Pub Date : 2021-10-28DOI: 10.11648/J.IJDE.20210604.12
M. Diane, Mbango-Ekouta Noel Désirée, N. Pierre, Assiene Oyong Damase Serge, Eloumou Bagnaka Servais, A. Dieudonné
Introduction: C-peptide is the best indicator of endogenous insulin secretion; it makes it possible to optimize the treatment, and to prevent the occurrence and the evolution of the damages resulting from type 2 diabetes. The present study reports the variation of C-peptide levels according to the types of treatment administrated and the high blood pressure in type 2 diabetes in two hospitals (General Hospital and Gyneco-Obstetric and Pediatric Hospital) in the city of Douala Cameroon. Methodology Over a period of 9 months (from October, 1st 2017 to June, 30th 2018), we conducted an analytical cross-sectional study involving subjects with type 2 diabetes regularly monitored at the General Hospital and Gyneco-Obstetric and Pediatric Hospital of Douala Cameroon. Inclusion criteria we included any subject whose diagnosis of type 2 diabetes was mentioned in the medical file. The fasting C-peptide assays were performed according to the principle of electrochemiluminescence. The ANOVA and PEARSON tests were use to investigate on the one hand the correlations between the C peptide levels and the types of treatment administered, and on the other hand between the C-peptide levels and arterial hypertension. The significant threshold was set at P <0.05. Results: Our population, made up of 90 subjects, had a mean age of 58±12.31 years, sex ratio 0.8 in favor of women. The mean duration of diabetes was 8.71±6, 94 years, we had 30 hypertensive subjects under hypertensive treatment, the mean C-peptide levels was 2.50±1.68ng / ml. We found that C-peptide levels increased with patient ages (P=0.004), a significant correlation between C-peptide levels and high blood pressure (P=0.022), and C-Peptide levels varied significantly depending on the type of treatment (P=0.04). Conclusion: Type 2 diabetic patients on oral antidiabetic drugs, and having a low level of C-peptide, should undergo a modification of their treatment by the addition (or the replacement) of insulin, for better glycemic control. Diabetic and hypertensive patients are more exposed to micro and macrovascular complications. Hence the importance of instituting more assiduous blood pressure control, appropriate hypotensive therapy, as well as training patients in self-management and prevention of the onset of complications related to diabetes.
{"title":"Evaluation of C-peptide in Type 2 Diabetic Patients in Douala Cameroon: C-peptide Correlation with Arterial Hypertension and the Types of Treatment Administered","authors":"M. Diane, Mbango-Ekouta Noel Désirée, N. Pierre, Assiene Oyong Damase Serge, Eloumou Bagnaka Servais, A. Dieudonné","doi":"10.11648/J.IJDE.20210604.12","DOIUrl":"https://doi.org/10.11648/J.IJDE.20210604.12","url":null,"abstract":"Introduction: C-peptide is the best indicator of endogenous insulin secretion; it makes it possible to optimize the treatment, and to prevent the occurrence and the evolution of the damages resulting from type 2 diabetes. The present study reports the variation of C-peptide levels according to the types of treatment administrated and the high blood pressure in type 2 diabetes in two hospitals (General Hospital and Gyneco-Obstetric and Pediatric Hospital) in the city of Douala Cameroon. Methodology Over a period of 9 months (from October, 1st 2017 to June, 30th 2018), we conducted an analytical cross-sectional study involving subjects with type 2 diabetes regularly monitored at the General Hospital and Gyneco-Obstetric and Pediatric Hospital of Douala Cameroon. Inclusion criteria we included any subject whose diagnosis of type 2 diabetes was mentioned in the medical file. The fasting C-peptide assays were performed according to the principle of electrochemiluminescence. The ANOVA and PEARSON tests were use to investigate on the one hand the correlations between the C peptide levels and the types of treatment administered, and on the other hand between the C-peptide levels and arterial hypertension. The significant threshold was set at P <0.05. Results: Our population, made up of 90 subjects, had a mean age of 58±12.31 years, sex ratio 0.8 in favor of women. The mean duration of diabetes was 8.71±6, 94 years, we had 30 hypertensive subjects under hypertensive treatment, the mean C-peptide levels was 2.50±1.68ng / ml. We found that C-peptide levels increased with patient ages (P=0.004), a significant correlation between C-peptide levels and high blood pressure (P=0.022), and C-Peptide levels varied significantly depending on the type of treatment (P=0.04). Conclusion: Type 2 diabetic patients on oral antidiabetic drugs, and having a low level of C-peptide, should undergo a modification of their treatment by the addition (or the replacement) of insulin, for better glycemic control. Diabetic and hypertensive patients are more exposed to micro and macrovascular complications. Hence the importance of instituting more assiduous blood pressure control, appropriate hypotensive therapy, as well as training patients in self-management and prevention of the onset of complications related to diabetes.","PeriodicalId":13900,"journal":{"name":"International Journal of Diabetes and Endocrinology","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90890702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-16DOI: 10.46715/ijde2021.10.1000120
Marlen Alejandra Alvarez Castillo
We report a case of a 49‑year‑old female with papillary thyroid cancer, hospitalized for progressive dysphonia of 2 months of evolution with a neck USG reporting right lymph node level III of 0.97 cm in short axis, suspected of malignancy. We administered 2 doses of percutaneous polidocanol injection. In the follow- up there was complete disappearance of the node
{"title":"Percutaneous Polidocanol Injection as an Alternative Treatment in Differentiated Thyroid Cancer Oligometastasis","authors":"Marlen Alejandra Alvarez Castillo","doi":"10.46715/ijde2021.10.1000120","DOIUrl":"https://doi.org/10.46715/ijde2021.10.1000120","url":null,"abstract":"We report a case of a 49‑year‑old female with papillary thyroid cancer, hospitalized for progressive dysphonia of 2 months of evolution with a neck USG reporting right lymph node level III of 0.97 cm in short axis, suspected of malignancy. We administered 2 doses of percutaneous polidocanol injection. In the follow- up there was complete disappearance of the node","PeriodicalId":13900,"journal":{"name":"International Journal of Diabetes and Endocrinology","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81348801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-12DOI: 10.11648/J.IJDE.20210604.11
