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Journal of Diabetes and Its... Apr 2022
Topics: Diabetes Complications; Diabetes Mellitus, Type 1; Diabetic Neuropathies; Humans; Oral Health
PubMed: 35256267
DOI: 10.1016/j.jdiacomp.2022.108146 -
Biomedicine & Pharmacotherapy =... Jan 2021Diabetes mellitus (type 1 and type 2) and its various complications continue to place a huge burden on global medical resources, despite the availability of numerous... (Review)
Review
Diabetes mellitus (type 1 and type 2) and its various complications continue to place a huge burden on global medical resources, despite the availability of numerous drugs that successfully lower blood glucose levels. The major challenging issue in diabetes management is the prevention of various complications that remain the leading cause of diabetes-related mortality. Moreover, the limited long-term durability of monotherapy and undesirable side effects of currently used anti-diabetic drugs underlie the urgent need for novel therapeutic approaches. Phytochemicals represent a rich source of plant-derived molecules that are of pivotal importance to the identification of compounds with therapeutic potential. In this review, we aim to discuss recent advances in the identification of a large array of phytochemicals with immense potential in the management of diabetes and its complications. Given that metabolic inflammation has been established as a key pathophysiological event that drives the progression of diabetes, we focus on the protective effects of representative phytochemicals in metabolic inflammation. This paper also discusses the potential of phytochemicals in the development of new drugs that target the inflammation in the management of diabetes and its complications.
Topics: Animals; Anti-Inflammatory Agents; Autoimmunity; Diabetes Complications; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Energy Metabolism; Humans; Hypoglycemic Agents; Inflammation Mediators; Phytochemicals; Signal Transduction
PubMed: 33212375
DOI: 10.1016/j.biopha.2020.110975 -
International Journal of Molecular... Dec 2021Diabetes mellitus (DM) leads to complications, the majority of which are nephropathy, retinopathy, and neuropathy. Redox imbalance and inflammation are important... (Review)
Review
Diabetes mellitus (DM) leads to complications, the majority of which are nephropathy, retinopathy, and neuropathy. Redox imbalance and inflammation are important components of the pathophysiology of these complications. Many studies have been conducted to find a specific treatment for these neural complications, and some of them have investigated the therapeutic potential of melatonin (MEL), an anti-inflammatory agent and powerful antioxidant. In the present article, we review studies published over the past 21 years on the therapeutic efficacy of MEL in the treatment of DM-induced neural complications. Reports suggest that there is a real prospect of using MEL as an adjuvant treatment for hypoglycemic agents. However, analysis shows that there is a wide range of approaches regarding the doses used, duration of treatment, and treatment times in relation to the temporal course of DM. This wide range hinders an objective analysis of advances and prospective vision of the paths to be followed for the unequivocal establishment of parameters to be used in an eventual therapeutic validation of MEL in neural complications of DM.
Topics: Animals; Diabetes Complications; Diabetes Mellitus; Diabetic Neuropathies; Diabetic Retinopathy; Humans; Melatonin
PubMed: 35008523
DOI: 10.3390/ijms23010100 -
Diabetic Medicine : a Journal of the... Dec 2019To conduct a systematic review and meta-analysis of longitudinal studies assessing the bi-directional association between depression and diabetes macrovascular and... (Meta-Analysis)
Meta-Analysis
To conduct a systematic review and meta-analysis of longitudinal studies assessing the bi-directional association between depression and diabetes macrovascular and microvascular complications. Embase, Medline and PsycINFO databases were searched from inception through 27 November 2017. A total of 4592 abstracts were screened for eligibility. Meta-analyses used multilevel random/mixed-effects models. Quality was assessed using the Newcastle-Ottawa scale. Twenty-two studies were included in the systematic review. Sixteen studies examined the relationship between baseline depression and incident diabetes complications, of which nine studies involving over one million participants were suitable for meta-analysis. Depression was associated with an increased risk of incident macrovascular (HR = 1.38; 95% CI: 1.30-1.47) and microvascular disease (HR = 1.33; 95% CI: 1.25-1.41). Six studies examined the association between baseline diabetes complications and subsequent depression, of which two studies involving over 230 000 participants were suitable for meta-analysis. The results showed that diabetes complications increased the risk of incident depressive disorder (HR = 1.14; 95% CI: 1.07-1.21). The quality analysis showed increased risk of bias notably in the representativeness of selected cohorts and ascertainment of exposure and outcome. Depression in people with diabetes is associated with an increased risk of incident macrovascular and microvascular complications. The relationship between depression and diabetes complications appears bi-directional. However, the risk of developing diabetes complications in depressed people is higher than the risk of developing depression in people with diabetes complications. The underlying mechanisms warrant further research.
