An Experimental study of Macroangiopathy, a common complication of Diabetes Mellitus, with Ayurveda perspective Prof. Ojha S. N. M.D.(Ayu.) Ph.D. Principal Dr. D.Y Patil college of ayurved and research centre Pimpri pune 18 . ► The prevalence of macroangiopathy is increased in Diabetes Mellitus. ► Endothelial cell injury is thought to be an early event leading to atherosclerosis…

Macrovascular disease is a disease of any large (macro) blood vessels in the body. It is a disease of the large blood vessels, including the coronary arteries, the aorta, and the sizable arteries in the brain and in the limbs. This sometimes occurs when a person has had diabetes for an extended period of time. Fat and blood clots build up in the large blood vessels and stick to the vessel walls. Three common macrovascular diseases are coronary disease (in the heart), cerebrovascular disease (in the brain), and peripheral vascular disease (in the limbs) Macrovascular disease (macroangiopathy) refers to atherosclerosis. Atherosclerosis is a form of arteriosclerosis (thickening and hardening of arterial walls), characterized by plaque deposits of lipids, fibrous connective tissue, calcium, and other blood substances. Atherosclerosis, by definition, affects only medium and large arteries (excluding arterioles). Macrovascular disease is associated with the development of coronary artery disease, ...

To the Editor:. We have read with interest the article by Wilcox et al,1 in which they demonstrated the positive effect of pioglitazone on stroke recurrence in patients with type 2 diabetes mellitus (DM). However, we would like to stress a particular concern regarding a basic concept in the difficult question of DM and stroke. In this study, as in other previous studies, stroke is considered a macrovascular event in diabetic patients, but is this statement true? Traditionally, retinopathy, neuropathy, and nephropathy have been designated microvascular complications of DM, and stroke, myocardial infarction and gangrene are termed macrovascular complications.2 However, we think it is time to change this commonly accepted concept.. The pathophysiology of cerebrovascular disease in patients with DM is not fully characterized, but both large and small blood vessels seem to be affected. Thus, the etiology of strokes in diabetics is frequently microvascular disease from fibrinoid necrosis, which causes ...

This study will compare the effects of olmesartan medoxomil and amlodipine on beta-cell function and the incidence diabetic angiopathy in type 2 diabetic

Symptoms of Microvascular Complications of Diabetes, Susceptibility to, 2 including 5 medical symptoms and signs of Microvascular Complications of Diabetes, Susceptibility to, 2, alternative diagnoses, misdiagnosis, and correct diagnosis for Microvascular Complications of Diabetes, Susceptibility to, 2 signs or Microvascular Complications of Diabetes, Susceptibility to, 2 symptoms.

Purpose: : Human kallistatin is a secreted, glycoprotein and a serine proteinase inhibitor that specifically binds to tissue kallikrein, and it has multiple functions, e.g., anti-angiogenic, anti-fibrogenic, anti-inflammatory, and anti-oxidative activities independent of its direct tissue kallikrein inhibition. It is produced mostly by the liver, but is also secreted by the retina and blood vessels. Human kallistatin is decreased in the vitreous space of diabetics with retinopathy versus that in controls. Recently, our group reported that serum kallistatin is significantly elevated in type 1 diabetic patients with microvascular complications, compared to non-diabetic controls or diabetic patients without complications. Our hypothesis is that average serum kallistatin may be increased in the sera of type 2 diabetic patients compared to non-diabetic controls and type 2 patients without microvascular complications. Methods: : We collected serum samples from patients at the University of Oklahoma ...

Why this is important:- Many people with critical limb ischaemia, especially those with diabetic vascular disease, also have disease of the infra-geniculate (below the knee) arteries in the calf. For many years, the standard of care has been bypass surgery. Although such surgery may be associated with significant morbidity, the resulting long-term amputation-free survival rates are generally good. In recent years there has been a trend towards treating infra-geniculate disease with angioplasty, on the grounds that it is associated with less morbidity than surgery. However, this change in practice is not evidence-based, and serious concerns remain about the durability of angioplasty in this anatomical area. A multicentre, randomised controlled trial with a full health economic analysis is required to address this. The primary endpoint should be amputation-free survival, with secondary endpoints including overall survival, health-related quality of life, healing of tissue loss, and relief of ...

1. Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th ed. Diabetes Res Clin Pract 2019;157:107843-107843.. 2. Weyer C, Bogardus C, Mott DM, Pratley RE. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J Clin Invest 1999;104:787-794.. 3. American Diabetes Association. 10. Cardiovascular disease and risk management: Standards of medical care in diabetes-2021. Diabetes Care 2021;44:Suppl 1:S125-S150.. 4. Das SR, Everett BM, Birtcher KK, et al. 2020 expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 2020;76:1117-1145.. 5. Orasanu G, Plutzky J. The pathologic continuum of diabetic vascular disease. J Am Coll ...