S. A. Raharinavalona, R. Raherison, Thierry Razanamparany, S. Ralamboson, Andrinirina Dave Patrick Rakotomalala, H. M. D. Vololontiana, R. Andrianasolo
Introduction: The non-adherence to therapy of diabetics is grafted with heavy morbidity and mortality. Our study aims to determine the factors of non-adherence with antidiabetic drugs in type 2 diabetics. Methods: This was a descriptive and analytical cross-sectional study, carried out in the Endocrinology Unit of the Joseph Raseta University Hospital Center. Befelatanana, Antananarivo, over a period of 7 months. Adherence to treatment was assessed by the Morisky scale. Results: We retained 104 patients with an average age of 58.36 years, consisting of 52.88% of women. Adherence was high, medium, and low in 6.73%, 31.73% and 61.54% of cases, respectively. From their attending physician, explanations of the diabetic disease and their treatment were received by 90.38% and 66.35% of patients, respectively. However, these patients were aware of their disease and treatment in 18.27% and 41.35% of cases, respectively. The most observed non-adherence factors were the absence of an appointment given by the physician (30.77%), the feeling of well-being (24.04%), the lack of money (21.15%), forgetting (20.19%) and advice from a traditional practitioner (16.35%). Only the doctor's explanation for diabetes treatment was significantly associated with medication nonadherence (p=0.0310). Conclusion: Continuing medical education for physician is essential so that they can strengthen therapeutic education and follow-up for their diabetics.
{"title":"Factors of Non-adherence to Antidiabetic Drugs in Type 2 Diabetics, Antananarivo Madagascar","authors":"S. A. Raharinavalona, R. Raherison, Thierry Razanamparany, S. Ralamboson, Andrinirina Dave Patrick Rakotomalala, H. M. D. Vololontiana, R. Andrianasolo","doi":"10.11648/J.IJDE.20210604.11","DOIUrl":"https://doi.org/10.11648/J.IJDE.20210604.11","url":null,"abstract":"Introduction: The non-adherence to therapy of diabetics is grafted with heavy morbidity and mortality. Our study aims to determine the factors of non-adherence with antidiabetic drugs in type 2 diabetics. Methods: This was a descriptive and analytical cross-sectional study, carried out in the Endocrinology Unit of the Joseph Raseta University Hospital Center. Befelatanana, Antananarivo, over a period of 7 months. Adherence to treatment was assessed by the Morisky scale. Results: We retained 104 patients with an average age of 58.36 years, consisting of 52.88% of women. Adherence was high, medium, and low in 6.73%, 31.73% and 61.54% of cases, respectively. From their attending physician, explanations of the diabetic disease and their treatment were received by 90.38% and 66.35% of patients, respectively. However, these patients were aware of their disease and treatment in 18.27% and 41.35% of cases, respectively. The most observed non-adherence factors were the absence of an appointment given by the physician (30.77%), the feeling of well-being (24.04%), the lack of money (21.15%), forgetting (20.19%) and advice from a traditional practitioner (16.35%). Only the doctor's explanation for diabetes treatment was significantly associated with medication nonadherence (p=0.0310). Conclusion: Continuing medical education for physician is essential so that they can strengthen therapeutic education and follow-up for their diabetics.","PeriodicalId":13900,"journal":{"name":"International Journal of Diabetes and Endocrinology","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88299212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perspectives of Diabetes, Heart Failure and Chronic Kidney Disease (Ckd) Treating By Sodium-Glucose Cotransporter-2 Inhibitor (Sglt2i)","authors":"","doi":"10.36266/ijed/121","DOIUrl":"https://doi.org/10.36266/ijed/121","url":null,"abstract":"","PeriodicalId":13900,"journal":{"name":"International Journal of Diabetes and Endocrinology","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79193035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-27DOI: 10.11648/J.IJDE.20210603.14
Anna-Maria Borissovа, B. Trifonova, L. Dakovska, E. Michaylova, M. Vukov
Gestational hypothyroidism affects the maturation and function of the beta cell, which can influence glucose metabolism. The aim of the study is to investigate the relationship between Hypothyroidism and Hyperglycemia in Bulgarian pregnant women and to look for the influence of various factors on the manifestation of each of these diseases separately, as well as their role in cases of simultaneous combination of the two diseases. Маterial: We studied 547 pregnant women, mean 30±5 years. The cross-sectional population-based multicenter study was conducted in 84 Bulgarian towns and villages. Pregnant women were divided into 4 groups according to the presence or absence of Diabetes (Diab) resp. Hypothyroidism (Thyr): Group 0 – 62.7% (n-343) – without Thyr or Diab; Group 1 – 22.9% (n-125) – Thyr; Group 2 – 11% (n-60) – Diab; Group 3 – 3.5% (n-19) – with Thyr and Diab. Methods: Fasting morning venous blood (TSH, FT4 - determined by ECLIA method) and fresh morning urine sample (to determine urine iodine concentration - UIC) was taken. A two-hour, 75 g oral glucose tolerance test (OGTT) was performed. The peripheral levels of 25(OH)D were tested using a standard assay in a central laboratory on the day of the sampling. The statistical analysis was conducted using standard SPSS 13.0 for Windows. Results: Group 2 were the oldest and Group 1 - the youngest, P 500 µg / L), compared with the Group with Normoglycemia (n-368). Conclusion: All international guidelines specifically emphasize the main risk factors when pregnant women should be screened for early detection of major endocrine diseases. However, the role of some additional factors, such as deficiency of 25(OH)D and iodine, should not be underestimated.