Topics: Depression; Diabetes Complications; Diabetic Angiopathies; Humans; Longitudinal Studies; MEDLINE; Microvessels; Risk Factors
PubMed: 31215077
DOI: 10.1111/dme.14054 -
European Archives of... Oct 2021Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels, which, over time, lead to major chronic complications in various organs... (Review)
Review
Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels, which, over time, lead to major chronic complications in various organs of the body. A growing body of research suggests that diabetes could also result in degenerative changes in the auditory system. To date, several attempts have been made to prevent and reduce diabetes-induced auditory complications. Such attempts have generally focused on disease modifying as well as other pharmacological treatments involving several herbal and non-herbal agents such as vitamins C and E, rutin, resveratrol, coffee, trigonelline, Dioscorea nipponica, red ginseng, Pterostilbene Bofutsushosan, Daisaikoto, tolrestat, ACE inhibitors (enalapril), Ca antagonists (nimodipine), Lipo-prostaglandin E1, methylprednisolone, dexamethasone, and chlorogenic acid and also other strategies like acupuncture. However, there is no consensus about which are the most effective strategies for preventing and reducing auditory complications in diabetic patients with few side effects and maximum efficacy. This paper provides a comprehensive review of interventions for preventing and treating diabetes-induced auditory complications to help therapists.
Topics: Diabetes Complications; Diabetes Mellitus; Humans
PubMed: 33555440
DOI: 10.1007/s00405-021-06630-x -
International Journal of Molecular... Jun 2021Aortic stenosis (AS) and diabetes mellitus (DM) are both progressive diseases that if left untreated, result in significant morbidity and mortality. Several studies... (Review)
Review
Aortic stenosis (AS) and diabetes mellitus (DM) are both progressive diseases that if left untreated, result in significant morbidity and mortality. Several studies revealed that the prevalence of DM is substantially higher in patients with AS and, thus, the progression from mild to severe AS is greater in those patients with DM. DM and common comorbidities associated with both diseases, DM and AS, increase patient management complexity and make aortic valve replacement the only effective treatment. For that reason, a better understanding of the pathogenesis underlying both these diseases and the relationships between them is necessary to design more appropriate preventive and therapeutic approaches. In this review, we provided an overview of the main aspects of the relationship between AS and DM, including common comorbidities and risk factors. We also discuss the established treatments/therapies in patients with AS and DM.
Topics: Aortic Valve Stenosis; Diabetes Complications; Humans; Risk Factors
PubMed: 34207517
DOI: 10.3390/ijms22126212 -
Diabetes Mar 2020The results of the Diabetes Control and Complications Trial (DCCT) have given rise to much encouragement in the battle to stave off the complications of type 1 diabetes,... (Review)
Review
The results of the Diabetes Control and Complications Trial (DCCT) have given rise to much encouragement in the battle to stave off the complications of type 1 diabetes, showing dramatic declines in the development of severe retinopathy, nephropathy, and neuropathy in those treated intensively compared with conventional therapy. Particularly encouraging has been the continuing difference between the two groups despite both having similar HbA (∼8%) since the end of DCCT, when 96% of participants entered the observational Epidemiology of Diabetes Interventions and Complications (EDIC) study. This continuing relative benefit has been termed "metabolic memory," which implies altered metabolic regulation. Based on evidence from both the Epidemiology of Diabetes Complications (EDC) prospective cohort study of childhood-onset type 1 diabetes and DCCT/EDIC, we show that the metabolic memory effect can be largely explained by lower cumulative glycemic exposure in the intensive therapy group, and, on average, the development of complications increases with greater glycemic exposure, irrespective of whether this results from a high exposure for a short time or a lower exposure for a longer time. Thus, there is no need for a concept like "metabolic memory" to explain these observations. Potential mechanisms explaining the cumulative glycemic effect are also briefly discussed.
