQ) və onlarda olan dəyişikliklərin xüsusiyyətləri müəyyən edilmişdir. Xəstələr 28 xəstədə ŞD-II aşkar edilmişdir. Nəticə olaraq xəstələrdə lipid spektri və qlükozanın qan zərdabında səviyyəsi ilə ümumi yuxu arteriyalarında intima-media kompleksinin qalınlığı arasında əlaqənin dərəcəsi müəyyən edilmişdir.
... Clinically up to 97% of patients with diabetes are dyslipidemic which is highly associated with atherosclerosis. The characteristic dyslipidemia (High LDL, Low HDL and high Triglyceride) and the peculiar small and dense LDL particle size are proved to be more atherogenic [28] . Diabetes damages both microvasculature & macrovasculature of the body. ...
Cardiovascular Diseases (CVDs) are taking the biggest toll on human health since the last few decades. Around the middle of the 20th century, morbidity and mortality due to CVDs began to increase exponentially due to drastic change in lifestyle and rapid urbanization. At that point of time a very little was known about its causes or risk factors. Identification of risk factors is crucial in planning the treatment and prevention strategies for any disease. Profound research works have been conducted worldwide to identify risk factors of CVDs. Conventional risk factors like obesity, smoking, hypertension, diabetes, dyslipidemia, physical inactivity etc are already given due importance in risk prediction, prevention and management of CVDs. The risk assessment tools available at present are mainly based on these conventional risk factors. Even after adjusting the conventional risk factors, CVD related morbidity and mortality are still growing. Moreover CVDs are now reported at an early age. Hence there is also a need to identify novel risk factors which can be helpful in predicting and identifying CVDs earlier. The future of CVD risk assessment is an integration of both traditional as well as emerging risk factors for better prediction, diagnosis and planning therapeutic and preventive interventions of CVDs.
... Dyslipidemia is highly correlated with atherosclerosis and up to 97 % of patients with diabetes are dyslipidemic. 3 In diabetes, predominant form of low-density lipoprotein (LDL) cholesterol is small, dense form which is more atherogenic than large dense LDL. Oxidized LDL produces several abnormal responses such as attracting leucocytes to the intima of the vessel, stimulating proliferation of leucocytes which are steps in the formation of atherosclerotic plaque. ...
BACKGROUND Diabetes mellitus (DM) single-handedly accounts for 75 – 90 % of excess coronary artery disease (CAD) risk seen in persons suffering from it and it also enhances and amplifies the effects of other traditional cardiovascular risk factors. After adjusting for concomitant risk factors such as hypertension and hyperlipidemia, there still remains an excess risk for cardiovascular disease (CVD) in people with diabetics. In this study, we wanted to evaluate left ventricular (LV) systolic and diastolic dysfunction in normotensive diabetic patients. METHODS A cross sectional comparative study was performed from January 2016 to September 2017 on 50 diabetics and 50 age and sex matched healthy controls. Adult patients of both sexes with diabetes mellitus who are normotensive were included as cases. Patients with known heart disease, chronic kidney disease, thyroid disorders were excluded from the study. 2D transthoracic echocardiogram (ECHO) with M mode was used for assessing systolic and diastolic function. RESULTS Mean ejection fraction was lower in patients group (59.76) as compared to control group (64.74) with 8 % of cases with a value of< 50 %. Fractional shortening was also lower in patients (29.14) compared to controls (34.86) with 12 % patients having a value of < 25 %. E/A ratio was 1.12 in patients when compared to 1.36 in controls with 32 % of patients having value < 1. Mean isovolumic relaxation time was 96.52 in patients when compared to 87.42 in controls with 24 % patients having value > 100 msec. CONCLUSIONS Normotensive diabetics are prone to left ventricular dysfunction. Diastolic dysfunction is more common than systolic dysfunction. KEYWORDS Diabetes Mellitus, Systolic Dysfunction, Diastolic Dysfunction, Cardiovascular Disease
... [6] Approximately 70%-97% of adults with type 2 diabetes have one or more lipid abnormalities. [7] Abnormal serum lipids contribute to the risk of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM) and assessment of the serum lipid levels in people with diabetes is now considered as a standard of the diabetes care. [8] Abnormal lipid profiles and lipoprotein oxidation are more common in diabetes and are elevated with a poor glycemic control. ...
Context: Diabetes mellitus is associated with an increased risk of mortality and morbidity from cardiovascular disease (CVD), which is
mainly because of dyslipidemias. Several researchers have suggested that increased serum lipid fractions such as low-density lipoprotein
cholesterol (LDL-C) and total cholesterol (TC) were linked to decreased heart rate variability (HRV). Until now no papers have studied the association between serum triglyceride (TG) values and HRV.
Aims: The objective of this study was to evaluate the relationship
between serum TG levels and HRV in patients with type 2 diabetes mellitus.
Materials and Methods: The study included 120 patients with
type 2 diabetes mellitus (both male and female) of the age group 35–65 years, who visited Belgaum Diabetes Centre. They were selected
by simple random sampling and recruited into the study. The patients were divided into three groups depending on the duration of
diabetes. The study duration was 6 months. One-minute HRV was analyzed during deep breathing and defined as the difference between
the shortest and the longest heart rate interval measured by Lead II electrocardiographic recording during six cycles of deep breathing
using an electrocardiograph (BPL Cardiart 6208 BPL Medical Technologies Pvt Ltd, Bannerghatta Road, Bangalore, India). Kubios
HRV Standard (version 3.0, Department of Applied Physics, University of Eastern Finland, Kuopio, Finland) software tool was used to
analyze HRV. Fasting serum TG of all the patients (5 mL of venous blood) was analyzed using semiautomatic analyzer (Transasia Erba
Chem –5 Plu, Transasia Bio-Medicals, Andheri east, Mumbai, Maharashtra, India). Data were analyzed by using Statistical Package for the Social Sciences (SPSS 20.0 version, IBM Bangalore, Karnataka, India) software program, version 20.0. One-way analysis of variance
(ANOVA) followed by Tukey’s multiple post hoc tests was used for comparison and Karl Pearson’s correlation coefficient was used to test the correlation between serum TG values and HRV in the three groups. The statistical significance was set at 5% level (P < 0.05). Results: No significant difference was observed in the TG levels (P > 0.05) between the three groups of patients with type 2 diabetes mellitus. The TG levels were significant and negative correlation was observed with HRV (r = 0.6141, P = <0.001) at 5% level of significance in all the three groups.
Conclusion: From this study, we conclude that the hypertriglyceridemia in patients with type 2 diabetes mellitus could affect HRV. Further studies are needed to prospectively validate the impact of this novel finding.
Keywords: Deep breathing, heart rate variability, Serum triglycerides, type 2 diabetes
Key Message: Hypertriglyceridemia in patients with type 2 diabetes mellitus is very hazardous and is negatively associated with HRV.
... People with DM are likely to have dyslipidemia, hypertension, nephropathy, retinopathy, neuropathy, cardiovascular, peripheral vascular, or cerebrovascular diseases. 16,17 In addition to blood glucose-lowering agents, a patient with DM will take various medications to treat or prevent comorbidities. Consequently, people with DM are likely to be exposed to polypharmacy. ...
Objective:
This scoping review aims to explore and map studies investigating potentially inappropriate prescribing (PIP) for adults with diabetes mellitus.
Introduction:
Inappropriate prescribing for people with diabetes mellitus has been reported by various authors focusing on different aspects of inappropriateness. A preliminary search revealed no published reviews on PIP for adults with diabetes mellitus. As a result, it is difficult to obtain a comprehensive map of PIP in this patient group.
Inclusion criteria:
This scoping review will consider all studies on PIP for adults with the diagnosis of type 1 or type 2 diabetes mellitus from any clinical setting. Studies conducted in pediatric populations or in adults with pre-diabetes or gestational diabetes will be excluded.
Methods:
A three-step search strategy (i.e. an initial limited search in PubMed and ProQuest Central databases, a main search of eight databases and gray literature, and manual searches of reference lists of included articles) will be utilized. No language restrictions will be applied. All retrieved articles will be screened against the inclusion/exclusion criteria at title, abstract, and full-text stages. Data to be extracted from each study will include, but not be limited to, country, objective, study population, study methodology, type of PIP studied, examples of PIP events, medications involved, and criteria used for PIP identification. Data will be extracted by study team members using an online application for conducting systematic synthesis of evidence.
