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Álvarez-Aguilar C, Arroyo-Ramírez E, Gómez-García A, Alvarez-Paredes AR, Rodríguez-Orozco AR, Flores-Guajardo G, Rangel-López A. [BNP predicts mortality of cardiovascular disease in patients with end-stage renal disease treated]. Rev Med Inst Mex Seguro Soc 2017; 55:S158-S166. [PMID: 29697237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Mortality for cardiovascular disease (CVD) in patients with chronic kidney disease (CKD) is higher. In the end-stage renal disease (ESRD) the mortality is 20 times greater in comparison with general population. Natriuretic peptides, particularly type-B natriuretic peptide (BNP) have been studied as potential markers of risk of cardiovascular (CV) mortality. The aim of this paper is to determine whether BNP acts as a prognostic marker for CV mortality in patients with ESRD. METHODS We studied 53 patients with ESRD prevalent in peritoneal dialysis without clinical evidence of heart failure at baseline was studied. The impact of variables was performed with linear regression model. The probability of survival was estimated by Kaplan-Meir analysis and the difference between survivals between groups with log-rank test according the levels of BNP. Adjusted hazard ratios were calculated with Cox proportional hazards analysis. RESULTS BNP strongly predicts CVD mortality. The Cox regression model showed that BNP is a predictor of death from CVD. Patients with high levels of BNP were at increased risk of death. Several pathophysiological mechanisms not well defined are involved. CONCLUSIONS BNP predicts CVD mortality in patients with ESRD. Serum measurement of this peptide can be useful for risk stratification in these patients and adjust treatment.
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Affiliation(s)
- Cleto Álvarez-Aguilar
- Hospital General Regional No. 1, Instituto Mexicano del Seguro Social, Morelia, Michoacán de Ocampo, México
Correo electrónico:
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152
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Ebrahimi M, Guilan-Nejad TN, Pordanjani AF. Effect of yoga and aerobics exercise on sleep quality in women with Type 2 diabetes: a randomized controlled trial. ACTA ACUST UNITED AC 2017; 10:68-72. [PMID: 28966742 DOI: 10.5935/1984-0063.20170012] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was investigating the effect of 12 weeks of yoga and aerobic exercise (running on a treadmill) on the sleep quality in women with Type 2 diabetes. MATERIALS AND METHODS 39 diabetic women were selected from Semnan city with the mean age of 46.85±3.35 years, weight of 69.79±17.18 kg, height of 155.03±5.00, BMI of 29.64±5.00 kg/m2 who had a background of diabetes for 6.46±2.69 years. They were then randomly divided into yoga exercise (n=15), aerobic exercise (n=13), and control group (n=11). The exercise program was performed for 12 weeks, three sessions per each week. In order to measure the sleep quality, the Pittsburgh Sleep Quality Index (PSQI) was used. The data were analyzed by non-parametric wilcoxon and Kruskal-Wallis Test at significance level of p<0.05. RESULTS Overall score of sleep quality improved after six (p=0.001) and 12 (p=0.001) weeks of yoga exercise. Also, significant effect was observed after 6 weeks of aerobic exercise (p=0.039). However, the positive effect was diminished to under significant levels after 12 weeks of aerobic exercise (p=0.154). Kruskal-Wallis Test showed significant differences between yoga and aerobic groups after 12 weeks of exercise (p=0.002). No significant differences were observed in control groups in all situation. CONCLUSIONS It can be concluded that yoga exercise is more effective in improving the sleep quality in comparison with the same course of aerobic exercise in women suffering from diabetes Type 2. Thus, yoga exercise can be suggested to these patients.
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Affiliation(s)
- Mohsen Ebrahimi
- Department of Sports Sciences, Semnan University, Semnan, Iran
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Hung AM, Roumie CL, Greevy RA, Grijalva CG, Liu X, Murff HJ, Ikizler TA, Griffin MR. Comparative Effectiveness of Second-Line Agents for the Treatment of Diabetes Type 2 in Preventing Kidney Function Decline. Clin J Am Soc Nephrol 2016; 11:2177-2185. [PMID: 27827311 PMCID: PMC5142060 DOI: 10.2215/cjn.02630316] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/01/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Diabetes is the leading cause of ESRD. Glucose control improves kidney outcomes. Most patients eventually require treatment intensification with second-line medications; however, the differential effects of those therapies on kidney function are unknown. DESIGN, SETTING, PARTICIPANTS & MEASUREMENTS We studied a retrospective cohort of veterans on metformin monotherapy from 2001 to 2008 who added either insulin or sulfonylurea and were followed through September of 2011. We used propensity score matching 1:4 for those who intensified with insulin versus sulfonylurea, respectively. The primary composite outcome was persistent decline in eGFR≥35% from baseline (GFR event) or a diagnosis of ESRD. The secondary outcome was a GFR event, ESRD, or death. Outcome risks were compared using marginal structural models to account for time-varying covariates. The primary analysis required persistence with the intensified regimen. An effect modification of baseline eGFR and the intervention on both outcomes was evaluated. RESULTS There were 1989 patients on metformin and insulin and 7956 patients on metformin and sulfonylurea. Median patient age was 60 years old (interquartile range, 54-67), median hemoglobin A1c was 8.1% (interquartile range, 7.1%-9.9%), and median creatinine was 1.0 mg/dl (interquartile range, 0.9-1.1). The rate of GFR event or ESRD (primary outcome) was 31 versus 26 per 1000 person-years for those who added insulin versus sulfonylureas, respectively (adjusted hazard ratio, 1.27; 95% confidence interval, 0.99 to 1.63). The rate of GFR event, ESRD, or death was 64 versus 49 per 1000 person-years, respectively (adjusted hazard ratio, 1.33; 95% confidence interval, 1.11 to 1.59). Tests for a therapy by baseline eGFR interaction for both the primary and secondary outcomes were not significant (P=0.39 and P=0.12, respectively). CONCLUSIONS Among patients who intensified metformin monotherapy, the addition of insulin compared with a sulfonylurea was not associated with a higher rate of kidney outcomes but was associated with a higher rate of the composite outcome that included death. These risks were not modified by baseline eGFR.
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Affiliation(s)
- Adriana M. Hung
- Health Services Research and Development Center, Veterans Health Administration Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, Nashville, Tennessee
- Veterans Health Administration Tennessee Valley Healthcare System Clinical Science Research and Development, Nashville, Tennessee; and
- Departments of Medicine
| | - Christianne L. Roumie
- Health Services Research and Development Center, Veterans Health Administration Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, Nashville, Tennessee
- Veterans Health Administration Tennessee Valley Healthcare System Clinical Science Research and Development, Nashville, Tennessee; and
- Departments of Medicine
| | - Robert A. Greevy
- Health Services Research and Development Center, Veterans Health Administration Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, Nashville, Tennessee
- Biostatistics, and
| | - Carlos G. Grijalva
- Health Services Research and Development Center, Veterans Health Administration Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, Nashville, Tennessee
- Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Xulei Liu
- Health Services Research and Development Center, Veterans Health Administration Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, Nashville, Tennessee
- Biostatistics, and
| | - Harvey J. Murff
- Health Services Research and Development Center, Veterans Health Administration Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, Nashville, Tennessee
- Departments of Medicine
| | - T. Alp Ikizler
- Veterans Health Administration Tennessee Valley Healthcare System Clinical Science Research and Development, Nashville, Tennessee; and
- Departments of Medicine
| | - Marie R. Griffin
- Health Services Research and Development Center, Veterans Health Administration Tennessee Valley Healthcare System Geriatric Research Education Clinical Center, Nashville, Tennessee
- Departments of Medicine
- Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
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154
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Palevsky PM, Zhang JH, Seliger SL, Emanuele N, Fried LF. Incidence, Severity, and Outcomes of AKI Associated with Dual Renin-Angiotensin System Blockade. Clin J Am Soc Nephrol 2016; 11:1944-1953. [PMID: 27679519 PMCID: PMC5108193 DOI: 10.2215/cjn.03470316] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 07/22/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND OBJECTIVES The benefit of dual blockade of the renin-angiotensin system is limited by adverse effects. We performed a secondary analysis of the Veterans Affairs Nephropathy in Diabetes (VA NEPHRON-D) Study to describe the effect of increased intensity of renin-angiotensin system blockade on the incidence, risk factors, and outcomes of AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In the VA NEPHRON-D Study, we randomized 1148 veterans receiving outpatient care with type 2 diabetes mellitus, eGFR of between 30 and 89.9 ml/min per 1.73 m2, and urinary albumin excretion of at least 300 μg/mg creatinine (or a urinary total protein of at least 0.5 mg/mg creatinine) to either combination therapy with losartan and lisinopril or monotherapy with losartan. We identified hospitalized AKI events and their outcomes during a median follow-up of 2.2 years through systematic reporting of serious adverse events. RESULTS The incidence of AKI was 12.2 (95% confidence interval, 10.5 to 14.0) versus 6.7 (95% confidence interval, 5.6 to 8.2) per 100 patient-years in the combination arm versus monotherapy arms (P<0.001). Individuals with AKI were more likely to develop the primary study end point of death, ESRD, or decline in kidney function (hazard ratio, 1.78; 95% confidence interval, 1.34 to 2.26; P<0.001). Patients with AKI in the combination arm had greater recovery of kidney function (75.9% versus 66.3%; P=0.04), lower 30-day mortality (4.7% versus 15.0%; P<0.01), and lower hazard for development of the primary study end point (hazard ratio, 0.60; 95% confidence interval, 0.37 to 0.98). CONCLUSIONS Dual renin-angiotensin system blockade was associated with an increased risk of AKI compared with monotherapy, but AKI in the setting of monotherapy was associated with lower rates of recovery of kidney function, higher mortality, and higher risk of progression of kidney disease.
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Affiliation(s)
- Paul M. Palevsky
- Medical Service, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jane H. Zhang
- Cooperative Studies Program Coordinating Center, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
| | - Stephen L. Seliger
- Medical Service, Veterans Affairs Maryland Healthcare System, Baltimore, Maryland
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Nicholas Emanuele
- Medical Service, Edward Hines, Jr. Veterans Affairs Hospital, Hines, Illinois; and
- Department of Medicine, Stritch School of Medicine, Loyola University, Maywood, Illinois
| | - Linda F. Fried
- Medical Service, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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155
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Jafari J, Karimi Moonaghi H, Zary N, Masiello I. Exploring educational needs and design aspects of internet-enabled patient education for persons with diabetes: a qualitative interview study. BMJ Open 2016; 6:e013282. [PMID: 27799245 PMCID: PMC5093674 DOI: 10.1136/bmjopen-2016-013282] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The objective of this article is to explore the educational needs and design aspects of personalised internet-enabled education for patients with diabetes in Iran. DESIGN Data were collected using semistructured interviews and then qualitatively analysed using inductive content analysis. PARTICIPANTS 9 patients with type 2 diabetes were included. Inclusion criteria were access to and knowledge on how to use the internet. The selection ensured representation based on gender, age, occupation and educational background. SETTING The sample population was patients with diabetes who were admitted to an outpatient diabetes clinic in Mashhad, a large city of Iran with about 3 million inhabitants. RESULTS 4 core categories emerged from the data: (1) seeking knowledge about diabetes, including specific knowledge acquisition, patient's interactions and learning requirements; (2) teaching and learning, including using different teaching methods and different ways to learn about the disease; (3) facilitators, including internet and mobile phone use to learn about the disease; and (4) barriers, including lack of internet access, uncertainty of access to the internet and lack of website in the local language and also perceived cultural barriers, such as patients' fears of the internet, lack of time and awareness. CONCLUSIONS This study provides a better understanding of the patient's educational expectations and technical needs in relation to internet-enabled education. This knowledge will inform the development of functional mock-ups in the next research phase using a design-based research approach in order to design internet-enabled patient education for self-management of diabetes.
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Affiliation(s)
- Javad Jafari
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hosein Karimi Moonaghi
- Evidence-Based Caring Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nabil Zary
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Italo Masiello
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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Shin MY, Kim JM, Kang YE, Kim MK, Joung KH, Lee JH, Kim KS, Kim HJ, Ku BJ, Shong M. Association between Growth Differentiation Factor 15 (GDF15) and Cardiovascular Risk in Patients with Newly Diagnosed Type 2 Diabetes Mellitus. J Korean Med Sci 2016; 31:1413-8. [PMID: 27510384 PMCID: PMC4974182 DOI: 10.3346/jkms.2016.31.9.1413] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 05/18/2016] [Indexed: 11/20/2022] Open
Abstract
We investigated an association between serum Growth Differentiation Factor 15 (GDF15) level and cardiovascular risk in patients with newly diagnosed type 2 diabetes mellitus (T2D). A total of 107 participants were screened for T2D and divided into a T2D group and a control group (without diabetes). We used the Framingham risk score (FRS) and the New Pooled Cohort Equation score to estimate the 10-year risk of atherosclerotic cardiovascular disease. Serum GDF15 levels were measured using an enzyme-linked immunosorbent assay. Correlation analyses were performed to evaluate the associations between GDF15 level and cardiovascular risk scores. The mean serum GDF15 level was elevated in the T2D group compared to the control group (P < 0.001). A positive correlation was evident between serum GDF15 level and age (r = 0.418, P = 0.001), the FRS (r = 0.457, P < 0.001), and the Pooled Cohort Equation score (r = 0.539, P < 0.001). After adjusting for age, LDL-C level, and body mass index (BMI), the serum GDF15 level was positively correlated with the FRS and the New Pooled Cohort Equation score. The serum GDF15 level is independently associated with cardiovascular risk scores of newly diagnosed T2D patients. This suggests that the level of GDF15 may be a useful predictive biomarker of cardiovascular risk in newly diagnosed T2D patients.