Prolonged exposure to hyperglycaemia may contribute to the development of microvascular complications and loss of ~-cell viability in diabetes. In the past decade it has become clear that glucose itself acts as a signalling molecule via the induction of candidate genes which contribute to the disease process. ChREBP is a glucose responsive transcription factor with a response element in the promoter region of various genes, and is one of the targets through which glucose exerts its effect on gene expression. Both aldose reductase and thioredoxin interacting protein are under ChREBP mediated, glucose dependent regulation. Aldose reductase has been indicated in the process of diabetic complications, whereas the TXNIP protein is described as a central proapoptotic factor in the loss of ~-cell viability and is also emerging as a candidate gene for microvascular complication of diabetes. The current study has investigated the role of ChREBP, AR and TXNIP in these disease processes by collecting PBMCs ...

Diabetes mellitus (DM) is one of the commonest global noncommunicable health-care problem, carrying a predicted pandemic score of 366 million population by 2030.

Treatment strategy for type 2 diabetes from the perspective of systemic vascular protection and insulin resistance Kazunori UtsunomiyaDivision of Diabetes, Metabolism and Endocrinology, Jikei University School of Medicine, Tokyo, JapanAbstract: This paper provides an update on the mechanisms of vascular impairment associated with insulin resistance and the pathogenesis of diabetic nephropathy and peripheral artery disease (PAD). It also considers the optimal treatment strategies for systemic vascular protection in light of recent findings. This area is of major clinical importance given the ongoing global epidemic of type 2 diabetes and the pivotal role played by insulin resistance in the mechanism of vascular impairment that manifests as macroangiopathy and microangiopathy. Timely diagnosis and intervention is critical in patients with systemic arteriosclerotic disease. Therefore, treatment strategies are aimed not only at targeting the presenting pathology, but also at reducing the risk of

Prognosis of Microvascular Complications of Diabetes, Susceptibility to, 7 including probable outcomes, duration, recurrence, complications, deaths, and survival rates.

Intriguingly, these mechanisms resemble those accountable for the development of macrovascular problems this sort of as atherosclerosis. Consequently,RO4929097

Hypertension and dyslipidemia, among other risk factors for CVD, are common in subjects with diabetes. Together, they can explain most, but not all, of the excess of risk of CVD in patients affected by the disease. High blood glucose has long been considered a risk factor for developing atherosclerosis, but data directly relating this alteration to the development and progression of CVD are conflicting. In this context, several glucose-lowering trials in both type 1 and type 2 diabetes showing significant reductions in microvascular complications have systematically failed to achieve significant reductions in macrovascular events (5). Nevertheless, it should also be mentioned that some systematic reviews and metanalysis performed in type 1 and type 2 diabetes (in the case of type 1 diabetes including some studies with few subjects and none or very small number of CV events) have suggested that attempts to improve glycemia reduce the incidence of CVD (9,10).. Before going through proper trials ...

In this study, we show for the first time that sitagliptin increases EPCs in type 2 diabetic patients, as an ancillary effect of DPP-4 inhibition, possibly mediated by the SDF-1α/CXCR4 axis.. Experimental studies demonstrate that EPCs stimulate endothelial repair and angiogenesis (1). These cells are reduced in diabetic patients at an early stage and are further impaired in patients with macro-/microvascular complications (2,8,9). Low baseline progenitor cell levels predict adverse outcomes of macro- and microangiopathy (3,4,10), and EPC reduction is now considered a novel route to development and worsening of diabetes complications. In response to ischemia, SDF-1α is upregulated and, upon binding to its receptor CXCR4, stimulates the bone marrow to release EPCs that are eventually recruited at ischemic sites (7). In diabetic animals a blunted SDF-1α response to ischemia is associated with inhibited progenitor cell release from the bone marrow and defective postischemic angiogenesis (11). ...

Recent estimates indicate there were 171 million people in the world with diabetes in the year 2000 and this is projected to increase to 366 million by 2030-. Diabetes is a condition primarily defined by the level of hyperglycaemia giving rise to risk of microvascular damage (retinopathy, nephropathy and neuropathy). It is associated with reduced life expectancy, significant morbidity due to specific diabetes related microvascular complications, increased risk of macrovascular complications (ischaemic heart disease, stroke and peripheral vascular disease), and diminished quality of life ...

