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Shen Z, Chen M, Li Q, Ma J. Decreased glucagon in diabetic peripheral neuropathy patients with long duration type 2 diabetes. Postgrad Med J 2024:qgae056. [PMID: 38646729 DOI: 10.1093/postmj/qgae056] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/06/2023] [Accepted: 04/06/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the association of fasting C-peptide and glucagon with diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes (T2DM). METHODS A comprehensive evaluation was conducted on 797 patients with T2DM to assess the various risk factors affecting DPN. The subjects were categorized into short duration and long duration group according to the duration of diabetes with a threshold of 10 years. Logistic regression analysis was employed to examine the association between DPN and islet function, as well as other parameters. Receiver operating characteristic curve analysis was performed to evaluate the predictive capability of glucagon. RESULTS The fasting C-peptide levels were significantly lower in the DPN patients with short duration of diabetes, but lost significance in the long duration group. Conversely, a decreased level of glucagon was only observed in DPN patients with long duration of diabetes. For the group with long duration of diabetes, glucagon was the sole risk factor associated with DPN. The receiver operating characteristic curve analysis revealed that glucagon in the long duration group exhibited a moderate area under the curve of 0.706. CONCLUSIONS The serum glucagon levels in T2DM patients with DPN exhibited bidirectional changes based on the duration of diabetes. Decreased glucagon was associated with DPN in T2DM patients with long duration of diabetes.
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Affiliation(s)
- Ziyang Shen
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000, China
| | - Mengxing Chen
- Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000, China
| | - Qian Li
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000, China
| | - Jianhua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000, China
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Krstevska B, Mishevska SJ, Nakova VV, Bitoska I, Guceva NL, Ahmeti I, Markovic S, Todorova B, Mladenovska I. Assessment of Prevalence and Risk Factors for Diabetic Retinopathy in Patients with Type 1 and Type 2 Diabetes Examined at a Tertiary Care. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2023; 44:23-30. [PMID: 37453120 DOI: 10.2478/prilozi-2023-0021] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Introduction: Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus and the leading cause of visual impairment and blindness. The aim of the study was to estimate and compare the prevalence of DR and to determine an association between DR and systemic risk factors in hospitalized type 1 (DMT1) and type 2 (DMT2) diabetic patients. Material and methods: We analyzed 260 patients with diabetes, 43 with DMT1 and 217 with DMT2. The following data were collected: age, gender, type and duration of diabetes, glycemic control, blood pressure, estimated glomerular filtration rate, ophthalmologic examinations and routine biochemical parameters. Results: Out of the total number of 260 patients, 77 (29.6%) had non-proliferative DR (NPDR), 21 (8.1%) had proliferative DR (PDR), 29 (11.1%) had diabetic macular edema (DME), and 69 (23.5%) had diabetic cataracts. Forty-three (16.5%) patients were previously diagnosed with DMT1 and 217 (83.5%) with DMT2. The duration of diabetes was not significantly longer in DMT1 (12.8±11.2 years) in comparison to DMT2 (11.07±8.1 years). The prevalence of NPDR and PDR did not differ statistically in either groups. DME was more prevalent in DMT2 than in DMT1 (P<0.05). Diabetic cataract was found in 26.7% vs. 6.7% of patients with DMT2 and DMT1, respectively (p<0.01). The duration of diabetes significantly correlated with NPDR and PDR in DMT1 (r=o.31, p<0.05; r=0.55, p<0.001, respectively). In DMT2, significant correlations were found between the duration of diabetes and cataract, NPDR, PDR and DME (r=0.31, p<0.001; r=0.43 p<0.01, r=0.16 p<0.05 and r=0.20 p<0.01, respectively). Fasting plasma glucose (FPG) significantly correlated with PDR (r=0.258, p<0.05), while HbA1c with DME (r= 0.15 p<0.05). Conclusion: The duration of diabetes and hyperglycemia were associated with DR in both types of diabetes.
