Current Issue : April - June Volume : 2016 Issue Number : 2 Articles : 7 Articles
Background: The main purpose of the present study is to evaluate whether treatment with long-acting human\nglucagon-like peptide-1 liraglutide was associated with an improvement of excessive daytime sleepiness (EDS) in\nobese subjects with type-2 diabetes.\nMethods: This single-centre retrospective study included 158 obese (body mass index [BMI] ââ?°Â¥ 30 kg/m2) adult\nsubjects with type-2 diabetes who were initiated with liraglutide treatment at least 3 months before study\ninclusion. Data of the Epworth Sleepiness Scale (ESS), anthropometric parameters, glucose-control and metabolic\nparameters were collected at liraglutide initiation (baseline) and at months 1 and 3 after liraglutide initiation.\nResults: Significant reductions in ESS score were achieved at months 1 (âË?â??1.3 Ã?± 2.8, p < 0.001) and 3 (âË?â??1.5 Ã?± 3.0, p < 0.001)\nafter liraglutide introduction. After 3 months of treatment with liraglutide, significant changes in body weight (p < 0.001),\nBMI (p < 0.001), waist (p < 0.001) and neck circumferences (p < 0.005), HbA1c (p < 0.001), mean blood glucose (p < 0.001),\nfasting plasma glucose (p < 0.001), triglycerides (p < 0.01) and total cholesterol (p < 0.001) were achieved.\nConclusions: After 3 months of treatment with liraglutide a significant reduction in EDS was observed in obese\nsubjects with type-2 diabetes. Besides this, significant changes in body weight and metabolic parameters of\ndiabetes control were also accomplished. Further investigation is required to determine whether liraglutide could\nimprove other abnormal sleep patterns and obstructive sleep apnoea....
Diabetes and obesity are major health hazards in Latin America nowadays. Their prevalence has\nsteadily increased since the eighties. Today, more than 50% of the population are overweight, 15%\nhas obesity and 6% to 15% has diabetes. The nutrition transition is a long-term process that\nbrings chronic metabolic diseases as an undesired consequence, whilst ultra processed foods become\nincreasingly part of daily food choices. These changes bring impacts in all fields of daily life,\nespecially in the economic and legal fieldsââ?¬â?the ââ?¬Å?Right to Healthââ?¬Âââ?¬â?and regarding autonomy of the\nindividual and their choices, when confronted with an ideal of health and well-being. Governments\nand citizens struggle to propose new pathways and find effective solutions to control both epidemics\nand solve these issues. This article poses the evolution of diabetes and obesity in the Mercosur,\nseeking a better understanding of these chronic, non-communicable diseases, and looking\nfor concrete, effective solutions towards health in South America....
GLP-1 receptor agonists are approved for the treatment of type 2 diabetes, and more recently for\nobesity treatment. The glucagon-like-peptide-1 (GLP-1) is a glucose dependent hormone produced\nby intestinal cells, which is involved in insulin secretion and glucagon suppression. This hormone\ncontrols glucose plasma levels and reduces food intake. Additional effects were reported in slowing\ngastric emptying and in inducing satiety. In clinical practice, the GLP-1 receptor agonists are\nassociated with significant reductions in glycosylated hemoglobin (HbA1c) and weight loss, despite\nshowing a low risk of hypoglycemia. Beneficial effects have also been observed on blood pressure\nand lipid profile. The most common side effects associated with GLP-1 receptor agonists are gastrointestinal\nmotility disorders, such as nausea, vomiting and diarrhea, which are not associated with\nlong-term health risks. Therefore, GLP-1 receptor agonists represent a relevant medication for type\n2 diabetes, whose benefits may go far beyond glycemic control....
The successes of interventions to obtain weight loss and prevent relapse are limited. Moreover, comorbidities like type 2 diabetes mellitus,\nhypertension, hypercholesterolemia, hypertriglyceridemia and gout, have so far been treated as separate diseases, although mounting evidence\nshows that these morbidities are consequences of the failing metabolism due to insulin resistance. Weight loss, in other words treating obesity,\nimproves comorbidities and improves quality of life. Treatment of obesity and its comorbidities is a multidisciplinary matter. It can be done in primary\ncare. It should be widely recognized that a low carbohydrate diet and exercise are the two main aspects of treatment that lead to the desired\nresult: considerable weight loss and diminishment of comorbidities, visible through improvement of blood parameters and improved quality of life.\n \n \n \n \n\n\n \ntrainers. Family physicians and nurse practioners need to be aware of the important role diet and lifestyle play. In insulin resistance medication\nis not the preferred treatment; it should be avoided as much as possible. By accepting this challenge in primary care, health professionals can\nchange the prevalence and consequences of obesity and its comorbidities, thus reducing health care costs considerably. Persons that are insulin\nresistant may regain their health through these measures. They will always stay insulin resistant to a certain extent, and cannot eat normal\nquantities of carbohydrates that are commonly used and advised in general dietary guidelines....