Therapy in most individuals with type 1 or type 2 diabetes should be targeted to achieve an A1C ≤7.0% in order to reduce the risk of microvascular [Grade A, Level 1A (1,2) ] and, if implemented early in the course of disease, macrovascular complications [Grade B, Level 3 (3,4) ...

Objective: Although coronary artery disease (CAD) is the leading cause of death in type 2 diabetic patients, it is frequently asymptomatic. Myocardial perfusion imaging (MPI) is reported to show ischemia in a significant number of asymptomatic diabetic patients. We studied the prevalence and severity of myocardial perfusion defects in asymptomatic diabetic patients and its clinical impact. Methods and patients: One hundred thirty consecutive asymptomatic patients, aged 35-65 years with type 2 diabetes mellitus and with no history of CAD and no cardiac symptoms were recruited in the study. Echocardiography, electrocardiography (ECG), routine laboratory tests and exercise treadmill test (ETT) were performed and patients with weakly positive or negative ETT underwent Dipyridamole MPI. Patients with positive ETT were referred to coronary angiography. Patients were followed for at least 17 months (mean 21.7 months) and any cardiac event was recorded. Results: We studied 81 female and 49 male patients with

Diabetic microvascular disease The 3 main manifestations of diabetic microvascular disease, retinopathy, nephropathy, and neuropathy are reviewed.. Retinopathy: Diabetic microvascular disease is strongly associated with hyperglycemia. In the range of chronic hyperglycemia commonly seen in practice, there is an 11-fold increase in retinopathy compared to a 2-fold increase in coronary artery disease. Despite the importance of hyperglycemia, some patients may develop early evidence of retinopathy up to 7 years before the development of Franks type 2 diabetes mellitus, indicating the contribution of insulin resistance.. In addition to the severity of hyperglycemia and the duration of diabetes mellitus, other factors associated with retinopathy include hypertension, smoking, and dyslipidemia. These and other pathophysiological mechanisms, including insulin resistance and inflammation, contribute to the diabetic microvascular disease process.. The early histopathological sign of retinopathy related ...

Diabetic Microvascular Complications are 3 main manifestations of microvascular disease, retinopathy, nephropathy, and neuropathy are reviewed.

Red blood cell count as an indicator of microvascular complications in Chinese patients with type 2 diabetes mellitus Zhan-Sheng Wang,1,2 Zhan-Chun Song,1 Jing-Hui Bai,1 Fei Li,3 Tao Wu,1 Ji Qi,2 Jian Hu11Department of Cardiology, First Affiliated Hospital of China Medical University, 2Second Department of Cardiology, Fourth People's Hospital of Shenyang, Shenyang, 3Department of Cardiology, Shenzhou Hospital of Shenyang Medical College, Shenyang, People's Republic of ChinaBackground: Rheological disorders of red blood cells (RBC) and decreased RBC deformability have been involved in the development of diabetic microangiopathy. However, few studies have evaluated the association of RBC count with microvascular complications in patients with type 2 diabetes mellitus (T2DM). The purpose of this study was to investigate the association of RBC count with microvascular complications in patients with T2DM.Methods: This study involved 369 patients with T2DM: 243 with one or more microvascular

The UK prospective diabetes study (UKPDS), a clinical trial of a policy of intensive control of blood glucose after diagnosis of type 2 diabetes, which achieved a median haemoglobin A1c (HbA1c) of 7.0% compared with 7.9% in those allocated to conventional treatment over a median 10.0 years of follow up, has shown a substantial reduction in the risk of microvascular complications, with a reduction in the risk of myocardial infarction of borderline significance.1 Complementary information for estimates of the risk of complications at different levels of glycaemia can be obtained from observational analyses of data during the study.. In patients with type 2 diabetes previous prospective studies have shown an association between the degree of hyperglycaemia and increased risk of microvascular complications, 2 3 sensory neuropathy, 3 4 myocardial infarction, 2 5 6 stroke,7 macrovascular mortality,8-10 and all cause mortality. 9 11-14 Generally, these studies measured glycaemia as being high or low or ...

The UK prospective diabetes study (UKPDS), a clinical trial of a policy of intensive control of blood glucose after diagnosis of type 2 diabetes, which achieved a median haemoglobin A1c (HbA1c) of 7.0% compared with 7.9% in those allocated to conventional treatment over a median 10.0 years of follow up, has shown a substantial reduction in the risk of microvascular complications, with a reduction in the risk of myocardial infarction of borderline significance.1 Complementary information for estimates of the risk of complications at different levels of glycaemia can be obtained from observational analyses of data during the study.. In patients with type 2 diabetes previous prospective studies have shown an association between the degree of hyperglycaemia and increased risk of microvascular complications, 2 3 sensory neuropathy, 3 4 myocardial infarction, 2 5 6 stroke,7 macrovascular mortality,8-10 and all cause mortality. 9 11-14 Generally, these studies measured glycaemia as being high or low or ...