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Affiliation(s)
- Min Young Shin
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Ji Min Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Yea Eun Kang
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Min Kyeong Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Kyong Hye Joung
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Ju Hee Lee
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Koon Soon Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hyun Jin Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Bon Jeong Ku
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
| | - Minho Shong
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
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Nadkarni GN, Rao V, Ismail-Beigi F, Fonseca VA, Shah SV, Simonson MS, Cantley L, Devarajan P, Parikh CR, Coca SG. Association of Urinary Biomarkers of Inflammation, Injury, and Fibrosis with Renal Function Decline: The ACCORD Trial. Clin J Am Soc Nephrol 2016; 11:1343-1352. [PMID: 27189318 PMCID: PMC4974890 DOI: 10.2215/cjn.12051115] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 04/12/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVES Current measures for predicting renal functional decline in patients with type 2 diabetes with preserved renal function are unsatisfactory, and multiple markers assessing various biologic axes may improve prediction. We examined the association of four biomarker-to-creatinine ratio levels (monocyte chemotactic protein-1, IL-18, kidney injury molecule-1, and YKL-40) with renal outcome. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We used a nested case-control design in the Action to Control Cardiovascular Disease Trial by matching 190 participants with ≥40% sustained eGFR decline over the 5-year follow-up period to 190 participants with ≤10% eGFR decline in a 1:1 fashion on key characteristics (age within 5 years, sex, race, baseline albumin-to-creatinine ratio within 20 μg/mg, and baseline eGFR within 10 ml/min per 1.73 m(2)), with ≤10% decline. We used a Mesoscale Multiplex Platform and measured biomarkers in baseline and 24-month specimens, and we examined biomarker associations with outcome using conditional logistic regression. RESULTS Baseline and 24-month levels of monocyte chemotactic protein-1-to-creatinine ratio levels were higher for cases versus controls. The highest quartile of baseline monocyte chemotactic protein-1-to-creatinine ratio had fivefold greater odds, and each log increment had 2.27-fold higher odds for outcome (odds ratio, 5.27; 95% confidence interval, 2.19 to 12.71 and odds ratio, 2.27; 95% confidence interval, 1.44 to 3.58, respectively). IL-18-to-creatinine ratio, kidney injury molecule-1-to-creatinine ratio, and YKL-40-to-creatinine ratio were not consistently associated with outcome. C statistic for traditional predictors of eGFR decline was 0.70, which improved significantly to 0.74 with monocyte chemotactic protein-1-to-creatinine ratio. CONCLUSIONS Urinary monocyte chemotactic protein-1-to-creatinine ratio concentrations were strongly associated with sustained renal decline in patients with type 2 diabetes with preserved renal function.
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Affiliation(s)
- Girish N. Nadkarni
- Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Veena Rao
- Department of Medicine, Division of Nephrology, Yale University School of Medicine, New Haven, Connecticut
| | - Faramarz Ismail-Beigi
- Department of Medicine, Division of Clinical and Molecular Endocrinology, Case Western Reserve University, Cleveland, Ohio
| | - Vivian A. Fonseca
- Department of Medicine, Division of Endocrinology, Tulane University, New Orleans, Louisiana
| | - Sudhir V. Shah
- Department of Medicine, Division of Nephrology, University of Arkansas Medical Sciences, Little Rock, Arkansas; and
| | - Michael S. Simonson
- Department of Medicine, Division of Clinical and Molecular Endocrinology, Case Western Reserve University, Cleveland, Ohio
| | - Lloyd Cantley
- Department of Medicine, Division of Nephrology, Yale University School of Medicine, New Haven, Connecticut
| | - Prasad Devarajan
- Department of Pediatrics, Division of Nephrology, University of Cincinnati, Cincinnati, Ohio
| | - Chirag R. Parikh
- Department of Medicine, Division of Nephrology, Yale University School of Medicine, New Haven, Connecticut
| | - Steven G. Coca
- Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York
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158
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Amor M, Moreno Viedma V, Sarabi A, Grün NG, Itariu B, Leitner L, Steiner I, Bilban M, Kodama K, Butte AJ, Staffler G, Zeyda M, Stulnig TM. Identification of matrix metalloproteinase-12 as a candidate molecule for prevention and treatment of cardiometabolic disease. Mol Med 2016; 22:487-496. [PMID: 27385318 DOI: 10.2119/molmed.2016.00068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/22/2016] [Indexed: 01/01/2023] Open
Abstract
Obesity is strongly associated with metabolic syndrome, a combination of risk factors that predispose to the development of the cardiometabolic diseases: atherosclerotic cardiovascular disease and type 2 diabetes mellitus. Prevention of metabolic syndrome requires novel interventions to address this health challenge. The objective of this study was the identification of candidate molecules for the prevention and treatment of insulin resistance and atherosclerosis, conditions that underlie type 2 diabetes mellitus and cardiovascular disease, respectively. We used an unbiased bioinformatics approach to identify molecules that are upregulated in both conditions by combining murine and human data from a microarray experiment and meta-analyses. We obtained a pool of eight genes that were upregulated in all the databases analysed. This included well known and novel molecules involved in the pathophysiology of type 2 diabetes mellitus and cardiovascular disease. Notably, matrix metalloproteinase 12 (MMP12) was highly ranked in all analyses and was therefore chosen for further investigation. Analyses of visceral and subcutaneous white adipose tissue from obese compared to lean mice and humans convincingly confirmed the up-regulation of MMP12 in obesity at mRNA, protein and activity levels. In conclusion, using this unbiased approach an interesting pool of candidate molecules was identified, all of which have potential as targets in the treatment and prevention of cardiometabolic diseases.
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Affiliation(s)
- M Amor
- Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - V Moreno Viedma
- Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - A Sarabi
- Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - N G Grün
- Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - B Itariu
- Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - L Leitner
- Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - I Steiner
- Center for Medical Statistics, Informatics, and Intelligent Systems, Section for Medical Statistics, Medical University of Vienna, Austria
| | - M Bilban
- Core Facility Genomics, Core Facilities, Medical University of Vienna, Vienna, Austria
| | - K Kodama
- Institute for Computational Health Sciences. University of California, San Francisco, EEUU
| | - A J Butte
- Institute for Computational Health Sciences. University of California, San Francisco, EEUU
| | | | - M Zeyda
- Department of Pediatrics and Adolescent Medicine, Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Medical University of Vienna
| | - T M Stulnig
- Christian Doppler Laboratory for Cardio-Metabolic Immunotherapy and Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
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159
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Ma J, Guan M, Bowden DW, Ng MC, Hicks PJ, Lea JP, Ma L, Gao C, Palmer ND, Freedman BI. Association Analysis of the Cubilin (CUBN) and Megalin (LRP2) Genes with ESRD in African Americans. Clin J Am Soc Nephrol 2016; 11:1034-1043. [PMID: 27197912 PMCID: PMC4891762 DOI: 10.2215/cjn.12971215] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 02/23/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVES Genetic variation in the cubilin (CUBN) gene is associated with albuminuria and CKD. Common and rare coding variants in CUBN and the gene encoding its transport partner megalin (LRP2) were assessed for association with ESRD in blacks. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Sixty-six CUBN and LRP2 single-nucleotide polymorphisms (SNPs) were selected and analyzed in this multistage study. Exome sequencing data from 529 blacks with type 2 diabetes (T2D) -associated ESRD and 535 controls lacking T2D or nephropathy (the Type 2 Diabetes Genes [T2D-GENES] Consortium) were first evaluated, focusing on coding variants in CUBN and LRP2; 15 potentially associated SNPs identified from the T2D-GENES Consortium as well as 51 other selected SNPs were then assessed in an independent T2D-ESRD sample set of blacks (the Affymetrix Axiom Biobank Genotyping Array [AXIOM]; 2041 patients with T2D-ESRD, 627 patients with T2D without nephropathy, and 1140 nondiabetic, non-nephropathy controls). A meta-analysis combining the T2D-GENES Consortium and the AXIOM data was performed for 18 overlapping SNPs. Additionally, all 66 SNPs were genotyped in the Wake Forest School of Medicine samples of blacks with nondiabetic ESRD (885 patients with nondiabetic ESRD and 721 controls). Association testing with ESRD was performed in models including age, sex, African ancestry proportion, and apolipoprotein L1 gene renal-risk variants. RESULTS CUBN SNP rs1801239 (I2984V), previously associated with albuminuria, was significantly associated with T2D-ESRD in blacks (the T2D-GENES Consortium and the AXIOM meta-analysis, P=0.03; odds ratio, 1.31; 95% confidence interval, 1.03 to 1.67; minor allele frequency =0.028). A novel LRP2 missense variant, rs17848169 (N2632D), was also significantly protective from T2D-ESRD (the T2D-GENES Consortium and the AXIOM, P<0.002; odds ratio, 0.47; 95% confidence interval, 0.29 to 0.75; meta-analysis minor allele frequency =0.007). Neither SNP was associated with T2D when contrasting patients with T2D with controls lacking diabetes. CUBN and LRP2 SNPs were not associated with nondiabetic etiologies of ESRD. CONCLUSIONS Evidence for genetic association exists between a cubilin and a rare megalin variant with diabetes-associated ESRD in populations with recent African ancestry.
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Affiliation(s)
- Jun Ma
- Department of Internal Medicine, Section on Nephrology and
- Department of Nephrology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; and
| | - Meijian Guan
- Department of Biochemistry and Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Donald W. Bowden
- Department of Biochemistry and Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Maggie C.Y. Ng
- Department of Biochemistry and Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Pamela J. Hicks
- Department of Biochemistry and Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Janice P. Lea
- Division of Renal Medicine, Department of Medicine, Emory School of Medicine, Atlanta, Georgia
| | - Lijun Ma
- Department of Internal Medicine, Section on Nephrology and
| | - Chuan Gao
- Department of Biochemistry and Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nicholette D. Palmer
- Department of Biochemistry and Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Abstract
Prolonged P-wave duration has been observed in diabetes. However, the underlying mechanisms remain unclear. The aim of this study was to elucidate the possible mechanisms. A rat model of type 2 diabetes mellitus (T2DM) was used. P-wave durations were obtained using surface electrocardiography and sizes of the left atrium were determined using echocardiography. Cardiac inward rectifier K(+) currents (Ik1), Na(+) currents (INa), and action potentials were recorded from isolated left atrial myocytes using patch clamp techniques. Left atrial tissue specimens were analyzed for total connexin-40 (Cx40) and connexin-43 (Cx43) expression levels on western-blots. Specimens were also analyzed for Cx40 and Cx43 distribution and interstitial fibrosis by immunofluorescent and Masson trichrome staining, respectively. The mean P-wave duration was longer in T2DM rats than in controls; however, the mean left atrial sizes of each group of rats were similar. The densities of Ik1 and INa were unchanged in T2DM rats compared to controls. The action potential duration was longer in T2DM rats, but there was no significant difference in resting membrane potential or action potential amplitude compared to controls. The expression level of Cx40 protein was significantly lower, but Cx43 was unaltered in T2DM rats. However, immunofluorescent labeling of Cx43 showed a significantly enhanced lateralization. Staining showed interstitial fibrosis was greater in T2DM atrial tissue. Prolonged P-wave duration is not dependent on the left atrial size in rats with T2DM. Dysregulation of Cx40 and Cx43 protein expression, as well as fibrosis, might partly account for the prolongation of P-wave duration in T2DM.
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Affiliation(s)
- Bin Li
- Department of Cardiology, Shenjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yilong Pan
- Department of Cardiology, Shenjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaodong Li
- Department of Cardiology, Shenjing Hospital of China Medical University, Shenyang, Liaoning, China
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161
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Kim EK, Oh TJ, Kim LK, Cho YM. Improving Effect of the Acute Administration of Dietary Fiber-Enriched Cereals on Blood Glucose Levels and Gut Hormone Secretion. J Korean Med Sci 2016; 31:222-30. [PMID: 26839476 PMCID: PMC4729502 DOI: 10.3346/jkms.2016.31.2.222] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 12/10/2015] [Indexed: 12/12/2022] Open
Abstract
Dietary fiber improves hyperglycemia in patients with type 2 diabetes through its physicochemical properties and possible modulation of gut hormone secretion, such as glucagon-like peptide 1 (GLP-1). We assessed the effect of dietary fiber-enriched cereal flakes (DC) on postprandial hyperglycemia and gut hormone secretion in patients with type 2 diabetes. Thirteen participants ate isocaloric meals based on either DC or conventional cereal flakes (CC) in a crossover design. DC or CC was provided for dinner, night snack on day 1 and breakfast on day 2, followed by a high-fat lunch. On day 2, the levels of plasma glucose, GLP-1, glucose-dependent insulinotropic polypeptide (GIP), and insulin were measured. Compared to CC, DC intake exhibited a lower post-breakfast 2-hours glucose level (198.5±12.8 vs. 245.9±15.2 mg/dL, P<0.05) and a lower incremental peak of glucose from baseline (101.8±9.1 vs. 140.3±14.3 mg/dL, P<0.001). The incremental area under the curve (iAUC) of glucose after breakfast was lower with DC than with CC (P<0.001). However, there were no differences in the plasma insulin, glucagon, GLP-1, and GIP levels. In conclusion, acute administration of DC attenuates postprandial hyperglycemia without any significant change in the representative glucose-regulating hormones in patients with type 2 diabetes (ClinicalTrials.gov. NCT 01997281).