... T2DM is a known direct primary risk factor for both micro-and macro-vascular complications through complex pathophysiology pathways (Dokken, 2008). T2DM is also an indirect risk factor for CVD as it has been reported that 97% of patients with T2DM could have some type of dyslipidemia (Fagot-campagna et al., 2000). Like many countries in the Gulf Council region and the Middle East, the United Arab Emirates (UAE) has high prevalence rates of T2DM and other metabolic risk factors for CVD such as obesity. ...
Background
The United Arab Emirates (UAE) population has a high rate of type 2 diabetes mellitus (T2DM) and other metabolic risk factors for coronary artery disease (CAD). Previous studies have indicated strong genetic associations between T2DM and CAD. The objective of this study was to replicate previously reported significant genetic associations for T2DM and CAD which were in a genome-wide significance level in a cohort from the Arab population of the UAE, and to investigate the associations of these loci with twelve cardiometabolic traits that may influence the development of T2DM and CAD.
Methods
A total of nine hundreds and fourteen Emiratis were recruited to this study to investigate associations of 101 loci for T2DM (422 patients and 455 controls), and 53 loci for CAD (160 patients and 245 controls), using logistic regression models which incorporating possible confounding factors. Results are presented using odds ratios with their corresponding 95% confidence intervals and p-values. Linear regression models, which included possible covariates were applied to determine any associations between the T2DM and CAD reported loci with the twelve cardiometabolic traits and results were presented as effect sizes (beta), standard errors, and p-values. Furthermore, the overall risks for all the loci found to be associated with T2DM and CAD were determined using the cumulative effects of the risk alleles. For those found to be associated with the twelve cardiometabolic traits, risks were determined using calculations of their polygenic risk scores.
Results
The mean age of the T2DM group was 61.5±11.3 and of the CAD group was 66.2±9.3 years. The prevalence of most of the cardiovascular disease risk factors in this cohort were high: mean body mass index (BMI) = 29.4, T2DM (51.9%), hypertension (60.9%), dyslipidemia (68.8%), and smoking (47.9%). All individuals who were tested for CAD (n=405) also had a diagnosis of T2DM. The highest association variant for T2DM was in SNP rs1977833 in HHEX (p = 0.0016, OR = 0.56 for allele A), which is a multi-ethnic locus for T2DM. The strongest association with CAD was detected with SNP rs264 in LPL, which encodes lipoprotein lipase (p =0.009, OR=1.96 for allele A). For the cardiometabolic traits analyses, most notable associations were those of FTO with BMI and waist circumference; ABO with height; KCNK16 with diastolic blood pressure; PROX1-AS1, GCKR, and MIR129-LEP with fasting blood glucose; random blood glucose with ZEB2 and THADA; HbA1c levels with TLE1 and FAM99B loci; HDL-cholesterol levels with BRAF; and triglyceride levels with ZEB2. Furthermore, accumulation of risk alleles and polygenic scores of the associated loci was clearly associated with increased risks for all tested diseases and traits in this cohort.
Conclusions
The present study highlighted many known genetic loci, which are linked to T2DM and CAD and their associations with major cardiometabolic traits in Arab descendants. We confirmed that some loci are associated with T2DM, CAD, and metabolic traits independently of the ethnic background, with a novel association also detected between height and ABO.
... For instance, diabetes can significantly enhance the likelihood of severe carotid atherosclerosis [101]. This is because of several reasons, firstly, diabetic blood is more likely to be rich in triglycerides due to impaired lipid flux, a function which is regulated by insulin [102]. In addition to a high level of triglycerides and decreased HDL cholesterol in the plasma, abnormalities have also been noticed in the structure of LDL particles of diabetic patients. ...
Cardiovascular disease (CVD) is the leading cause of deaths globally. It accounted for more than 17.6 million deaths in 2016 and the number is expected to reach 23.6 million by 2030 [1, 2]. In the USA, CVDs were responsible for 840,678 deaths in 2016, which accounts for 1 in every 3 deaths [3]. The CVDs that contributed to this mortality included coronary heart disease (CHD) (43.2%), stroke (16.9%), hyper- tension (9.8%), heart failure (9.3%), diseases of the arteries (3.0%), and other CVDs (17.7%). In the UK, CVDs accounts for nearly 34% of all deaths each year [4]. This figure rises to reach approximately 40% in the European Union. Besides this, CVDs also accounted for ap- proximately 14% of the total health expenditures in 2014-2015, which is more than any other major diagnostic group. Total direct medical costs of CVD are projected to increase to $749 billion by 2035, which would lead to a significantly high socio-economic loss [5].
The prevalence of CVDs is predicted to increase worldwide because of the rise in associated risk factors, even in countries that were pre- viously categorized as low-risk countries. Presently, more than 80% of the global burden of CVDs occurs in low-income and middle-income countries. By 2020, CVDs are expected to surpass infectious diseases to become the major cause of mortality in most developing nations [6]. Not only CVD is a leading cause of mortality, but it is the foremost cause of loss of disability-adjusted life years globally [7]. According to the World Health Organization (WHO), 75% of premature CVDs are preventable by ameliorating risk factors [8]. This can significantly re- duce the overall rise in CVD burden on both individuals and healthcare providers.
While aging is one of the principal risk factors for the progression of CVDs, autopsy evidence has shown that the process of developing CVD in later years is not unavoidable, which provides risk reduction fundamental importance [8]. The INTERHEART study elucidated the causative effects of CVD risk factors such as dyslipidemia, smoking, hypertension, diabetes and abdominal obesity. These risk factors exist consistently across all the population and socioeconomic levels, which suggests the viability of uniform approaches towards the prevention of CVDs globally [9].
... For instance, diabetes can significantly enhance the likelihood of severe carotid atherosclerosis [101]. This is because of several reasons, firstly, diabetic blood is more likely to be rich in triglycerides due to impaired lipid flux, a function which is regulated by insulin [102]. In addition to a high level of triglycerides and decreased HDL cholesterol in the plasma, abnormalities have also been noticed in the structure of LDL particles of diabetic patients. ...
Cardiovascular diseases (CVDs) are the leading cause of premature death and disability in humans and their incidence is on the rise globally. Given their substantial contribution towards the escalating costs of health care, they also generate a high socio-economic burden in the general population. The underlying pathogenesis and progression associated with nearly all CVDs is predominantly of atherosclerotic origin that leads to the development of coronary artery disease, cerebrovascular disease, venous thromboembolism and, peripheral vascular disease, subsequently causing myocardial infarction, cardiac arrhythmias or stroke. The aetiological risk factors leading to the onset of CVDs are well recognized and include hyperlipidaemia, hypertension, diabetes, obesity, smoking and, lack of physical activity. They collectively represent more than 90% of the CVD risks in all epidemiological studies. Despite the critical fatality rate of CVDs, the identification and careful prevention of the underlying risk factors can significantly reduce the global epidemic of CVDs. Primary regimes for the prevention and treatment of CVDs include lipid-lowering drugs, antihypertensives, antiplatelet and anticoagulation therapies. Despite their effectiveness, significant gaps in the treatment of CVDs remain. In this review, we discuss the epidemiology and pathology of the major CVDs that are prevalent globally. We also determine the contribution of well-recognized risk factors towards the development of CVDs and the prevention strategies. In the end, currently available therapies for the control and treatment of CVDs will be discussed.
... The lipid abnormalities are common in DM because insulin resistance or deficiency affects key enzymes and pathways in lipid metabolism [14]. A range of 70% to 97% of adults with type 2 diabetes have one or more lipid abnormalities, this called diabetic dyslipidemia or atherogenic dyslipidemia [15,16]. Diabetic dyslipidemia is characterized by elevated Triglycerides (TG) level, low High-Density Lipoprotein Cholesterol (HDL-C) level and the presence of smaller and denser Low-Density Lipoprotein Cholesterol (LDL-C) particles [17,18]. ...
Background
Patients with diabetes mellitus are at high risk of cardiovascular events because of abnormal lipid levels status. Dyslipidemia is common in patients with type 2 diabetes mellitus. However; in Yemen this issue was not yet addressed. The aim of this study is to determine the prevalence and patterns of dyslipidemia in patients with T2DM in Mukalla city, Yemen, in 2017.