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Affiliation(s)
- Brankica Krstevska
- 1Internal Medicine Center "Srce"
- 2Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | - Sasha Jovanovska Mishevska
- 2Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
- 3University Clinic of Endocrinology, diabetes and metabolic disorders, Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | - Valentina Velkoska Nakova
- 4Clinical Hospital - Stip, RN Macedonia
- 5Faculty of Medical Science, Goce Delcev University in Stip, RN Macedonia
| | - Iskra Bitoska
- 2Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
- 3University Clinic of Endocrinology, diabetes and metabolic disorders, Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | - Nevenka Laban Guceva
- 3University Clinic of Endocrinology, diabetes and metabolic disorders, Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
- 5Faculty of Medical Science, Goce Delcev University in Stip, RN Macedonia
| | - Irfan Ahmeti
- 2Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
- 3University Clinic of Endocrinology, diabetes and metabolic disorders, Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | - Snezana Markovic
- 2Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
- 3University Clinic of Endocrinology, diabetes and metabolic disorders, Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | - Biljana Todorova
- 2Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
- 3University Clinic of Endocrinology, diabetes and metabolic disorders, Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
| | - Ivana Mladenovska
- 2Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
- 3University Clinic of Endocrinology, diabetes and metabolic disorders, Medical Faculty, Ss. Cyril and Methodius University in Skopje, RN Macedonia
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Rajput S, Parashar R, Sharma JP, Raghuwanshi P, Pakhare AP, Joshi R, Hulke S. Assessment of Pulmonary Functions and Dysfunctions in Type II Diabetes Mellitus: A Comparative Cross-Sectional Study. Cureus 2023; 15:e35081. [PMID: 36945284 PMCID: PMC10024785 DOI: 10.7759/cureus.35081] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 02/19/2023] Open
Abstract
Background Diabetes mellitus causes microvascular complications in the eyes and kidneys as well as the nervous system, among other parts of the body. Lungs are a potential target organ for diabetic microvascular complications and remain the least researched among diabetic patients. The aim of this study was to explore whether there is any difference in pulmonary functions in patients with diabetes mellitus compared to those without. Methodology A comparative cross-sectional study was conducted on 50 participants each with and without type II diabetes mellitus. Pulmonary function parameters, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1 as a percentage of FVC in percentage (FEV1%), peak expiratory flow rate in L/second (PEFR), forced expiratory flow rate in L/second in 25% of FVC (FEF25%), forced expiratory flow rate in L/second in 50% of FVC (FEF50%), forced expiratory flow rate in L/second in 75% of FVC (FEF75%), forced expiratory flow rate during 25-75% of expiration (FEF25-75%), and maximal voluntary ventilation (MVV), of both groups were analyzed using the NDD Large True Flow (Easy One) spirometer (NDD Meditechnik AG., Switzerland). A fully automated chemistry analyzer and linear chromatography were used for glycemic control measurements. Results All pulmonary function test parameter values were lower in participants with diabetes mellitus compared to those without, except FEV1% and PEFR, which indicates a mixed pattern of lung dysfunction. FVC had a significant negative correlation with the duration of diabetes (r = -0.299, p = 0.034). Conclusions Type II diabetes mellitus patients had significant dysfunction in pulmonary functions with early involvement of restrictive parameters which can be monitored/diagnosed by regularly following up patients by measuring pulmonary functions, and, hence, can be taken care of.