Topics: Blood Glucose; Cohort Studies; Diabetes Complications; Diabetes Mellitus, Type 1; Diabetic Nephropathies; Diabetic Neuropathies; Diabetic Retinopathy; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Insulin; Patient Care Planning; Prospective Studies; Randomized Controlled Trials as Topic; Time Factors
PubMed: 32079705
DOI: 10.2337/db19-0514 -
International Journal of Cardiology Sep 2019Randomized, cross-sectional, and prospective studies have demonstrated that microvascular complications in patients with diabetes are not only the cause of blindness,... (Review)
Review
Randomized, cross-sectional, and prospective studies have demonstrated that microvascular complications in patients with diabetes are not only the cause of blindness, renal failure and non-traumatic amputations, but also powerful predictors of cardiovascular complications. Beside the metabolic theory, the pathophysiology of diabetic microvascular complications is determined by the interaction among several factors, including epigenetic modifications and the reduced release of progenitor cells by the bone marrow, that contribute simultaneously to damage and impaired vascular protection against hyperglycemia. Identifying and preventing microvascular complications has the significant potential to reduce major adverse cardiovascular events. For these reasons, there may no longer be a rational to consider microangiopathy and macroangiopathy as entirely separate entities, but they should most likely be viewed as a continuum of the widespread vascular damage determined by diabetes mellitus.
Topics: Blood Glucose; Cardiologists; Cross-Sectional Studies; Diabetes Complications; Diabetes Mellitus; Diabetic Angiopathies; Humans; Microvessels; Prospective Studies
PubMed: 30833106
DOI: 10.1016/j.ijcard.2019.02.030 -
Acta Diabetologica Feb 2021Emerging evidence suggests that HbA1c variability, in addition to HbA1c itself, can be used as a predictor for mortality. The present study aims to examine the... (Observational Study)
Observational Study
INTRODUCTION
Emerging evidence suggests that HbA1c variability, in addition to HbA1c itself, can be used as a predictor for mortality. The present study aims to examine the predictive power of mean HbA1c and HbA1c variability measures for diabetic complications as well as mortality.
METHODS
The retrospective observational study analyzed diabetic patients who were prescribed insulin at outpatient clinics of the Prince of Wales Hospital and Shatin Hospital, Hong Kong, from 1 January to 31 December, 2009. Standard deviation (SD), root mean square (RMS), and coefficient of variation were used as measures of HbA1c variability. The primary outcomes were all-cause and cardiovascular mortality. Secondary outcomes were diabetes-related complications.
RESULTS
The study cohort consists of 3424 patients, including 3137 patients with at least three HbA1c measurements. The low mean HbA1c subgroup had significantly shorter time-to-death for all-cause mortality (P < 0.001) but not cardiovascular mortality (P = 0.920). The high Hba1c subgroup showed shorter time-to-death for all-cause (P < 0.001) and cardiovascular mortality (P < 0.001). Mean Hba1c and Hba1c variability predicted all-cause as well as cardiovascular-specific mortality. In terms of secondary outcomes, mean HbA1c and HbA1c variability significantly predicted diabetic ketoacidosis/hyperosmolar hyperglycemic state/diabetic coma, neurological, ophthalmological, and renal complications. A significant association between dichotomized HbA1c variability and hypoglycemia frequency was found (P < 0.0001).
CONCLUSION
High HbA1c variability is associated with increased risk of all-cause and cardiovascular mortality, as well as diabetic complications. The association between hypoglycemic frequency, HbA1c variability, and mortality suggests that intermittent hypoglycemia resulting in poorer outcomes in diabetic patients.
Topics: Adult; Aged; Aged, 80 and over; Cohort Studies; Comorbidity; Diabetes Complications; Diabetes Mellitus; Female; Follow-Up Studies; Glycated Hemoglobin; Hong Kong; Humans; Longitudinal Studies; Male; Middle Aged; Prognosis; Retrospective Studies
PubMed: 32939583
DOI: 10.1007/s00592-020-01605-6 -
Deutsche Medizinische Wochenschrift... Nov 2020Diabetes mellitus is a chronic metabolic disease associated with multiple long-term complications. Besides macro- and microvascular complications, patient's well-being...
Diabetes mellitus is a chronic metabolic disease associated with multiple long-term complications. Besides macro- and microvascular complications, patient's well-being can be severely impaired by complications affecting the nervous system. About 50 % of patients with diabetes suffer from polyneuropathy. Moreover, the risk of developing cognitive impairment and dementia is also increased in older people with diabetes. Insufficient glycemic control, young age at diagnosis of diabetes are discussed as risk factors for developing diabetes complications. The early identification and prevention of factors predicting diabetes complications that affect the nervous system are still challenging and in need for further research.
Topics: Cognitive Dysfunction; Dementia; Diabetes Complications; Diabetic Neuropathies; Humans; Risk Factors
PubMed: 33142326
DOI: 10.1055/a-1038-0102