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Cell Death & Disease Aug 2019Rapamycin (Sirolimus) slows aging, extends life span, and prevents age-related diseases, including diabetic complications such as retinopathy. Puzzlingly, rapamycin can... (Review)
Review
Rapamycin (Sirolimus) slows aging, extends life span, and prevents age-related diseases, including diabetic complications such as retinopathy. Puzzlingly, rapamycin can induce insulin sensitivity, but may also induce insulin resistance or glucose intolerance without insulin resistance. This mirrors the effect of fasting and very low calorie diets, which improve insulin sensitivity and reverse type 2 diabetes, but also can cause a form of glucose intolerance known as benevolent pseudo-diabetes. There is no indication that starvation (benevolent) pseudo-diabetes is detrimental. By contrast, it is associated with better health and life extension. In transplant patients, a weak association between rapamycin/everolimus use and hyperglycemia is mostly due to a drug interaction with calcineurin inhibitors. When it occurs in cancer patients, the hyperglycemia is mild and reversible. No hyperglycemic effects of rapamycin/everolimus have been detected in healthy people. For antiaging purposes, rapamycin/everolimus can be administrated intermittently (e.g., once a week) in combination with intermittent carbohydrate restriction, physical exercise, and metformin.
Topics: Animals; Diabetes Complications; Fasting; Glucose Intolerance; Humans; Insulin Resistance; Kidney Transplantation; Sirolimus
PubMed: 31406105
DOI: 10.1038/s41419-019-1822-8 -
Acta Diabetologica Nov 2021The first reports of a link between thiamine and diabetes date back to the 1940s. Some years later, a role for thiamine deficiency in diabetic neuropathy became evident,...
The first reports of a link between thiamine and diabetes date back to the 1940s. Some years later, a role for thiamine deficiency in diabetic neuropathy became evident, and some pilot studies evaluated the putative effects of thiamine supplementation. However, the administration of thiamine and its lipophilic derivative benfotiamine for the treatment of this complication gained consensus only at the end of the '90 s. The first evidence of the beneficial effects of thiamine on microvascular cells involved in diabetic complications dates to 1996: from then on, several papers based on in vitro and animal models have addressed the potential use of this vitamin in counteracting diabetic microangiopathy. A few pilot studies in humans reported beneficial effects of thiamine administration on diabetic nephropathy, but, despite all promising proofs-of-concept, the possible role of thiamine in counteracting development or progression of retinopathy has not been addressed until now. Thiamine is a water-soluble vitamin, rapidly expelled from the body, with no issues of over-dosage or accumulation; unfortunately, it is non-patentable, and neither industry nor independent donors are interested in investing in large-scale randomized controlled clinical trials to investigate its potential in diabetes and its complications. Consequently, science will not be able to disprove a promising hypothesis and, more importantly, diabetic people remain deprived of a possible way to ameliorate their condition.
Topics: Animals; Diabetes Complications; Diabetes Mellitus; Diabetic Nephropathies; Diabetic Neuropathies; Humans; Thiamine
PubMed: 34091762
DOI: 10.1007/s00592-021-01752-4 -
Experimental and Clinical Endocrinology... Dec 2019
Topics: Accidents, Traffic; Diabetes Complications; Humans; Practice Guidelines as Topic
PubMed: 31860932
DOI: 10.1055/a-1018-9262 -
Anatolian Journal of Cardiology Oct 2023The aim of the study was to map microvascular complications associated with diabetes mellitus from personal health records and to guide chronic disease management by...
BACKGROUND
The aim of the study was to map microvascular complications associated with diabetes mellitus from personal health records and to guide chronic disease management by revealing the economic burden of the disease.
METHOD
The data of patients with diabetes who developed microvascular complications were obtained from the e-Pulse database of the Ministry of Health, with the definitions of the disease. First, the distribution of patients by province and gender was determined and then patients with multiple complications were identified. Only direct costs and their distribution on the basis of complications were determined from the database according to the cost of illness methodology from the payer’s perspective. Then, average annual per-patient costs were determined using a top-down costing approach.
RESULTS
Between 2016 and 2020, a total of 7 656 700 patients with diabetes were reached. The number of patients with microvascular complications between 2016 and 2020 obtained from the e-Pulse database with the above definitions was 1 466 387. Regarding the complications, a total of 66 838 people developed nephropathy, 314 706 people developed retinopathy, and 1 084 843 people developed neuropathy. The total cost of patients with microvascular complications was $1 482 278 950.76 and the average annual cost per patient was $1010.84. The average annual cost of neuropathy is $659 862 971.96, retinopathy is $356 594 282.51 and nephropathy is $465 821 696.29, with per-patient costs of $701.82, $1495.24, and $10 516.11, respectively.
CONCLUSION
Diabetes mellitus, with its microvascular complications, causes significant disease and economic burden. Türkiye’s national health database system, e-Pulse, is an important database that provides patient follow-up at both individual and population levels and helps with the management of the disease and taking preventive measures before the development of the complications.