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Affiliation(s)
- Eun Ky Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Lee-Kyung Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Young Min Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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162
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Choi K, Oh TJ, Lee JC, Kim M, Kim HC, Cho YM, Kim S. In-Silico Trials for Glucose Control in Hospitalized Patients with Type 2 Diabetes. J Korean Med Sci 2016; 31:231-9. [PMID: 26839477 PMCID: PMC4729503 DOI: 10.3346/jkms.2016.31.2.231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/28/2015] [Indexed: 02/01/2023] Open
Abstract
Although various basal-bolus insulin therapy (BBIT) protocols have been used in the clinical environment, safer and more effective BBIT protocols are required for glucose control in hospitalized patients with type 2 diabetes (T2D). Modeling approaches could provide an evaluation environment for developing the optimal BBIT protocol prior to clinical trials at low cost and without risk of danger. In this study, an in-silico model was proposed to evaluate subcutaneous BBIT protocols in hospitalized patients with T2D. The proposed model was validated by comparing the BBIT protocol and sliding-scale insulin therapy (SSIT) protocol. The model was utilized for in-silico trials to compare the protocols of adjusting basal-insulin dose (BBIT1) versus adjusting total-daily-insulin dose (BBIT2). The model was also used to evaluate two different initial total-daily-insulin doses for various levels of renal function. The BBIT outcomes were superior to those of SSIT, which is consistent with earlier studies. BBIT2 also outperformed BBIT1, producing a decreased daily mean glucose level and longer time-in-target-range. Moreover, with a standard dose, the overall daily mean glucose levels reached the target range faster than with a reduced-dose for all degrees of renal function. The in-silico studies demonstrated several significant findings, including that the adjustment of total-daily-insulin dose is more effective than changes to basal-insulin dose alone. This research represents a first step toward the eventual development of an advanced model for evaluating various BBIT protocols.
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Affiliation(s)
- Karam Choi
- Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, Korea
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung Chan Lee
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Seoul National University Hospital, Seoul, Korea
| | - Myungjoon Kim
- Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, Korea
| | - Hee Chan Kim
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Seoul National University Hospital, Seoul, Korea
| | - Young Min Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sungwan Kim
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Engineering, Seoul National University Hospital, Seoul, Korea
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163
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Lee JA, Sunwoo S, Kim YS, Yu BY, Park HK, Jeon TH, Yoo BW. The Effect of Sleep Quality on the Development of Type 2 Diabetes in Primary Care Patients. J Korean Med Sci 2016; 31:240-6. [PMID: 26839478 PMCID: PMC4729504 DOI: 10.3346/jkms.2016.31.2.240] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/22/2015] [Indexed: 11/29/2022] Open
Abstract
Sleep has important effects on physical and mental health, and sleep disorders are associated with increased mortality and morbidity. This study was conducted to evaluate the relationship between sleep duration or sleep quality and the risk of type 2 diabetes. The FACTS (FAmily CohorT Study in primary care) was established to investigate the relations between familial environment and health which was conducted at 22 family medicine outpatient clinics in general hospitals. Total 563 patients without diabetes who received ≥1 year follow-up examination were included in the analysis. We used the Pittsburgh Sleep Quality Index to determine sleep quality, and a score of ≥5 was considered to define poor sleep quality. Patients taking oral hypoglycemic agents, having a fasting glucose level of >126 mg/dL, or diagnosed with diabetes by physicians were classified as having diabetes. The median follow-up period was 2.5 years. Poor sleep quality was associated with a higher risk of diabetes after adjusting for age, sex, body mass index, income, physical activity, and family history of diabetes (relative risk=2.64; 95% confidence interval, 1.03-6.78). As a risk factor for the development of diabetes, poor sleep quality may independently increase the incidence of diabetes.
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Affiliation(s)
- Jung Ah Lee
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Sunwoo
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Sik Kim
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byung Yeon Yu
- Department of Family Medicine, Konyang University Hospital, Konyang University, Daejeon, Korea
| | - Hoon Ki Park
- Department of Family Medicine, Hanyang University Hospital, Hanyang University, Seoul, Korea
| | - Tae Hee Jeon
- Department of Family Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Byung Wook Yoo
- Department of Family Medicine, Seoul Soonchunhyang University Hospital, Soonchunhyang University, Seoul, Korea
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164
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Sahin T, Bozgeyik Z, Menzilcioglu MS, Citil S, Erbay MF. Importance of Diffusion Weighted Magnetic Resonance Imaging in Evaluation of the Treatment Efficacy in Multiple Sclerosis Patients with Acute Attacks. Pol J Radiol 2015; 80:544-8. [PMID: 26740826 PMCID: PMC4687941 DOI: 10.12659/pjr.895325] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 07/30/2015] [Indexed: 11/30/2022] Open
Abstract
Background We planned to investigate contribution of DWMR to the treatment efficacy with ADC values which were measured in acute and chronic plaque before and after MS treatment. ADC changes in normal appearing white matter (NAWM) in patients with MS and healthy volunteers were also evaluated in this study. Material/Methods 25 patients with MS and 30 healthy subjects with normal brain MR findings were included to our study. Contrast enhancement in plaque was evaluated as an acute, and non-contrast enhancement in plaque was evaluated as a chronic. Also, ADC measurements were performed using the same parameters in NAWM in plaque neighborhood and volunteers. Results were compared with appropriate statistical methods. Results ADC values in acute and chronic plaques were decreased after the treatment, and these reductions were statistically significant for acute plaqus in b500 and for chronic plaques in b500 and b1000. The mean ADC values were measured as 1.53±0.49×10−3 and 1.43±0.58×10−3 in acute plaques and 1.40±0.35×10−3 and 1.34±0.36×10−3 mm2/sec in chronic plaques before and after the treatment. Conclusions We think that DWMR have important role due to quantitative measurement ability in the evaluation of the treatment efficacy of the MS patients with acute attack in addition to contrast-enhanced MR sequence.
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Affiliation(s)
- Tuna Sahin
- Department of Radiology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Zülküf Bozgeyik
- Department of Radiology, Elazig Firat University Hospital, Elazig, Turkey
| | | | - Serdal Citil
- Department of Radiology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Mehmet Fatih Erbay
- Department of Radiology, Gozde Hospital, Clinical of Radiology, Malatya, Turkey
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165
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Ried-Larsen M, Christensen R, Hansen KB, Johansen MY, Pedersen M, Zacho M, Hansen LS, Kofoed K, Thomsen K, Jensen MS, Nielsen RO, MacDonald C, Langberg H, Vaag AA, Pedersen BK, Karstoft K. Head-to-head comparison of intensive lifestyle intervention (U-TURN) versus conventional multifactorial care in patients with type 2 diabetes: protocol and rationale for an assessor-blinded, parallel group and randomised trial. BMJ Open 2015; 5:e009764. [PMID: 26656025 PMCID: PMC4679918 DOI: 10.1136/bmjopen-2015-009764] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Current pharmacological therapies in patients with type 2 diabetes (T2D) are challenged by lack of sustainability and borderline firm evidence of real long-term health benefits. Accordingly, lifestyle intervention remains the corner stone in the management of T2D. However, there is a lack of knowledge regarding the optimal intervention programmes in T2D ensuring both compliance as well as long-term health outcomes. Our objective is to assess the effects of an intensive lifestyle intervention (the U-TURN intervention) on glycaemic control in patients with T2D. Our hypothesis is that intensive lifestyle changes are equally effective as standard diabetes care, including pharmacological treatment in maintaining glycaemic control (ie, glycated haemoglobin (HbA1c)) in patients with T2D. Furthermore, we expect that intensive lifestyle changes will decrease the need for antidiabetic medications. METHODS AND ANALYSIS The study is an assessor-blinded, parallel group and a 1-year randomised trial. The primary outcome is change in glycaemic control (HbA1c), with the key secondary outcome being reductions in antidiabetic medication. Participants will be patients with T2D (T2D duration <10 years) without complications who are randomised into an intensive lifestyle intervention (U-TURN) or a standard care intervention in a 2:1 fashion. Both groups will be exposed to the same standardised, blinded, target-driven pharmacological treatment and can thus maintain, increase, reduce or discontinue the pharmacological treatment. The decision is based on the standardised algorithm. The U-TURN intervention consists of increased training and basal physical activity level, and an antidiabetic diet including an intended weight loss. The standard care group as well as the U-TURN group is offered individual diabetes management counselling on top of the pharmacological treatment. ETHICS AND DISSEMINATION This study has been approved by the Scientific Ethical Committee at the Capital Region of Denmark (H-1-2014-114). Positive, negative or inconclusive findings will be disseminated in peer-reviewed journals, at national and international conferences. TRIAL REGISTRATION NUMBER NCT02417012.
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Affiliation(s)
- Mathias Ried-Larsen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark
| | - Robin Christensen
- Musculoskeletal Statistics Unit, Department of Rheum, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Katrine B Hansen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Diabetes and Metabolism, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette Y Johansen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Pedersen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Morten Zacho
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise S Hansen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Katja Kofoed
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Katja Thomsen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette S Jensen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rasmus O Nielsen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Chris MacDonald
- Department of CopenRehab, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Henning Langberg
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of CopenRehab, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Allan A Vaag
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Diabetes and Metabolism, Copenhagen University Hospital, Copenhagen, Denmark
| | - Bente K Pedersen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kristian Karstoft
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
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166
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Hadi NR, Abdelhussein MA, Rudha ARM, Jamil DA, Al-Aubaidy HA. Simvastatin Use in Patients with Type 2 Diabetes Mellitus: The Effects on Oxidative Stress. Oman Med J 2015; 30:237-40. [PMID: 26366256 DOI: 10.5001/omj.2015.49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Studies have shown that people with type 2 diabetes mellitus (T2DM) may develop atherosclerosis due to the disturbance in oxidative control and progressive dyslipidemia. Our study aimed to highlight the benefits of simvastatin treatment in improving serum lipids and reducing oxidative damage in patients with T2DM. METHODS Our randomized control trial included 56 patients with T2DM and dyslipidemia. The participants were on glibenclamide (5mg/day) during the period of the study. The patients were divided into two study groups (groups 1 and 2). Group 1 was the control group and consisted of 31 patients. Group 2 consisted of 25 participants, who were given simvastatin 20mg tablet once daily for 12 weeks. The control group did not receive simvastatin. Both groups were followed-up for measurement of blood pressure, pulse rate, serum lipids, and parameters of oxidative stress. RESULTS The simvastatin treated group showed a significant improvement with reduced erythrocyte glutathione compared to the control group (p<0.001). This was also associated with a significant reduction in erythrocyte malondialdehyde in the simvastatin treated group compared to the control group (p<0.001). Serum lipids reflected a similar improvement in the levels of erythrocyte malondialdehyde. CONCLUSION Our study highlights the beneficial role of simvastatin in improving the degree of oxidative stress in patients with T2DM through its effects on serum lipids and lipid peroxidation.
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Affiliation(s)
- Najah R Hadi
- Department of Pharmacology, Kufa University, Najaf, Iraq
| | | | | | - Dina A Jamil
- School of Medicine, University of Tasmania, Tasmania, Australia
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167
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Kim WJ, Kim SS, Lee HC, Song SH, Bae MJ, Yi YS, Jeon YK, Kim BH, Kim YK, Kim IJ. Association between Serum Fibroblast Growth Factor 21 and Coronary Artery Disease in Patients with Type 2 Diabetes. J Korean Med Sci 2015; 30:586-90. [PMID: 25931789 PMCID: PMC4414642 DOI: 10.3346/jkms.2015.30.5.586] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 12/12/2014] [Indexed: 01/06/2023] Open
Abstract
The aim of this study was to evaluate the association of plasma fibroblast growth factor (FGF)-21 with angiographically significant coronary artery disease (CAD) in patients with type 2 diabetes mellitus. Serum FGF-21 was measured in 120 patients undergoing coronary angiography. Patients were divided into 4 groups based on the presence/absence of type 2 diabetes mellitus and of significant CAD. The atherosclerotic burden was obtained by two angiographic scores: Gensini score (GS) and Extent score (ES). FGF-21 levels were higher in type 2 diabetes mellitus than in non-diabetic patients (P = 0.014). FGF-21 levels were significantly correlated with GS (r = 0.358, P < 0.001) and ES (r = 0.324, P < 0.001) in univariate analysis with all patients. After adjusting for several confounding factors, both GS and ES were associated with FGF-21 in all patients (r = 0.271, P = 0.014; r = 0.217, P = 0.041, respectively). However, FGF-21 lost significant correlation with both GS and ES with type 2 diabetes mellitus in the final model. The patients with type 2 diabetes mellitus and CAD feature had elevated FGF-21 levels. Despite of a limited role in diabetic patients, FGF-21 levels are independently associated with angiographic severity and extent of CAD.