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Affiliation(s)
- Saumya Rajput
- Department of Internal Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Rachna Parashar
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Jai Prakash Sharma
- Department of Anesthesiology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Pragati Raghuwanshi
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Abhijit P Pakhare
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Rajnish Joshi
- Department of Internal Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Sandip Hulke
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
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Yu Y, Xie K, Lou Q, Xia H, Wu D, Dai L, Hu C, Shan S, Wang K, Tang W. The clinical characteristics of Chinese elderly patients with different durations of type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2022; 13:904347. [PMID: 35966087 PMCID: PMC9372462 DOI: 10.3389/fendo.2022.904347] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS To explore the clinical characteristics among elderly (aged ≥60 years) patients with type 2 diabetes (T2DM) of different durations. METHODS Clinical characteristics were investigated in 3840 elderly T2DM patients according to their different durations of diabetes (< 1 year, 1~5 years, 5~10 years, and ≥ 10 years). Kruskal-Wallis and Dunn tests were used to assess the differences among groups for continuous variables. The chi-square and post hoc tests were carried out for dichotomous variables. The logistic regression was adopted to investigate the relationships between various durations of diabetes and the control rates of achieving the control targets for T2DM as well as diabetic vascular complications. RESULTS There were 972, 896, 875 and 1097 patients with a duration of diabetes of <1, 1~5, 5~10 and ≥10 years, respectively. In logistic regression models adjusted for age, sex, education, BMI, smoking and family history of diabetes, elderly T2DM patients with a duration of diabetes of ≥10 years were more likely to reach the comprehensive control targets for TC (ORTC = 1.36, 95% CI =1.14-1.63), LDL-C (ORLDL-C = 1.39, 95% CI =1.17-1.66), TG (ORTG = 1.76, 95% CI =1.46-2.12) and BMI (ORBMI = 1.82, 95% CI =1.52-2.18). Elderly T2DM patients with a duration of diabetes of 1~5 years were more likely to achieve the HbA1c control target (ORHbA1c = 1.92, 95% CI = 1.59-2.31) than elderly T2DM patients with a duration of diabetes of <1 year. Furthermore, in elderly T2DM patients with a duration of diabetes of 5~10 years or ≥ 10 years, the duration of diabetes was positively associated with diabetic macrovascular complications (coronary heart disease and peripheral artery disease). In elderly T2DM patients with a duration of diabetes of over 10 years, the duration of diabetes was associated with diabetes kidney disease (all P < 0.05). CONCLUSIONS It is worth noting that the clinical characteristics of elderly patients with type 2 diabetes in different durations of diabetes are different.
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Affiliation(s)
- Yun Yu
- Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Kaipeng Xie
- Department of Public Health, Nanjing Maternity and Child Health Care Hospital, Women’s Hospital of Nanjing Medical University, Nanjing, China
| | - Qinglin Lou
- Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Xia
- Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Dan Wu
- Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Lingli Dai
- Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Cuining Hu
- Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Shan Shan
- Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Kunlin Wang
- Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Tang
- Department of Endocrinology and Metabolism, Geriatric Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Wei Tang,
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Zhang J, Deng Y, Wan Y, Wang J, Xu J. Diabetes duration and types of diabetes treatment in data-driven clusters of patients with diabetes. Front Endocrinol (Lausanne) 2022; 13:994836. [PMID: 36457559 PMCID: PMC9705576 DOI: 10.3389/fendo.2022.994836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study aimed to cluster patients with diabetes and explore the association between duration of diabetes and diabetes treatment choices in each cluster. METHODS A Two-Step cluster analysis was performed on 1332 Chinese patients with diabetes based on six parameters (glutamate decarboxylase antibodies, age at disease onset, body mass index, glycosylated hemoglobin, homeostatic model assessment 2 to estimate β-cell function and insulin resistance). Associations between the duration of diabetes and diabetes treatment choices in each cluster of patients were analyzed using Kaplan-Meier survival curves and logistic regression models. RESULTS The following five replicable clusters were identified: severe autoimmune diabetes (SAID), severe insulin-deficient diabetes (SIDD), severe insulin-resistant diabetes (SIRD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD). There were significant differences in blood pressure, blood lipids, and diabetes-related complications among the clusters (all P < 0.05). Early in the course of disease (≤5 years), compared with the other subgroups, the SIRD, MOD, and MARD populations were more likely to receive non-insulin hypoglycemic agents for glycemic control. Among the non-insulin hypoglycemic drug options, SIRD had higher rates of receiving metformin, alpha-glucosidase inhibitor (AGI), and glucagon-like peptide-1 drug; the MOD and MARD groups both received metformin, AGI and sodium-glucose cotransporter 2 inhibitor (SGLT-2i) drug ratio was higher. While the SAID and SIDD groups were more inclined to receive insulin therapy than the other subgroups, with SAID being more pronounced. With prolonged disease course (>5 years), only the MOD group was able to accept non-insulin hypoglycemic drugs to control the blood sugar levels, and most of them are still treated with metformin, AGI, and SGLT-2i drugs. While the other four groups required insulin therapy, with SIDD being the most pronounced. CONCLUSIONS Clustering of patients with diabetes with a data-driven approach yields consistent results. Each diabetes cluster has significantly different disease characteristics and risk of diabetes complications. With the development of the disease course, each cluster receives different hypoglycemic treatments.