Topics: Humans; Diabetes Mellitus, Type 2; Financial Stress; Diabetes Complications; Retinal Diseases
PubMed: 37779367
DOI: 10.14744/AnatolJCardiol.2023.3762 -
Journal of the Formosan Medical... Nov 2019The 2019 Diabetes Atlas delineated both accomplishments and challenges in diabetes care in Taiwan between 2005 and 2014. The series reported that Taiwan had...
The 2019 Diabetes Atlas delineated both accomplishments and challenges in diabetes care in Taiwan between 2005 and 2014. The series reported that Taiwan had significantly improved aspects of care quality for patients with diabetes. For example, the mortality rate decreased, the difference between the life expectancies of patients with diabetes and those of the general population decreased, and the rates of hospitalization because of heart diseases, cerebrovascular diseases, chronic kidney diseases, and unsatisfactory glycemic control decreased. However, despite these achievements, the 2019 Diabetes Atlas also reported some substantial challenges that have not been overcome. For example, the incidence of diabetes among women aged <19 years and 20-39 years increased by 27% and 33%, respectively. Furthermore, a high prevalence of macrovascular complications, a continuous increase in the dialysis prevalence rates among men with diabetes of all ages, and a low participation rate (<20%) of patients with diabetes in the pay-for-performance program were observed. The publication of the 2019 Diabetes Atlas is a milestone that demonstrates a strong will in medical societies to improve the quality of diabetes care. We expect this initiative can be reorganized every 5 years to report the results of continuous monitoring and surveillance and update the epidemiological features of diabetes in Taiwan.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Diabetes Complications; Diabetes Mellitus; Female; Humans; Incidence; Infant; Infant, Newborn; Male; Middle Aged; Prevalence; Reimbursement, Incentive; Taiwan; Young Adult
PubMed: 31387840
DOI: 10.1016/j.jfma.2019.06.018 -
International Journal of Molecular... Sep 2022Type 2 diabetes mellitus (T2D) affects millions of people around the world, and its complications have serious health consequences. In addition to external factors, the... (Review)
Review
Type 2 diabetes mellitus (T2D) affects millions of people around the world, and its complications have serious health consequences. In addition to external factors, the causes of morbidity and increased risk were also sought in the variability of the human genome. A phenomenon that can answer these questions is the occurrence of single-nucleotide polymorphisms (SNP). They constitute a field for research into genetic determinants responsible for the increase in the risk of the discussed metabolic disease. This article presents the outline of two enzymes: metalloproteinases 2 and 9 (MMP-2, MMP-9), their biological activity and the effect caused by differences in individual alleles in the population, as well as the reports on the importance of these DNA sequence variations in the occurrence of diabetes mellitus type 2 and associated conditions. The results of the conducted research indicate a relationship between two MMP-2 polymorphisms (rs243865, rs243866) and two MMP-9 polymorphisms (rs3918242, rs17576) and the presence of T2D. This could offer a promising possibility to use them as predictive and diagnostic markers. However, due to the low number of reports, more research is needed to clearly confirm the link between these SNPs and diabetes.
Topics: Humans; Case-Control Studies; Diabetes Complications; Diabetes Mellitus, Type 2; Genetic Predisposition to Disease; Genotype; Matrix Metalloproteinase 2; Matrix Metalloproteinase 9; Polymorphism, Single Nucleotide
PubMed: 36142480
DOI: 10.3390/ijms231810571 -
International Journal of Circumpolar... Dec 2024Many people with diabetes mellitus experience minimal or no complications. Our objective was to determine the proportion of Alaska Native people who experienced four...
Many people with diabetes mellitus experience minimal or no complications. Our objective was to determine the proportion of Alaska Native people who experienced four major complications or mortality and to identify factors that may be associated with these outcomes. We used records in a diabetes registry and clinical and demographic variables in our analyses. We used logistic regression and Cox Proportional Hazards models to evaluate associations of these parameters with death and complications that occurred prior to 2013. The study included 591 Alaska Native people with non-type 1 diabetes mellitus, diagnosed between 1986 and 1992. Over 60% of people in this study remained free of four major diabetes-related complications for the remainder of life or throughout the approximately 20-year study period. Lower BMI, higher age at diagnosis of diabetes, and use of at least one diabetes medication were associated with death and a composite of four complications. A majority of Alaska Native people with DM had none of four major complications over a 20-year period. Lower BMI and use of diabetes medications were associated with higher hazard for some deleterious outcomes. This suggests that goals in care of elders should be carefully individualised. In addition, we discuss several programme factors that we believe contributed to favourable outcomes.
