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Frontiers in Endocrinology 2021Diabetes mellitus and the associated complications are metabolic diseases with high morbidity that result in poor quality of health and life. The lack of diagnostic... (Review)
Review
Diabetes mellitus and the associated complications are metabolic diseases with high morbidity that result in poor quality of health and life. The lack of diagnostic methods for early detection results in patients losing the best treatment opportunity. Oral hypoglycemics and exogenous insulin replenishment are currently the most common therapeutic strategies, which only yield temporary glycemic control rather than curing the disease and its complications. Exosomes are nanoparticles containing bioactive molecules reflecting individual physiological status, regulating metabolism, and repairing damaged tissues. They function as biomarkers of diabetes mellitus and diabetic complications. Considering that exosomes are bioactive molecules, can be obtained from body fluid, and have cell-type specificity, in this review, we highlight the multifold effects of exosomes in the pathology and therapy of diabetes mellitus and diabetic complications.
Topics: Animals; Biomarkers; Diabetes Complications; Diabetes Mellitus; Exosomes; Humans; Molecular Targeted Therapy
PubMed: 34764939
DOI: 10.3389/fendo.2021.756581 -
Acta Clinica Croatica Nov 2022The course of diabetes is marked by the development of chronic complications that, in addition to affecting health, also affect the quality of life of patients. The... (Review)
Review
The course of diabetes is marked by the development of chronic complications that, in addition to affecting health, also affect the quality of life of patients. The purpose of this study was to compare the quality of life of patients with type 2 diabetes based on their chronic complications. The study, which was conducted from March 2019 until March 2020, included 382 diabetic patients, specific data from medical records, and the application of the World Health Organization Quality of Life-Brief questionnaire. There were more men than women included in the study, with the majority of respondents belonging to the age group of 61 to 70 years. In the quality-of-life assessment, the mean value of physical functioning was 57.14 (42.86-71.43), psychological functioning was 66.67 (54.17-79.17), social functioning 66.67 (50.00-75.00), and environmental functioning was 68.75 (50.00-75.00). The domains of social functioning were lowest in patients with diabetic retinopathy and neuropathy, while the physical functioning domains were rated lowest in patients with diabetic nephropathy, diabetic foot ulcer, and multiple chronic complications. All domains were rated lowest by patients with multiple complications and highest by those without any complications. In conclusion, differences in the assessment of quality of life of diabetic patients depend on the type of chronic complication.
Topics: Male; Humans; Female; Middle Aged; Aged; Diabetes Mellitus, Type 2; Quality of Life; Diabetic Foot; Diabetic Nephropathies; Diabetic Retinopathy; Diabetes Complications
PubMed: 37492372
DOI: 10.20471/acc.2022.61.03.18 -
Mini Reviews in Medicinal Chemistry 2015
Topics: Diabetes Complications; Diabetes Mellitus; Humans; Hypoglycemic Agents
PubMed: 26459815
DOI: 10.2174/138955751514151006154616 -
European Journal of Preventive... Dec 2019The global prevalence of diabetes is predicted to increase dramatically in the coming decades as the population grows and ages, in parallel with the rising burden of... (Review)
Review
The global prevalence of diabetes is predicted to increase dramatically in the coming decades as the population grows and ages, in parallel with the rising burden of overweight and obesity, in both developed and developing countries. Cardiovascular disease represents the principal cause of death and morbidity among people with diabetes, especially in those with type 2 diabetes mellitus. Adults with diabetes have 2-4 times increased cardiovascular risk compared with adults without diabetes, and the risk rises with worsening glycaemic control. Diabetes has been associated with 75% increase in mortality rate in adults, and cardiovascular disease accounts for a large part of the excess mortality. Diabetes-related macrovascular and microvascular complications, including coronary heart disease, cerebrovascular disease, heart failure, peripheral vascular disease, chronic renal disease, diabetic retinopathy and cardiovascular autonomic neuropathy are responsible for the impaired quality of life, disability and premature death associated with diabetes. Given the substantial clinical impact of diabetes as a cardiovascular risk factor, there has been a growing focus on diabetes-related complications. While some population-based studies suggest that the epidemiology of such complications is changing and that rates of all-cause and cardiovascular mortality among individuals with diabetes are decreasing in high-income countries, the economic and social burden of diabetes is expected to rise due to changing demographics and lifestyle especially in middle- and low-income countries. In this review we outline data from population-based studies on recent and long-term trends in diabetes-related complications.