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Affiliation(s)
- Jie Zhang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yuanyuan Deng
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yang Wan
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jiao Wang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, Jiangxi, China
- Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, Jiangxi, China
| | - Jixiong Xu
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, Jiangxi, China
- Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, Jiangxi, China
- *Correspondence: Jixiong Xu,
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Tewari A, Tewari V, Tewari J. A Cross-Sectional Study for Prevalence and Association of Risk Factors of Chronic Kidney Disease Among People With Type 2 Diabetes in the Indian Setting. Cureus 2021; 13:e18371. [PMID: 34725618 PMCID: PMC8554643 DOI: 10.7759/cureus.18371] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Current evidence demonstrates that people with type 2 diabetes (T2D) are at a higher risk of developing chronic kidney disease (CKD) with greater morbidity and mortality. We, therefore, aimed to document and categorize demographic, anthropometric, and physiological risk factors of CKD in people with T2D in India. Additionally, we also attempted to evaluate the magnitude of each risk factor, namely age, duration of diabetes, HbA1c, and body mass index (BMI) in its etiology. METHODS This observational, single-center, and cross-sectional study was performed at a diabetes care center in Lucknow, India. Out of a total of 504 eligible patients, we could get the required data from 435 patients. The following data were collected: demographic data, estimated glomerular filtration rate (eGFR), serum creatinine, urinary albumin creatinine ratio (UACR), and HbA1c levels. Appropriate statistical tests were applied. RESULT The 435 eligible people with diabetes had a mean age (SD) of 51 (±10.52) years; female 48.02%, duration of diabetes 7 (±5.4) years; HbA1c 8.6 (±2.3)% and eGFR values 80.2 (±26.6) mL/min/1.73m2 at the time of presentation. The eGFR values correlated negatively with age and duration of diabetes, and positively with increasing BMI. The Spearman correlation coefficient showed that clinical parameters such as age, duration of diabetes, and BMI have a weak, but statistically significant correlation with eGFR while eGFR did not correlate with HbA1c level in the study. Further, we did not find a correlation between eGFR and UACR. CONCLUSION In people with T2D, age and duration of diabetes are important risk factors for the development of CKD based on the eGFR. Hence, even in the absence of high UACR values, a low eGFR should prompt periodic monitoring to reduce the risk of progression of CKD, especially, in older people with long-standing T2D. Our study did not find HbA1c as a suitable tool to assess the CKD progression risk, but historical glycaemic control over longer periods revealed by sequential values of HbA1c over the duration of disease may correlate with the progression of CKD.
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Affiliation(s)
- Ajoy Tewari
- Diabetes and Endocrinology, Jai Clinic & Diabetes Care Center, Lucknow, IND
| | - Vineeta Tewari
- Anatomy, Era's Lucknow Medical College and Hospital, Era University, Lucknow, IND
| | - Jay Tewari
- Medicine, King George's Medical University, Lucknow, IND
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Mathiyalagen P, Kanagasabapathy S, Kadar Z, Rajagopal A, Vasudevan K. Prevalence and Determinants of Peripheral Neuropathy Among Adult Type II Diabetes Mellitus Patients Attending a Non-communicable Disease Clinic in Rural South India. Cureus 2021; 13:e15493. [PMID: 34268025 PMCID: PMC8261778 DOI: 10.7759/cureus.15493] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 12/04/2022] Open
Abstract
Background Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of diabetes. Almost half of the diabetic patients develop foot ulcer as a complication of DPN during their lifetime. The aim was to estimate the prevalence and identify the risk factors of diabetic peripheral neuropathy among adult diabetes mellitus (DM) patients. Methods A cross-sectional study was conducted among 421 type 2 DM patients attending Non-Communicable Disease (NCD) clinic in rural Puducherry through systematic random sampling. The study instruments used for data collection were a pre-tested semi-structured questionnaire, Michigan Neuropathy Screening Instrument (MNSI), Morisky Green Levine Scale (MGLS), physical measurements and recent laboratory results. The data was captured using Epicollect5 and analyzed using SPSS version 20. Results The prevalence of DPN was 31.1% (95% confidence interval (CI): 27.1%-35.1%). The mean age, duration of diabetes, and duration of foot symptoms were 57.91±10.61, 7.00±6.23, 5.56±5.26 years. Smoking (adjusted odds ratio (AOR) 3.14; 95% CI 1.73-5.69), mean duration of diabetes>5years (AOR 2.74; 95% CI 1.71-4.40), hyperglycemic status(>200mg/dl) (AOR 2.24; 95% CI 1.08-4.64) and unemployment (AOR 2.05; 95% CI 1.11-3.76) were found to be statistically significant determinants of DPN on binary logistic regression analysis. Conclusions A considerable proportion of diabetics are at risk of developing DPN among rural DM patients. More diligent screening in a primary health care setting and addressing the modifiable risk factors like smoking, obesity, physical inactivity, and uncontrolled hyperglycemia will delay or hamper DPN development among diabetic patients.