The burden of diabetic vasculopathy on the global population is enormous and ever growing. Besides the well-known microvascular complications in type 2 diabetes (T2DM), there is a growing epidemic of macrovascular complications. People with T2DM have a higher risk of death from cardiovascular (CV) diseases than persons without diabetes. Like diabetes, impaired glucose tolerance (IGT) individuals also have associated risk of developing macrovascular complications. This calls for an early detection and intervention in patients with T2DM as well as IGT, not only to delay progression of IGT to T2DM but also to treat early macrovascular diseases in both groups. The traditional therapeutic approaches of T2DM emphasise on glycaemic control, which limits microvascular diseases but lacks an established benefit in macrovascular diseases. Type 2 diabetes is a metabolic disorder characterised by dyslipidaemia, hypertension, and hypercoagulability in addition to hyperglycaemia and hyperinsulinaemia. Each of ...

Clinical and biochemical variables and prevalence of complications at diagnosis of diabetes were assessed in 5098 Type 2 diabetic patients in the UK Prospective Diabetes Study of whom 82% were white Caucasian, 10% Asian of Indian origin, and 8% Afro-Caribbean. The Asian patients were (p | 0.001) younger (mean age 52.3, 47.0, 51.0 years), less obese (BMI 29.3, 26.7, 27.9 kg m-2), had a greater waist-hip ratio, lower blood pressure (systolic 145, 139, 144, diastolic 87, 86, 89 mmHg) and prevalence of hypertension. They were more often sedentary (19, 39, 15%), more often abstained from alcohol (21, 55, 25%) and had a greater prevalence of first degree relatives with known diabetes (36, 44, 34%). The Afro-Caribbean patients had (p | 0.001) higher fasting plasma glucose (11.9, 11.3, 12.5 mmol l-1), more severely impaired beta-cell function (45, 35, 28% normal) and less impaired insulin sensitivity (23, 19, 27% normal) by homeostasis model assessment, lower triglyceride (1.8, 1.8, 1.3 mmol l-1), and higher

Clinical and biochemical variables and prevalence of complications at diagnosis of diabetes were assessed in 5098 Type 2 diabetic patients in the UK Prospective Diabetes Study of whom 82% were white Caucasian, 10% Asian of Indian origin, and 8% Afro-Caribbean. The Asian patients were (p | 0.001) younger (mean age 52.3, 47.0, 51.0 years), less obese (BMI 29.3, 26.7, 27.9 kg m-2), had a greater waist-hip ratio, lower blood pressure (systolic 145, 139, 144, diastolic 87, 86, 89 mmHg) and prevalence of hypertension. They were more often sedentary (19, 39, 15%), more often abstained from alcohol (21, 55, 25%) and had a greater prevalence of first degree relatives with known diabetes (36, 44, 34%). The Afro-Caribbean patients had (p | 0.001) higher fasting plasma glucose (11.9, 11.3, 12.5 mmol l-1), more severely impaired beta-cell function (45, 35, 28% normal) and less impaired insulin sensitivity (23, 19, 27% normal) by homeostasis model assessment, lower triglyceride (1.8, 1.8, 1.3 mmol l-1), and higher

INTRODUCTION : Type 2 diabetes mellitus is a pandemic associated with disturbance inhaemostasis that could contribute to the development of diabetic vascular disease and accelerated atherosclerosis. In this population, hypercoagulation is prevalent, as well as pathological changes to erythrocytes. This is mainly due to upregulated circulating inflammatory markers. MATERIALS AND METHODS : Here we looked at tissue factor (TF) levels using ELISA, in a sample of diabetics, with and without cardiovascular complications. Diabetic subjects were recruited from the diabetic clinic at Steve Biko Academic Hospital, Pretoria, South Africa. 20 diabetics with cardiovascular disease and 22 without were enrolled to participate. RESULTS AND CONCLUSION : TF levels were significantly elevated in both diabetic groups when compared to the controls. We suggest that pathologic plasma TF activity, as marker of increased propensity of clot pathology, should be investigated. Agents that might lower TF levels might also ...

