Current Issue : January - March Volume : 2017 Issue Number : 1 Articles : 7 Articles
Background: Diabetes and hypertension increase arterial stiffness and cardiovascular events in all societies studied\nso far; sub-Saharan African studies are sparse. We investigated factors affecting arterial function in Ghanaians with\ndiabetes, hypertension, both or neither.\nMethod: Testing the hypothesis that arterial stiffness would progressively increase from controls to multiply\naffected patients, 270 participants were stratified into those with diabetes or hypertension only, with both, or\nwithout either. Cardio-ankle vascular index (CAVI), heartââ?¬â??ankle pulse wave velocity (haPWV), aortic PWV (PWVao)\nby Arteriograph, aortic and brachial blood pressures (BP), were measured.\nResults: In patients with both diabetes and hypertension compared with either alone, values were higher of\nCAVI (mean Ã?± SD, 8.3 Ã?± 1.2 vs 7.5 Ã?± 1.1 and 7.4 Ã?± 1.1 units; p < 0.05), PWVao (9.1 Ã?± 1.4 vs 8.7 Ã?± 1.9 and 8.1 Ã?± 0.\n9 m/s; p < 0.05) and haPWV (8.5 Ã?± 1 vs 7.9 Ã?± 1 and 7.2 Ã?± 0.7 m/s; p < 0.05) respectively. In multivariate analysis,\nage, having diabetes or hypertension and BMI were independently associated with CAVI in all participants (Ã?² = 0.49, 0.2,\n0.17 and -0.2 units; p < 0.01, respectively). Independent determinants of PWVao were heart rate, systolic BP and\nage (Ã?² = 0.42, 0.27 and 0.22; p < 0.01), and for haPWV were systolic BP, age, BMI, diabetes and hypertension status\n(Ã?² = 0.46, 0.32, -0.2, 0.2 and 0.11; p < 0.01).\nConclusion: In this sub-Saharan setting with lesser atherosclerosis than the western world, arterial stiffness is\nsignificantly greater in patients with coexistent diabetes and hypertension but did not differ between those with\neither diabetes or hypertension only. Simple, reproducibly measured PWV/CAVI may offer effective and efficient\ntargets for intervention...
There is no doubt that behavioral intervention is crucial for type 2 diabetes mellitus (T2DM) prevention and management. We\naimed to estimate dietary habits and diet-oriented knowledge as well as the level of physical activity in 2500 insulin-treated Polish\ntype 2 diabetes mellitus (T2DM) patients (55.4% women). The mean age of the study participants was 64.9 �± 9.3 years, mean\nBMI was 31.4 kg/m2\n�± 4.5, mean diabetes duration was 12.4 �± 6.9 years, and mean baseline HbA1c was 8.5% �± 1.2. At the study\nonset, all the patients completed a questionnaire concerning health-oriented behavior. Results showed a significant lack of dietrelated\nknowledge. For example, only 37.5% recognized that buckwheat contains carbohydrates; the percentage of correct answers\nin questions about fruit drinks and pasta was 56.4% and 61.2%, respectively. As for the physical activity, only 57.4% of examined\nT2DMpatients declared any formof deliberate physical activity. To conclude, the cohort of poorly controlled insulin-treated T2DM\npatients studied by us is characterized by insufficient diet-related knowledge and by a very low level of physical activity. Further\nstudies on other populations of insulin-treated T2DM patients are required to confirm these findings....
Background: Roux-en-Y gastric bypass surgery is widely applied to ameliorate morbid obesity, including diabetes\nin people with type 2 diabetes. The latter vanish a few days after surgery for many, but not in all patients before\nany weight reduction has occurred. The explanation for this change in metabolic status is poorly understood, but\nthe observation may suggest that the fate obesity and diabetes is only partly linked after surgery.\nMethods: The trajectories of weight reduction measured as reduced body mass index (BMI) in 741obese subjects\nwith and without diabetes were evaluated. Evaluation was performed on three groups: 1) subjects that were\nnon-diabetic before and after surgery; 2) subjects that were diabetics before surgery but non-diabetics after\nsurgery; and 3) subjects that were diabetics before surgery and remained diabetics after surgery. The diabetic\nstate was established at HbA1c above 48 mmol/mol.\nResults: The trajectories differ significantly between groups and any sub-populations of groups, the latter identified by\nthe distance between individual trajectories using a k-means procedure. The results suggest that different domains in\nthe enormous genetic network governing basic metabolism are perturbed in obesity and diabetes, and in fact some of\nthe patients are affected by two distinct diseases: obesity and diabetes mellitus type 2.\nConclusion: Although RYGB ââ?¬Å?normalizedââ?¬Â many glycaemic parameters in some of the diabetic subjects apparently\nconverting to a non-diabetics state, other diabetic subjects stay diabetic in the context of the new gut anatomy after\nsurgery. Thus, the obesity part of the glycaemic derangement may have been ameliorated, but some defects of the\ndiabetic state had not....