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Affiliation(s)
- Prakash Mathiyalagen
- Epidemiology and Public Health, Indira Gandhi Medical College and Research Institute, Puducherry, IND
| | - Sivagami Kanagasabapathy
- Epidemiology and Public Health, Indira Gandhi Medical College and Research Institute, Puducherry, IND
| | - Zubaidabegum Kadar
- Epidemiology and Public Health, Indira Gandhi Medical College and Research Institute, Puducherry, IND
| | - Anandaraj Rajagopal
- Epidemiology and Public Health, Indira Gandhi Medical College and Research Institute, Puducherry, IND
| | - Kavita Vasudevan
- Epidemiology and Public Health, Indira Gandhi Medical College and Research Institute, Puducherry, IND
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Otani T, Yokoyama H, Hanai K, Miura J, Uchigata Y, Babazono T. Rapid increase in the incidence of end-stage renal disease in patients with type 1 diabetes having HbA1c 10% or higher for 15 years. Clin Pediatr Endocrinol 2019; 28:113-125. [PMID: 31666764 PMCID: PMC6801355 DOI: 10.1297/cpe.28.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 03/11/2019] [Accepted: 07/17/2019] [Indexed: 12/19/2022] Open
Abstract
The incidence of end-stage renal disease (ESRD) in Japanese patients with type 1 diabetes
mellitus (T1DM) was investigated regarding the association between mean HbA1c values
during follow-up and the duration of follow-up/illness. The study includes 988 patients
diagnosed at ages younger than 30 yr. These patients were initially examined between 1962
and 1999, and HbA1 and/or HbA1c measurements were taken for at least 3 yr after 1980. The
follow-up period was from the date of the first HbA1 or HbA1c measurement to the final
measurement day, or HbA1c measurement day immediately before the development of ESRD. The
condition progressed to ESRD in 63 patients (mean duration of illness: 23.6 yr). Cox
regression analysis revealed that patients with HbA1c of ≥ 10% had a significantly
increased higher risk than those with HbA1c under 8% (P < 0.0001). The HbA1c cut-off
point was 10.0%. The HbA1c value was ≥ 10% at baseline and during follow-up in 128
patients. Assuming that HbA1c of ≥ 10% persisted since the time of diagnosis in these
patients, the cumulative incidence of ESRD abruptly increased after 15 yr of illness.
Thus, the incidence of ESRD increased after the persistence of HbA1c of ≥ 10% for 15
yr.
