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BMJ (Clinical Research Ed.) Jan 2015To summarise the evidence and evaluate the validity of the associations between type 2 diabetes and the risk of developing or dying from cancer. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To summarise the evidence and evaluate the validity of the associations between type 2 diabetes and the risk of developing or dying from cancer.
DESIGN
An umbrella review of the evidence across meta-analyses of observational studies of type 2 diabetes with risk of developing or dying from any cancer.
DATA SOURCES
PubMed, Embase, Cochrane database of systematic reviews, and manual screening of references.
ELIGIBILITY CRITERIA
Meta-analyses or systematic reviews of observational studies in humans that examined the association between type 2 diabetes and risk of developing or dying from cancer.
RESULTS
Eligible meta-analyses assessed associations between type 2 diabetes and risk of developing cancer in 20 sites and mortality for seven cancer sites. The summary random effects estimates were significant at P=0.05 in 20 meta-analyses (74%); and all reported increased risks of developing cancer for participants with versus without diabetes. Of the 27 meta-analyses, eventually only seven (26%) compiled evidence on more than 1000 cases, had significant summary associations at P ≤ 0.001 for both random and fixed effects calculations, and had neither evidence of small study effects nor evidence for excess significance. Of those, only six (22%) did not have substantial heterogeneity (I(2)>75%), pertaining to associations between type 2 diabetes and risk of developing breast, cholangiocarcinoma (both intrahepatic and extrahepatic), colorectal, endometrial, and gallbladder cancer. The 95% prediction intervals excluded the null value for four of these associations (breast, intrahepatic cholangiocarcinoma, colorectal, and endometrial cancer).
CONCLUSIONS
Though type 2 diabetes has been extensively studied in relation to risk of developing cancer and cancer mortality and strong claims of significance exist for most of the studied associations, only a minority of these associations have robust supporting evidence without hints of bias.
Topics: Diabetes Complications; Diabetes Mellitus, Type 2; Female; Humans; Neoplasms; Reproducibility of Results; Risk Factors
PubMed: 25555821
DOI: 10.1136/bmj.g7607 -
Singapore Medical Journal Jun 2018This paper discussed the importance of prevention of diabetic foot ulcers and our institution's protocol for prevention, reviewing the existing evidence in the...
This paper discussed the importance of prevention of diabetic foot ulcers and our institution's protocol for prevention, reviewing the existing evidence in the literature regarding the effectiveness of the preventive approach. Diabetes mellitus is the second most significant cause of disease in Singapore after ischaemic heart disease. National University Hospital, Singapore, adopts a two-pronged strategy for the management of diabetic foot ulcers. The most important strategy is prevention, and education is key. Education should mainly be directed at patients and caregivers, but also professionals (general practitioners, allied health professionals and nurses) so that they can effectively educate patients and caregivers. Patient education includes care of diabetes mellitus, care of the foot and use of appropriate footwear. Patients also tend to have poor foot hygiene. Annual foot screening for diagnosed diabetics plays an important role. However, prolonged and sustained government intervention is necessary to provide education and screening on a national scale.
Topics: Algorithms; Caregivers; Diabetes Complications; Diabetic Foot; Foot; Hospitals, University; Humans; Patient Education as Topic; Preventive Medicine; Risk Factors; Singapore
PubMed: 29974120
DOI: 10.11622/smedj.2018069 -
Emergency Medicine Practice Feb 2020For patients presenting with suspected diabetic ketoacidosis (DKA) and the hyperosmolar hyperglycemic state (HHS) understanding of the etiology and pathophysiology will...
For patients presenting with suspected diabetic ketoacidosis (DKA) and the hyperosmolar hyperglycemic state (HHS) understanding of the etiology and pathophysiology will ensure optimal emergency management. Morbidity and mortality is most often due to the underlying precipitating cause, which may include infection, infarction/ischemia, noncompliance with insulin therapy, pregnancy, and dietary indiscretion. Current guidelines are based primarily on expert opinion and consensus statements, but more recent evidence suggests that recommendations related to arterial blood gas, insulin bolus, and IV fluid replacement should be re-evaluated. This issue presents an approach to DKA and HHS management based on current evidence, with a simplified pathway for emergency department management.
