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Journal of Vascular Surgery Feb 2020Abnormalities in glucose metabolism are common in patients with arterial disease. Chronic hyperglycemia and insulin resistance contribute to the complexity of vascular... (Review)
Review
BACKGROUND
Abnormalities in glucose metabolism are common in patients with arterial disease. Chronic hyperglycemia and insulin resistance contribute to the complexity of vascular disorders. They also overlap with the effects of perioperative hyperglycemia on adverse perioperative outcomes. We provide an overview of the pathophysiologic consequences of dysglycemia and the evidence behind glycemic control in patients undergoing vascular surgery.
METHODS
We searched the literature for major studies evaluating the pathophysiology of hyperglycemia in microvascular and macrovascular beds, randomized trials in perioperative populations, and meta-analyses. The literature was summarized to guide therapy in the population of vascular patients and for the perioperative period.
RESULTS
National standards for glycemic control after vascular interventions were not identified. Mounting evidence exists for the long-term consequences of poor glycemic control on the progression of vascular disease. Similarly, there is a large body of evidence supporting tight control of hyperglycemia after general and cardiac surgery during the critical perioperative period. The absolute glucose target remains controversial. Randomized controlled studies are lacking in vascular surgery patients, but the current evidence can be extrapolated to guide management after vascular interventions. Glycated hemoglobin is a biomarker for increased mortality and vascular morbidity after vascular surgery.
CONCLUSIONS
Hyperglycemia contributes to poor outcome in the vascular patient. Further vascular focused studies are required to determine the proper perioperative serum glucose target and the long-term glycated hemoglobin range.
Topics: Diabetes Complications; Diabetes Mellitus; Humans; Hyperglycemia; Postoperative Complications; Risk Factors; Vascular Surgical Procedures
PubMed: 31327619
DOI: 10.1016/j.jvs.2019.05.027 -
Reviews in Endocrine & Metabolic... Mar 2013The vascular endothelium has been identified as an important component in diabetes-associated complications, which include many cardiovascular disorders such as... (Review)
Review
The vascular endothelium has been identified as an important component in diabetes-associated complications, which include many cardiovascular disorders such as atherosclerosis, hypertension and peripheral neuropathy. Additionally, insulin's actions on the endothelium are now seen as a major factor in the metabolic effects of the hormone by increasing access to insulin sensitive tissues. Endothelial function is impaired in diabetes, obesity, and the metabolic syndrome, which could reduce insulin access to the tissue, and thus reduce insulin sensitivity independently of direct effects at the muscle cell. As such, the endothelium is a valid target for treatment of both the impaired glucose metabolism in diabetes, as well as the vascular based complications of diabetes. Here we review the basics of the endothelium in insulin action, with a focus on the skeletal muscle as insulin's major metabolic organ, and how this is affected by diabetes. We will focus on the most recent developments in the field, including current treatment possibilities.
Topics: Animals; Diabetes Complications; Diabetes Mellitus; Endothelium, Vascular; Humans; Insulin; Models, Biological
PubMed: 23306780
DOI: 10.1007/s11154-012-9233-5 -
Scientific Reports Mar 2021There is growing evidence for a role of maternal diabetes in the pathogenesis of neurodevelopmental disorders. However, the specific association between gestational... (Meta-Analysis)
Meta-Analysis
There is growing evidence for a role of maternal diabetes in the pathogenesis of neurodevelopmental disorders. However, the specific association between gestational diabetes (GDM), as opposed to pre-gestational diabetes, has been poorly isolated. Thus the aim was to systematically review and meta-analyse literature pertaining to prevalence and risk for two neurodevelopmental disorders: autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), when exposed to GDM. PubMed, Cochrane Library, EMBASE, PsycINFO and CINAHL were systematically searched for eligible literature, with forward and backward citation tracking. Screening for eligibility, risk of bias assessment and data extraction were performed by two independent reviewers. 18 studies measuring ASD and 15 measuring ADHD met inclusion criteria. On meta-analysis there was an increased risk of ASD (OR 1.42; 95% CI 1.22, 1.65) but not ADHD (OR 1.01; 95% CI 0.79, 1.28). We discuss potential mechanisms for these differing risks. Greater understanding of risk factors, including GDM, for these neurodevelopmental disorders and potential mechanisms may help inform strategies aimed at prevention of exposure to these adversities during pregnancy.