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Affiliation(s)
- Won Jin Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sang Soo Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Han Cheol Lee
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Sang Heon Song
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Min Jung Bae
- Kim Yong Ki Internal Medicine Clinic, Busan, Korea
| | | | - Yun Kyung Jeon
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Bo Hyun Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Yong Ki Kim
- Kim Yong Ki Internal Medicine Clinic, Busan, Korea
| | - In Joo Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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168
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Ramezankhani A, Pournik O, Shahrabi J, Azizi F, Hadaegh F. An application of association rule mining to extract risk pattern for type 2 diabetes using tehran lipid and glucose study database. Int J Endocrinol Metab 2015; 13:e25389. [PMID: 25926855 PMCID: PMC4393501 DOI: 10.5812/ijem.25389] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 12/17/2014] [Accepted: 12/27/2014] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Type 2 diabetes, common and serious global health concern, had an estimated worldwide prevalence of 366 million in 2011, which is expected to rise to 552 million people, by 2030, unless urgent action is taken. OBJECTIVES The aim of this study was to identify risk patterns for type 2 diabetes incidence using association rule mining (ARM). PATIENTS AND METHODS A population of 6647 individuals without diabetes, aged ≥ 20 years at inclusion, was followed for 10-12 years, to analyze risk patterns for diabetes occurrence. Study variables included demographic and anthropometric characteristics, smoking status, medical and drug history and laboratory measures. RESULTS In the case of women, the results showed that impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), in combination with body mass index (BMI) ≥ 30 kg/m(2), family history of diabetes, wrist circumference > 16.5 cm and waist to height ≥ 0.5 can increase the risk for developing diabetes. For men, a combination of IGT, IFG, length of stay in the city (> 40 years), central obesity, total cholesterol to high density lipoprotein ratio ≥ 5.3, low physical activity, chronic kidney disease and wrist circumference > 18.5 cm were identified as risk patterns for diabetes occurrence. CONCLUSIONS Our study showed that ARM is a useful approach in determining which combinations of variables or predictors occur together frequently, in people who will develop diabetes. The ARM focuses on joint exposure to different combinations of risk factors, and not the predictors alone.
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Affiliation(s)
- Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Omid Pournik
- Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran
| | - Jamal Shahrabi
- Department of Industrial Engineering, Amirkabir University of Technology, Tehran, IR Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Farzad Hadaegh, Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2122409301, Fax: +98-2122402463, E-mail:
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169
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Bin Abbas B, Al Fares A, Jabbari M, El Dali A, Al Orifi F. Effect of mobile phone short text messages on glycemic control in type 2 diabetes. Int J Endocrinol Metab 2015; 13:e18791. [PMID: 25745493 PMCID: PMC4338653 DOI: 10.5812/ijem.18791] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 08/13/2014] [Accepted: 09/01/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mobile phone text messaging has rapidly become a socially popular form of communication. Several studies showed that mobile phone might offer a useful means of providing information between clinic visits and might increase adherence to diabetes therapy regimens. OBJECTIVES We conducted a study to evaluate the effect of mobile phone short message service (SMS) on glycemic control in Saudi patients with type 2 diabetes. PATIENTS AND METHODS One hundred patients (mean age, 41 ± 9.5 years) were selected at the Security Forces Hospital, Riyadh, Saudi Arabia, and provided with daily educational, reminding SMS messages for four months. Glycosylated hemoglobin (HbA1c) level, frequency of hypoglycemic and hyperglycemic attacks, and compliance with blood glucose monitoring were recorded before and after the trial. RESULTS In addition to significant improvement in patients' knowledge, mean fasting blood glucose level improved from 8.60 ± 3.16 to 7.77 ± 3.11 mmol/L and mean HbA1c decreased from 9.9% ± 1.8% to 9.5% ± 1.7%. CONCLUSIONS Mobile phone text messaging increased adherence to diabetes therapy and improved the clinical outcome in Saudi patients with type 2 diabetes.
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Affiliation(s)
- Bassam Bin Abbas
- Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
- Corresponding author: Bassam Bin Abbas, Department of Pediatrics, Security Forces Hospital, P. O. Box: 3354, Riyadh, Saudi Arabia. Tel: +966-534341777, Fax: +966-114427784, E-mail:
| | - Abdullah Al Fares
- Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | | | - Abdelmoneim El Dali
- Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fahad Al Orifi
- Department of Telemedicine and E-Health, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Kim YJ, Kim JG, Lee JY, Lee KS, Joe SG, Park JY, Kim MS, Yoon YH. Development and progression of diabetic retinopathy and associated risk factors in Korean patients with type 2 diabetes: the experience of a tertiary center. J Korean Med Sci 2014; 29:1699-705. [PMID: 25469073 PMCID: PMC4248594 DOI: 10.3346/jkms.2014.29.12.1699] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 08/12/2014] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to evaluate the incidence of and risk factors for the development of diabetic retinopathy (DR) and progression to proliferative DR (PDR) in Korean patients. Patients diagnosed with type 2 diabetes and followed for more than 5 years at a university-based clinic since 2000 were consecutively enrolled in this retrospective cohort study. Based on the DR classification at the initial and final visits, the incidence and progression of DR was determined and patient characteristics were compared according to DR progression. Hazard ratios of each putative risk factor for DR progression were calculated with a multivariate Cox proportional hazard model. Rate of DR development and progression to PDR were 32.1/1,000 and 26.2/1,000 person-years, respectively. A longer duration of diabetes and higher mean HbA1c level were significant risk factors for the development of DR. Regarding progression to PDR, higher mean HbA1c level, higher standard deviation of HbA1c, and higher urine albumin-to-creatinine ratio were significant risk factors. The rates of development of DR and progression to PDR in Koreans with type 2 diabetes are lower than those reported over the last decade. An inadequate blood glycemic control is the common risk factor for development and progression of DR.
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Affiliation(s)
- Yoon Jeon Kim
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - June-Gone Kim
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Joo Yong Lee
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyoung Sub Lee
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Soo Geun Joe
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Joong-Yeol Park
- Department of Endocrinology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Min-Seon Kim
- Department of Endocrinology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Young Hee Yoon
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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171
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Sedighi O, Makhlough A, Shokrzadeh M, Hoorshad S. Association between plasma selenium and glutathione peroxidase levels and severity of diabetic nephropathy in patients with type two diabetes mellitus. Nephrourol Mon 2014; 6:e21355. [PMID: 25695036 PMCID: PMC4318010 DOI: 10.5812/numonthly.21355] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 07/06/2014] [Accepted: 07/19/2014] [Indexed: 11/16/2022] Open
Abstract
Background: Oxidative stress is thought to be involved in the pathogenesis of diabetic nephropathy. Selenium (Se), and antioxidant enzymes such as glutathione peroxidase (GPx) play an important protective role in diabetes complications. Objectives: This study aimed to evaluate the association between plasma Se and GPx levels with severity of diabetic nephropathy. Patients and Methods: In a case-control study, we measured plasma Se and GPx concentrations in patients with type two diabetes without microalbuminuria (group 1), with microalbuminuria (group 2), with macroalbuminuria (group 3), and healthy control subjects (group 4). We also assessed plasma glucose, urea, creatinine, and glycated hemoglobin levels in all study patients. Results: Plasma Se and GPx concentrations were significantly lower in diabetic patients with macroalbuminuria than other study groups (P < 0.001). Albuminuria (Alb/Cr in random urine sample) had a negative correlation with plasma Se (r = -0.40, P = 0.01), and GPx (r = -0.23, P = 0.03) concentrations. Conclusions: Plasma Se and GPx levels were lower in type two diabetic patients with macroalbuminuria and related to the stage of diabetic nephropathy.
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Affiliation(s)
- Omid Sedighi
- Department of Nephrology, Faculty of Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Atieh Makhlough
- Diabetes Research Center, Faculty of Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran
- Corresponding author: Atieh Makhlough, Diabetes Research Center, Faculty of Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran. Tel: +98-9111510564, E-mail:
| | - Mohammad Shokrzadeh
- Pharmaceutical Sciences Research Center, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Shiva Hoorshad
- Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, IR Iran
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172
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Hyassat D, Al Sitri E, Batieha A, EL-Khateeb M, Ajlouni K. Prevalence of Hypomagnesaemia among Obese Type 2 Diabetic Patients Attending the National Center for Diabetes, Endocrinology and Genetics (NCDEG). Int J Endocrinol Metab 2014; 12:e17796. [PMID: 25237327 PMCID: PMC4166041 DOI: 10.5812/ijem.17796] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/05/2014] [Accepted: 05/09/2014] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Some observations suggested that magnesium supplementation could be helpful in the treatment of diabetic patients by improving glycemic control and preventing the development of diabetes-related complications. OBJECTIVES To estimate the prevalence of hypomagnesaemia among obese patients with type 2 diabetes attending the National Center for Diabetes, Endocrinology and Genetics (NCDEG) in Amman, Jordan. PATIENTS AND METHODS A cross-sectional study was carried out at the National Center for diabetes, Endocrinology and Genetics (NCDEG) in Amman-Jordan. A total of 1105 patients with type 2 diabetes (51.9% females and 48.1% males) who attended this center between first of October 2011and end of February 2012 were included in the study. The mean age and duration of diabetes were 57.1 years and 5.1 years, respectively and the mean value of HbA1c was 7.9%. Our study also performed a comparison of the prevalence of hypomagnesaemia between our studied sample and 3600 individuals enrolled in the National Vitamin D study completed in Jordan in 2009. The obtained data included patients' age, gender, smoking history, HbA1c level, comorbid history including hypertension, dyslipidemia, and presence of neuropathy and retinopathy. RESULTS Out of 1105 patients with type 2 diabetes, 210 patients (19%) (95% CI, 16.8%-21.4%) were hypomagnesaemic. Female gender, hypertension, statin therapy, HbA1c between 7-7.9% or ≥ 9% and patients with diabetes duration more than five years were independent risk factors for hypomagnesaemia. No association between hypomagnesaemia and age distribution, smoking history, neuropathy and retinopathy was found. In comparison with individuals enrolled in the National Vitamin D study, diabetic patients in this study had a much higher prevalence of hypomagnesaemia (19% vs. 0.7%) with odd's ratio of 32 (95% CI, 21-48.2). CONCLUSIONS As the prevalence of hypomagnesaemia among patients with type 2 diabetes treated at the NCDEG was found to be 19% (95% CI, 16.8%-21.4%), we recommend periodic determination of magnesium level and appropriate magnesium replacement therapy particularly among the above defined groups.
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Affiliation(s)
- Dana Hyassat
- The National Center for Diabetes, Endocrinology and Genetics Center, Amman, Jordan
| | - Ebtihaj Al Sitri
- The National Center for Diabetes, Endocrinology and Genetics Center, Amman, Jordan
| | - Anwar Batieha
- Jordan University of Science and Technology (JUST), Amman, Jordan
| | - Mohammed EL-Khateeb
- The National Center for Diabetes, Endocrinology and Genetics Center, Amman, Jordan
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology and Genetics Center, Amman, Jordan
- Corresponding author: Kamel Ajlouni, The National Center for Diabetes, Endocrinology and Genetics Center, P.O.Box: 13165, Amman, Jordan. Tel: +96-265347810, Fax: +96-265356670, E-mail:
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173
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Al-Sinani S, Al-Shafaee M, Al-Mamari A, Woodhouse N, El-Shafie O, Hassan MO, Al-Yahyaee S, Albarwani S, Jaju D, Al-Hashmi K, Al-Abri M, Rizvi S, Bayoumi R. Impaired Fasting Glucose in Omani Adults with no Family History of Type 2 Diabetes. Sultan Qaboos Univ Med J 2014; 14:e183-e189. [PMID: 24790740 PMCID: PMC3997534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 01/05/2014] [Accepted: 01/30/2014] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES The aim of this study was to estimate the prevalence of impaired fasting glucose (IFG) among Omani adults with no family history (FH) of diabetes and to investigate the factors behind the risk of developing type 2 diabetes (T2D), while excluding a FH of diabetes. METHODS A total of 1,182 Omani adults, aged ≥40 years, visited the Family Medicine & Community Health Clinic at Sultan Qaboos University Hospital, Oman, on days other than the Diabetes Clinic days, from July 2010 to July 2011. The subjects were interviewed and asked if they had T2D or a FH of T2D. RESULTS Only 191 (16%) reported no personal history of T2D or FH of the disease. Of these, anthropometric and biochemical data was complete in 159 subjects. Of these a total of 42 (26%) had IFG according to the American Diabetes Association criteria. Body mass index, fasting insulin, haemoglobin A1C and blood pressure (BP), were significantly higher among individuals with IFG (P <0.01, P <0.05, P <0.01 and P <0.01, respectively). In addition, fasting insulin, BP and serum lipid profile were correlated with obesity indices (P <0.05). Obesity indices were strongly associated with the risk of IFG among Omanis, with waist circumference being the strongest predictor. CONCLUSION Despite claiming no FH of diabetes, a large number of Omani adults in this study had a high risk of developing diabetes. This is possibly due to environmental factors and endogamy. The high prevalence of obesity combined with genetically susceptible individuals is a warning that diabetes could be a future epidemic in Oman.
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Affiliation(s)
- Sawsan Al-Sinani
- Departments of Biochemistry, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Mohammed Al-Shafaee
- Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Ali Al-Mamari
- Departments of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Nicolas Woodhouse
- Medicine, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Omayma El-Shafie
- Departments of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Mohammed O. Hassan
- Physiology, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Said Al-Yahyaee
- Genetics, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Sulayma Albarwani
- Physiology, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Deepali Jaju
- Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Khamis Al-Hashmi
- Medicine, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Mohammed Al-Abri
- Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Syed Rizvi
- Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Riad Bayoumi
- Departments of Biochemistry, College of Medicine & Health Sciences, Sultan Qaboos University
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174
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Jimmy B, Jose J, Al-Hinai ZA, Wadair IK, Al-Amri GH. Adherence to Medications among Type 2 Diabetes Mellitus Patients in Three Districts of Al Dakhliyah Governorate, Oman: A cross-sectional pilot study. Sultan Qaboos Univ Med J 2014; 14:e231-e235. [PMID: 24790747 PMCID: PMC3997541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 01/02/2014] [Accepted: 01/16/2014] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES This pilot study aimed to assess the medication adherence of type 2 diabetes mellitus (T2DM) patients in three wilayats (districts) of the Al Dakhliyah governorate, Oman, and to identify the probable reasons for medication non-adherence. METHODS A cross-sectional questionnaire-based pilot survey was conducted among T2DM Omani patients between February and June 2012 to assess their medication adherence and the relationship between their socio-demographic characteristics and adherence levels. RESULTS A total of 158 patients participated in the survey. The majority of the participants were unemployed or were housewives (66.5%). Forgetfulness was the most frequent reason for medication non-adherence (36.4%). Participants demonstrated an excellent level of adherence to their medicines (median total score = 3). No significant difference in median total adherence scores was observed based on the evaluated parameters. CONCLUSION The medication adherence of T2DM patients in the area under study was good. A larger study in a wider population is warranted to obtain a more representative picture of this important factor which contributes to public health.