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Affiliation(s)
- Toshika Otani
- Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Omiya Kyoritsu Hospital, Saitama, Japan
| | | | - Ko Hanai
- Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Junnosuke Miura
- Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Yasuko Uchigata
- Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.,Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Tetsuya Babazono
- Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
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Gverović Antunica A, Bućan K, Kaštelan S, Kaštelan H, Ivanković M, Šikić M. Prevalence of diabetic retinopathy in the Dubrovnik-Neretva County. Cent Eur J Public Health 2019; 27:160-164. [PMID: 31241293 DOI: 10.21101/cejph.a5213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 09/14/2017] [Accepted: 04/29/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Diabetic retinopathy is one of the leading causes of blindness. We estimated the prevalence of diabetic retinopathy among a diabetic population in the Dubrovnik-Neretva County in the Republic of Croatia and searched for potential risk factors. METHODS A prospective study was performed with 600 diabetic patients from different parts of the Dubrovnik-Neretva County who attended regular medical and ophthalmological check-ups at the General Hospital Dubrovnik from September 2014 to September 2015. Patients underwent a complete medical assessment by two ophthalmologists. Retinal examination included evaluation of the presence of diabetic retinopathy. Any retinopathy present was graded as mild non-proliferative retinopathy, moderate-severe non proliferative retinopathy or proliferative retinopathy. RESULTS Retinopathy was present in 44.5% of the study sample. 20.7% had the mild form of diabetic retinopathy, 18.8% had the moderate-severe form, and 5.0% had proliferative diabetic retinopathy. The mean duration of diabetes was 12.94 years ± 6.85; 12.89 years ± 9.18 in men, 12.94 ± 6.54 in women. The mean BMI was 27.14 ± 2.98; for diabetics without diabetic retinopathy 26.19 ± 2.75; for those with the mild form 28.06 ± 3.01; for those with the moderate-severe form 28.49 ± 2.54; for those with proliferative diabetic retinopathy 28.79 ± 3.16. 168 (28%) patients were treated by laser and 22 (3.7%) by vitrectomy. CONCLUSION The prevalence of diabetic retinopathy in the Dubrovnik-Neretva County is 44.5%. Regular screening to detect diabetic retinopathy is highly recommended as timely intervention can prevent most diabetic causes of blindness.
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Affiliation(s)
| | - Kajo Bućan
- University Department of Ophthalmology, Clinical Hospital Split, Split, Croatia
| | - Snježana Kaštelan
- Department of Ophthalmology, Clinical Hospital Dubrava, Zagreb, Croatia
| | - Helena Kaštelan
- Department of Ophthalmology, General Hospital Dubrovnik, Dubrovnik, Croatia
| | - Mira Ivanković
- Department of Neurology, General Hospital Dubrovnik, Dubrovnik, Croatia
| | - Maja Šikić
- Medical Centre Dubrovnik, Dubrovnik, Croatia
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Roy S, Kim N, Desai A, Komaragiri M, Baxi N, Jassil N, Blessinger M, Khan M, Cole R, Desai N, Terrigno R, Hunter K. Cognitive Function and Control of Type 2 Diabetes Mellitus in Young Adults. N Am J Med Sci 2015; 7:220-6. [PMID: 26110134 PMCID: PMC4462818 DOI: 10.4103/1947-2714.157627] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Type 2 diabetes mellitus (T2DM) has been associated with impairment of cognitive function. Studies show a strong negative correlation between the levels of glycosylated hemoglobin and cognitive function in adult patients above the mean age of 60 years. In healthy adults, age-related cognitive impairment is mostly reported after the age of 60 years, hence the decline in cognitive function can be a part of normal aging without diabetes. Since the majority of patients with diabetes are between the ages of 40 and 59 years, it is crucial to ascertain whether the levels of glycosylated hemoglobin negatively correlate with the levels of cognitive function scores in adult patients of age 60 years or younger, similar to the way it correlates in patients older than 60 years of age, or not. Aims: We observed the relationship between the levels of glycosylated hemoglobin and the levels of cognitive function in patients of age 60 years or younger with T2DM. Materials and Methods: Eighty-two patients with T2DM underwent cognitive assessment testing by using a Modified Mini-Mental State Examination (3MS), and their cognitive function scores were correlated with their glycosylated hemoglobin levels, durations of diabetes, and levels of education. Results: Cognitive impairment was observed in 19.5% of the studied patients. We found a weakly negative relationship between the glycosylated hemoglobin level and cognitive function score (r = -0.292), a moderately negative relationship between the duration of diabetes and cognitive function score (r = -0.303), and a weakly positive relationship between the level of education and cognitive function score (r = 0.277). Conclusion: Cognitive impairment affects one-fifth of the patients of age 60 years or younger with T2DM. It is weakly negatively related to the glycosylated hemoglobin level, moderately negatively related to the duration of diabetes, and weakly positively related to the level of education.