Topics: Adolescent; Adult; Attention Deficit Disorder with Hyperactivity; Autism Spectrum Disorder; Child; Child, Preschool; Diabetes Complications; Diabetes, Gestational; Female; Humans; Male; Pregnancy; Risk Factors
PubMed: 33664319
DOI: 10.1038/s41598-021-84573-3 -
International Journal of Medical... 2019Diabetes mellitus is a global issue with increasing incidence rate worldwide. In an uncontrolled case, it can advance to various organ-related complications leading to... (Review)
Review
Diabetes mellitus is a global issue with increasing incidence rate worldwide. In an uncontrolled case, it can advance to various organ-related complications leading to an increase in morbidity and mortality. Long non-coding RNA (lncRNA) Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) appears to be a fairly novel lncRNA that is relevant to diabetes and its role in diabetic-related diseases initiation and progression have long been a subject of attention to many scholars. The expression of MALAT1 is elevated in different diabetic-related diseases. In this review, we demonstrate the various functions of MALAT1 in the different diabetes-related complications including ischemic reperfusion injury, retinopathy, cataract, atherosclerosis, cardiomyopathy, non-alcoholic steatohepatitis, gastroparesis, kidney disease, and gestational diabetes. The emerging evidence showed that the role of MALAT1 in diabetic-related complications is both pro-inflammatory and apoptosis in different cell types. These results concluded that MALAT1 is a potential diagnostic and future targeted therapy for diabetes-associated complications.
Topics: Apoptosis; Cell Lineage; Diabetes Complications; Gene Expression Regulation; Humans; Inflammation; RNA, Long Noncoding
PubMed: 31171906
DOI: 10.7150/ijms.30097 -
Frontiers in Endocrinology 2020Diabetes mellitus is becoming more prevalent and even with new advancements which improve glycaemic control, complications of diabetes are common. Vascular complications... (Review)
Review
Diabetes mellitus is becoming more prevalent and even with new advancements which improve glycaemic control, complications of diabetes are common. Vascular complications of diabetes include the microvascular complications: retinopathy, nephropathy, and peripheral and autonomic neuropathy. Macrovascular complications are also common in patients with diabetes and arguably more concerning as they confer a high mortality risk yet are sometimes under-treated. Risk factors for diabetes complications start to occur in childhood and adolescents and some youths may be diagnosed with complications before transition to adult care. This article discusses the prevalence, risk factors, screening, and treatment recommendations for vascular complications in children and adolescents with diabetes.
Topics: Adolescent; Diabetes Complications; Humans; Risk Factors; Vascular Diseases
PubMed: 32582034
DOI: 10.3389/fendo.2020.00370 -
Archivio Italiano Di Urologia,... Dec 2020To investigate the incidence of diabetic cystopathy in relation to age, gender, type of diabetes, duration of diabetic disease and clinical evidence of peripheral...
OBJECTIVE
To investigate the incidence of diabetic cystopathy in relation to age, gender, type of diabetes, duration of diabetic disease and clinical evidence of peripheral neuropathy and to analyze the physiopathology of the various forms of diabetic cystopathy due to sensory impairment, motor-sensory impairment, motor impairment and hyperreflexia.