Methodology
A Cross-sectional study was conducted in a randomly selected eligible patients from the diabetic registry of the AL Noor Charity Center (ACC), Mukalla city in eastern Yemen during the period from May-July 2017. A well structured questionnaire and blood investigation for lipid profile and blood sugar were the tools of data collection from 120 randomly selected T2DM patients registered in the ACC.
Results
The prevalence of dyslipidemia in type 2 diabetic patients was 85%, prevalence of dyslipidemia in males was 86% while in females was 84% but the difference was not significant (P-value 0.4). Regarding age group, BMI and duration of DM, there is no significant association exist with dyslipidemia. About half of the studied T2DM patients have high serum cholesterol level (52.5%), while 22.5% had low serum HDL- C levels and 39.2% had high serum triglyceride level, most of patients had serum LDL-C levels above normal range (67.5%), so the common patterns of dyslipidemia in this study were LDL-C followed by cholesterol.
Conclusion
High prevalence of dyslipidemia among type 2 diabetes mellitus in Mukalla city were observed and so the common patterns of dyslipidemia is LDL-C followed by cholesterol. This study emphasizes the importance of screening of lipid profile as these abnormalities may lead to development of cardiovascular diseases.
... Clinically, dyslipidemia is highly correlated with atherosclerosis, and up to 97% of patients with diabetes are dyslipidemia (12). Khan and associates reported that severity of dyslipidemia increases in patients with higher HbA1c value (13). ...
Introduction: Diabetes mellitus type 2 has become a global health-care problem of modern society due to a pronounced increase of prevalence to pandemic proportions and vascular complications. At present, glycated hemoglobin (HbA1c) is widely accepted as a measure of glycemic control in established diabetes. The aim of this study was to analyze the lipid profile in serum of patients with diabetes mellitus type 2, and its relationship with HbA1c levels.
Methods: The observational cross-sectional study included 60 diabetic patients, 30 men, and 30 women, age 32–94 years. Patients were assigned into two groups based on HbA1c values; Group 1: HbA1c ≤ 7% (good glycemic control) and Group 2: HbA1c > 7% (poor glycemic control). We analyzed the concentration of glucose, HbA1c, and lipid profile including total cholesterol levels, triglycerides (TAG), low-density lipoproteins (LDL), and high-density lipoproteins (HDL).
Results: Significantly lower values of glucose concentration, TAG and the ratio TAG/HDLc were obtained in the group of patients with good glycemic control. (p < 0.0005) Patients with good glycemic control had lower values of Castelli 1 and Castelli 2 index, and atherogenic index of plasma, compared to patients with poor glycemic control, but this difference was not significant. (p > 0.005) Our study revealed a significant positive correlation between HbA1c and triglyceride level (r = 0.375; p = 0.003) and HbA1c and ratio triglyceride/HDLc (r = 0.335; p = 0.009).
Conclusion: HbA1c can also be used as a predictor of dyslipidemia in type 2 diabetics in addition to as a glycemic control parameter.
... Les perturbations des activités des enzymes lipolytiques et des protéines de transport de lipides contribuent à augmenter la dyslipidémie (Antikainen et al., 1993). En outre, celle-ci est généralement associée au diabète : en effet, 90% des patients diabétiques présentent également une mauvaise absorption des lipides par l'intestin et le foie (Fagot-Campagna et al., 2000). ...
La lipémie postprandiale se caractérise par une augmentation des lipoprotéines riches en triglycérides après un repas, et joue un rôle important dans la biodisponibilité des lipides alimentaires pour les tissus périphériques. En effet, une lipémie postprandiale élevée est souvent associée à l'obésité et à une dyslipidémie, deux composantes du syndrome métabolique qui peuvent engendrer des complications médicales, incluant diabète et maladies cardiovasculaires. La lactoferrine (Lf) inhibe l'épuration hépatique des chylomicrons, conduisant à une élévation de la lipémie postprandiale par des mécanismes moléculaires non élucidés. Il est aussi établi que le Lipolysis Stimulated Receptor (LSR) contribuait à l'épuration des lipoprotéines riches en triglycérides pendant la phase postprandiale. L'objectif était de déterminer s'il existait une interaction entre la Lf et le LSR. Les études de cultures cellulaires ont montré que si la Lf n'affectait pas le taux d'expression du LSR dans des cellules Hepa 1-6 de souris, elle co-localisait avec le LSR en présence d'oléate, un composé requis pour l'activation du récepteur. Des expériences de ligand-blotting ont également montré que la Lf se fixait sur le LSR purifié et inhibait la fixation de lipoprotéines riches en triglycérides. Les domaines N et C-terminaux isolés de cette protéine, ainsi qu'un mélange de peptides obtenu après double hydrolyse de la Lf par la trypsine et la chymotrypsine, conservent cette propriété. Nous proposons que l'élévation de la lipémie postprandiale observée in vivo suite à un traitement par la Lf soit médiée par son interaction avec le LSR, inhibant ainsi l'épuration des chylomicrons et de leurs remnants
... But the serum level of HDL was significantly lower in diabetic subjects than in control subjects. Clinically, dyslipidemia has been correlated with atherosclerosis and up to 97 % of patients with diabetes are dyslipidemic [38]. ...
Introduction: Sedentary lifestyle is a lifestyle with no or irregular physical activity, found in both individuals that live in developed and developing world. Objective: The study was done to evaluate the cardiovascular status of apparently healthy subjects who reside in Nnewi, South Eastern, Nigeria. Method: Based on the fasting blood sugar (FBS), subjects were classified into diabetics and non-diabetics. Using standard routine analysis for FBS the subjects were grouped into 50 adult diabetic and 50 non-diabetic subjects which serve as control group. Ethical approval was obtained from the Ethics Review Committee and written informed consent was sort from each participant. Also, questionnaire was used to obtain their Biodata and risk levels of both modifiable and non-modifiable factors. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using sphingnomanometer. Fasting lipid profile was assayed using standard routine analysis. The cardiovascular risk score was calculated using Framingham risk calculator to determine the risk of the subjects to cardiovascular diseases in the next 10 years. Student t-test was used for data analysis. Results: The serum level of FBS was significantly higher in diabetic subjects than in control subjects (p<0.05). The SBP and DBP values were significantly higher in diabetic subjects than in control subjects (p<0.05). The mean age was significantly higher in diabetic subjects than in control subjects (p<0.05). The serum levels of Triglycerides (TG), Low density lipoprotein (LDL) and Total cholesterol (T chol) were significantly higher in diabetic subjects than in control subjects (p<0.05). But the serum level of High density lipoprotein (HDL) was significantly lower in diabetic subjects than in control subjects (p<0.05). The Framingham cardiovascular risk score was significantly higher in diabetic subjects than in control subjects (p<0.05). Conclusion: The findings showed that diabetic subjects may likely die from cardiovascular diseases than apparently healthy individuals.
... The general pathogenesis of atherosclerosis has been reviewed elsewhere [6] but several factors specific to diabetes are worth mentioning here. Clinically, dyslipidaemia is highly correlated with atherosclerosis, and up to 97% of subjects with diabetes are dyslipidaemia [7]. In addition to the characteristic pattern of increased triglycerides and decreased HDL cholesterol found in the plasma of subjects with diabetes, abnormalities are seen in the structure of the lipoprotein particles [8]. ...
Type II diabetic mellitus (DM) is a chronic metabolic disease that impairs normal insulin production and glucose transport to the liver and muscles. In the India, about 1–5% population suffer from diabetes or related complication. So there is need to cure this disease. DM chronic auditory complications may include spiral ganglia atrophy, degeneration of the vestibulocochlear nerve myelin sheath, reduction of the number of spiral lamina nerve fibres, and thickening of the capillary walls of the stria vascularis and small arteries. This study aims to know the incidence of common parameters, blood sugar levels, levels of lipids and the hearing thresholds of individuals. It is a Noise-Induced Hearing Loss research study featuring hearing impairment in transport workers diagnosed as type II diabetic. All individuals were interviewed by various questioners related to listening ability of subjects and underwent a physical examination, blood investigations and audiometry. Hearing impairment was more prevalent among adults with diabetes. Sensory neuron hearing loss is predominant in both study groups. Mixed Bilateral Hearing Loss showed significant p value in (>.001) by audiometry. The percentage of hearing loss in diabetes (ranges 5.3–28.1%) and in non-diabetics (ranges 3.4–24.1%) and risk factors in diabetes (ranges 22.8–35.1%) over nondiabetics (ranges 17.2–20.1%) which is eye opener. The correlation between type II diabetes and hearing impairment was independent of known risk factors for hearing impairment, such as noise exposure, build-up wax, ototoxic medication, smoking, tobacco chewing etc.
