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Pyrgioti EE, Karakousis ND, Georgakopoulos PN, Papanas N. Metformin in Type 2 Diabetes: Evidence for its Beneficial Effects on Frailty and Sarcopenia. Curr Diabetes Rev 2024; 20:e270723219177. [PMID: 37497698 DOI: 10.2174/1573399820666230727101141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/01/2023] [Accepted: 06/27/2023] [Indexed: 07/28/2023]
Abstract
This narrative review aimed to discuss the potential interplay among frailty syndrome, sarcopenia and metformin in type 2 diabetes mellitus (T2DM). There is emerging evidence on the potential protective role of metformin on both frailty and sarcopenia. However, results are not always consistent. Thus, further research is needed to provide a definitive answer on any role of metformin in improving frailty and/or sarcopenia in T2DM.
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Affiliation(s)
| | - Nikolaos D Karakousis
- Second Department of Internal Medicine, Diabetes Centre-Diabetic Foot Clinic, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Nikolaos Papanas
- Second Department of Internal Medicine, Diabetes Centre-Diabetic Foot Clinic, Democritus University of Thrace, Alexandroupolis, Greece
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Karakousis ND, Pyrgioti EE, Georgakopoulos PN, Karagiannakis DS, Papanas N. Vitamin E and Diabetic Foot Ulcers. Curr Diabetes Rev 2024; 20:e140923221099. [PMID: 37711108 DOI: 10.2174/1573399820666230914155232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/23/2023] [Accepted: 07/18/2023] [Indexed: 09/16/2023]
Abstract
This narrative mini-review discusses vitamin E levels in subjects with diabetic foot ulcers (DFUs). Vitamin E may be reduced in subjects with DFUs, but this finding is inconsistent. Its administration appears to benefit patients with DM, delaying the onset of complications, including DFUs. There is also evidence that it may promote DFUs healing. Nonetheless, further studies are required to confirm these promising results and estimate vitamin E administration's costeffectiveness.
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Affiliation(s)
- Nikolaos D Karakousis
- Second Department of Internal Medicine, Diabetes Centre-Diabetic Foot Clinic, Democritus University of Thrace, Alexandroupolis, Greece
| | | | | | - Dimitrios S Karagiannakis
- Academic Department of Gastroenterology, Laiko General Hospital, Medical School of National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papanas
- Second Department of Internal Medicine, Diabetes Centre-Diabetic Foot Clinic, Democritus University of Thrace, Alexandroupolis, Greece
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Karakousis ND, Pyrgioti EE, Georgakopoulos PN, Apergi K, Popovic DS, Papanas N. Zinc Levels and Diabetic Foot Ulcers: A Mini Review. INT J LOW EXTR WOUND 2023:15347346231214209. [PMID: 37941343 DOI: 10.1177/15347346231214209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The aim of this nonsystematic mini review was to discuss serum levels of zinc in subjects with diabetic foot ulcers (DFUs). Most studies have reported low zinc levels in subjects with DFUs. Furthermore, there is some evidence that oral zinc supplementation may have a positive and beneficial impact on DFUs healing. Nonetheless, findings have so far not provided definitive answers. More studies are needed to clarify the role of zinc and its supplementation in this setting.
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Affiliation(s)
- Nikolaos D Karakousis
- Second Department of Internal Medicine, Diabetes Centre-Diabetic Foot Clinic, Democritus University of Thrace, Thrace, Greece
| | | | | | - Kyriaki Apergi
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Djordje S Popovic
- Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Centre of Vojvodina, Novi Sad, Serbia
- Medical Faculty, University of Novi Sad, Novi Sad, Serbia
| | - Nikolaos Papanas
- Second Department of Internal Medicine, Diabetes Centre-Diabetic Foot Clinic, Democritus University of Thrace, Thrace, Greece
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Chowdhury SR, Chakrabarti A, Datta PK. Sarcopenia in patients with diabetes mellitus, an overlooked perioperative condition. Br J Anaesth 2023; 131:e65-e67. [PMID: 37394326 DOI: 10.1016/j.bja.2023.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 07/04/2023] Open
Affiliation(s)
- Sumit R Chowdhury
- Department of Neuroanesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
| | - Asmita Chakrabarti
- Department of Emergency Medicine and Staff Health, Tata Medical Center, Kolkata, India
| | - Priyankar K Datta
- Department of Anesthesiology Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
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González-Colaço Harmand M, Tejera Concepción A, Farráis Expósito FJ, Domínguez González J, Ramallo-Fariña Y. Pilot Study on the Relationship between Malnutrition and Grip Strength with Prognosis in Diabetic Foot. Nutrients 2023; 15:3710. [PMID: 37686742 PMCID: PMC10490286 DOI: 10.3390/nu15173710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Sarcopenia and malnutrition have been associated in the elderly population with a poor prognosis in wound healing and with other adverse events, such as institutionalization or functional impairment. However, it is not known how these factors influence the prognosis of diabetic foot in the elderly. To answer this question, a prospective observational study of 45 patients over 65 years of age admitted with diagnoses of diabetic foot in a tertiary hospital has been conducted. All patients were assessed at admission and at 3 months after returning home to determine quality of life, pain, mobility and healing, overall hospital stay in relation to the presence of malnutrition (measured by BMI, CIPA scale and analytical parameters at admission of serum proteins and albumin), and sarcopenia measured by grip force, among other geriatric syndromes. The results found a relationship between altered sarcopenia and more pain and poorer quality of life, and altered BMI was related to a lower cure rate and worse mobility at follow-up. This study seems to indicate that, in the elderly population with diabetic foot, malnutrition and sarcopenia should be managed at the same time as the treatment of the diabetic foot itself.