The UK Prospective Diabetes Study (UKPDS) is a multi-centre, prospective, randomised, intervention trial of 5100 newly-diagnosed patients with Type 2 (non-insulin-dependent) diabetes mellitus which aims to determine whether improved blood glucose control will prevent complications and reduce the associated morbidity and mortality. Newly presenting Type 2 diabetic patients aged 25-65 years inclusive, median age 53 years, median body mass index 28 kg/m2 and median fasting plasma glucose 11.3 mmol/l, were recruited and treated initially by diet. Ninety five percent remained hyperglycaemic (fasting plasma glucose greater than 6 mmol/l) and were randomly allocated to different therapies. In the main randomisation, those who were asymptomatic and had fasting plasma glucose under 15 mmol/l were allocated either to diet policy, or to active policy with either insulin or sulphonylurea aiming to reduce the fasting plasma glucose to under 6 mmol/l. Over 3 years, the median fasting plasma glucose in those allocated

The objective of the U.K. Prospective Diabetes Study is to determine whether improved blood glucose control in type II diabetes will prevent the complications of diabetes and whether any specific therapy is advantageous or disadvantageous. The study will report in 1998, when the median duration from randomization will be 11 years. This report is on the efficacy of therapy over 6 years of follow-up and the overall incidence of diabetic complications. Subjects comprised 4,209 newly diagnosed type II diabetic patients who after 3 months diet were asymptomatic and had fasting plasma glucose (FPG) 6.0-15.0 mmol/l. The study consists of a randomized controlled trial with two main comparisons: 1) 3,867 patients with 1,138 allocated to conventional therapy, primarily with diet, and 2,729 allocated to intensive therapy with additional sulfonylurea or insulin, which increase insulin supply, aiming for FPG ,6 mmol/l; and 2) 753 obese patients with 411 allocated to conventional therapy and 342 allocated to ...

The objective of the U.K. Prospective Diabetes Study is to determine whether improved blood glucose control in type II diabetes will prevent the complications of diabetes and whether any specific therapy is advantageous or disadvantageous. The study will report in 1998, when the median duration from randomization will be 11 years. This report is on the efficacy of therapy over 6 years of follow-up and the overall incidence of diabetic complications. Subjects comprised 4,209 newly diagnosed type II diabetic patients who after 3 months diet were asymptomatic and had fasting plasma glucose (FPG) 6.0-15.0 mmol/l. The study consists of a randomized controlled trial with two main comparisons: 1) 3,867 patients with 1,138 allocated to conventional therapy, primarily with diet, and 2,729 allocated to intensive therapy with additional sulfonylurea or insulin, which increase insulin supply, aiming for FPG ,6 mmol/l; and 2) 753 obese patients with 411 allocated to conventional therapy and 342 allocated to ...

Diabetes mellitus is characterized by a widespread endothelial dysfunction20 and a 2- to 3-fold increased risk of developing cardiovascular diseases. As previously highlighted by our group, circulating blood cells in diabetes are subjected to many biochemical alterations attributable to the high oxidative stress and the unfavorable vascular environment.21,22. The present study demonstrates that number and function of circulating EPCs are profoundly altered in type 2 diabetic patients with PAD compared with diabetic patients without PAD. Moreover, we show strong correlations between circulating EPC levels and the severity of carotid and lower extremity arterial disease.. In this work we have used 2 independent methods to study endothelial progenitors: flow cytometry of fresh blood and ex vivo culture. Flow cytometry is considered the gold standard for quantitative enumeration of EPC, being sensitive, precise and reproducible23: using this technique, we have defined EPCs by the surface expression ...

Persistent Problems of Diabetes Mellitus Flashcards. Kidneys might have a problem removing potassium in the event that renal deficiency is available.. MALE IMPOTENCE can be a common long lasting problem of diabetes. Macrovascular Complications Of Diabetes Mellitus Include Quizlet -- In the event that discovered early, and blood sugar brought in check, these types of

Angela Manning lost her left leg to diabetic vascular disease. But it didnt stop her from wearing chunky, colorful, attention-grabbing high heels.

Insulin Resistance in Type 1 Diabetes Mellitus and its Association with Patients Micro and Macrovascular Complications, Sex Hormones and Other Clinical Data

Archives of Ophthalmology 2004;122:1631-1640. Published:Nov-2004. PMID:15534123. doi:10.1001/archopht.122.11.1631. A model to estimate the lifetime health outcomes of patients with type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS 68) ...

Medical Decision Making 2002;4:340-349. Published:Aug-2002. PMID:12150599. doi:10.1177/0272989X0202200412. Risk of Stroke in Type 2 Diabetes Estimated by the UK Prospective Diabetes Study Risk Engine ...