Topics: Diabetes Complications; Diabetes Mellitus; Diabetic Ketoacidosis; Fluid Therapy; Humans; Hyperglycemia; Hyperglycemic Hyperosmolar Nonketotic Coma; Hypoglycemic Agents; Insulin
PubMed: 31978294
DOI: No ID Found -
Journal of Diabetes Research 2016
Topics: Diabetes Complications; Diabetes Mellitus; Diabetic Nephropathies; Diabetic Neuropathies; Diabetic Retinopathy; Epigenesis, Genetic; Humans
PubMed: 27822482
DOI: 10.1155/2016/6989453 -
Journal of Diabetes and Its... Oct 2022Urologic complications such as bladder and sexual dysfunction among men and women with diabetes have received relatively little attention. This is despite emerging... (Review)
Review
Urologic complications such as bladder and sexual dysfunction among men and women with diabetes have received relatively little attention. This is despite emerging evidence that demonstrates that urologic complications increase with age in the general population and are more common in individuals with diabetes compared to those without diabetes. Here we summarize the latest information about the epidemiology of urologic complications in the setting of diabetes and the most recent findings regarding pathophysiology. In addition, we identify knowledge gaps and need for future funding to address these gaps that will reduce the burden of urologic complications in diabetes and optimize quality of life for all individuals affected by it.
Topics: Diabetes Complications; Diabetes Mellitus; Female; Humans; Male; Quality of Life; Sexual Dysfunction, Physiological
PubMed: 36088680
DOI: 10.1016/j.jdiacomp.2022.108288 -
Current Opinion in Lipidology Aug 2016The purpose is to discuss recent developments in the understanding of lipoprotein metabolism in diabetes, the cardiovascular risk associated with both type 1 and type 2... (Review)
Review
PURPOSE OF REVIEW
The purpose is to discuss recent developments in the understanding of lipoprotein metabolism in diabetes, the cardiovascular risk associated with both type 1 and type 2 diabetes, recently published guidelines on the management of this risk, concerns over the use of statin treatment in diabetes, and other therapeutic options.
RECENT FINDINGS
Diabetic dyslipidaemia can be gross with massive hypertriglyceridemia, or subtle with a lipid profile which would be regarded as normal in a nondiabetic patient, but which hides underlying increases in atherogenic subfractions of LDL (e.g., small dense LDL, glycated LDL) and remnant lipoproteins. Statins can decrease these without the clinician being aware from routine biochemistry. In type 2 diabetes, HDL cholesterol levels are often reduced, whereas in type 1, insulin can raise HDL, but its antiatherogenic properties are compromised. Dyslipidaemia and hypertension predate the onset of glycaemia of diabetic proportions (metabolic syndrome). Obese people can thus die of diabetes before they develop it. Obesity should be prevented and treated. Statins decrease the risk of cardiovascular disease in diabetes or metabolic syndrome regardless of whether glycaemia worsens.
SUMMARY
One unassailable truth is that statin therapy is beneficial and should rarely, if ever, be withheld.
Topics: Diabetes Complications; Dyslipidemias; Humans; Risk
PubMed: 27213628
DOI: 10.1097/MOL.0000000000000318 -
Seminars in Musculoskeletal Radiology Jul 2016Skeletal fragility has been recognized as an important feature of diabetes mellitus type 1 (T1D) and type 2 (T2D). While patients with DM1 typically display low bone... (Review)
Review
Skeletal fragility has been recognized as an important feature of diabetes mellitus type 1 (T1D) and type 2 (T2D). While patients with DM1 typically display low bone mineral density (BMD) and concomitant increases in fracture risk, T2D bone disease is more complex and less understood. Although BMD is often normal or even slightly elevated, the risk of fragility fractures is disproportionally high. Alterations in bone quality (i.e., bone microstructure and matrix properties) have been reported by independent groups of researchers. Cortical porosity and the deposition of advanced glycation end-products appear to play key roles. Paired with low bone turnover, another distinct feature of T2D bone disease, secondary complications (including nephropathy, neuropathy, and angiopathy) are adding up to form a complex entity distinct from postmenopausal and age-related osteoporosis. This article offers an overview of current concepts in pathophysiology, clinical features, and imaging features of diabetic bone disease.