Background: To evaluate the neonatal and obstetric outcomes of pregnancies complicated by gestational diabetes\nmellitus (GDM). Screening and treatment ââ?¬â?? diet-only versus additional insulin therapy ââ?¬â?? were based on the 2010\nnational Dutch guidelines.\nMethods: Retrospective study of the electronic medical files of 820 singleton GDM pregnancies treated between\nJanuary 2011 and September 2014 in a university and non-university hospital. Pregnancy outcomes were compared\nbetween regular care treatment regimens ââ?¬â??diet-only versus additional insulin therapy- and pregnancy outcomes of\nthe Northern region of the Netherlands served as a reference population.\nResults: A total of 460 women (56 %) met glycaemic control on diet-only and 360 women (44 %) required\nadditional insulin therapy. Between the groups, there were no differences in perinatal complications (mortality, birth\ntrauma, hyperbilirubinaemia, hypoglycaemia), small for gestational age, large for gestational age (LGA), neonate\nweighing >4200 g, neonate weighing ââ?°Â¥4500 g, Apgar score <7 at 5 min, respiratory support, preterm delivery, and\nadmission to the neonatology department. Neonates born in the insulin-group had a lower birth weight compared\nwith the diet-group (3364 vs. 3467 g, p = 0.005) and a lower gestational age at birth (p = 0.001). However, birth\nweight was not different between the groups when expressed in percentiles, adjusted for gestational age,\ngender, parity, and ethnicity. The occurrence of preeclampsia and gestational hypertension was comparable\nbetween the groups. In the insulin-group, labour was more often induced and more planned caesarean\nsections were performed (p = 0.001). Compared with the general obstetric population, the percentage of LGA\nneonates was higher in the GDM population (11.0 % vs.19.9 %, p = <0.001).\nConclusions: Neonatal and obstetric outcomes were comparable either with diet-only or additional insulin\ntherapy. However, compared with the general obstetric population, the incidence of LGA neonates was\nsignificantly increased in this GDM coho...
Aims. A new perspective on autoantibodies as pivotal players in the pathogenesis of type 1 diabetes (T1D) has recently emerged. Our\nkey objective was to examinewhether increased levels of autoantibodies against the ...
Background: Factual data exploring the relationship between obesity and diabetes mellitus prevalence from\nrural areas of sub-Saharan Africa remain scattered and are unreliable. To address this scarceness, this work reports\npopulation study data describing the relationship between the obesity and the diabetes mellitus in the general\npopulation of the rural area of Katana (South Kivu in the Democratic Republic of the Congo).\nMethods: A cohort of three thousand, nine hundred, and sixty-two (3962) adults (>15 years old) were followed\nbetween 2012 and 2015 (or 4105 person-years during the observation period), and data were collected using the\nlocally adjusted World Health Organization�s (WHO) STEPwise approach to Surveillance (STEPS) methodology. The\nhazard ratio for progression of obesity was calculated. The association between diabetes mellitus and obesity was\nanalyzed with logistic regression.\nResults: The diabetes mellitus prevalence was 2.8 % versus 3.5 % for obese participants and 7.2 % for those with\nmetabolic syndrome, respectively. Within the diabetes group, 26.9 % had above-normal waist circumference and\nonly 9.8 % were obese. During the median follow-up period of 2 years, the incidence of obesity was 535/100,000\nperson-years. During the follow-up, the prevalence of abdominal obesity significantly increased by 23 % (p <0.0001),\nwhereas the increased prevalence of general obesity (7.8 %) was not significant (p = 0.53). Finally, diabetes mellitus\nwas independently associated with age, waist circumference, and blood pressure but not body mass index.\nConclusion: This study confirms an association between diabetes mellitus and abdominal obesity but not with\ngeneral obesity. On the other hand, the rapid increase in abdominal obesity prevalence in this rural area population\nwithin the follow-up period calls for the urgent promoting of preventive lifestyle measures....
Background: Acarbose slows down the intestinal absorption of carbohydrates, but its effects on the secretion of\nincretins are still poorly known. This study aimed to examine the effects of single-dose acarbose on the secretion of\nincretins in patients with newly diagnosed type 2 diabetes mellitus (T2DM).\nMethods: In this pilot study, twenty-three patients diagnosed with T2DM were randomly assigned to the oral\nglucose tolerance test (OGTT) group (n = 11) and the mixed meal test (MMT) group (n = 12). Fourteen subjects with\nnormal OGTT were included as controls. Plasma glucose, insulin, glucagon, glucagon-like peptide-1 (GLP-1), and\nglucose-dependent insulinotropic peptide (GIP) were measured at 0 (fasting), 15, 30, 60, 90, and 120 min after\nnutrient load. A week later, controls underwent MMT, the OGTT group underwent OGTT receiving 100 mg\nacarbose, and the MMT group underwent MMT receiving 100 mg acarbose. The same blood markers were\nmeasured again.\nResults: No significant difference was observed in the OGTT group before and after administering acarbose. In the\nMMT group, postprandial levels of glucose (P < 0.01), insulin (P < 0.01), glucagon at 15 min (P < 0.05), glucagon area\nunder the curve (AUC) (P < 0.05), GIP levels at 30 min (P < 0.05), and GIP AUC (P < 0.05) were decreased after\nreceiving acarbose with a mixed meal, but GLP-1 levels and GLP-1 AUC did not change.\nConclusions: Single-dose acarbose could reduce the secretion of GIP and glucagon after a mixed meal in patients\nwith newly diagnosed T2DM. The influence of acarbose on incretin levels could be related to the types of\ncarbohydrate being consumed...
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