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Affiliation(s)
- Satyajeet Roy
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Nami Kim
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Anjali Desai
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Mahathi Komaragiri
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Namrata Baxi
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Navinder Jassil
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Megan Blessinger
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Maliha Khan
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Robert Cole
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Nayan Desai
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Rocco Terrigno
- Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA
| | - Krystal Hunter
- Cooper Research Institute, Cooper Medical School of Rowan University, Camden, New Jersey, USA
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Jee D, Lee WK, Kang S. Prevalence and risk factors for diabetic retinopathy: the Korea National Health and Nutrition Examination Survey 2008-2011. Invest Ophthalmol Vis Sci 2013; 54:6827-33. [PMID: 24065813 DOI: 10.1167/iovs.13-12654] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We evaluated the prevalence and risk factors for diabetic retinopathy (DR) in a representative Korean population. METHODS This cross-sectional study involved 16,109 subjects aged >40 years who had participated in the Korean National Health and Nutrition Survey from 2008 to 2011. Seven standard retinal fundus photographs were obtained after pupil dilatation from both eyes. The DR was graded using the modified Airlie House classification system. Risk factors for DR and vision-threatening diabetic retinopathy (VTDR) were evaluated, including age, sex, diabetes duration, glycated hemoglobin (HbA1c), hypertension, lipid profiles, and refractive error. RESULTS Of the 16,109 eligible individuals participating in the study, 14,595 (90.6%) had fasting blood glucose results available. Of these, 2023 (13.8%) were diagnosed with diabetes mellitus. Among these, gradable photographs were available for 1678 subjects (82.9%), including 1323 subjects with known diabetes mellitus (KDM) and 355 with newly diagnosed diabetes mellitus (NDM). The prevalences of any DR and VTDR were 15.8% (95% confidence interval [CI], 14.1-17.5), and 4.6% (95% CI, 3.6-5.6), respectively. Any DR was associated with a longer duration of diabetes (odds ratio [OR], 1.08; 95% CI, 1.06-1.10), higher HbA1C level (OR, 1.52; 95% CI, 1.28-1.80), higher systolic blood pressure (OR, 1.02; 95% CI, 1.01-1.03), and lower body mass index (OR, 0.91; 95% CI, 0.87-0.96) in a multivariate analysis. CONCLUSIONS We provide data on the prevalence and risk factors for DR in a representative Korean population. The prevalence of any DR and VTDR in the Korean population was lower than that reported previously. The condition of DR was associated with a longer duration of diabetes, poor glycemic control, and higher systemic blood pressure.
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Affiliation(s)
- Donghyun Jee
- Department of Ophthalmology and Visual Science, St. Vincents' Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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12
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Hwang J, Johnson JA. Relationship between duration of type 2 diabetes and self-reported participation in diabetes education in Korea. Asia Pac J Public Health 2012; 27:NP311-21. [PMID: 22500039 DOI: 10.1177/1010539512440592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/16/2022]
Abstract
The increasing prevalence of diabetes is a pressing issue in Korea. The aim of this study was to determine the relationship between duration of diabetes and self-reported participation in diabetes education among diabetic patients in Korea. This study used data from the Korean National Health and Nutrition Examination Survey in 2005. A total of 1405 respondents older than 19 years and having diabetes were included in the analyses. The relationship between these variables was assessed using logistic regression after adjusting for age, sex, and socioeconomic status. The authors observed that duration of diabetes was associated with having never attended diabetes education programs (odds ratio = 0.95; 95% confidence interval = 0.93-0.96; P < .001), with the greatest risk of not attending seen in recently diagnosed patients. In addition, having lower educational attainment and living in non-Metro Seoul regions were independent factors for never attending diabetes education programs among diabetic patients in Korea. This finding suggests the need for developing effective education programs to encourage diabetic patients, particularly recently diagnosed patients, to participate. Such programs could help deliver appropriate information for diabetes management to all diabetic patients in Korea.