Topics: Cardiovascular Diseases; Diabetes Complications; Diabetes Mellitus, Type 2; Global Health; Humans; Risk Factors
PubMed: 31722562
DOI: 10.1177/2047487319878371 -
Endocrine May 2015The oral health is influenced by systemic health, and one of the most common chronic diseases encountered in dental practice is diabetes mellitus. Diabetes can worsen... (Review)
Review
The oral health is influenced by systemic health, and one of the most common chronic diseases encountered in dental practice is diabetes mellitus. Diabetes can worsen oral infections and vice versa. In the literature, periodontitis and diabetes in the young to middle-aged adults have been the most widely researched area. Understanding the patho-physiology, clinical manifestations and management of different types of orofacial diseases in diabetic patients are important to the diabetologist and the dentist for the optimal care of patients with these diseases. This review explores the inter-link between diabetes and oral health.
Topics: Diabetes Complications; Humans; Oral Health; Periodontal Diseases
PubMed: 25487035
DOI: 10.1007/s12020-014-0496-3 -
Arteriosclerosis, Thrombosis, and... Aug 2020Peripheral artery disease (PAD) stems from atherosclerosis of lower extremity arteries with resultant arterial narrowing or occlusion. The most severe form of PAD is...
Peripheral artery disease (PAD) stems from atherosclerosis of lower extremity arteries with resultant arterial narrowing or occlusion. The most severe form of PAD is termed chronic limb-threatening ischemia and carries a significant risk of limb loss and cardiovascular mortality. Diabetes mellitus is known to increase the incidence of PAD, accelerate disease progression, and increase disease severity. Patients with concomitant diabetes mellitus and PAD are at high risk for major complications, such as amputation. Despite a decrease in the overall number of amputations performed annually in the United States, amputation rates among those with both diabetes mellitus and PAD have remained stable or even increased in high-risk subgroups. Within this cohort, there is significant regional, racial/ethnic, and socioeconomic variation in amputation risk. Specifically, residents of rural areas, African-American and Native American patients, and those of low socioeconomic status carry the highest risk of amputation. The burden of amputation is severe, with 5-year mortality rates exceeding those of many malignancies. Furthermore, caring for patients with PAD and diabetes mellitus imposes a significant cost to the healthcare system-estimated to range from $84 billion to $380 billion annually. Efforts to improve the quality of care for those with PAD and diabetes mellitus must focus on the subgroups at high risk for amputation and the disparities they face in the receipt of both preventive and interventional cardiovascular care. Better understanding of these social, economic, and structural barriers will prove to be crucial for cardiovascular physicians striving to better care for patients facing this challenging combination of chronic diseases.
Topics: Amputation, Surgical; Diabetes Complications; Health Care Costs; Humans; Peripheral Arterial Disease; Risk; Risk Factors
PubMed: 32580632
DOI: 10.1161/ATVBAHA.120.314595 -
The Journal of Small Animal Practice Jan 2015Diabetes mellitus and pancreatitis are two distinct diseases encountered commonly in small animal practice. Whilst the clinical signs of diabetes mellitus are usually... (Review)
Review
Diabetes mellitus and pancreatitis are two distinct diseases encountered commonly in small animal practice. Whilst the clinical signs of diabetes mellitus are usually unmistakeable, a firm diagnosis of pancreatitis can prove more elusive, as clinical signs are often variable. Over the past 10 to 15 years, despite the fact that the clinical signs of diabetes mellitus are remarkably consistent, it has become more apparent that the underlying pathology of diabetes mellitus in dogs and cats is heterogeneous, with exocrine pancreatic inflammation accompanying diabetes mellitus in a number of cases. However, the question remains as to whether the diabetes mellitus causes the pancreatitis or whether, conversely, the pancreatitis leads to diabetes mellitus--as there is evidence to support both scenarios. The concurrence of diabetes mellitus and pancreatitis has clinical implications for case management as such cases may follow a more difficult clinical course, with their glycaemic control being "brittle" as a result of variation in the degree of pancreatic inflammation. Problems may also arise if abdominal pain or vomiting lead to anorexia. In addition, diabetic cases with pancreatitis are at risk of developing exocrine pancreatic insufficiency in the following months to years, which can complicate their management further.
