Current Issue : October - December Volume : 2017 Issue Number : 4 Articles : 7 Articles
Background: This study aimed to examine the associations of age with the presence of complications and\nglycemic control in the Northwest of Iran.\nMethods: A total of 649 people with diabetes who were >25 years old and had a caring record in diabetes clinics\nin two Northwestern provinces of Iran during 2014ââ?¬â??15, were recruited in this cross-sectional study. General\ninformation including demographic, socioeconomic status and lifestyle factors were collected by trained\ninterviewers. Clinical information was retrieved from clinic's record. Univariate and multivariate logistic regression\nwere performed to assess the predictors of diabetes outcome of interest as well as to clarify the role of age in\nrelation to these outcomes.\nResults: Compared to the age group of ââ?°Â¤49, the middle age group (50ââ?¬â??59) and the older age group (60 years of age\nand older) were less likely to report poor glycemic control (OR fully adjusted = 0.49 95% CI: 0.28ââ?¬â??0.86 and (OR = 0.44\n95% CI: 0.24ââ?¬â??0.80), respectively. Additionally, poor glycemic control was associated with income level, disease duration,\nhypercholesterolemia, high level of LDL and hypertension. In contrast, age was associated with the highest percentage\nof complications. People with duration of >7 years of disease record were 6 times more likely to have complications\n(ORadj = 5.98 95% CI: 2.35ââ?¬â??15.22).\nConclusion: Although the prevalence of complications was higher among the older diabetic patients, they had a\nbetter glycemic control. The influential factors were variably associated with the two diabetes-related outcomes;\ntherefore, a more comprehensive risk profiles assessment is needed for glycemic control...
We aimed to identify the variation in the clinical background of children diagnosed\nwith type 1 diabetes mellitus (T1DM) at King Salman Military Hospital\n(KSMH), Tabuk City, Kingdom of Saudi Arabia, from 2000 to 2010.\nMethods: This retrospective observational study was based on the clinical\nrecords of pediatric diabetes outpatients at KSMH. All children aged <12 years\nwho were diagnosed with T1DM and were followed up at the diabetes clinic\nfrom 2000 to 2010, were enrolled. The local variables associated with the clinical\npresentation in these patients, including age, sex, body mass index (BMI),\nand season of onset, were evaluated. Results: Of 313 patients recruited, female\npatients were predominant (p = 0.002). The mean age of onset was 6.46 years\n(standard deviation, 3.02). One-third of the newly diagnosed patients were\noverweight (35.5%). Diabetic ketoacidosis (DKA) was the presenting feature\nin 38.0% of patients, wherein female patients and those aged 0 - 3 years exhibited\nthe highest likelihood of developing DKA (odds ratio, 1.7 and 2.9, respectively).\nMoreover, underweight children had a greater DKA incidence\nthan healthy, overweight, or obese children (p = 0.02). Conclusion: This\nstudy provides additional data on T1DM in the population of the Kingdom of\nSaudi Arabia. In particular, we found a female predominance at presentation\nas well as 2 peaks for age at onset. Moreover, the BMI was lower in younger\nage groups overall, but was greater in older boys. Furthermore, the DKA rates\nwere high in younger children. Thus, our data confirm the presence of variable\nclinical patterns in the Kingdom of Saudi Arabia, which requires further\nepidemiological analysis using national registry data....
Background: Rapid-acting insulin analogs (RAIs) have not been examined for long-term safety in randomized\nclinical trials. We performed a nationwide longitudinal cohort study among individuals with type 2 diabetes (T2DM)\nto address cardiovascular safety and mortality among users of lispro, aspart and glulisine insulins.\nMethods: We used four national registers, following patients previously not treated with RAI but with continuous\nuse of RAIs in 2005-2014 up to 6.4 years, to examine HbA1c and weight, and the occurrence of severe\nhyperglycemia or hypoglycemia, renal failure, cardiovascular events or death. The treatment groups were compared\nusing a weighted Cox proportional hazards model.\nResults: We included 17,620 patients, mean age slightly higher than 60 years, diabetes duration 9.9ââ?¬â??11.7 years,\nmean BMI 30.5 kg/m2, HbA1c around 70 mmol/mol (8.6% NGSP), and 40.9ââ?¬â??54.0% of the patients exhibiting eGFR\n<60 ml/min/1.73 m2 in the three groups. Around 95% of the patients also used another insulin, and 24.2ââ?¬â??24.7% had\na history of cardiovascular disease (CVD).\nMean HbA1c and weight levels were stable and similar. Incidence rates of death were 234.4, 284.9 and 156.7 per\n1000 person-years among users of lispro, aspart, and glulisine; incidence rates of all cardiovascular events were 668.\n4, 622.4, and 699.5 per 1000 person-years, respectively.\nThere were no differences in mortality, CVD, renal failure or severe hypoglycemia or hyperglycemia, although a\nlower mortality risk in patients on glulisine compared with aspart, and lower risk of stroke in users of glulisine was\nsuggested. The risk of severe hyperglycemia was higher with lispro than aspart, and lower of severe hypoglycemia\nthan aspart or glulisine among the older age group.\nConclusions: Overall, there do not appear to be any major important differences in effects on hypoglycemia,\nhyperglycemia, weight or long-term safety between the three available RAIs among insulin-naive individuals with\nT2DM in clinical practice....