MATERIALS AND METHODS
In a retrospective multicenter cohort study the medical records of a cohort of 126 diabetic patients with (128 patients) or without (48 patients) urological symptoms were analyzed. Patients were observed at the Città di Alessandria Clinic of Policlinico di Monza and/or at the outpatient clinic of Alessandria Hospital from June 2018 to June 2020. The study excluded patients with central and/or peripheral neuropathy, spina bifida (mylomeningocele or meningocele) or spina bifida occulta; with persistent urinary infections; in anticholinergic treatment for enteric dysfunctions; in medical treatment for cervical-prostatic-urethral obstruction; with vaginal and/or rectal prolapse of II, III, IV degree; with previous spinal or pelvic surgery including radical prostatectomy, Wertheim hysterectomy or colorectal surgery. All the patients were studied with computed tomography (CT) scan of the urinary tract, voiding cystourethrography (VCUG), uroflowmetry, cystomanometry with intrinsic pressure assessment and compliance evaluation, electromyography (EMG) of the anal sphincter, pressure flow analysis, urethral pressure profile and, when advised, pharmacological tests.
RESULTS
Out of 126 diabetic patients, 48 did not show any signs or symptoms of urine voiding dysfunction; 30 were men and 18 women with an average age of 62.6 years; 20 had type I diabetes and were in treatment with insulin and 28 type II diabetes treated with oral hypoglycemic medication. The remaining 78 patients (48 men and 30 women), with an average age of 64.8 years, presented urological symptoms; 31 had type I diabetes and 47 had II type diabetes.
CONCLUSIONS
Diagnosis of the various forms of diabetic cystopathy and early treatment decreases complications and consequently accesses to outpatient facilities and hospital admissions, resulting in an improved quality of life.
Topics: Cohort Studies; Diabetes Complications; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Urinary Bladder Diseases
PubMed: 33348955
DOI: 10.4081/aiua.2020.4.314 -
Current Opinion in Hematology May 2019Microvascular ischemic disease of the brain is a common cause of cognitive impairment and dementia, particularly in the context of preexisting cardiovascular risk... (Review)
Review
PURPOSE OF REVIEW
Microvascular ischemic disease of the brain is a common cause of cognitive impairment and dementia, particularly in the context of preexisting cardiovascular risk factors and aging. This review summarizes our current understanding of the emerging molecular themes that underlie progressive and irreparable vascular disease leading to neuronal tissue injury and dementia.
RECENT FINDINGS
Cardiometabolic risk factors including diabetes and hypertension are known to contribute to vascular disease. Currently, the impact of these risk factors on the integrity and function of the brain vasculature has been target of intense investigation. Molecularly, the consequences associated with these risk factors indicate that reactive oxygen species are strong contributors to cerebrovascular dysfunction and injury. In addition, genetic linkage analyses have identified penetrant monogenic causes of vascular dementia. Finally, recent reports begun to uncover a large number of polymorphisms associated with a higher risk for cerebrovascular disease.
SUMMARY
A comprehensive picture of key risk factors and genetic predispositions that contribute to brain microvascular disease and result in vascular dementia is starting to emerge. Understanding their relationships and cross-interactions will significantly aid in the development of preventive and intervention strategies for this devastating condition.
Topics: Animals; Dementia, Vascular; Diabetes Complications; Genetic Predisposition to Disease; Humans; Hypertension; Risk Factors
PubMed: 30883434
DOI: 10.1097/MOH.0000000000000502 -
Frontiers in Endocrinology 2024
Topics: Humans; Comorbidity; Diabetes Mellitus; Diabetes Complications; Diabetes Mellitus, Type 2
PubMed: 38660511
DOI: 10.3389/fendo.2024.1406131 -
British Medical Journal Nov 1955
Topics: Diabetes Complications; Diabetic Neuropathies; Disease; Humans; Muscles; Muscular Diseases
PubMed: 13269852
DOI: 10.1136/bmj.2.4951.1287 -
Canadian Medical Association Journal Aug 1956
Topics: Diabetes Complications; Diabetic Retinopathy; Disease; Retina; Retinal Diseases
PubMed: 13343072
DOI: No ID Found