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175
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Bell DSH. The potent synergistic effects of the combination of liraglutide and canagliflozin on glycemic control and weight loss. Am J Case Rep 2014; 15:152-4. [PMID: 24753783 PMCID: PMC3992216 DOI: 10.12659/ajcr.890626] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 03/15/2014] [Indexed: 11/17/2022]
Abstract
Patient: Male, 57 Final Diagnosis: Diabetes mellitus type 2 Symptoms: Weight loss Medication: — Clinical Procedure: — Specialty: Endocrinology and Metabolic
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Affiliation(s)
- David S H Bell
- Department of Endocrinology, Southside Endocrinology, Mountain Brook, AL, U.S.A
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176
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Tavakolizadeh J, Moghadas M, Ashraf H. Effect of Self-regulation Training on Management of Type 2 Diabetes. Iran Red Crescent Med J 2014; 16:e13506. [PMID: 24910800 PMCID: PMC4028773 DOI: 10.5812/ircmj.13506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Revised: 12/24/2013] [Accepted: 02/22/2014] [Indexed: 11/16/2022]
Abstract
Background: Diabetes is the most common metabolic disorder which is required to be taken under control. According to some studies, the impact of self-regulation on health has been considered as a monitoring strategy to achieve individual’s goals. Objectives: This study, which was performed in 2012, aimed at determining the consequences of self-regulation on controlling type 2 diabetes. Patients and Methods: In this double-blind clinical trial, 60 patients with type 2 diabetes - who were referred to Diabetes Clinic of Bisto-Dou Bahman Hospital in Gonabad, Iran - were divided randomly into case and control groups. Self-regulation questionnaire, nutritional information and physical activity checklists were completed by both groups once at the beginning and once at end of the training. Fasting blood sugar (FBS) of both groups were measured as well. Case group was trained for a month, whereas the control group received no special training. Data were analyzed by SPSS version 19 software, K-square and paired t-tests. Results: Comparing the case with the control group before and after the training showed that teaching patients self-regulatory strategies had significant impact on lowering blood sugar (-16.50 vs. -2.47, P < 0.001), observing dietary behaviors (5.97 vs. -0.87, P < 0.001) and increasing physical activities (6.2 vs. -0.73, P < 0.001) of the former group. Conclusions: Learning self-regulations has a role to play in controlling type 2 diabetes. Therefore, it is suggested to professionals in healthcare centers to educate patients about self-regulatory techniques and use them as auxiliary methods for keeping type 2 diabetes under control.
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Affiliation(s)
- Jahanshir Tavakolizadeh
- Department of Basic Medical Sciences, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, IR Iran
| | - Mehri Moghadas
- Health and Treatment Network of Bajestan, Gonabad University of Medical Sciences, Gonabad, IR Iran
- Corresponding Author: Mehri Moghadas, Health and Treatment Network of Bajestan, Gonabad University of Medical Sciences, Gonabad, IR Iran. Tel: +98-5337225027, E-mail:
| | - Hami Ashraf
- Department of Research and Education, Razavi Hospital, Mashhad, IR Iran
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177
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Kim YJ, Park S, Yi W, Yu KS, Kim TH, Oh TJ, Choi J, Cho YM. Seasonal variation in hemoglobin a1c in korean patients with type 2 diabetes mellitus. J Korean Med Sci 2014; 29:550-5. [PMID: 24753703 PMCID: PMC3991799 DOI: 10.3346/jkms.2014.29.4.550] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 01/09/2014] [Indexed: 11/28/2022] Open
Abstract
A seasonal variation of glucose homeostasis in humans has been reported in various geographic regions. In this study, we examined seasonal variations in hemoglobin A1c (HbA1c) in patients with type 2 diabetes living in Korea. We analyzed 57,970 HbA1c values from 4,191 patients and the association of these values with ambient temperature for 3.5 yr. Overall, HbA1c exhibited its highest values from February to March and its lowest values from September to October (coefficient for cos t = -0.0743, P = 0.058) and the difference between the peak and nadir in a year was 0.16%-0.25%. A statistically significant seasonal variation was observed in the patients who were taking oral anti-diabetic drugs (OADs) without insulin treatment (coefficient for cos t = -0.0949, P < 0.05). The Spearman correlation coefficient between daily HbA1c values and the corresponding 3-month moving average ambient temperature was -0.2154 (95% confidence interval [CI]: -0.2711, -0.1580; P < 0.05). In conclusion, HbA1c values exhibited a seasonal variation in Korean patients with type 2 diabetes, with the highest values during the cold season, particularly in those who were treated with OADs, which should be taken into account in clinical practice for stable glucose control during the cold season.
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Affiliation(s)
- Yoon Ji Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seongkeun Park
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea
| | - Wangjin Yi
- Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Tae Hyuk Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jinwook Choi
- Department of Biomedical Engineering, Seoul National University, Seoul, Korea
| | - Young Min Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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178
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Rahati S, Shahraki M, Arjomand G, Shahraki T. Food pattern, lifestyle and diabetes mellitus. Int J High Risk Behav Addict 2014; 3:e8725. [PMID: 24971303 PMCID: PMC4070192 DOI: 10.5812/ijhrba.8725] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 08/28/2013] [Accepted: 09/15/2013] [Indexed: 01/26/2023]
Abstract
Background: Prevalence of Type 2 diabetes is increasing rapidly worldwide. Recent data is reprehensive of increasing diabetes prevalence from 285 millions in 2010 (6.4%) to 439 millions in 2030 in adults aged 20 to 79 in different countries. Lifestyle and particularly dietary habits play an important role in the development of diabetes. Additionally, specific individual food groups and diet components such as monounsaturated fatty acids, fruits, vegetables, whole grain cereals, dietary fiber, fish, magnesium and nuts may protect against the development of diabetes, possibly through the amelioration of insulin sensitivity and its anti-inflammatory actions, while consumption of red and processed meats and saturated fat may increase the risk of type 2 diabetes. Objectives: In this section, we studied dietary and other factors related to the effect of lifestyle in type 2 diabetes. These factors may affect the incidence of type 2 diabetes which could be corrected by lifestyle modifications. Results: Unfortunately, dietary habits in the developed and developing countries are changing towards an unhealthier direction. Consequently, emphasis should be given on encouraging at population and individual levels for adopting a healthier lifestyle, including dietary habits, to prevent the development of type 2 diabetes. Here we reviewed epidemiologic and clinical trial evidence regarding nutrients, foods and dietary patterns to diabetes risk and involved possible mechanisms. Conclusions: Type 2 diabetes is increasingly growing in young population of developing countries, which causes a large burden on individuals and the society.
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Affiliation(s)
- Sara Rahati
- Department of Nutrition, Nutrition Faculty, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mansour Shahraki
- Department of Nutrition, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Mansour Shahraki, Department of Nutrition, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-5413425735, Fax: +98-5413425728, E-mail:
| | - Golnaz Arjomand
- Department of Nutrition, Nutrition Faculty, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Touran Shahraki
- Department of Pediatrics, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
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179
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Jin SM, Song SO, Jung CH, Chang JS, Suh S, Kang SM, Jung I, Park CY, Kim JH, Cho JH, Lee BW. Risk of bladder cancer among patients with diabetes treated with a 15 mg pioglitazone dose in Korea: a multi-center retrospective cohort study. J Korean Med Sci 2014; 29:238-42. [PMID: 24550651 PMCID: PMC3924003 DOI: 10.3346/jkms.2014.29.2.238] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Accepted: 11/29/2013] [Indexed: 11/26/2022] Open
Abstract
It has not yet been determined whether chronic exposure to relatively low doses of pioglitazone increases risk of bladder cancer. We aimed to assess the risk of bladder cancer associated with pioglitazone in Korean patients. This was a retrospective cohort study of diabetic patients who had ≥ 2 clinic visits between November 2005 and June 2011 at one of four tertiary referral hospitals in Korea. A prevalent case-control analysis nested within the cohort was conducted to further adjust confounders. A total of 101,953 control patients and 11,240 pioglitazone-treated patients were included, in which there were 237 and 30 cases of incidental bladder cancer (64.9 and 54.9 per 100,000 person-years; age, sex-adjusted HR 1.135, 95% confidence interval [CI] 0.769-1.677), respectively. In the prevalent case-control analysis nested within the cohort, use of pioglitazone for a duration of > 6 months, but not ever use of pioglitazone, was associated with an increased rate of bladder cancer as compared to never use of pioglitazone. In conclusion, we failed to exclude the possible association between use of pioglitazone for a duration of > 6 months and bladder cancer.
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Affiliation(s)
- Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Ok Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Division of Endocrinology, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Chang Hee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin-Sun Chang
- Department of Endocrinology and Metabolism, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Sunghwan Suh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Seung Min Kang
- Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
| | - Inkyung Jung
- Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
| | - Cheol-Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyoung Cho
- Department of Endocrinology and Metabolism, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Byung-Wan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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180
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Makhlough A, Kashi Z, Akha O, Zaboli E, Yazdanicharati J. Effect of spironolactone on diabetic nephropathy compared to the combination of spironolactone and losartan. Nephrourol Mon 2014; 6:e12148. [PMID: 24719811 PMCID: PMC3968951 DOI: 10.5812/numonthly.12148] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 05/31/2013] [Accepted: 06/09/2013] [Indexed: 01/13/2023] Open
Abstract
Background: Diabetic nephropathy is the most important cause of end stage renal disease (ESRD). Aldosterone is involved in renal damage through induction of fibrosis, inflammation and necrosis in the kidney tissue. Previous studies have demonstrated that the combination of angiotensin receptor blocker (ARB) and spironolactone (an anti-aldosterone drug) are efficient for albuminuria reduction. Objectives: This study was designed to evaluate the effect of spironolactone alone on diabetic nephropathy. Patients and Methods: In this double blind randomized clinical trial, 60 type II diabetic patients with microalbuminuria were enrolled. They were divided into two groups: case group (spironolactone 25 mg and placebo, 30 cases) and control (spironolactone 25 mg plus losartan 25 mg, 30 cases). The treatment success rate (more than 50% reduction in microalbuminuria) was compared between the two groups. Results: After three months, successful treatment was seen in 70% (95% CI: 52 - 83) and 83.3% (CI 95%: 66 - 93) of case and control groups, respectively (P = 0.4). Mean ± SD of serum potassium levels after three months in case and control groups were 4.56 ± 0.38 and 4.39 ± 0.34 mEq/L, respectively (P = 0.08). Mean ± SD of systolic blood pressures in case and control groups were 129.67 ± 9.4 and 130.97 ± 9.4 mmHg, respectively (P = 0.6). Mean ± SD of serum creatinine levels at the end of the study were 0.95 ± 0.15 in case and 0.90 ± 0.22 mg/dL in control group (P = 0.4). Conclusions: Spironolactone alone is as effective as the combination of spironolactone and losartan on albuminuria reduction in type 2 diabetic patients and can be used alone as an effective drug for diabetic nephropathy.
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Affiliation(s)
- Atieh Makhlough
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
- Molecular and Cellular Biology Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Zahra Kashi
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
- Corresponding author: Zahra Kashi, Diabetes Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Razi Street, Sari, IR Iran. Tel: +98-1512261701; Ext:4, Fax: +98-1512278789, E-mail:
| | - Ozra Akha
- Molecular and Cellular Biology Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Ehsan Zaboli
- Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Jamshid Yazdanicharati
- Department of Biostatistics and Epidemiology, Mazandaran University of Medical Sciences, Sari, IR Iran
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181
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Mohammadzadeh G, Ghaffari MA. Additional effect of diabetes mellitus type 2 on the risk of coronary artery disease: role of serum adiponectin. Iran Red Crescent Med J 2014; 16:e8742. [PMID: 24719717 PMCID: PMC3964435 DOI: 10.5812/ircmj.8742] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 10/08/2013] [Accepted: 11/12/2013] [Indexed: 12/16/2022]
Abstract
Background: Adiponectin, an adipocyte-derived hormone, is implicated in diabetes mellitus type 2 and atherosclerosis. The study was designed to investigate whether serum adiponectin levels in patients with both coronary artery disease (CAD) and diabetes mellitus type 2 (T2DM) are lower than in patients with CAD alone and control subjects. Objectives: In this present study, we measured serum adiponectin levels in consecutive CAD patients with and without T2DM and investigated whether decreased adiponectin is associated with risk factors of CAD. Materials and Methods: The study included 198 subjects, 138 patients with CAD (72 of whom had both CAD and T2DM), and 60 control subjects. We measured serum adiponectin, interleukin-6 (IL-6) and insulin by ELISA. In addition, Lipid profile, glucose and anthropometrical measurements were performed in all subjects. Results: The results revealed significant difference in serum adiponectin levels between patients with CAD+T2DM and patients with CAD alone (3.80 ± 1.52 vs. 5.25 ± 2.35, P = 0.007), between patients with CAD and control (5.25 ± 2.35 vs. 7.04 ± 3.32, P = 0.001), and between patients with CAD + T2DM and control (3.80 ± 1.52 vs. 7.04 ± 3.32, P < 0.001). Serum adiponectin level was significantly higher in women in contrast to men (5.97 ± 3.15 vs. 4.62 ± 2.81 µg/ml, P = 0.002). Serum adiponectin levels were correlated significantly with insulin (r = -0.178, P = 0.013), total cholesterol (r = -0.313, P < 0.001), low density lipoprotein (r = -0.154, P = 0.016), body mass index (r = -0.171, P = 0.016), glucose (r = -0.202, P = 0.006), HOMA-IR (r= -0.251, P = 0.001), and IL-6 levels (r = -0.321, P = 0.001). Adiponectin was correlated positively only with high density lipoprotein (r = 0.389, P < 0.001). Conclusions: It is speculated that increased insulin resistance and increase in other adipokines such as IL-6 may contribute to the decreased serum levels of adiponectin in patients with both CAD and T2DM.