... But the serum level of HDL was significantly lower in diabetic subjects than in control subjects. Clinically, dyslipidemia has been correlated with atherosclerosis and up to 97 % of patients with diabetes are dyslipidemic [38]. ...
Abstract:
Introduction: Sedentary lifestyle is a lifestyle with no or irregular physical activity, found in both individuals that live in developed and developing world.
Objective: The study was done to evaluate the cardiovascular status of apparently healthy subjects who reside in Nnewi, South Eastern, Nigeria.
Method: Based on the fasting blood sugar (FBS), subjects were classified into diabetics and non-diabetics. Using standard routine analysis for FBS the subjects were grouped into 50 adult diabetic and 50 non-diabetic subjects which serve as control group. Ethical approval was obtained from the Ethics Review Committee and written informed consent was sort from each participant. Also, questionnaire was used to obtain their Biodata and risk levels of both modifiable and non-modifiable factors. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using sphingnomanometer. Fasting lipid profile was assayed using standard routine analysis. The cardiovascular risk score was calculated using Framingham risk calculator to determine the risk of the subjects to cardiovascular diseases in the next 10 years. Student t-test was used for data analysis.
Results: The serum level of FBS was significantly higher in diabetic subjects than in control subjects (p<0.05). The SBP and DBP values were significantly higher in diabetic subjects than in control subjects (p<0.05). The mean age was significantly higher in diabetic subjects than in control subjects (p<0.05). The serum levels of Triglycerides (TG), Low density lipoprotein (LDL) and Total cholesterol (T chol) were significantly higher in diabetic subjects than in control subjects (p<0.05). But the serum level of High density lipoprotein (HDL) was significantly lower in diabetic subjects than in control subjects (p<0.05). The Framingham cardiovascular risk score was significantly higher in diabetic subjects than in control subjects (p<0.05).
Conclusion: The findings showed that diabetic subjects may likely die from cardiovascular diseases than apparently healthy individuals. Keywords: Cardiovascular diseases, sedentary lifestyle, Framingham risk calculator.
... Diabetes has reached epidemic proportions in the general Chinese adult population and about 92.4 million adults 20 years of age or older (9.7% of the adult population) have diabetes [3] . Dyslipidemia is a common co-morbidity in T2DM patients [4] , and over 70% of adults with T2DM have one or more lipid abnormalities [5] . Low levels of high-density lipoprotein (HDL) cholesterol, often associated with elevated triglyceride levels, is the most prevalent form of dyslipidemia in T2DM patients. ...
Objective:
No previous studies have evaluated the association between dyslipidemia, alcohol drinking, and diabetes in an Inner Mongolian population. We aimed to evaluate the co-effects of drinking and dyslipidemia on diabetes incidence in this population.
Methods:
The present study was based on 1880 participants from a population-based prospective cohort study among Inner Mongolians living in China. Participants were classified into four subgroups according to their drinking status and dyslipidemia. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used to evaluate the association between alcohol drinking, dyslipidemia, and diabetes.
Results:
During the follow-up period, 203 participants were found to have developed diabetes. The multivariable-adjusted odds ratios (95% confidence interval) for the incidence of non-dyslipidemia/drinkers, dyslipidemia/non-drinkers, and dyslipidemia/drinkers in diabetic patients were 1.40 (0.82-2.37), 1.73 (1.17-2.55), and 2.31 (1.38-3.87), respectively, when compared with non-dyslipidemia/non-drinkers. The area under the ROC curve for a model containing dyslipidemia and drinking status along with conventional factors (AUC=0.746) was significantly (P=0.003) larger than the one containing only conventional factors (AUC=0.711).
Conclusion:
The present study showed that dyslipidemia was an independent risk factor for diabetes, and that drinkers with dyslipidemia had the highest risk of diabetes in the Mongolian population. These findings suggest that dyslipidemia and drinking status may be valuable in predicting diabetes incidence.
... Diabetes is the main risk factor for atherosclerotic, thrombotic and cardiovascular disease. Hyperglycaemia probably contributes to diabetic complications by interfering with vascular cellular metabolism, vascular matrix molecules and circulating lipoproteins [3].Hyperlipidemia is one of the metabolic complications of both clinical and experimental diabetes [4], and up to 97% of diabetic patients are dyslipidemic which is highly correlated with atherosclerosis [5]. Alloxan is another diabetogenic agent used for induction of diabetesin various animal models which causes necrosis of the islets on administration and several features observed in human diabetes [6]. ...
... Dyslipidemia is highly correlated with atherosclerosis, and almost all patients with diabetes are dyslipidemic 40 . In the present study, significantly increased levels of plasma cholesterol, LDL-c and triglycerides levels were found in obese diabetic patients and obese patients with cardiovascular disease compared to obese controls and obese patients without CVD respectively. ...
Adiponectin is a collagen-like protein that is solely secreted by adipocytes. Different studies showed that it plays an important role in the pathophysiology of insulin resistance, diabetes and dyslipidemia and thus affects risk for cardiovascular disease and obesity. In the present study the role of adiponectin in pathogenesis of type 2 diabetes mellitus was evaluated. The current study was carried on 51 diabetic patients with documented NIDDM and 22 age and sex matched healthy controls. Diabetic patients were subdivided into 2 subgroups according to BMI where 40 were obese and 11 were non obese and according to the presence of cardiovascular disease with obesity where 16 were obese with CVD and 24 were obese with no CVD. Controls were subdivided according to BMI where 7 were non obese and 15 were obese. The levels of plasma adiponectin, insulin, c-peptide, fasting blood glucose, glycated hemoglobin, lipid profile, NO and lipid peroxides. The results of the present study showed that adiponectin was significantly lower in all groups with variations compared to controls, in obese patients with CVD than those without CVD. NO and MDA levels were higher in diabetic patients than in controls and the highest levels of MDA were observed in patients with cardiovascular disease. Lipid profile was altered in diabetic patients showing higher levels than in controls. In the diabetic patients, adiponectin was significantly positively correlated with NOand HDL, while it was significantly negatively correlated with glucose, HbA1C, Cholesterol, LDL, insulin and c-peptide. The ability of adiponectin to increase insulin sensitivity in conjunction with its anti-inflammatory and anti-atherogenic properties have made this novel adipocytokine a promising therapeutic tool for the future.
... Dyslipidemia is highly correlated with atherosclerosis, and up to 97 % of patients with diabetes are dyslipidemic [16]. Atherosclerosis is the major threat to the macrovasculature for patients with and without diabetes. ...
Increased risk of cerebrovascular accident in diabetes cannot be fully explained by traditional risk factors. Epidemiological studies show that postprandial hyperglycemia is strongly associated with cerebrovascular events and cerebrovascular-associated mortality. Postprandial hyperglycemia contributes to vascular damage by several mechanisms such as endothelial dysfunction, arthrosclerosis, oxidative stress, inflammation, and hypercoagulability. Hyperglycemia has deleterious effects on the vascular endothelium and leads to the development of cerebrovascular disease. Thus, an important strategy to reduce cerebrovascular risk in patients with diabetes is to reduce postprandial hyperglycemia. Glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and α-glucosidase inhibitors predominantly reduce postprandial plasma glucose levels. Among all of these, α-glucosidase inhibitors reduces postprandial hyperglycemia by delaying carbohydrate absorption from the intestine and this mechanism provides glycemic control without exacerbating coexisting cerebrovascular risk factors. Good glycemic control is proven to reduce the risk of cardiovascular complications, but equivalent evidence for cerebrovascular risk reduction is lacking. This review examines the evidences that postprandial hyperglycemia plays a major role in vascular damage, along with the complex interplay between hyperglycemia and coexisting risk factors. Furthermore, the mechanism by which α-glucosidase inhibitors may prevent this vascular damage as well as risk of hypoglycemia with α-glucosidase inhibitors are examined. Thus, this review suggests that α-glucosidase inhibitors are useful in reducing the risk of cerebrovascular events in patients with diabetes.
© Georg Thieme Verlag KG Stuttgart · New York.