Topics: Bone Density; Bone Diseases; Bone and Bones; Diabetes Complications; Fractures, Bone; Humans
PubMed: 27741545
DOI: 10.1055/s-0036-1592366 -
Current Vascular Pharmacology 2020
Topics: Animals; Diabetes Complications; Diabetes Mellitus, Type 2; Humans; Hypoglycemic Agents; Treatment Outcome
PubMed: 32013814
DOI: 10.2174/157016111802200101155519 -
Chemistry & Biodiversity Oct 2022Diabetes is linked with various microvascular and macrovascular complications. Nephropathy, neuropathy and retinopathy are important microvascular complications of... (Review)
Review
Diabetes is linked with various microvascular and macrovascular complications. Nephropathy, neuropathy and retinopathy are important microvascular complications of diabetes. Different types of secondary metabolites including glycosides have been studied for their effects in diabetic complications. Various glycosides such as flavanoid glycosides and saponin glycosides are reported for their beneficial effects in diabetic nephropathy, neuropathy, retinopathy and cardiomyopathy by action on various pathways involved in the progression of these complications. Coumarin glycosides and cryanogenic glycosides have been studied for their effective role in diabetic nephropathy. Phenolic glycosides and anthraquinone glycosides also have beneficial role in diabetic neuropathy. The present review focuses on various classes of glycosides and their role in the prevention and treatment of vascular complications of diabetes.
Topics: Humans; Diabetic Nephropathies; Glycosides; Diabetes Complications; Cardiovascular Diseases; Retinal Diseases; Coumarins; Anthraquinones; Saponins; Diabetes Mellitus, Type 2
PubMed: 36181446
DOI: 10.1002/cbdv.202200067 -
Current Diabetes Reviews 2023Diabetes mellitus, defined as long-standing hyperglycemic conditions caused by a defect in insulin production and activity, has become a major healthcare burden as the... (Review)
Review
Diabetes mellitus, defined as long-standing hyperglycemic conditions caused by a defect in insulin production and activity, has become a major healthcare burden as the number of catastrophic and life-threatening complications rises. Microvascular complications (neuropathy, retinopathy, and nephropathy), and also diabetes-related macrovascular complications are common problems that arise as the life expectancy of diabetic patients has increased despite improved treatment options. While it is impossible to pinpoint the specific crucial timing when the complications become fully entrenched, looking for novel sensitive biomarkers to identify physiological changes in the initial stages would be needed. An increasing amount of data shows that miRNAs, particularly miRNA146a, are stable in a range of body fluids and can be used to identify pathogenic changes at the cellular or tissue level. In this brief review, we highlight the important functioning of miRNA146a and its putative target of action in diabetic microvascular and cardiovascular complications. A decrease in miRNA146a levels may play a critical role in the onset and development of diabetes complications, whereas its anti-inflammatory properties were revealed to be associated with the pathogenesis of numerous diabetic complications, including diabetic nephropathy, retinopathy, neuropathy, and diabetes-related cardiovascular disorders, even tending to be a potential biomarker of the disease's inflammatory status.
Topics: Humans; Cardiovascular Diseases; Diabetes Complications; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Diabetic Retinopathy; Hyperglycemia; Retinal Diseases; MicroRNAs
PubMed: 36239723
DOI: 10.2174/1573399819666221014095715