Aim: To evaluate the effect of different anti-diabetic treatment strategy on oxidative stress markers in patients with\ntype 2 diabetes mellitus (T2DM).\nSubject and methods: A total of 93 patients with T2DM treated with metformin (G1 = 25), OHA (G2 = 22), OA and\ninsulin (G3 = 26) and insulin alone (G4 = 20). In all patients, lipid profile and glycemic indices were assessed using\nroutine laboratory tests. MDA and Oxidized LDL were assessed using commercially available ELISA kits. Laboratory\ntests were performed at baseline and at a control visit after 24 weeks of treatment.\nResults: A significant decrease in the levels of MDA with improvement of glycemic control was observed in the\ngroup receiving OHA in combination with insulin therapy. A similar decrease of oxLDL was observed in all diabetic\nsubgroups with borderline significance in those receiving metformin alone. The remaining clinical and biochemical\nparameters were not changed during follow-up in any of the involved groups.\nConclusion: A combination therapy with insulin was more effective in glycemic control and MDA reduction in T2DM.\nWhereas, a significant oxLDLc reduction was observed in T2DM irrespective of categories of antidiabetic treatment or\nglycemic control....
Background: Obesity may have a role in the development of gestational diabetes mellitus (GDM). Single-nucleotidepolymorphisms\n(SNPs) of the FTO (fat mass and obesity associated) gene have been associated with obesity. The aim\nof this study was to investigate SNPs rs8050136, rs9939609, and rs1421085 of the FTO gene in women with GDM and\ntheir associations with maternal pre-pregnancy weight and body mass index, gestational weight gain and mediators\nof insulin resistance in GDM like leptin, adiponectin, ghrelin and tumor necrosis factor-alpha (TNF-alpha), compared\nwith healthy pregnant controls.\nMethods: 80 women with GDM and 80 women with normal pregnancy were considered for the present study.\nGenotyping of selected SNPs in all study subjects was done using the Taq-Man assay and the adipokines and ghrelin\nwere measured by immunoassays. Chi square test, odds ratios (OR) and their respective 95% confidence intervals\nwere used to measure the strength of association between FTO SNPs and GDM.\nResults: There was no association among FTO SNPs and GDM. Interestingly, in GDM group, women carrying the risk\nalleles of the three SNPs had increased TNF-alpha, and decreased adiponectin levels; these associations remained\nsignificant after adjusting for pre-gestational body weight and age. Moreover, the risk allele of rs1421085 was also\nassociated with increased weight gain during pregnancy.\nConclusions: The FTP SNPs rs8050136, rs9939609, and rs1421085 are not a major genetic regulator in the etiology of\nGDM in the studied ethnic group. However, these SNPs were associated with adiponectin and TNF-alpha concentrations\nin GDM subjects....
We aimed to determine the relationship between lower extremity peripheral arterial disease (PAD), 10-year coronary heart\ndisease (CHD), and stroke risks in patients with type 2 diabetes (T2DM) using the UKPDS risk engine. We enrolled 1178\nhospitalized T2DM patients. The patients were divided into a lower extremity PAD group (ankle-brachial index ââ?°Â¤ 0 9 or\n>1.4; 88 patients, 7.5%) and a non-PAD group (ankle-brachial index > 0 9 and ââ?°Â¤1.4; 1090 patients, 92.5%). Age;\nduration of diabetes; systolic blood pressure; the hypertension rate; the use of hypertension drugs, ACEI /ARB, and\nstatins; CHD risk; fatal CHD risk; stroke risk; and fatal stroke risk were significantly higher in the PAD group than in\nthe non-PAD group (P < 0 05 for all). Logistic stepwise regression analysis indicated that ABI was an independent\npredictor of 10-year CHD and stroke risks in T2DM patients. Compared with those in the T2DM non-PAD group, the odds\nratios (ORs) for CHD and stroke risk were 3.6 (95% confidence interval (CI), 2.2ââ?¬â??6.0; P < 0 001) and 6.9 (95% CI, 4.0ââ?¬â??11.8;\nP < 0 001) in those with lower extremity PAD, respectively. In conclusion, lower extremity PAD increased coronary heart\ndisease and stroke risks in T2DM....
Hepatic lipase (HL) functions as a lipolytic enzyme that hydrolyzes triglycerides and phospholipids present in circulating plasma\nlipoproteins. Plasma HL activity is known to be regulated by hormonal and metabolic factors, but HL responsiveness to insulin\nas well as its role in modulating atherosclerotic risk is still controversial. We investigated on the influence of a known\npolymorphism in the neurotransmitter neuropeptide Y (NPY) on HL activity in two different cohorts consisting of diabetic and\nnondiabetic patients. HL activity was 24% and 34% higher on nondiabetic and diabetic subjects in the presence of the 7Pro\nallele in NPY, respectively. The presence of the 7Pro allele was an independent predictor of HL activity in multivariate analyses\nin both cohorts. These data suggest a regulatory effect of NPY on HL activity. Among carriers of the 7Pro allele, we also found a\nstatistically significant lower absolute number of infarctions compared to noncarriers (p < 0 05) and a nonsignificant trend\ntowards less myocardial infarction in the 7Pro allele diabetic carriers (p = 0 085). In conclusion, the common 7Pro allele in NPY\nwas associated with higher HL activity in nondiabetic and diabetic subjects and its presence seems to coincide with a lower\nfrequency of certain cardiovascular events....
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