With over 280 million people suffering from diabetes mellitus, it is globally one of the most common non-communicable diseases [1,2]. The increasing prevalence of both types of diabetes [3,4], especially in low-income countries, poses a challenge to healthcare and to society at large. Diabetes is associated with microangiopathy, such as retinopathy, nephro-pathy, and peripheral (poly)neuropathy, as well as macroangiopathy. More recently, awareness has been increasing that diabetes also affects the brain [5]. Although this was recognized in the early 1920s [6], and further studied in post mortem research in the 1960s [7,8], in the past decade, with advances in neuroimaging techniques, this research field has been growing. Patients with diabetes show cognitive decrements in a wide range of functions, such as working memory, information processing speed, and executive functions, including mental flexibility and verbal fluency [9-11]. In addition, changes compared with control subjects have been ...

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Type 2 diabetes mellitus is increasing in prevalence and is a common cause of morbidity and mortality. In persons with diabetes, vascular complications are the usual cause of adverse outcomes, and the latter often are divided into macrovascular (i.e., coronary artery disease, cerebrovascular disease, and peripheral vascular disease) and microvascular (i.e., retinopathy, nephropathy, and neuropathy). Tight glucose control reduces microvascular complications but does not affect macrovascular changes. Controlling cardiovascular risk factors in persons with diabetes can reduce macrovascular complications, and guidelines for the management of hypercholesterolemia in patients with type 2 diabetes have been formulated by the American College of Physicians (ACP).. Snow and colleagues in the Clinical Efficacy Assessment Subcommittee of the ACP developed guidelines for hyperlipidemia management in type 2 diabetes based on a systematic review of the evidence performed by Vijan and colleagues. Because there ...

Prognosis of Diabetes mellitus depends from an optimal metabolic control, as shown by large clinical studies like DCCC. Patients under continued hyperglycemic conditions are prone to high risk for developing complications like diabetic angiopathy, neuropathy, retinopathy or nephropathy. ON the other hand, hypoglycemia bears high acute threats. ...

Diabetes is one of the key risk factors for CAD, and its prevalence has increased over the last few years. The analysis of cultured EPCs and CD34+KDR+ cells and their functions in clinical studies identified type II diabetes as a major determinant of impairment. Patients with type I and type II diabetes exhibit lower number of CD34+KDR+ EPCs or cultured EPCs,14-16 and the reduced number of CD34+KDR+ cells was associated with the severity of diabetic vasculopathy.17. These results were consistent with animal experiments with obese diabetic mice (Lerdb), in which the function of progenitor and proangiogenic cells were impaired.18,19 Of note, diabetes was not only associated with a reduction of cell numbers but led to a profound impairment of cell functionality such as reduced migration toward cytokines, reduced proliferation, and reduced ability of the cells to integrate into vascular networks in vitro.9,15 The impaired migratory response resembled the previously shown diminished response of ...

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Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. ...

Diabetic shoes need a special stitch in its making, as the requirements of diabetic patients are unique. Here look at our 10 Best & Comfortable Diabetic Shoes.

Macrovascular complications of type 2 diabetes mellitus (T2DM) include vascular calcification and arterial stiffness (AS). Measurement of arterial stiffness is currently of scientific interest due to its independent ...

Diabetic patients are considered to be at increased risk of preoperative morbidity and mortality because of the involvement of their vital organs and the auton...

Introduction: Asymptomatic diabetic patients are at increased risk of cardiovascular complications. Myocardial perfusion scan may be effective in risk evaluation in this population. Methods: 106 asymptomatic diabetic patients (age: min: 37, max: 82, mean: 57.73±8.88), including 56 females (52.8%) and 50 males (47.2%) were enrolled in the study. Myocardial perfusion scintigraphy was performed by Gated Single Photon Emission Computed Tomography (Gated-SPECT) method. Perfusion and function status was evaluated by qualitative and semi-quantitative parameters. Results: By visual analysis totally 40 out of 106 patients (37.7%) showed abnormal scan. From which, 26(24.5%) showed involvement in one, 13(12.3%) in two, and 1(0.9%) in all three vessel territories. By semi-quantitative method, from 103 patients, 28 (27.2%) were abnormal and 75 (72.8%) were normal. From all the asymptomatic diabetic patients, 11 patients (10.4%) had dilated left ventricles. Transient Ischemic Dilation (TID) was noted in 10