Topics: Humans; Alaska; Male; Female; Middle Aged; Alaska Natives; Aged; Diabetes Mellitus; Diabetes Complications; Adult; Body Mass Index; Proportional Hazards Models; Logistic Models; Age Factors; Young Adult
PubMed: 38718274
DOI: 10.1080/22423982.2024.2341988 -
Diabetes & Metabolism Journal Jan 2021We investigated the cardiovascular complications and mortality rates of patients with diabetes in South Korea. The rates of hospitalization due to cardiovascular...
We investigated the cardiovascular complications and mortality rates of patients with diabetes in South Korea. The rates of hospitalization due to cardiovascular complications and mortality were analyzed using the Korean National Health Insurance Service-National Sample Cohort. From 2006 to 2015, the rates of hospitalization due to major cardiovascular complications decreased, while those due to heart failure (from 72 to 146 and 124 to 161 per 10,000 men and women, respectively) and peripheral artery disease (from 39 to 55 and 19 to 35 per 10,000 men and women, respectively) increased. In the period 2007 to 2015, the mortality rates for cancer, cerebrovascular disease, diabetes, heart disease, and hypertensive disease all decreased. However, the mortality rate for pneumonia increased. We observed a continuous reduction in cardiovascular complications and mortality in adults with diabetes. However, with the increase in some diabetes complications, more efforts are needed to prevent diabetes complications.
Topics: Adult; Diabetes Complications; Diabetes Mellitus; Female; Heart Failure; Hospitalization; Humans; Male; Republic of Korea
PubMed: 33290647
DOI: 10.4093/dmj.2020.0175 -
Romanian Journal of Internal Medicine =... Dec 2020Diabetes mellitus is a predominant cause of mortality and morbidity worldwide. One of its serious health problems is cardiovascular complications. Advanced glycation end... (Review)
Review
Diabetes mellitus is a predominant cause of mortality and morbidity worldwide. One of its serious health problems is cardiovascular complications. Advanced glycation end products (AGEs) are a group of heterogeneous toxic oxidant compounds that are formed after a non-enzymatic reaction between monosaccharides and free amino groups of proteins, compound lipids, and nucleic acids. AGE interacts with various types of cells through a receptor for AGE (RAGE). The interaction between AGE and RAGE is responsible for a cascade of inflammation, oxidative stress, and disruption of calcium homeostasis in cardiac cells of diabetic patients. There is striking evidence that the AGE/RAGE axis with its consequences on inflammation and oxidative stress plays a major role in the development of cardiovascular complications. Therefore, considering AGE as a therapeutic target with foreseeable results would be a wise direction for future research. Interestingly, several studies on nutraceutical, pharmaceutical, and natural products have begun to reveal promising therapeutic results, and this could lead to better health outcomes for many diabetic patients worldwide. This article discusses the current literature addressing the connection between protein glycation and diabetes cardiovascular complications and suggests future avenues of research.
Topics: Cardiovascular Diseases; Diabetes Complications; Glycation End Products, Advanced; Humans
PubMed: 32759408
DOI: 10.2478/rjim-2020-0021 -
PloS One 2019Diabetes is associated with poor outcomes in critically ill populations. The goal of this study was to determine if diabetic patients suffer poorer outcomes following...
Diabetes is associated with poor outcomes in critically ill populations. The goal of this study was to determine if diabetic patients suffer poorer outcomes following trauma. Collaborative trauma patient data from 2012-2018 was analyzed. Patients with no signs-of-life, Injury Severity Score (ISS) <5, age <16 years, and hospitalization <1 day were excluded. Multivariable logistic and linear regression were used to compare patients with and without diabetes for selected outcomes. Risk-adjustment variables included demographics, physiology, comorbidities, and injury scoring. Of 106,141 trauma patients, 14,150 (13%) had diabetes. On admission, diabetes was associated with significantly increased risk of any, serious, infectious, urinary tract, sepsis, pneumonia, and cardiac complications. Diabetes was also associated with increased ventilator days (7.5 vs. 6.6 days, p = 0.003), intensive care unit days (5.8 vs. 5.3 days, p<0.001), and hospital length of stay (5.7 vs. 5.3 days, p<0.001). Subgroup analysis revealed the least injured diabetic category (ISS 5-15) suffered higher odds of hospital mortality and any, serious, infectious and cardiac complications. The association between diabetes, hospital mortality and complication rates in mild traumatic injury is independent of age. Trauma patients with diabetes experience higher rates of complications and resource utilization. The largest cohort of diabetics experience the least severe injuries and suffer the greatest in hospital mortality and complication rates. A better understanding of the physiologic derangements associated with diabetes is necessary to develop novel approaches to reduce excess trauma morbidity, mortality and resource consumption.
Topics: Adolescent; Adult; Aged; Critical Illness; Diabetes Complications; Diabetes Mellitus; Female; Hospital Mortality; Hospitalization; Humans; Injury Severity Score; Length of Stay; Logistic Models; Middle Aged; Pneumonia; Trauma Centers; Wounds and Injuries; Young Adult
PubMed: 31461502
DOI: 10.1371/journal.pone.0221414