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Affiliation(s)
- Ghorban Mohammadzadeh
- Hyperlipidemia Research Center, Department of Biochemistry, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding Author: Ghorban Mohammadzadeh, Hyperlipidemia Research Center, Department of Biochemistry, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tell: +98-091134368125, Fax: +98-6113332036, E-Mail:
| | - Mohammad-Ali Ghaffari
- Cellular and Molecular Research Center, Department of Biochemistry, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
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182
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Lee MY, Choi DS, Lee MK, Lee HW, Park TS, Kim DM, Chung CH, Kim DK, Kim IJ, Jang HC, Park YS, Kwon HS, Lee SH, Shin HK. Comparison of acarbose and voglibose in diabetes patients who are inadequately controlled with basal insulin treatment: randomized, parallel, open-label, active-controlled study. J Korean Med Sci 2014; 29:90-7. [PMID: 24431911 PMCID: PMC3890482 DOI: 10.3346/jkms.2014.29.1.90] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 10/31/2013] [Indexed: 02/06/2023] Open
Abstract
We studied the efficacy and safety of acarbose in comparison with voglibose in type 2 diabetes patients whose blood glucose levels were inadequately controlled with basal insulin alone or in combination with metformin (or a sulfonylurea). This study was a 24-week prospective, open-label, randomized, active-controlled multi-center study. Participants were randomized to receive either acarbose (n=59, 300 mg/day) or voglibose (n=62, 0.9 mg/day). The mean HbA1c at week 24 was significantly decreased approximately 0.7% from baseline in both acarbose (from 8.43% ± 0.71% to 7.71% ± 0.93%) and voglibose groups (from 8.38% ± 0.73% to 7.68% ± 0.94%). The mean fasting plasma glucose level and self-monitoring of blood glucose data from 1 hr before and after each meal were significantly decreased at week 24 in comparison to baseline in both groups. The levels 1 hr after dinner at week 24 were significantly decreased in the acarbose group (from 233.54 ± 69.38 to 176.80 ± 46.63 mg/dL) compared with the voglibose group (from 224.18 ± 70.07 to 193.01 ± 55.39 mg/dL). In conclusion, both acarbose and voglibose are efficacious and safe in patients with type 2 diabetes who are inadequately controlled with basal insulin. (ClinicalTrials.gov number, NCT00970528).
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Affiliation(s)
- Mi Young Lee
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dong Seop Choi
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Moon Kyu Lee
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyoung Woo Lee
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae Sun Park
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Doo Man Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Choon Hee Chung
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Duk Kyu Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - In Joo Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea
| | - Hak Chul Jang
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yong Soo Park
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hyuk Sang Kwon
- Division of Endocrinology & Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
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183
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Yam FK, Adams AG, Divine H, Steinke D, Jones MD. Clinical inertia in type 2 diabetes: A retrospective analysis of pharmacist-managed diabetes care vs. usual medical care. Pharm Pract (Granada) 2013; 11:203-10. [PMID: 24367460 PMCID: PMC3869636 DOI: 10.4321/s1886-36552013000400005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 10/13/2013] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Evidence suggests that patients with type 2 diabetes (T2DM) suffer from a high rate of "clinical inertia" or "recognition of the problem but failure to act." OBJECTIVE THE AIM OF THIS STUDY IS TO QUANTIFY THE RATE OF CLINICAL INERTIA BETWEEN TWO MODELS OF CARE: Pharmacist-Managed Diabetes Clinic (PMDC) vs. Usual Medical Care (UMC). METHODS Patients in a university based medical clinic with type 2 diabetes (T2DM) were analyzed in this retrospective cohort study. Patients were exposed to either PMDC or UMC. The difference in days to intervention in response to suboptimal laboratory values and time to achieve goal hemoglobin A1c (A1c), systolic blood pressure (SBP) and low-density lipoprotein (LDL) was compared in the two models of care. RESULTS A total of 113 patients were included in the analysis of this study, 54 patients were in the PMDC and 59 patients were in the UMC group. Median time (days) to intervention for A1c values >7% was 8 days and 9 days in the PMDC and UMC groups, respectively (p>0.05). In patients with baseline A1c values >8%, median time to achieving A1c<7% was 259 days vs. 403 days in the PMDC and UMC groups, respectively (p<0.05). Median time to goal SBP was 124 days in the PMDC group and 532 days in the UMC group (p<0.05). Median time to goal LDL was 412 days in the PMDC group vs. 506 days in the UMC group (p<0.05). CONCLUSIONS Rates of clinical inertia, defined as time to intervention of suboptimal clinical values, did not differ significantly between patients enrolled in a PMDC compared to patients with UMC with respect to A1c, SBP and LDL. Participation in PMDC, however, was associated with achieving goal A1c, SBP, and LDL levels sooner compared to UMC.
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Affiliation(s)
- Felix K Yam
- UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California , San Diego. La Jolla, CA ( United States ).
| | - Aimee G Adams
- College of Pharmacy, University of Kentucky . Lexington, KY ( United States ).
| | - Holly Divine
- College of Pharmacy, University of Kentucky . Lexington, KY ( United States ).
| | - Douglas Steinke
- Manchester Pharmacy School, University of Manchester . Manchester ( United Kingdom ).
| | - Mikael D Jones
- College of Pharmacy, University of Kentucky . Lexington, KY ( United States ).
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184
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Dixon BE, Jabour AM, Phillips EO, Marrero DG. An informatics approach to medication adherence assessment and improvement using clinical, billing, and patient-entered data. J Am Med Inform Assoc 2013; 21:517-21. [PMID: 24076751 DOI: 10.1136/amiajnl-2013-001959] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The aim of this study was to describe an integrated informatics approach to aggregating and displaying clinically relevant data that can identify problems with medication adherence and facilitate patient-provider communication about strategies to improve medication use. We developed a clinical dashboard within an electronic health record (EHR) system that uses data from three sources: the medical record, pharmacy claims, and a personal health record. The data are integrated to inform clinician-patient discussions about medication adherence. Whereas prior research on assessing patterns of medication adherence focused on a single approach using the EHR, pharmacy data, or patient-entered data, we present an approach that integrates multiple electronic data sources increasingly found in practice. Medication adherence is a complex challenge that requires patient and provider team input, necessitating an integrated approach using advanced EHR, clinical decision support, and patient-controlled technologies. Future research should focus on integrated strategies to provide patients and providers with the right combination of informatics tools to help them adequately address the challenge of adherence to complex medication therapies.
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Affiliation(s)
- Brian E Dixon
- Department of BioHealth Informatics, Indiana University School of Informatics and Computing, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
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185
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Palizgir M, Bakhtiari M, Esteghamati A. Association of depression and anxiety with diabetes mellitus type 2 concerning some sociological factors. Iran Red Crescent Med J 2013; 15:644-8. [PMID: 24578829 PMCID: PMC3918186 DOI: 10.5812/ircmj.12107] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/12/2013] [Accepted: 07/22/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Diabetes is a metabolic disorder with a high worldwide prevalence. It has been reported that diabetic patients are more prone to depression and anxiety. OBJECTIVES This study aimed to evaluate the prevalence of depression and anxiety among diabetic patients with regards to some factors such as age, gender, level of education and occupational status. MATERIALS AND METHODS One hundred and eighty four diabetic patients have participated in this study. To assess the severity of depression and anxiety Beck depression inventory and Beck anxiety inventory questionnaire were used respectively. Binary logistic regressions were used to analyze the data. RESULTS The results of the present study have shown that 70.7% of the diabetic patients were suffered from depression. Besides, 69.6% of them were diagnosed with anxiety. According to the result, diabetes related depression is affected by sex (OR: 2.767), age (OR: 2.222), level of education (OR: 4.145) and job status (OR: 3.901). It has been also resulted that gender (OR: 2.274), age (OR: 2.706) and Job Status (OR: 2.441) are the effective factors leading to anxiety. CONCLUSIONS Depression and anxiety have higher prevalence among diabetic patients and some sociological factors such as age, gender, job and education are related to these psychological disorders.
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Affiliation(s)
- Maryam Palizgir
- Department of Psychology, Islamic Azad University, Najafabad Branch, Isfahan, IR Iran
| | - Maryam Bakhtiari
- Department of Clinical Psychology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Maryam Bakhtiari, Department of Clinical Psychology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel.: 98-91227773873, E-mail:
| | - Alireza Esteghamati
- Department of Endocrinology, Tehran University of Medical Sciences, Tehran, IR Iran
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186
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Adisa R, Fakeye TO. Effect of number and type of antidiabetes medications on adherence and glycemia of ambulatory type 2 diabetes patients in southwestern Nigeria. Pharm Pract (Granada) 2013; 11:156-65. [PMID: 24223081 PMCID: PMC3809134 DOI: 10.4321/s1886-36552013000300006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 07/21/2013] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To determine the influence of number and type of antidiabetes medications on adherence and glycemia of ambulatory type 2 diabetes patients in southwestern Nigeria. METHODS A cross-sectional study using pre-tested structured questionnaire among 176 consented patients recruited from the endocrinology clinics of two teaching hospitals between November, 2010 and January, 2011; and a retrospective review of case notes of the cohort for details of prescribed medications and blood glucose values. Descriptive statistics were used to summarize the data. Tests of proportions were evaluated using Chi-square or Fisher's exact test as appropriate. The differences in mean fasting blood glucose (FBG) between and among categorical variables were compared using student t-test and ANOVA respectively, with p<0.05 considered significant. RESULTS Mean number of prescribed medications was 4.6 ±1.4. Almost two thirds 103 (60.6%) were placed on >4 medications. Adherence was better among patients on >4 medications compared to those on ≤4 medications (p=0.05). However, patients on >4 medications were mostly older adults (>60 years of age), and they were in the majority (66.7%) who had tertiary education compared to 33.3% of those on ≤4 medications who had tertiary education (p=0.02). Adherence rates to antidiabetes medications were in the ranking of oral antidiabetes medications (OAM) alone (50.0%) > insulin plus OAM (44.0%) > insulin alone (41.7%) with no significant difference (p=0.77). There was a significant difference in mean FBG among patients on >4 medications (172.1 ±61.1mg/dL) versus (198.8 ±83.8mg/dL) among those on ≤4 medications (p=0.02). CONCLUSIONS Prescribing more than four medications is linked to improved adherence and glycemic outcome. However, age and educational background of patients are important factors that need to be considered when prescribing multiple medications for type 2 diabetes.
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Affiliation(s)
- Rasaq Adisa
- Department of Clinical Pharmacy & Pharmacy Administration, Faculty of Pharmacy, University of Ibadan . Ibadan ( Nigeria )
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187
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Ali BA, Abdallah ST, Abdallah AM, Hussein MM. The Frequency of Type 2 Diabetes Mellitus among Diabetic Children in El Minia Governorate, Egypt. Sultan Qaboos Univ Med J 2013; 13:399-403. [PMID: 23984025 DOI: 10.12816/0003262] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 10/20/2012] [Accepted: 05/30/2013] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES Type 2 diabetes mellitus (T2DM) in children and adolescents is becoming an increasingly important public health concern throughout the world. This study aimed to estimate the frequency of T2DM among diabetic young people in El-Minia Governorate, Egypt, and to detect its risk factors. METHODS A total of 210 diabetic patients under 18 years old in Minia Governorate were included in the study and underwent a thorough history-taking, a physical examination and laboratory investigations. RESULTS T2DM was present in 28 patients (13.3%); it was significantly present in 18 females (64.3%) and 20 (71.4%) of them had a positive family history of DM. T2DM patients had significantly higher BMI and waist circumference centiles for age and sex than those with T1DM. Also, haemoglobin A1c %, serum C-peptide and cholesterol levels were significantly higher in T2DM than T1DM patients. Finally, there were weak significant positive correlations between C-peptide level and both BMI and waist circumference. CONCLUSION T2DM is no longer a disease of adults but can also occur in children and adolescents. The results suggested that obesity, female gender and a positive family history of DM are risk factors for T2DM. Also, patients with T2DM had poorer glycaemic control and hypercholesterolemia than those with other types of diabetes.