... The general pathogenesis of atherosclerosis has been reviewed elsewhere [6] , but several factors specific to diabetes are worth mentioning here. Clinically, dyslipidemia is highly correlated with atherosclerosis, and up to 97% of patients with diabetes are dyslipidemic [7] . In addition to the characteristic pattern of increased triglycerides and decreased HDL cholesterol found in the plasma of patients with diabetes, abnormalities are seen in the structure of the lipoprotein particles [8] . ...
... The general pathogenesis of atherosclerosis has been reviewed elsewhere [6] , but several factors specific to diabetes are worth mentioning here. Clinically, dyslipidemia is highly correlated with atherosclerosis, and up to 97% of patients with diabetes are dyslipidemic [7] . In addition to the characteristic pattern of increased triglycerides and decreased HDL cholesterol found in the plasma of patients with diabetes, abnormalities are seen in the structure of the lipoprotein particles [8] . ...
... The general pathogenesis of atherosclerosis has been reviewed elsewhere [6] , but several factors specific to diabetes are worth mentioning here. Clinically, dyslipidemia is highly correlated with atherosclerosis, and up to 97% of patients with diabetes are dyslipidemic [7] . In addition to the characteristic pattern of increased triglycerides and decreased HDL cholesterol found in the plasma of patients with diabetes, abnormalities are seen in the structure of the lipoprotein particles [8] . ...
Type II diabetic Mellitus (DM) is a chronic metabolic disease that impairs normal insulin production and glucose transport to the liver and muscles. In the India, about 1-5% population suffer from diabetes or related complication. So there is need to cure this disease. DM chronic auditory complications may include spiral ganglia atrophy, degeneration of the vestibulocochlear nerve myelin sheath, reduction of the number of spiral lamina nerve fibers, and thickening of the capillary walls of the stria vascularis and small arteries. Aim and objective: This study aims to know the incidence of common parameters, blood sugar levels, levels of lipids and the hearing thresh-olds of individuals. Materials and Methods: It is a cross-sectional research study featuring hearing impairment in transport workers diagnosed as type II diabetic. All individuals were interviewed by various sets of questions relat-ed to listening ability of subjects and underwent a physical examination, blood investigations, glucose and lipids (Cholesterol, Triglyceride, HDL, LDL & VLDL) were measured and Ear examination performed for presence of wax. Results: There are positive findings in common parameters, clinical parameters and common questionary related to hearing impairment. Conclusion: Statistically significant differences were seen in common, blood sugar levels, lipid levels ans clinical and adaptive (acquired) parameter findings of diabetic subjects when compared to nondiabetic subjects. The findings and results gathered in this study point to the existence of a relationship between diabetic, lipid levels and hearing loss in heavy vehicle transport subjects.
Key words: Hyperglycemia, hyperlipidemia, hearing impairment.
... The general pathogenesis of atherosclerosis has been reviewed elsewhere [6] , but several factors specific to diabetes are worth mentioning here. Clinically, dyslipidemia is highly correlated with atherosclerosis, and up to 97% of patients with diabetes are dyslipidemic [7] . In addition to the characteristic pattern of increased triglycerides and decreased HDL cholesterol found in the plasma of patients with diabetes, abnormalities are seen in the structure of the lipoprotein particles [ Hearing is the ability to perceive sound. ...
Introduction: Type II diabetic mellitus (DM) is a chronic metabolic disease that impairs normal insulin production and glucose transport to the liver and muscles. In the India, about 1-5% population suffer from diabetes or related complication. So there is need to cure this disease. DM chronic auditory complications may include spiral ganglia atrophy, degeneration of the vestibulocochlear nerve mye-lin sheath, reduction of the number of spiral lamina nerve fibers, and thickening of the capillary walls of the stria vascularis and small arteries. Aim and objective: This study aims to know the incidence of common parameters, blood sugar levels, levels of lipids and the hearing thresholds of individuals. Materials and Methods: It is a cross sectional research study featuring hearing impairment in transport workers diagnosed as type II diabetic. All individuals were interviewed by various sets of questions related to listening ability of subjects and underwent a physical examination, blood investigations, glucose and lipids (Cholesterol, Triglyceride, HDL, LDL & VLDL) were measured and Ear examination performed for presence of wax. Results: There are positive findings in common parameters , clinical parameters and common questionary related to hearing impairment. Conclusion: Statistically significant differences were seen in common, blood sugar levels, lipid levels ans clinical and adaptive (acquired) parameter findings of diabetic subjects when compared to nondiabetic subjects. The findings and results gathered in this study point to the existence of a relationship between diabetic, lipid levels and hearing loss in heavy vehicle transport subjects.
... The general pathogenesis of atherosclerosis has been reviewed elsewhere [6] , but several factors specific to diabetes are worth mentioning here. Clinically, dyslipidemia is highly correlated with atherosclerosis, and up to 97% of patients with diabetes are dyslipidemic [7] . In addition to the characteristic pattern of increased triglycerides and decreased HDL cholesterol found in the plasma of patients with diabetes, abnormalities are seen in the structure of the lipoprotein particles [ Hearing is the ability to perceive sound. ...
Introduction: Type II diabetic mellitus (DM) is a chronic metabolic disease that impairs normal insulin production and glucose transport to the liver and muscles. In the India, about 1-5% population suffer from diabetes or related complication. So there is need to cure this disease. DM chronic auditory complications may include spiral ganglia atrophy, degeneration of the vestibulocochlear nerve mye-lin sheath, reduction of the number of spiral lamina nerve fibers, and thickening of the capillary walls of the stria vascularis and small arteries. Aim and objective: This study aims to know the incidence of common parameters, blood sugar levels, levels of lipids and the hearing thresholds of individuals. Materials and Methods: It is a cross sectional research study featuring hearing impairment in transport workers diagnosed as type II diabetic. All individuals were interviewed by various sets of questions related to listening ability of subjects and underwent a physical examination, blood investigations, glucose and lipids (Cholesterol, Triglyceride, HDL, LDL & VLDL) were measured and Ear examination performed for presence of wax. Results: There are positive findings in common parameters , clinical parameters and common questionary related to hearing impairment. Conclusion: Statistically significant differences were seen in common, blood sugar levels, lipid levels ans clinical and adaptive (acquired) parameter findings of diabetic subjects when compared to nondiabetic subjects. The findings and results gathered in this study point to the existence of a relationship between diabetic, lipid levels and hearing loss in heavy vehicle transport subjects.
... It has been shown that a lack of, or a disorder in its function are factors that affect HDL levels and the effectiveness of reverse cholesterol transport [16]. A study by Fagot--Campagna et al. [4] found that 97% of diabetics had at least one abnormal feature in their lipid profile. ...
... The general pathogenesis of atherosclerosis has been reviewed elsewhere [6] , but several factors specific to diabetes are worth mentioning here. Clinically, dyslipidemia is highly correlated with atherosclerosis, and up to 97% of patients with diabetes are dyslipidemic [7] . In addition to the characteristic pattern of increased triglycerides and decreased HDL cholesterol found in the plasma of patients with diabetes, abnormalities are seen in the structure of the lipoprotein particles [8] . ...
Introduction: Type II diabetic mellitus (DM) is a chronic metabolic disease that impairs normal insulin production and glucose transport to the liver and muscles. In the India, about 1-5% population suffer from diabetes or related complication. So there is need to cure this disease. DM chronic auditory complications may include spiral ganglia atrophy, degeneration of the vestibulocochlear nerve mye- lin sheath, reduction of the number of spiral lamina nerve fibers, and thickening of the capillary walls of the stria vascularis and small arteries. Aim and objective: This study aims to know the incidence of common parameters, blood sugar levels, levels of lipids and the hearing thresh- olds of individuals. Materials and Methods: It is a cross sectional research study featuring hearing impairment in transport workers diagnosed as type II diabetic. All indi- viduals were interviewed by various sets of questions relat- ed to listening ability of subjects and underwent a physical examination, blood investigations, glucose and lipids (Cholesterol, Triglyceride, HDL, LDL & VLDL) were measured and Ear examination performed for presence of wax. Results: There are positive findings in common pa- rameters, clinical parameters and common questionary related to hearing impairment. Conclusion: Statistically significant differences were seen in common, blood sugar levels, lipid levels ans clinical and adaptive (acquired) pa- rameter findings of diabetic subjects when compared to nondiabetic subjects. The findings and results gathered in this study point to the existence of a relationship between diabetic, lipid levels and hearing loss in heavy vehicle transport subjects.