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Koshy AS, Kumari SJ, Ayyar V, Kumar P. Evaluation of serum vitamin B12 levels in type 1 diabetics attending a tertiary care hospital: A preliminary cross - sectional study. Indian J Endocrinol Metab 2012; 16 Suppl 1:S79-S82. [PMID: 22701852 PMCID: PMC3354937 DOI: 10.4103/2230-8210.94270] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIMS AND OBJECTIVES To estimate serum vitamin B12 levels in type 1 diabetes and to evaluate the influence of duration of diabetes, diabetic control, and age on B 12 levels. IMPORTANCE OF STUDY: Vitamin B12 deficiency is known to be associated with autoimmune disorders. However, currently there is very limited and controversial data regarding the prevalence of B12 deficiency in type 1 diabetes in South Indian population. If our study demonstrates the presence of low serum B12 levels in type1 diabetes in our population, a recommendation for regular screening and supplementation of vitamin B12 could be considered in these patients. MATERIALS AND METHODS This was a cross- sectional study. Ninety type 1 diabetic patients (44 males and 46 females) were randomly selected based on inclusion/ exclusion criteria from the diabetes registry at Bangalore Diabetes Centre. Serum vitamin B12 level and parameters for diabetic controls were estimated using fully automated methods. All statistical analysis was carried out using SPSS version 16. RESULTS The study showed that 45.5% of the diabetics had low B12 using the manufacturer's cut - off of 180 pg/mL and 54% had low B12 using the published cut - off of 148 pmol/l (200pg/mL). There was no significant difference in B12 levels between males and females (mean difference = - 14.3: P > 0.05). The study did not demonstrate any significant correlation between vitamin B12 levels and age, duration of diabetes, and diabetes control (the r values being - 0.18, - 0.11, and - 0.08 respectively and the P-value > 0.05). CONCLUSION Results of our study shows the presence of low serum B12 levels in type 1 diabetics. These findings merits further research on a larger population to investigate into the cause of deficiency and the benefit of B12 supplementation in these patients.
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Affiliation(s)
- Ann Sarah Koshy
- MBBS student, Department of Biochemistry, St John's Medical College, Bangalore, India
| | - S. Jaya Kumari
- Department of Biochemistry, St John's Medical College, Bangalore, India
| | - Vageesh Ayyar
- Department of Endocrinology, St John's Medical College, Bangalore, India
| | - Prasanna Kumar
- Department of Endocrinology, Bangalore Diabetes Centre, Bangalore, India
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Yim JE, Kim YS, Cho MR, Choue R. Ratio of fat to energy intake independently associated with the duration of diabetes and total cholesterol levels in type 2 diabetes. Nutr Res Pract 2011; 5:157-62. [PMID: 21556230 PMCID: PMC3085805 DOI: 10.4162/nrp.2011.5.2.157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/11/2010] [Revised: 04/03/2011] [Accepted: 04/05/2011] [Indexed: 11/19/2022] Open
Abstract
The importance of dietary intake in the treatment of type 2 diabetes was emphasized. This study was performed to investigate the dietary intakes of Korean type 2 diabetes patients according to the treatment and duration of diabetes and to examine the relationships between their diet and serum lipid profiles. The subjects were 111 type 2 diabetic patients who were treated by medical nutrition therapy only, oral hypoglycemic agents (OHA), or insulin with medical nutrition therapy. Dietary intake was assessed by a registered dietitian using semi-quantitative food frequency questionnaires. Comparisons according to treatment type were made using covariance analyses. General linear models identified the independent effects of the different treatments after covarying for age, duration of diabetes, and 2-way interactions. There were no significant differences in age and BMI but was in duration of diabetes according to treatment type in these subjects. Carbohydrate to energy ratio was higher in the OHA group (P < 0.05), whereas the fat to energy ratio was higher in the insulin group for males (P < 0.05). Carbohydrate (R2 = 0.24, P = 0.005) and fat (R2 = 0.26, P = 0.02) to energy ratios were independently associated with the duration of diabetes after covarying for age, sex, treatment, and 2-way interactions. The levels of triglyceride (TG; R2 = 0.32, P = 0.02) and total cholesterol (TC) were associated independently with energy intake and the carbohydrate (R2 = 0.15, P = 0.02) and fat (R2 = 0.15, P = 0.01) to energy ratios, respectively. The concern that the independent association of dietary intake with either duration of diabetes or dietary factors affects blood lipid levels could suggest that specific dietary recommendations may work better for identifiable groups of diabetes patients.
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Affiliation(s)
- Jung-Eun Yim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Seocheon-dong, Giheung-gu, Yongin, Gyeonggi 446-701, Korea
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