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Affiliation(s)
- Basma A Ali
- Pediatric department, Faculty of Medicine, Minia University, Egypt
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188
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Oh TJ, Jung HS, Bae JH, Kim YG, Park KS, Cho YM, Park KS, Kim SY. Clinical characteristics of the responders to dipeptidyl peptidase-4 inhibitors in Korean subjects with type 2 diabetes. J Korean Med Sci 2013; 28:881-7. [PMID: 23772153 PMCID: PMC3678005 DOI: 10.3346/jkms.2013.28.6.881] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 04/01/2013] [Indexed: 11/20/2022] Open
Abstract
We investigated characteristics associated with the efficacy of dipeptidyl peptidase-4 inhibitors (DPP4i) in Korean patients with type 2 diabetes. We reviewed medical records of 477 patients who had taken sitagliptin or vildagliptin longer than 40 weeks. Response to DPP4i was evaluated with HbA1c change after therapy (ΔHbA1c). The Student's t-test between good responders (GR: ΔHbA1c > 1.0%) and poor responders (PR: ΔHbA1c < 0.5%), a correlation analysis among clinical parameters, and a linear multivariate regression analysis were performed. The mean age was 60 yr, duration of diabetes 11 yr and HbA1c was 8.1%. Baseline fasting plasma glucose (FPG), HbA1c, C-peptide, and creatinine were significantly higher in the GR compared to the PR. Duration of diabetes, FPG, HbA1c, C-peptide and creatinine were significantly correlated with ΔHbA1c. In the multivariate analysis, age (r(2) = 0.006), duration of diabetes (r(2) = 0.019), HbA1c (r(2) = 0.296), and creatinine levels (r(2) = 0.024) were independent predictors for the response to DPP4i. Body mass index and insulin resistance were not associated with the response to DPP4i. In conclusion, better response to DPP4i would be expected in Korean patients with type 2 diabetes who have higher baseline HbA1c and creatinine levels with shorter duration of diabetes.
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Affiliation(s)
- Tae Jung Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hye Seung Jung
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hyun Bae
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yeong Gi Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyeong Seon Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Young Min Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Yeon Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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189
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Bahar A, Makhlough A, Yousefi A, Kashi Z, Abediankenari S. Correlation between prediabetes conditions and microalbuminuria. Nephrourol Mon 2013; 5:741-4. [PMID: 23841037 PMCID: PMC3703132 DOI: 10.5812/numonthly.7646] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 08/31/2012] [Accepted: 09/11/2012] [Indexed: 01/27/2023] Open
Abstract
Background Impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) are two prediabetes conditions which have some correlation with macrovascular disorders. The risk of microvascular complications in these groups is not clear. Objectives The prevalence of albuminuria in subjects with IFG and IGT was evaluated in the present study. Patients and Methods In this study three groups of subjects were entered (45 subjects in each group): IFG, IGT, and normal glucose tolerance as control. The urine albumin-creatinine ratio was studied in morning spot urine samples to detect microalbuminuria. The subjects were followed up for two years, and blood sugar and urine albumin and glycosylated hemoglobin (HbA1C) were measured every 6 months. Results The prevalence rate of microalbuminuria was 15.5% in the prediabetic groups, while no one had microalbuminuria in the control group (P = 0.005). The prevalence of microalbuminuria in patients with IFG or IGT was not significantly different (17.8% vs. 13.3%) (P = 0.4). Fourteen subjects (4 in IFG group and 10 in IGT group) developed diabetes mellitus within a 2-year follow-up period (P = 0.1). Thirty six percent of subjects with albuminuria, and twelve percent of subjects without albuminuria progressed to diabetes mellitus during a 2-year follow-up (P = 0.02, odd ratio = 4.1; CI95%, 1.13-15.1). Conclusions The risk of microalbuminuria in prediabetic subjects is high, and probably prediabetic subjects are at higher risk of progression to diabetes mellitus. We suggest periodically evaluation of albuminuria in prediabetic patients after the diagnosis.
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Affiliation(s)
- Adele Bahar
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Atieh Makhlough
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Atefe Yousefi
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Zahra Kashi
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
- Corresponding author: Zahra Kashi, Diabetes Research Center, Imam Khomeini Hospital, Razi Street, Sari, IR Iran. Tel/Fax: +98-15122787894, E-mail:
| | - Saeid Abediankenari
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
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190
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Chin KH, Sathyasurya DR, Abu Saad H, Jan Mohamed HJB. Effect of ethnicity, dietary intake and physical activity on plasma adiponectin concentrations among malaysian patients with type 2 diabetes mellitus. Int J Endocrinol Metab 2013; 11:167-74. [PMID: 24348588 PMCID: PMC3860115 DOI: 10.5812/ijem.8298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 02/21/2013] [Accepted: 03/04/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Malaysian Health and morbidity Survey (2006) reported the highest prevalence of type 2 diabetes mellitus (T2DM) among the Indian population compared to the Malay and Chinese populations. Many studies have supported the important role of adiponectin in insulin-sensitizing, which is associated with T2DM. These studies have raised a research question whether the variation in prevalence is related to the adiponectin concentrations or the lifestyle factors. OBJECTIVES The purpose of this study is to determine whether the adiponectin concentrations differ between the Malay, Chinese and the Indian populations with T2DM. It is to investigate the association of adiponectin concentrations with ethnicity, dietary intake and physical activity too. MATERIALS AND METHODS In this cross-sectional study, a total of 210 T2DM patients with mean (SD) age of 56.73 (10.23) years were recruited from Penang, Malaysia. Data on demographic background, medical history, anthropometry (weight, height, visceral fat, percentage of body fat and waist circumference), dietary intake (3 days 24 hours diet recall) and physical activity (International Physical Activity Questionnaire) were obtained accordingly. Plasma adiponectin and routine laboratory tests (fasting blood sugar, HbA1c, total cholesterol, LDL, HDL and triglyceride) were performed according to standard procedure. RESULTS After adjustment for physical activity and dietary intakes, the Indian population had significantly lower adiponectin concentrations (P = 0.003) when compared with the Malay and the Chinese populations, The Indian population also had significantly higher value of HbA1c (P = 0.017) and significantly lower HDL (P = 0.013). Plasma adiponectin concentrations was significantly associated with ethnicity (P = 0.011), dietary carbohydrate (P = 0.003) and physical activity total MET score (P = 0.026), after medical history, age, sex, total cholesterol and visceral fat adjusted. However, dietary carbohydrate and physical activity did not show significantly difference among the various ethnic groups. CONCLUSIONS In conclusion, lower concentration of adiponectin in the Indian population when compared with the Malay and the Chinese populations is not associated with lifestyle factors. The possibility of adiponectin gene polymorphism should be discussed further.
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Affiliation(s)
- Koo Hui Chin
- Nutrition Program, School of Health Sciences, Universiti Sains Malaysia, Malaysia, Malaysia
| | | | - Hazizi Abu Saad
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia
| | - Hamid Jan B Jan Mohamed
- Nutrition Program, School of Health Sciences, Universiti Sains Malaysia, Malaysia, Malaysia
- Corresponding author: Hamid Jan B Jan Mohamed, Nutrition Program, School of Health Sciences, Universiti Sains Malaysia, Malaysia. Tel.: +60-126456477, Fax: +60-97677515, E-mail:
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191
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Kim TH, Chun KH, Kim HJ, Han SJ, Kim DJ, Kwak J, Kim YS, Woo JT, Park Y, Nam M, Baik SH, Ahn KJ, Lee KW. Direct medical costs for patients with type 2 diabetes and related complications: a prospective cohort study based on the Korean National Diabetes Program. J Korean Med Sci 2012; 27:876-82. [PMID: 22876053 PMCID: PMC3410234 DOI: 10.3346/jkms.2012.27.8.876] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 05/20/2012] [Indexed: 01/31/2023] Open
Abstract
We analyzed the direct medical costs for Korean patients with type 2 diabetes according to the type of complications and the number of microvascular complications. We analyzed costs for type 2 diabetes and associated complications in 3,125 patients. These data were obtained from the Korean National Diabetes Program (KNDP), a large, ongoing, prospective cohort study that began in 2005. The cost data were prospectively collected, using an electronic database, for the KNDP cohort at six hospitals. The costs were analyzed according to complications for 1 yr from enrollment in the study. Among 3,125 patients, 918 patients had no vascular complications; 1,883 had microvascular complications only; 51 had macrovascular complications only; and 273 had both complications. The annual direct medical costs for a patient with only macrovascular, only microvascular, or both macrovascular and microvascular complications were 2.7, 1.5, and 2.0 times higher than the medical costs of patients without complications. Annual direct medical costs per patient increased with the number of microvascular complications in patients without macrovascular complications. The economic costs for type 2 diabetes are attributable largely to the management of microvascular and macrovascular complications. Proper management of diabetes and prevention of related complications are important for reducing medical costs.
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Affiliation(s)
- Tae Ho Kim
- Division of Endocrinology, Department of Internal Medicine, Kwandong University College of Medicine, Myongji Hospital, Goyang, Korea
| | - Ki Hong Chun
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Hae Jin Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Seung Jin Han
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Jiyeong Kwak
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Young Seol Kim
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jeong Taek Woo
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Yongsoo Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Moonsuk Nam
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Sei Hyun Baik
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyu Jeung Ahn
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kwan Woo Lee
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
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192
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Lee WJ, Song KH, Noh JH, Choi YJ, Jo MW. Health-related quality of life using the EuroQol 5D questionnaire in Korean patients with type 2 diabetes. J Korean Med Sci 2012; 27:255-60. [PMID: 22379335 PMCID: PMC3286771 DOI: 10.3346/jkms.2012.27.3.255] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 01/02/2012] [Indexed: 11/23/2022] Open
Abstract
We aimed; 1) to determine the validity of the EuroQol 5D (EQ-5D) for the health-related quality of life (HRQOL) of Korean patients with type 2 diabetes, and 2) to identify associated factors of the HRQOL of these patients. Follow-up surveys were conducted for consecutive patients with type 2 diabetes. HRQOL was assessed using the EQ-5D and the Short Form-36 (SF-36). The validity of EQ-5D was assessed with the perspectives of known group, convergent and discriminant validity. Additionally, a linear mixed model using a backward elimination was used for identify associated factors. Of the 1,072 patients included in the first survey, 858 (80.0%) completed the questionnaires in the follow-up. In the known group validity, the problem rates in each EQ-5D dimension were highest among women, elderly people, and less-educated subjects. The Spearman's ρ between the EQ-5D and the SF-36 scales were larger in the comparable dimensions than those in the less comparable dimensions. In the final model, we found that sex, age, education, body mass index, atrial fibrillation, stroke, and retinopathy were statistically significant. Our data suggest that the EQ-5D is a valid tool for Korean patients with type 2 diabetes and that various factors could affect their HRQOL.
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Affiliation(s)
- Woo Je Lee
- Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee-Ho Song
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jung Hyun Noh
- Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Yon Jong Choi
- Department of Regulatory Affairs & Market Access, Sanofi-Aventis Korea Co. Ltd., Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
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193
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Saito O, Saito T, Asakura S, Akimoto T, Inoue M, Ando Y, Muto S, Kusano E. Effects of raloxifene on bone metabolism in hemodialysis patients with type 2 diabetes. Int J Endocrinol Metab 2012; 10:464-9. [PMID: 23843805 PMCID: PMC3693610 DOI: 10.5812/ijem.3794] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 02/17/2012] [Accepted: 02/22/2012] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Osteoporosis and chronic kidney disease are common conditions in older adults, and often occur concurrently. Bone disease is caused by increased bone turnover accompanying secondary hyperparathyroidism, and by factors such as bone metabolic disorder accompanying kidney disease and postmenopausal or age-related osteoporosis, even in hemodialysis patients. Raloxifene is commonly used for the treatment of postmenopausal osteoporosis in the general population, and may be a treatment option for osteoporosis in hemodialysis patients. However, the effects of raloxifene in hemodialysis patients with type 2 diabetes have not been examined in detail. OBJECTIVES This study was performed to investigate the effects of raloxifene on bone turnover markers and bone density in postmenopausal women with type 2 diabetes mellitus who were undergoing hemodialysis in Japan. PATIENTS AND METHODS The subjects were 60 female patients on maintenance hemodialysis (non-diabetic, n=30; diabetic, n=30). Raloxifene hydrochloride (60 mg) was administered to 14 diabetic patients and 14 non-diabetic patients for one year, and these patients were compared with control groups (no raloxifene) of 16 diabetic patients and 16 non-diabetic patients. Serum levels of N-terminal cross-linking telopeptide of type I collagen (NTx), bone alkaline phosphatase, and intact parathyroid hormone (iPTH) were measured, and bone density was determined by quantitative heel ultrasound at the speed of sound (SOS) in the calcaneus during this period. RESULTS There were no significant differences in the levels of bone turnover markers except for iPTH after treatment of diabetic and non-diabetic patients with raloxifene for one year. SOS increased after treatment with raloxifene, but was significantly decreased in the control groups. Treatment with raloxifene resulted in a significant decrease in NTx and a significant increase in SOS in both diabetic and non-diabetic patients. There were no significant differences between the diabetic and non-diabetic patients who received raloxifene. CONCLUSIONS Treatment with raloxifene can suppress reduction in bone density in postmenopausal women with type 2 diabetes who are undergoing hemodialysis.