... О р и г и н а л ь н ы е р а б о т ы К ак правило, ожирение у больных сахарным диабетом 2 типа (СД2) ухудшает течение артериальной гипертензии, усугубляет инсулинорезистентность, дислипидемию, повышает уровень провоспалительных маркеров [4,15,17]. ...
The aim of the present study was to investigate whether insulin treatment-induced weight gain had an adverse impact on cardiovascular risk factors in insulin-treated type 2 diabetic patients during the first year after initiating insulin therapy when insulin analogues or human insulins are used. A total of 157 patients with newly insulinized type 2 diabetes were included in the study. The patients were divided in two groups. First group consisted of subjects (mean age 57 [45; 73], duration of diabetes of 10 years [4; 16]) who had received long-acting basal (glargine, detemir), premixed (biphasic insulin aspart 30, Humalog Mix 25) or short-acting (aspart, lispro) insulin analogues. Patients from second group (mean age 59 [46; 75], duration of diabetes of 10 years [5; 15]) were treated with intermediate-acting basal (Protophane, Humulin NPH insulin), premixed (biphasic human insulin 30, Humulin M3) and regular (Actrapid, Humulin R) human insulins. Our study has shown that insulin-induced weight gain may not adversely affect cardiovascular risk factors, particularly, lipid profile, in insulin-treated type 2 diabetic patients during the first year after initiating insulin therapy. Use of insulin analogues for treatment of type 2 diabetes patients results in better glycaemic control, significant declines in blood lipid concentrations, less increase in waist circumference compared with human insulins during the first year after initiating insulin therapy.
... The general pathogenesis of atherosclerosis has been reviewed elsewhere [6] , but several factors specific to diabetes are worth mentioning here. Clinically, dyslipidemia is highly correlated with atherosclerosis, and up to 97% of patients with diabetes are dyslipidemic [7] . In addition to the characteristic pattern of increased triglycerides and decreased HDL cholesterol found in the plasma of patients with diabetes, abnormalities are seen in the structure of the lipoprotein particles [ Hearing is the ability to perceive sound. ...
Introduction: Type II diabetic mellitus (DM) is a chronic metabolic disease that impairs normal insulin production and glucose transport to the liver and muscles. In the India, about 1-5% population suffer from diabetes or related complication. So there is need to cure this disease. DM chronic auditory complications may include spiral ganglia atrophy, degeneration of the vestibulocochlear nerve mye-lin sheath, reduction of the number of spiral lamina nerve fibers, and thickening of the capillary walls of the stria vascularis and small arteries. Aim and objective: This study aims to know the incidence of common parameters, blood sugar levels, levels of lipids and the hearing thresh-olds of individuals. Materials and Methods: It is a cross sectional research study featuring hearing impairment in transport workers diagnosed as type II diabetic. All indi-viduals were interviewed by various sets of questions relat-ed to listening ability of subjects and underwent a physical examination, blood investigations, glucose and lipids (Cholesterol, Triglyceride, HDL, LDL & VLDL) were measured and Ear examination performed for presence of wax. Results: There are positive findings in common pa-rameters, clinical parameters and common questionary related to hearing impairment. Conclusion: Statistically significant differences were seen in common, blood sugar levels, lipid levels ans clinical and adaptive (acquired) pa-rameter findings of diabetic subjects when compared to nondiabetic subjects. The findings and results gathered in this study point to the existence of a relationship between diabetic, lipid levels and hearing loss in heavy vehicle transport subjects.
... It has been shown that a lack of, or a disorder in its function are factors that affect HDL levels and the effectiveness of reverse cholesterol transport [16]. A study by Fagot--Campagna et al. [4] found that 97% of diabetics had at least one abnormal feature in their lipid profile. ...
Introduction:
An important way of preventing type 2 diabetes is by adopting a proper diet by which means appropriate control over blood glycaemia and lipids can be achieved.
Objectives:
To assess selected biochemical and haematological markers in overweight subjects or those suffering from type 2 diabetes in relation to their estimated dietary intake.
Material and methods:
The study was conducted in 2012 on n = 86 overweight or obese subjects living in Warsaw or its environs, of whom n = 43 had type 2 diabetes. Dietary intakes were compared between non-diabetics (control group) and diabetics (test group) by 3 day records, whilst the relevant blood biochemistry and haematology results were obtained from medical records; with patient consent.
Results:
Diabetic subjects had significantly higher serum glucose and CRP levels than controls, respectively; 190 vs 98 mg/ dl and 1.4 vs 1.1 mg/dl. Lipid profiles were however more significantly abnormal in controls, compared to diabetics with respectively; total cholesterol 220 vs 194 mg/dl, LDL-cholesterol 131 vs 107 mg/dl and triglycerides 206 vs 157 mg/dl. There were no significant differences in HDL-cholesterol; respectively 55 vs 51 mg/dl. In the diabetics, calorific intakes from carbohydrates, especially sugars, were significantly lower than controls i.e. 9% vs 13%. The proportional share of calories derived from dietary fats did not differ between groups, nevertheless a positive correlation was observed between dietary fat content with blood cholesterol concentrations in diabetics.
Conclusions:
Disorders of carbohydrate metabolism were confirmed in both overweight and diabetic (type 2) subjects. In addition, both groups demonstrated untoward lipid profiles that correlated with their improper nutrition.
... Dyslipidemia is a common co-morbidity in T2DM patients [1]. According to the Center for Disease Control and Prevention (CDC), 70% to 97% of T2DM adults have one or more lipid abnormalities [2]. In T2DM patients, dyslipidemia is characterized by an elevated triglyceride (TG) level, a decrease in high density lipoprotein cholesterol (HDL-C) level and the presence of smaller and denser low density lipoprotein cholesterol (LDL-C) particles [1,3]. ...
Drug-Related Problems (DRPs) commonly occur among type 2 diabetes mellitus (T2DM) patients. However, few studies have been performed on T2DM patients with dyslipidemia. This purpose of this study was to assess drug-related problems (DRPs) and factors associated with its occurrence.
The retrospective study involved 208 T2DM in-patients and out-patients with dyslipidemia, and was conducted at a tertiary hospital in Malaysia from January 2009 to December 2011. The identification and assessment of DRPs were based on the Pharmaceutical Care Network Europe (PCNE) tool version 5.01. The potentially inappropriate medication use in older adults was assessed based on the American Geriatrics Society updated Beers Criteria.
A total of 406 DRPs were identified. Among these patients, 91.8% had at least one DRP, averaging 1.94 +/- 1.10 problems per patient. The majority of T2DM patients with dyslipidemia (91.8%) had at least one DRP. The most frequent types of DRP were potential drug-drug interaction (18.0%), drug not taken or administered (14.3%) and insufficient awareness of health and diseases (11.8%). Anti-hypertensive, lipid-modifying and anti-diabetic agents were the drug classes that were most likely to be associated with DRPs. Male gender, renal impairment, polypharmacy and poor lipid control were factors that were significantly associated with DRP in diabetic dyslipidemia patients.
Early identification of DRPs and factors associated with them are essential to prevent and resolve DRPs in T2DM patients with dyslipidemia.
... Dyslipidemia is a common co-morbidity in T2DM patients [1]. According to the Center for Disease Control and Prevention (CDC), 70% to 97% of T2DM adults have one or more lipid abnormalities [2]. In T2DM patients, dyslipidemia is characterized by an elevated triglyceride (TG) level, a decrease in high density lipoprotein cholesterol (HDL-C) level and the presence of smaller and denser low density lipoprotein cholesterol (LDL-C) particles [1,3]. ...
Background: Drug-Related Problems (DRPs) commonly occur among type 2 diabetes mellitus (T2DM) patients. However, few studies have been performed on T2DM patients with dyslipidemia. This purpose of this study was to assess drug-related problems (DRPs) and factors associated with its occurrence.
... Clinically, dyslipidemia is highly correlated with atherosclerosis, and up to 97% of patients with diabetes are dyslipidemic. 8 In addition to the characteristic pattern of increased triglycerides and decreased HDL cholesterol found in the plasma of patients with diabetes, abnormalities are seen in the structure of the lipoprotein particles. In diabetes, the predominant form of LDL cholesterol is the small, dense form. ...