TY - JOUR. T1 - Macrophage foam cell formation is augmented in serum from patients with diabetic angiopathy. AU - Cui, Xinglong. AU - Kushiyama, Akifumi. AU - Yoneda, Masayasu. AU - Nakatsu, Yusuke. AU - Guo, Ying. AU - Zhang, Jun. AU - Ono, Haruya. AU - Kanna, Machi. AU - Sakoda, Hideyuki. AU - Ono, Hiraku. AU - Kikuchi, Takako. AU - Fujishiro, Midori. AU - Shiomi, Masashi. AU - Kamata, Hideaki. AU - Kurihara, Hiroki. AU - Kikuchi, Masatoshi. AU - Kawazu, Shoji. AU - Nishimura, Fusanori. AU - Asano, Tomoichiro. PY - 2010/1/1. Y1 - 2010/1/1. N2 - The differentiation of macrophages into cytokine-secreting foam cells plays a critical role in the development of diabetic angiopathy. J774.1, a murine macrophage cell line, reportedly differentiates into foam cells when incubated with oxidized LDL, ApoE-rich VLDL or WHHLMI (myocardial infarction-prone Watanabe heritable hyperlipidemic) rabbit serum. In this study, serum samples from Type 2 diabetic patients were added to the medium with J774.1 cells ...

Background: As one of the most frequent risk factors for cardiovascular disease, type 2 diabetes mellitus (T2DM) is one of the largest causes of death. However, an acute cardiac presentation is not uncommon in diabetic patients, and the current investigative approach remains often inadequate. The aim of our study was to retrospectively stratify the risk of asymptomatic T2DM patients using low-dose 640-slice coronary computed tomography angiography (CCTA). Materials and methods: CCTA examinations of 62 patients (mean age, 65 years) with previous diagnosis of type 2 diabetes and without cardiac symptoms were analyzed. Image acquisition was performed using a 640-slice CT. Per-patient, per-vessel and per-plaque analyses were performed. Stratification risk was evaluated according to the ESC guidelines. The patients were followed up after 2.21 ± 0.56 years from CCTA examination. Results: Coronary artery disease (CAD) was found in 58 patients (93.55%) presenting 290 plaques. Analysis of all samples ...

This scientific statement provides an updated summary and review of the pathogenesis and effects of diabetic microvascular disease.

Fresh fruit consumption in relation to incident diabetes and diabetic vascular complications: A 7-y prospective study of 0.5 million Chinese adults.

Health,lar and macrovascular complications. It likely reflects problems in en...The researchers found that the decreased plasma thiamine concentration...The researchers feel that important areas for future study are: confir......,Researchers,find,vitamin,B1,deficiency,key,to,vascular,problems,for,diabetic,patients,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news

Metabolic abnormalities, including hyperglycemia, obesity, hypertension, and dyslipidemia, are frequently present inpatients with type 2 diabetes and are risk factors for both microvascular and macrovascular disease. The risk is further increased in patients with microalbuminuria. Clinical trial evidence has shown that reducing plasma glucose levels, blood pressure, or both slows the development or progression of microvascular complications. Individual trials have focused on 1 or, at most, 2 interventions. However, in routine clinical practice, multifactorial interventions are often needed to improve the many possible metabolic derangements. Gaede and colleagues study shows the benefits of intensively managing type 2 diabetes. A major strength of the study is its pragmatic design that compares multifactorial interventions (similar to those recommended by the American Diabetes Association) in a diabetes center with routine care by primary care providers. An impressive reduction in the ...

Drug-eluting stents (DES) implantation has been demonstrated to dramatically reduce restenosis and repeat revascularisation (RR) in diabetic patients. However, diabetic patients are prone to an accelerated atherosclerotic process and the impact of atherosclerotic disease progression (ADP) on RR and mid-term clinical outcome after DES implantation is not well known To determine whether RR in diabetic patients treated with prior DES is the result of either DES restenosis or native progression of atherosclerotic disease in the coronary vasculature, and to evaluate the impact of ADP on the mid-term clinical outcome. We followed 316 consecutive diabetic patients (227 men, age 69 ± 9 years) treated between June 2005 and September 2006 with at least one DES. Of these patients, 260 (82%) had a multivessel coronary disease, 148 (41%) had previous coronary revascularisation and 104 (32%) had insulin-dependent diabetes. During the follow-up (mean 590 ± 194 days) the cumulative incidence of major adverse ...

The DECIDE study will identify whether cardiovascular complication rates (the composite rate of myocardial infarction (MI), Percutaneous Coronary Intervention (PCI), Coronary Artery Bypass Grafting (CABG), stroke, carotid endarterectomy, peripheral revascularization, and peripheral amputation) are lower in patients who participate in managed diabetes care by ADEC in comparison to provincial and national rates. Comparison statistics will be provided by the Institute of Evaluative Sciences (ICES) Atlas 2003 and other Diabetes studies such as the 2005 DICE study. Complications such as nephropathy and retinopathy will be documented, along with hospitalization rates and all cause mortality. Clinical outcomes relevant to diabetes management such as blood pressure and lipids will also be compared ...