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Affiliation(s)
- Osamu Saito
- Department of Nephrology, Jichi Medical University, Tochigi, Japan
- Corresponding author: Osamu Saito, Department of Nephrology, Jichi Medical University, Simotsuke, 329-0498, Tochigi, Japan. Tel.: +81-285587346, Fax: +81-285444869, E-mail:
| | - Takako Saito
- Department of Nephrology, Jichi Medical University, Tochigi, Japan
| | | | - Tetsu Akimoto
- Department of Nephrology, Jichi Medical University, Tochigi, Japan
| | - Makoto Inoue
- Department of Nephrology, Jichi Medical University, Tochigi, Japan
| | - Yasuhiro Ando
- Department of Nephrology, Jichi Medical University, Tochigi, Japan
| | - Shigeaki Muto
- Department of Nephrology, Jichi Medical University, Tochigi, Japan
| | - Eiji Kusano
- Department of Nephrology, Jichi Medical University, Tochigi, Japan
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194
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Lee S, Kim IT, Park HB, Hyun YK, Kim YJ, Song SO, Kim H. High-sensitivity C-reactive protein can predict major adverse cardiovascular events in Korean patients with type 2 diabetes. J Korean Med Sci 2011; 26:1322-7. [PMID: 22022185 PMCID: PMC3192344 DOI: 10.3346/jkms.2011.26.10.1322] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 08/29/2011] [Indexed: 11/20/2022] Open
Abstract
Inflammation is thought to play a role in the pathogenesis of major adverse cardiovascular events (MACE). It has been suggested that the measurement of markers of inflammation may aid in predicting the risk of such events. Here, the relationship between high-sensitivity C-reactive protein (hs-CRP) levels and MACE in Korean patients with type 2 diabetes is assessed. A retrospective cohort study was conducted as a follow-up among 1,558 patients with type 2 diabetes and without cardiovascular diseases over a mean period of 55.5 months. A Cox proportional-hazards model was used to determine whether increased hs-CRP levels are useful as a predictor for future MACE. The hazard ratio of MACE was 1.77 (95% CI; 1.16-2.71) in subjects who had the highest hs-CRP levels (> 0.21 mg/dL) compared to subjects who had the lowest hs-CRP levels (< 0.08 mg/dL), after adjusting for age, regular physical activity, current smoking, and duration of diabetes. The present results indicate that high hs-CRP levels can act as a predictor for the MACE occurrence in Korean patients with type 2 diabetes.
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Affiliation(s)
- Sangheun Lee
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - In Tae Kim
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - Hyung Bok Park
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - Yu Kyung Hyun
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - Yoon Ji Kim
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - Sun Ok Song
- Department of Internal Medicine, College of Medicine, Kwandong University, Goyang, Korea
| | - Hyeongjin Kim
- Department of Endocrinology, College of Medicine, Kwandong University, Goyang, Korea
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195
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Lim JH, Lee YS, Chang HC, Moon MK, Song Y. Association between dietary patterns and blood lipid profiles in Korean adults with type 2 diabetes. J Korean Med Sci 2011; 26:1201-8. [PMID: 21935277 PMCID: PMC3172659 DOI: 10.3346/jkms.2011.26.9.1201] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 07/13/2011] [Indexed: 12/15/2022] Open
Abstract
We aimed to explore the associations of dietary patterns with blood lipid profiles and obesity in adults with type 2 diabetes. The data were obtained from the Forth Korean National Health and Nutrition Examination Survey, 2007-2008. Adults 30 yr or older, from which had both biochemical and dietary data were obtained. Among them, 680 subjects were defined as having diabetes based on criteria of fasting glucose ≥ 126 mg/dL, anti-diabetic treatment, or previously diagnosed diabetes. Dietary data from a 24-hr recall were used to derive dietary patterns by factor analysis. Four dietary patterns by factor analysis were identified: 'Bread & Meat & Alcohol', 'Noodles & Seafood', 'Rice & Vegetables', and 'Korean Healthy' patterns. Serum cholesterol levels in the highest quartile of the 'Bread & Meat & Alcohol' pattern were significantly higher compared with those in the lowest quartile. In addition, total cholesterol and triglyceride levels in the highest quartile of the 'Korean Healthy' pattern were significantly lower after adjusting for potential confounders. Dietary patterns of adults with diabetes were found to be associated with blood lipid profiles. 'Korean Healthy' pattern including whole grains, legumes, vegetables, and fruits could thus improve lipid profiles among those with type 2 diabetes.
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Affiliation(s)
- Jeong Hyun Lim
- Departments of Food Service and Nutrition Care, Seoul National University, Seoul, Korea
| | - Yeon-Sook Lee
- Food and Nutrition/Research Institute of Human Ecology, Seoul National University, Seoul, Korea
| | - Hak Chul Chang
- Department of Internal Medicine, Seoul National University College of Medicine, Bundang Hospital, Seongnam, Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - YoonJu Song
- Major in Food and Nutrition, School of Human Ecology, The Catholic University of Korea, Bucheon, Korea
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196
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Simoens S, De Coster S, Lenie J, Hayen V, Laekeman G. Detecting pre-diabetes and the role of the pharmacist. Pharm Pract (Granada) 2011; 9:88-92. [PMID: 24688614 PMCID: PMC3969831 DOI: 10.4321/s1886-36552011000200005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 05/07/2011] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE This study aims to use a pharmacoepidemiological approach to study the drug use of patients during the year prior to diabetes diagnosis (i.e. pre-diabetic patients) and control patients. Drug use might reveal cardiovascular, metabolic and/or endocrinological changes and help to identify indicators for active monitoring of Type 2 diabetes mellitus. METHODS A retrospective case-control study compared drug use of patients with a future diagnosis of diabetes (experimental patients) with patients without a diabetes diagnosis (control patients) based on community pharmacy records. An experimental patient had used oral hypoglycaemic drugs during 2005 or 2006. Experimental and control patients were matched in terms of age, gender and quarter of index date. Drugs were selected based on possible co-morbidities of diabetes. Drug use was expressed as a binary variable, indicating whether or not a patient took specific drugs. Drug use was compared between experimental patients during the year prior to diagnosis and control patients using the chi-squared test. RESULTS Our dataset covered 5,064 patients (1,688 experimental and 3,376 control patients). A higher probability of taking cardiovascular drugs was observed for specific subgroups of patients with pre-diabetes as compared to control patients: this trend was observed for men as well as for women, for various cardiovascular drug classes, and for different age groups (p<0.05), although it was not always statistically significant for the 29-38 age group. For each selected age and gender group, patients with pre-diabetes had a higher probability of taking a combination of a lipid-modifying agent and an antihypertensive drug than control patients (p<0.005). CONCLUSIONS Using community pharmacy data, this study demonstrated that age and a characteristic drug use pattern could contribute to detecting pre-diabetes. There is a potential role for community pharmacists to follow up drug indicators of patients with a view to refer high-risk people for screening by a physician.
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Affiliation(s)
- Steven Simoens
- Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven ( Belgium )
| | - Sandra De Coster
- Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven ( Belgium )
| | - Jan Lenie
- Royal Pharmaceutical Society of Limburg, Hasselt (Belgium)
| | | | - Gert Laekeman
- Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven ( Belgium )
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197
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Ahn HR, Shin MH, Yun WJ, Kim HY, Lee YH, Kweon SS, Rhee JA, Choi JS, Choi SW. Comparison of the Framingham Risk Score, UKPDS Risk Engine, and SCORE for Predicting Carotid Atherosclerosis and Peripheral Arterial Disease in Korean Type 2 Diabetic Patients. Korean J Fam Med 2011; 32:189-96. [PMID: 22745854 PMCID: PMC3383126 DOI: 10.4082/kjfm.2011.32.3.189] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 03/21/2011] [Indexed: 11/05/2022] Open
Abstract
Background To compare the predictability of the Framingham Risk Score (FRS), United Kingdom Prospective Diabetes Study (UKPDS) risk engine, and the Systematic Coronary Risk Evaluation (SCORE) for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients. Methods Among 1,275 registered type 2 diabetes patients in the health center, 621 subjects with type 2 diabetes participated in the study. Well-trained examiners measured the carotid intima-media thickness (IMT), carotid plaque, and ankle brachial index (ABI). The subject's 10-year risk of coronary heart disease was calculated according to the FRS, UKPDS, and SCORE risk scores. These three risk scores were compared to the areas under the curve (AUC). Results The odds ratios (ORs) of all risk scores increased as the quartiles increased for plaque, IMT, and ABI. For plaque and IMT, the UKPDS risk score provided the highest OR (95% confidence interval) at 3.82 (2.36, 6.17) and at 6.21 (3.37, 11.45). For ABI, the SCORE risk estimation provided the highest OR at 7.41 (3.20, 17.18). However, no significant difference was detected for plaque, IMT, or ABI (P = 0.839, 0.313, and 0.113, respectively) when the AUCs of the three risk scores were compared. When we graphed the Kernel density distribution of these three risk scores, UKPDS had a higher distribution than FRS and SCORE. Conclusion No significant difference was observed when comparing the predictability of the FRS, UKPDS risk engine, and SCORE risk estimation for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients.
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Affiliation(s)
- Hye-Ran Ahn
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
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198
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Kim M, Suk J, Kim H, Jung H, Kim T, Park J. Post-prandial lipid levels for assessing target goal achievement in type 2 diabetic patients taking statin. J Korean Med Sci 2010; 25:387-92. [PMID: 20191037 PMCID: PMC2826752 DOI: 10.3346/jkms.2010.25.3.387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 06/16/2009] [Indexed: 11/20/2022] Open
Abstract
It is inconvenient to perform serum lipid analysis in fasting state in diabetic patients with drug treatment. In patients with statin treatment and Asian diet, it has not been clearly known whether non-fasting values could be used for the clinical decision making in diabetic patients. In this study, fasting and post-prandial plasma lipid profiles of hospitalized type 2 diabetic patients taking statin, were measured in whom standard diabetic breakfast in traditional Korean style were provided. In repeated-measures ANOVA, there were no significant differences among fasting, post-prandial 2 and 4 hr low-density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol values. When compared to fasting levels, both post-prandial 2 hr and 4 hr LDL cholesterol levels were misclassified as not achieved target goal only in 4% of patients. Post-prandial HDL cholesterol matched with fasting values in women, without exception. In conclusion, the fasting and post-prandial LDL and HDL cholesterol levels are not significantly different each other and can be used in the assessment of achieving target goal in type 2 diabetes taking statin after Korean diet.
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Affiliation(s)
- Mikyung Kim
- Department of Internal Medicine, Maryknoll Medical Center, Korea
- Molecular Therapy Lab, Paik Memorial Institute for Clinical Research, Inje University, Busan, Korea
| | - Jihye Suk
- Department of Internal Medicine, Maryknoll Medical Center, Korea
| | - Hyunjung Kim
- Department of Internal Medicine, Maryknoll Medical Center, Korea
| | - Hyesuk Jung
- Molecular Therapy Lab, Paik Memorial Institute for Clinical Research, Inje University, Busan, Korea
| | - Taeik Kim
- Department of Internal Medicine, Maryknoll Medical Center, Korea
| | - Jeonghyun Park
- Department of Internal Medicine, Pusan Paik Hospital, Inje University, Busan, Korea
- Molecular Therapy Lab, Paik Memorial Institute for Clinical Research, Inje University, Busan, Korea
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199
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Kim MH, Lee MK. The Incretins and Pancreatic beta-Cells: Use of Glucagon-Like Peptide-1 and Glucose-Dependent Insulinotropic Polypeptide to Cure Type 2 Diabetes Mellitus. Korean Diabetes J 2010; 34:2-9. [PMID: 20532013 PMCID: PMC2879907 DOI: 10.4093/kdj.2010.34.1.2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is increasing in prevalence worldwide. The complications associated with T2DM result in increased mortality and financial cost for those affected. T2DM has long been known to be associated with insulin resistance in peripheral tissues and a relative degree of insulin deficiency. However, the concept that insulin secretion and insulin sensitivity are not linked through a hyperbolic relationship in T2DM has continuously been demonstrated in many clinical trials. Thus, in order to prevent and treat T2DM, it is necessary to identify the substance(s) that will improve the function and survival of the pancreatic beta-cells in both normal and pathologic conditions, so that production and secretion of insulin can be enhanced. Incretin hormones, such as glucagon-like peptide (GLP)-1 and glucose-dependent insulinotropic polypeptide (GIP), have been shown to lower the postprandial and fasting glucose and the glycated hemoglobin levels, suppress the elevated glucagon level, and stimulate glucose-dependent insulin synthesis and secretion. In this report, we will review the biological actions and mechanisms associated with the actions of incretin hormones, GLP-1 and GIP, on beta-cell health and compare the differences between GLP-1 and GIP.
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Affiliation(s)
- Mi-Hyun Kim
- Division of Endocrinology and Metabolism, Samsung Biomedical Research Institute (SBRI), Seoul, Korea
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200
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Kim YK, Lee JE, Kim YG, Kim DJ, Oh HY, Yang CW, Kim KW, Huh W. Cardiac autonomic neuropathy as a predictor of deterioration of the renal function in normoalbuminuric, normotensive patients with type 2 diabetes mellitus. J Korean Med Sci 2009; 24 Suppl:S69-74. [PMID: 19194565 PMCID: PMC2633204 DOI: 10.3346/jkms.2009.24.s1.s69] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Accepted: 01/12/2009] [Indexed: 01/13/2023] Open
Abstract
Our study was performed to determine whether cardiac autonomic neuropathy can predict deterioration of the renal function in normoalbuminuric, normotensive people with type 2 diabetes mellitus (DM). One hundred and fifty-six normoalbuminuric, normotensive people with type 2 DM were included in our retrospective longitudinal study. We categorized normal patterns, early patterns, and definite or severe patterns according to the results of the cardiac autonomic function test. Of 156 patients included, 54 had normal patterns, 75 had early patterns, 25 had definite or severe patterns, and 2 had atypical patterns. During a median follow-up of nine years, glomerular filtration rates (GFR) remained stable in the normal and early pattern groups (mean changes, 4.50% and 0.77%, respectively) but declined in those with definite or severe patterns (mean change, -10.28%; p=0.047). An abnormal heart response to the deep breathing test of the cardiac autonomic function tests was an independent predictor of GFR decline. Our data suggest that cardiac autonomic neuropathy, especially with a definite or severe pattern, might be associated with a subsequent deterioration in renal function in normoalbuminuric, normotensive people with type 2 DM.
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Affiliation(s)
- Yong Kyun Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Eun Lee
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Goo Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dae Joong Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ha-Young Oh
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chul Woo Yang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kwang-Won Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wooseong Huh
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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