In Brief
The pathophysiology of the link between diabetes and cardiovascular disease(CVD) is complex and multifactorial. Understanding these profound mechanisms of disease can help clinicians identify and treat CVD in patients with diabetes, as well as help patients prevent these potentially devastating complications. This article reviews the biological basis of the link between diabetes and CVD, from defects in the vasculature to the cellular and molecular mechanisms specific to insulin-resistant states and hyperglycemia. It concludes with a discussion of heart failure in diabetes, a clinical entity that demonstrates many of the mechanisms discussed.
Over the last several decades, the global incidence and prevalence of diabetes mellitus has increased significantly. The raised incidence rate is projected to continue as greater numbers of persons adopt a western lifestyle and diet. Patients with diabetes mellitus are at heightened risk of both adverse microvascular and macrovascular complications. Moreover, once cardiovascular disease develops, diabetes mellitus exacerbates progression and worsens outcomes. The risk of cardiovascular diseases associated with diabetes is probably due to genetic determinants influencing both glucose homeostasis and development of atherosclerosis. Although many genetic factors for both CAD and diabetes have been discovered, bringing important insights towards pathogenesis of these diseases. But there is comparatively less progress in our understanding of genetic basis of diabetic vascular complications. Genome wide association studies are beginning to expand our horizon of understanding of genetic architecture relating to diabetic complications that might offer an opportunity for improved risk prediction along with development of new therapies.
Background: after becoming almost extinct during the Communism period (in an effort to raise the birth rate at any price, forbidding elective tubal ligation), the C-section is regaining - as a matter of course - its place in modern Obstetrics. Thereby the c-section represents a way to prevent obstetrical complications (with very high perinatal morbidity and mortality) and not just a way to resolve these complications (when it's often too late). This transition to normality is happening for almost 25 years, but in Romania of the 3rd millennium there are still a lot of issues to solve. Methods: Our study is based on the profound implications of the fact that restricted indications to perform a c-section were applied (sometimes forbidden) as a way to safely finalize a birth. We analyze National Statistical Data (2009-2013), Official International Data, and retrospective birth registers from The Department of Obstetrics and Gynecology from the Clinical Hospital Sf. Pantelimon in Bucharest (2005, 2006 and 2014). Results: The statistical data collected and analyzed point to a rising of the c-section index in Europe, but also in Romania (more pregnant in the capital and in the Academic Centers from our country), with an evident improvement of the medical act of giving birth and also with a clear social benefit on the long term. Conclusions: The rising dynamics of the median annual Apgar score that we reviewed (median annual Apgar score for all births, for c-sections, and for natural births) is proportional with the rising number of c-sections; although the total number of registered births is lower (a general trend seen throughout the country). Maybe the foremost conclusion of this study is that prophylaxis is the cheapest, most logical and safe method of treatment, since birth.
Endoscopic endonasal approach in treating nasosinusal tumors is a technique with hotspots, precise indications and has raised a lot of controversies. First of all, it is important to have a correct diagnosis and accurate staging based on CT/ MRI scan. Selection of the surgical technique and extension of the resection depends on the site and size of the lesion, its closeness to vital structures (internal carotid artery, optic nerve, orbital cavity, cavernous sinus, middle and anterior cranial fossa), age of patient, severity of signs and symptoms, malignancy or possibility of malignant degeneration. Endoscopic sinus surgery or classic surgery, both have their own pros and cons, limited by the optimum assessment on MRI/CT scan.
Introduction: In Romania and, in fact, throughout the whole Europe, the patients are nowadays allowed to choose to abort an unwanted pregnancy, they are allowed to choose to do plastic surgery (e.g. breast prosthesis), are allowed to opt for surgical sterilization, are allowed to choose assisted human reproduction (from an anonymous sperm donor or from an anonymous oocytes donor and a surrogate mother aged up to 65 years or from the simple intrauterine insemination up to the intracytoplasmic sperm injection). These patients are allowed to refuse surgery, including Cesarean (!) by the refusal to sign the informed consent. So they are taking all these decisions (on their behalf and on the behalf of their children, too) .. but they are not allowed to choose how to give birth! Since elective Cesarean is not yet legalized .. it is allowed only with strict surgical indication. Methods: To correctly analyze the real situation in Romania we have imagined three working methods: 1. A strictly anonymous interview (type A - an opinion questionnaire with 26 questions) addressed to the patients and the general public about their choices regarding the elective Cesarean and the usefulness of the legalization of such a procedure; 2. A strictly anonymous interview (type B - an opinion questionnaire with 15 questions) addressed to the obstetricians, about their choices and the need of legalization of the elective Cesarean; these answers were statistically analyzed; 3. We compared the number of Cesarean procedures (including their indications) during 2009-2014 in several major maternity hospitals in the country. Results: We gathered a database with over 1,000 type A filled questionnaires (respondents of all ages, sexes, educational levels, religious confessions from three regions of the country), we have more than 100 type B filled questionnaires (respondent obstetricians of all ages, grades, gender, seniority) from five major maternity hospitals in the country) and we analyzed over 8,000child deliveries between 2009 - 2014 (from five major maternity hospitals in the country). Statistics are presently in full process of analysis. Conclusions: The analysis of these broad statistical data will enable us to answer several key questions: patients have the right to choose how they want to give birth? If so, why don't we allow them to choose? If not, why don't they have this right? Who is opposing this legalization and why? Which steps should be followed? Which are the foreseeable consequences of these actions? The ultimate goal of this study is not only to elucidate reality and patients and obstetricians option vis-a-vis of the analyzed subject, but also a much larger project of initiation and more ambitious, in partnership with all stakeholders, issuing a possible project law that will allow pregnant women in Romania to give birth in decent, free elected and knowingly consented conditions.
Objective:To find the risk of dyslipidaemia in diabetic patients of different age groups.
Methods:This cross-sectional study was conducted at Holy Family Hospital, Rawalpindi, and Pakistan Ordnance Factories Hospital, Wah Cantonment, Pakistan, from February to July 2014, and comprised type 2 diabetic patients. Patients' body mass index was calculated and biochemical tests were performed for high-density lipoprotein, total cholesterol, low-density lipoprotein, triglyceride and glucose. Data was analysed using SPSS 20.
Results: Of the 40 patients, 17(42.5%) were men and 23(57.5%) women. The blood glucose control of younger age group (30-40 years) was 234±90.37mg/dl compared to older age group (60-70 years) with a mean of 173.4±54.2 mg/dl. Serum triglyceride levels of the youngest age group (30-40 years) were the highest with a mean value of 216±137 mg/dl. There was a significant association between age and triglyceride levels (p=0.03) , while the serum high-density lipoprotein level of this group was lowest with a mean of 29.6±13.4 mg/dl.
Conclusion: There was a significant association between triglyceride levels in the youngest age group of patients with type 2 diabetes.
Diabetes is the fourth leading cause of death of people in Taiwan. There are about one 1 million diabetic patients in Taiwan, and medical costs account for 1/8 of health insurance funds. Goals for diabetic dietary therapeutics are to control total caloric intake, provide an appropriate ratio of nutrient and fiber intake, and maintain stable blood sugar control; these will help reduce the occurrence of complications. Because home care patients receive no nutritional interventions, and caregivers have low or inadequate nutritional knowledge, the instability of blood sugar control caused by inappropriate nutritional support will affect the utilization of nutrients. In this study, a high-fiber diabetes nutritional formula provided a portion of the source of nutrition for diabetic patients. We assessed the effects of improving the nutritional status of poor-nutrition patients using indicators such as maintaining blood sugar levels and a better nutritional status. Thirty-nine cases were recruited in this study. The enrollment criteria were home care patients either with diabetes (fasting blood sugar of 126~180 mg/dL, having been diagnosed as having diabetes, having 6.5 % < HbA1c < 7.2 % and considered to be underweight (with a body mass index of < 18 kg/m2) , having lower serum albumin than normal (< 3.5 g/dL) , or having been assessed as being malnourished, with a poor dietary intake or dysphagia (including tube feeding) . The dose of the formula was 500 ± 56 kcal/day, and the duration of the intervention was 40 ± 12 days. Results showed that the subjects' triceps skin fold thickness significantly increased from 1.97 ±0.78 to 2.00 ±0.76 cm (p = 0.005) , serum albumin significantly increased from 4.02 ± 0.46 to 4.18 ± 0.49 g/dL (p = 0.001 ) , serum total protein significantly increased from 7.26 ±0.49 to 7.46 ±0.41 g/dL (p = 0.005) , and triglyceride levels significantly dropped from 158.6 ±89.4 to 126.4 ±59.5 mg/dL (p = 0.008) . This study showed that the high-fiber diabetes nutritional formula could improve diabetes patients' anthropometrics, nutritional status, and blood lipids when provided as a part of the source of nutrition for diabetic patients.