This study demonstrates that mean platelet volume (MPV) levels decrease after radioiodine (RAI) ablation therapy in hyperthyroid\npatients. Regarding the fact that large platelets are hemostatically more active, we suggest that hyperthyroid patients are at risk\nof cardiovascular disease despite all other cardiovascular risk factors. After RAI ablation therapy as MPV levels return to normal,\ncardiovascular risk for hyperthyroid patients reduces....
Background: Hospital inpatient care for patients with diabetes was estimated to cost $76 billion in 2012.\nSubstantial expense resulted from those patients having multiple hospitalizations. The objective was to compare\nthe risk for diabetesââ?¬â??related hospital readmission in patients with type 2 diabetes treated with sulfonylureas (SUs)\ncompared to those treated with other oral antihyperglycemic agents (AHAs).\nMethods: A retrospective cohort analysis was conducted using two-year panels, from 1999 to 2010, from the\nMedical Expenditure Panel Survey. The study included patients with type 2 diabetes taking an oral AHA who\nexperienced a diabetes-related hospitalization. A Cox proportional hazard regression predicting time to readmission\nwas used to estimate and compare the risks of readmission for SU-monotherapy versus other-AHA-monotherapy\npatients. Covariates included age, gender, marital status, cardiovascular disease, kidney disease, and eye disease,\nalong with a propensity score to control for selection bias. The lack of clinical data on disease severity and\nprogression limited our ability to estimate causal relationships between drug use and risk of hospital readmission.\nResults: From 1999 to 2010, an estimated 13.5 million patients experienced a diabetes-related hospital admission\nand subsequent AHA treatment. While 23.2 % (n = 746,579) of patients in the SU monotherapy cohort had a\nreadmission, only 16.1 % (n = 881,984) in the other-AHA monotherapy group were readmitted. Average readmission\nexpenditure for readmitted SU users (in 2010 dollars) was $11,148 (Ã?±$1,558) compared to $7,673 (Ã?±$763) for users\nof other oral AHAs. The estimated readmission hazard ratio was 1.29 (95 % CI: 1.01ââ?¬â??1.65; p-value = 0.04) for SU\nmonotherapy users. If a patientââ?¬â?¢s first hospital admission was during the time period 2008ââ?¬â??2010, a readmission was\nsignificantly less likely (HR 0.49, 95 % CI: 0.31ââ?¬â??0.78; p = 0.003) relative to 2004ââ?¬â??2007.\nConclusions: Among patients with type 2 diabetes, SU use was associated with an approximately 30 % increased\nrisk for readmission compared to other-AHA use, while each readmission for an SU user cost on average 45 % more\nthan one for an other-AHA patient. Because of the rapidly rising prevalence of diabetes in the U.S. and the large\nnumber of patients with prediabetes, preventing hospital readmissions will continue to be an important cost-saving\nstrategy in the future....
Background. Diabetes mellitus and thyroid diseases are common endocrine disorders in the general population and found to\nexist simultaneously. This study aimed to establish the prevalence of thyroid dysfunction among Omani type 2 diabetics and its\nassociation with glycemic control. Methodology. A retrospective cross-sectional randomized primary and secondary care based\nstudy of 285 Omani type 2 diabetics, â�¥ 30 years of age with known thyroid function. The following parameters were examined:\nage, sex, duration of diabetes, duration of thyroid disease, thyroid morphology, thyroid function, thyroid antibodies, and the mean\nglycated hemoglobin (mean HbA1C). The prevalence of thyroid dysfunction was compared to an independent control group of\nrandomly selected healthy individuals with known thyroid function. Results.Thyroid dysfunction was found in 12.6% of the diabetic\npatients compared to 4.9% in the control group. The prevalence was higher among the diabetic females (86%) compared to diabetic\nmales (14%). The commonest thyroid dysfunction among diabetics was overt hypothyroidism (4.6%). Subclinical hypothyroidism\nwas the commonest thyroid dysfunction seen in less controlled diabetics at a mean HbA1c of 7.8 (�± 0.7). Conclusion. Screening for\nthyroid dysfunction in patients with type 2 diabetes mellitus should be routinely performed considering the higher prevalence of\nthyroid diseases in this group compared to the general population....
Loading....