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Affiliation(s)
- Magali González-Colaço Harmand
- Department of Internal Medicine-Geriatric Medicine, Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain;
- Faculty of Health Sciences, Universidad Europea de Canarias, 38300 La Orotava, Spain
| | - Alicia Tejera Concepción
- Department of Internal Medicine-Geriatric Medicine, Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain;
- Internal Medicine Department, Universidad de la Laguna, 38200 La Laguna, Spain
| | | | | | - Yolanda Ramallo-Fariña
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), 35019 Las Palmas de Gran Canaria, Spain;
- Network for Research on Chronicity Primary Care and Health Promotion, 28029 Madrid, Spain
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Karakousis ND, Gourgoulianis KI, Kotsiou OS. Sarcopenia and Tuberculosis: Is There Any Connection? J Pers Med 2023; 13:1102. [PMID: 37511715 PMCID: PMC10381550 DOI: 10.3390/jpm13071102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) infection is a life-threatening infection caused by certain bacteria belonging to the Mycobacterium tuberculosis complex. More than 10 million subjects are newly sick from this infection every year globally. At the same time, TB is quite prevalent among subjects who come from lower socioeconomic layers of general population, and marginalized sections and areas. Sarcopenia is a muscle disease that derives from adverse muscle alterations and is related to the loss of muscle strength and mass. It is a major medical issue due to its increased adverse outcomes including falls, functional decline, frailty, hospitalizations, increased mortality, and healthcare costs. METHODS This study examined the potential interplay between the TB infection and sarcopenia through conducting a non-systematic review of the current literature. RESULTS It has been recorded that the prevalence of sarcopenia among TB survivors is high, whilst the danger of TB among the elderly increases with sarcopenia and physical inactivity. Nevertheless, sufficient protein and total energy intake are associated with a low risk of sarcopenia in TB survivors. CONCLUSIONS Further studies are needed to validate these findings and shed more light on the upcoming different aspects of this intriguing association.
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Affiliation(s)
- Nikolaos D Karakousis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Biopolis, 41110 Larissa, Greece
| | - Konstantinos I Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Biopolis, 41110 Larissa, Greece
| | - Ourania S Kotsiou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Biopolis, 41110 Larissa, Greece
- Laboratory of Human Pathophysiology, Faculty of Nursing, University of Thessaly, Gaiopolis, 41500 Larissa, Greece
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Karakousis ND, Pyrgioti EE, Georgakopoulos PN, Papanas N. Vitamin B 12 and Diabetic Foot: Α Mini-Review. INT J LOW EXTR WOUND 2022:15347346221143018. [PMID: 36448193 DOI: 10.1177/15347346221143018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
This narrative mini-review article aimed to investigate the potential association of vitamin B12 levels with diabetic neuropathy (DN) and diabetic foot ulcers (DFUs). It was demonstrated that B12 deficiency seems to be related to DFUs in cases of metformin administration and bariatric surgery. B12 supplementation with dietary measures and agents may improve DN and quality of life (QoL). However, data are still preliminary and more experience is needed.
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Affiliation(s)
| | | | | | - Nikolaos Papanas
- Second Department of Internal Medicine, Diabetes Centre-Diabetic Foot Clinic, Democritus University of Thrace, Alexandroupolis, Greece
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Karakousis ND, Kotsiou OS, Gourgoulianis KI. Bronchial Asthma and Sarcopenia: An Upcoming Potential Interaction. J Pers Med 2022; 12:1556. [PMID: 36294694 PMCID: PMC9605248 DOI: 10.3390/jpm12101556] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Sarcopenia seems to be an emerging health issue worldwide, concerning the progressive loss of skeletal muscle mass, accompanied by adverse outcomes. Asthma is a chronic inflammatory respiratory condition that is widespread in the world, affecting approximately 8% of adults. Although data are scarce, we aim to shed light on the potential association between low muscle mass and asthma and point out any probable negative feedback on each other. METHODS We searched within the PubMed, Scopus, MEDLINE, and Google Scholar databases. STUDY SELECTIONS Three studies were included in our analysis. Only original studies written in English were included, while the references of the research articles were thoroughly examined for more relevant studies. Moreover, animal model studies were excluded. RESULTS 2% to 17% of asthmatics had sarcopenia according to the existent literature. Sarcopenic asthmatic patients seem to have reduced lung function, while their mortality risk may be increased. Furthermore, patients with asthma- chronic obstructive pulmonary disease (COPD) overlap syndrome phenotype and sarcopenia might have a higher risk of osteopenia and osteoporosis progression, leading consequently to an increased risk of fractures and disability. CONCLUSIONS Emerging data support that pulmonologists should be aware of the sarcopenia concept and be prepared to evaluate the existence of low muscle mass in their asthmatic patients.
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Affiliation(s)
| | - Ourania S. Kotsiou
- Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
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