Defective insulin secretion & resistance to insulin action along with alterations of lipid and protein metabolism may leads to hyperglycaemia, which is characteristic of a chronic metabolic disorder i.e. Diabetes mellitus (DM). Diabetic morbidity is due to microvascular complications (Diabetic retinopathy, Diabetic nephropathy, Diabetic peripheral neuropathy, and Diabetic autonomic neuropathy) whereas diabetic mortality is result of macrovascular complications (Coronary heart disease, Peripheral vascular disease, cerebrovascular disease). Persistent hyperglycaemia causes microvascular complications but macrovascular complications are due to persistent hyperglycaemia associated with hypertension, dyslipidaemia, smoking. Principle aim of this review is to provide concise insights of diabetes & complications for pharmacy researchers as there is more research warranted on oral hypoglycaemic agents. This review also provides important pathophysiological characteristics of diabetic musculoskeletal & rheumatological complications.
The firm association of diabetes mellitus with congestive heart failure (CHF) has been undoubtedly established. Recent reports support the presence of the reciprocal interrelationships between CHF and glucose abnormalities. The present review provides an overview of some aspects of the multifactorial interrelationships between heart failure and diabetes mellitus. Patients with heart failure are generally at higher risk of developing type 2 diabetes mellitus. Several factors may be involved, such as a lack of physical activity, hypermetabolic state, intracellular metabolic defects, poor muscle perfusion, and poor nutrition. Serum levels of inflammatory cytokines and leptin are elevated in patients with heart failure. Activation of the sympathetic system in CHF not only increases insulin resistance but also decreases the release of insulin from the pancreatic β cells, increases hepatic glucose production by stimulating both gluconeogenesis and glycogenolysis, and increases glucagon production and lipolysis. People who develop type 2 diabetes mellitus usually pass through the phases of nuclear peroxisome proliferator-activated receptor modulation, insulin resistance, hyperinsulinemia, pancreatic β-cell stress and damage leading to progressively decreasing insulin secretion, and impaired fasting and postprandial blood glucose levels. Once hyperglycemia ensues, the risk of metabolic and cardiovascular complications also increases. It is possible that the cornerstone of diabetes mellitus prevention in patients with CHF could be controlled by increased physical activity in a cardiac rehabilitation framework. Pharmacologic interventions by some medications (metformin, orlistat, ramipril and acarbose) can also effectively delay progression to type 2 diabetes mellitus in general high risk populations, but the magnitude of the benefit in patients with CHF is unknown. In patients with CHF and overt diabetes mellitus, ACE inhibitors may provide a special advantage and should be the first-line agent. Recent reports have suggested that angiotensin receptor antagonists (angiotensin receptor blockers), similar to ACE inhibitors, provide beneficial effects in patients with diabetes mellitus and should be the second-line agent if ACE inhibitors are contraindicated. Treatment with HMG-CoA reductase inhibitors should probably now be considered routinely for all diabetic patients with CHF, irrespective of their initial serum cholesterol levels, unless there is a contraindication.
Background
Diabetes Mellitus is a chronic metabolic disorder which may lead to various complications, the important being dyslipidemia leading to Coronary Heart Disorders (CHD), the major cause for morbidity and mortality in diabetic patients. Diabetes Mellitus could be treated by nutritional therapy/drug therapy and others. But the drug therapy would have its own limitations and side effects. To overcome from this an herbal extract is recommended, such as Diallyl Disulphide (DADS) a principle compound of Garlic oil.
IN BRIEF
Because type 2 diabetes can be considered a cardiovascular disease in its own right, current American Diabetes Association and National Cholesterol Education Program guidelines recommend aggressive treatment of dyslipidemia in people with diabetes, particularly for elevated LDL cholesterol levels. Use of appropriate treatment as determined by the pattern of lipid abnormalities can substantially reduce the risk of macrovascular disease. Institution of tight glycemic control will be beneficial to most patients, but the majority of people with diabetes will also require diet therapy, weight reduction when necessary, and intensive lipid-lowering therapy, which commonly involves one of the statins or fibric acid derivatives.
The atherogenic lipid phenotype (ALP) and lipoprotein (a) [Lp(a)] are strongly implicated emerging risk factors for cardiovascular (CV) disease among diabetic patients. The ALP and Lp(a) have been strongly linked to CV disease by epidemiological prevalence, risk, and interventional studies. The origins of ALP, especially small, dense low-density lipoprotein (LDL) and reduced levels of total high-density lipoprotein (HDL) cholesterol and HDL2, are related to increased levels of triglyceride and increased hepatic production of very low-density lipoprotein 1 (VLDL1). Remodeling of VLDL1 in the circulation ultimately results in the formation of small, dense LDL and low levels of HDL. These molecular events are often tightly linked, so patients have a composite or profile of abnormalities including increased triglycerides, small LDL particle size, a preponderance of small, dense LDL particle mass, and diminished levels of total HDL cholesterol and HDL fraction 2 (HDL2). Methods used to measure these lipids center around ultracentrifugation, gel electrophoresis and nuclear magnetic resonance technology. The diagnostic criteria for these emerging CV risk factors remain somewhat ambiguous and require further clarification. Treatment of ALP and Lp(a) is currently quite effective according to data derived from preliminary studies. Therapies such as niacin products, fenofibrate, and atorvastatin are successful, but combination therapy with extended-release niacin and atorvastatin appears to be the best current treatment.
The metabolic goal of therapy in gestational diabetes (GD) is to maintain euglycemia, and when it is not achieved with diet alone, insulin therapy is added (1). Physical training has both acute and long-term effects on insulin sensitivity, insulin secretion, and glucose metabolism in both nondiabetic and diabetic subjects (2), and the benefit of training has also been shown in patients with GD, where controlled training achieves euglycemia with no need for insulin treatment (3). Nevertheless, physical exercise of moderate intensity has been associated with uterine contractions unless performed with the arms (4).
The clinical observation that light postprandial exercise …
Studies such as the Diabetes Control and Complications Trial have shown that, as in adult patients, intensive diabetes management in adolescent patients results in better glycemic control and delays the onset and slows the progression of vascular and neurological complications (1). However, a cross-sectional multinational study showed that less than one-third of the children and adolescents who underwent treatment for diabetes had adequate metabolic control (2). Providing a constant supply of basal insulin that mimics that of healthy individuals is an essential aspect of maintaining tight glycemic control in patients with type 1 diabetes. The traditional NPH insulin and ultralente basal insulin formulations do not provide a constant and reliable 24-h basal insulin supply because their duration of action is too short, and unwanted peaks of action in the night can cause nocturnal hypoglycemia (3). This is of particular relevance in children and adolescents, who are more prone to hypoglycemic episodes (4,5).
A new long-acting insulin analog has been developed using recombinant DNA technology. Insulin glargine differs from human insulin by the addition of two additional arginines on the COOH terminus of the B-chain and the replacement of an asparagine residue with glycine on the A-chain (6). The resulting molecule has a peakless, prolonged time-action profile and …
The receptor for advanced glycation end products (RAGE) has been implicated in the development of vascular complications of diabetes by both in vitro and in vivo studies (1). The most compelling evidence demonstrated that blocking of AGE/RAGE binding prevented atherosclerotic development in animal models (2). It is plausible that genetic differences in the RAGE gene could alter expression and function to affect disease development. In previous studies, we have identified a number of potentially functional polymorphisms: Gly82Ser in the AGE-binding domain (3) and two common promoter polymorphisms at positions −429 and −374 (4). The Gly82Ser polymorphism was not found to relate …
Nowadays, it is agreed that childhood type 1 diabetes is a progressively developing disease in which the clinical unmasking is usually triggered by an infectious (viral) disease, oftentimes during the yearly viral epidemic in autumn and winter (1). The timing of the onset of the autoimmune process and its initiating factor(s) are uncertain and controversial. One of the proposed mechanisms is that viruses damage the pancreatic β-cells and trigger the autoimmune process (2), which, by subsequent destruction at a loss of 70–80% of β-cells, causes the clinical disease.
Epidemiological studies performed by Z.L. and I.A. in recent years in Israel (3 …
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