Topics: Acute Disease; Animals; Cat Diseases; Cats; Chronic Disease; Diabetes Complications; Diabetes Mellitus; Dog Diseases; Dogs; Pancreas
PubMed: 25586806
DOI: 10.1111/jsap.12295 -
Metabolism: Clinical and Experimental Feb 2022Despite remarkable advances in diabetes care, patients with type 2 diabetes are still burdened by higher morbidity and mortality than non-diabetic individuals.... (Review)
Review
Despite remarkable advances in diabetes care, patients with type 2 diabetes are still burdened by higher morbidity and mortality than non-diabetic individuals. Atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease represent the most relevant causes of morbidity and mortality and sustain each other in a vicious circle. Cardiovascular diseases are the main cause of death in patients with chronic kidney disease, and, in turn, chronic kidney disease is a significant contributor to the risk of major cardiovascular events and hospitalization for heart failure. Cardiovascular outcome trials with SGLT-2 inhibitors in type 2 diabetes yielded unprecedented results on prevention of worsening heart failure and renal disease progression and mortality, further confirmed by randomized controlled trials in patients with baseline heart failure and chronic kidney disease, with or without diabetes, and observations from the real-world setting. However, the evidence regarding SGLT-2 inhibitors benefit on atherosclerotic cardiovascular events is conflicting. Hence, SGLT-2 inhibitors represent a remarkably valuable weapon in diabetes management, to be used in the context of a multi-targeted treatment strategy to address the many issues of this multifaceted disease.
Topics: Animals; Cardiovascular System; Cytoprotection; Diabetes Complications; Diabetes Mellitus, Type 2; Disease Progression; Humans; Kidney; Protective Agents; Sodium-Glucose Transporter 2 Inhibitors
PubMed: 34808144
DOI: 10.1016/j.metabol.2021.154937 -
Hypertension Research : Official... Jun 2018Elevated blood pressure is closely related to increased circulatory fluid volume and peripheral vascular resistance. Patients with diabetes mellitus experience increased... (Review)
Review
Elevated blood pressure is closely related to increased circulatory fluid volume and peripheral vascular resistance. Patients with diabetes mellitus experience increased peripheral artery resistance caused by vascular remodeling and increased body fluid volume associated with insulin resistance-induced hyperinsulinemia and hyperglycemia. Both of these mechanisms elevate systemic blood pressure. Thus, fully understanding the pathophysiology of hypertension in diabetes mellitus requires knowing the natural history of type 2 diabetes. Patients exhibit hyperinsulinemia with insulin resistance due to impaired glucose tolerance and early-stage diabetes. Hypertension occurs because of increased body fluid volume. After reaching mid-stage diabetes the vascular remodeling has progressed and peripheral vascular resistance also contributes to hypertension. Moreover, vascular remodeling strongly influences diabetic complications. Specifically, afferent arteriolar remodeling during diabetic nephropathy leads to increased glomerular pressure. Thus, treatment with a renin-angiotensin system inhibitor that promotes renal damage regression is critical to lowering the systemic blood pressure and dilating efferent arterioles to reduce glomerular pressure.
Topics: Blood Pressure; Diabetes Complications; Humans; Hypertension; Insulin
PubMed: 29556093
DOI: 10.1038/s41440-018-0034-4 -
BioMed Research International 2018Acupoint therapy is one of the therapeutic means in Traditional Chinese Medicine (TCM) concerning acupoints and meridians, including manual acupuncture,... (Review)
Review
Acupoint therapy is one of the therapeutic means in Traditional Chinese Medicine (TCM) concerning acupoints and meridians, including manual acupuncture, electroacupuncture, moxibustion, external application, acupoint injection, and catgut embedding. In the treatment of diabetes and its common chronic complications, acupoint therapy has proved to have specific curative effect and notable advantages. Single or combined with western medicine, it has superior efficacy and less side effects than western medicine alone. Studying its mechanism can provide experimental basis for clinical treatment. Relevant researches in the recent 5 years mainly focused on the mechanism of electroacupuncture, point injection, catgut embedding, etc. in the treatment of diabetes and common diabetic complications such as neuropathy, nephropathy, and hepatopathy. The possible theories involve the regulation of nerve conduction, signal pathways, hormone level, protein expression, oxidative stress level, structure restoration, etc. The most studied acupoints are Zusanli (ST36), Shenshu (BL23), Sanyinjiao (SP6), Yishu (EX-B3), and Zhongwan (CV12). However, most of the studies have been based on diabetes model rats rather than clinical trials. Moreover, the mechanism of acupoint therapy treating other chronic complications like diabetic retinopathy and that of other effective methods like pressing ear with beans, auricular points plaster therapy, and external application remain unclear. Therefore, this aspect still awaits further research.
Topics: Acupuncture Points; Animals; Chronic Disease; Diabetes Complications; Diabetes Mellitus, Experimental; Hormones; Humans; Protein Biosynthesis; Rats; Signal Transduction
PubMed: 30426006
DOI: 10.1155/2018/3128378