Impaired glucose tolerance (IGT) serves as a marker for the state of insulin resistance and predicts both largeand small-vessel vascular complications, independent of a patients progression to diabetes. Patients with IGT are at significantly increased risk for death and morbidity due to myocardial infarction, stroke, and large-vessel occlusive disease. IGT is more predictive of cardiovascular morbidity than impaired fasting glucose, probably because it is a better surrogate for the state of insulin resistance. IGT is also independently associated with traditional microvascular complications of diabetes, including retinopathy, renal disease, and polyneuropathy, which are the topics of this review. Inhibition of nitric oxide- mediated vasodilation, endothelial injury due to increased release of free fatty acids and adipocytokines from adipocytes, and direct metabolic injury of endothelial and end-organ cells contribute to vascular complications. Early detection of IGT allows intensive diet and ...

In this retrospective study, we evaluated the medical records of 557 patients with type 2 diabetes admitted to the Endocrinology Outpatient Clinic from January to March 2010 and 112 healthy controls randomly selected from individuals admitted to the hospital for a check-up and who had a laboratory result for serum 25-OH vitamin D concentrations at screening. The levels of 25-OH vitamin D in patients with type 2 diabetes and the relationship between 25-OH vitamin D deficiency and microvascular complications were investigated. ...

Conversely, those patients with microvascular complications, e.g. retinopathy, neuropathy, and nephropathy, should be treated more aggressively. Microvascular complications seem to correlate more strongly with higher AIC. Macrovascular disease, e.g.cardiovascular events, meaning acute coronary syndromes, stroke, and peripheral arterial disease, seem to correlate less with aic reduction, though risk may be diminished not only with lifestyle changes, but also certain diabetes medications. Metformin, certain sodium-glucose co-transporter 2 inhibitors inhibitors, and glucagon-like peptide1 agonists have been shown to reduce cardiovascular events in some settings ...

Statistical analyses used logistic regression stratified by treatment group and an exhaustive-search approach based on the likelihood score statistic.. Results: A total of 12 variables were significantly associated with any new first microvascular disease arising during the trial. Age, duration and control of diabetes (HbA1c), blood pressure, and prior cardiovascular disease (CVD) were strongly and independently associated with the development of microvascular disease. The on-study risk model for new disease over 5 years fitted relatively well, with a C-statistic of 0.652. No treatment-by-variable interactions were found. A simplified risk model developed for routine clinical practice maintained the predictive power.. Conclusions: Routinely measured clinical and biochemical variables can successfully identify most patients at high risk of developing microvascular disease. A simplified risk model may be usefully applied in clinical practice.. ...

Green recently investigated 14,671 patients with type 2 diabetes mellitus (T2DM) treated for 3 years with sitagliptin, a dipeptidyl peptidase (DPP)-4 inhibitor

DIABETIC ANGIOPATHY Prolonged and, especially, should be practiced as often propranolol alcohol use possible under the direction of the ophthalmologist. Damasio. 16. These propranollo develop signs and symptoms within the first decade and generally survive into adulthood.

(HealthDay)-In patients with type 2 diabetes, age or age at diabetes diagnosis and diabetes duration are independently associated with macrovascular events and death, but only duration of disease is independently associated ...

Rate of microvascular complications and myocardial infarction in the UKPDS according to the mean updated systolic blood pressure over the entire study duration (corrected for age, gender and ethnicity). Modified from [6 ...

A new kit has been developed that will allow doctors to find out within minutes if diabetic patients are suffering from inflammation. Current procedures require patients to wait for several hours for the results obtained from the conventional full blood count test. Type 2 diabetes is the most common and is usually treated with lifestyle…

Discussion The results of this study indicate a rapid raise in the number of adults who meet the criteria for T2DMduring the first decade of the 21st century. These patients are currently receiving treatment at the primary care level. This rapid rise in such a short period of time is particularly disturbing because it suggests that large changes at the population level can occur in a relatively short period of time. If there is no coordinated response to arrest this increase in T2DM, the consequences are formidable. Increases in health expenditure, diabetic complications and cardiovascular morbidity and mortality are all likely to occur. These findings are particularly problematic given the strong association of T2DMand an array of both micro and macrovascular complication. Therefore, these findings have important implications for the debate on introducing stratergies such as health checks and other public health interventions to arrest the progression to overt diabetes.An effective and ...

At-risk groups, Clinical skills, Comorbidities, Diabetes & Primary Care, Diagnosis and screening, Microvascular complications, ...