{"title":"Diabetes and Hypothyroidism Alone and Simultaneously in Bulgarian Pregnant Women - Frequency and Features of Various Risk Factors","authors":"Anna-Maria Borissovа, B. Trifonova, L. Dakovska, E. Michaylova, M. Vukov","doi":"10.11648/J.IJDE.20210603.14","DOIUrl":"https://doi.org/10.11648/J.IJDE.20210603.14","url":null,"abstract":"Gestational hypothyroidism affects the maturation and function of the beta cell, which can influence glucose metabolism. The aim of the study is to investigate the relationship between Hypothyroidism and Hyperglycemia in Bulgarian pregnant women and to look for the influence of various factors on the manifestation of each of these diseases separately, as well as their role in cases of simultaneous combination of the two diseases. Маterial: We studied 547 pregnant women, mean 30±5 years. The cross-sectional population-based multicenter study was conducted in 84 Bulgarian towns and villages. Pregnant women were divided into 4 groups according to the presence or absence of Diabetes (Diab) resp. Hypothyroidism (Thyr): Group 0 – 62.7% (n-343) – without Thyr or Diab; Group 1 – 22.9% (n-125) – Thyr; Group 2 – 11% (n-60) – Diab; Group 3 – 3.5% (n-19) – with Thyr and Diab. Methods: Fasting morning venous blood (TSH, FT4 - determined by ECLIA method) and fresh morning urine sample (to determine urine iodine concentration - UIC) was taken. A two-hour, 75 g oral glucose tolerance test (OGTT) was performed. The peripheral levels of 25(OH)D were tested using a standard assay in a central laboratory on the day of the sampling. The statistical analysis was conducted using standard SPSS 13.0 for Windows. Results: Group 2 were the oldest and Group 1 - the youngest, P 500 µg / L), compared with the Group with Normoglycemia (n-368). Conclusion: All international guidelines specifically emphasize the main risk factors when pregnant women should be screened for early detection of major endocrine diseases. However, the role of some additional factors, such as deficiency of 25(OH)D and iodine, should not be underestimated.","PeriodicalId":13900,"journal":{"name":"International Journal of Diabetes and Endocrinology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84679228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-13DOI: 10.11648/J.IJDE.20210603.13
Xiao-fen Fan, Linlin Liu, W. Zhu, Yumei Zhao, Haowei Zhang, Yang Wu, Jia Fu, H. Liang, Rui Han
Diabetic kidney disease (DKD) is an inflammatory disease caused by metabolic disorder. As an important signaling pathway in the inflammatory response, the JNK signaling pathway plays an crucial role in kidney injury in DKD. Vitamin D3 can reduce the inflammatory reaction and delay or even reverse DKD progression. Unfortunately, the mechanism by which vitamin D3 regulates DKD pathogenesis is unclear. This research established a DKD rat model and vitamin D3 and irbesartan were used as interventions. Then, urine and blood biochemistry; and inflammatory cytokine (IL-1 and IL-6), phosphorylated JNK pathway protein (MEK-4 and JNK1/2/3) and downstream factor (AP-1 and ATF-2) expression were assessed. We found that the DKD group showed body weight and insulin secretion were significantly decreased; significantly increased FPG, HOMA-IR and blood lipids; and significantly increased 24-h urinary protein (UPro) compared with normal group. Additionally, the levels of IL-1 and IL-6 and phosphorylated JNK pathway proteins were significantly elevated. These changes were improved by vitamin D3, especially at a low dosage. These results suggest that active vitamin D3 protects against DKD in rats by reducing IL-6 and IL-1 release, downregulating the JNK inflammatory signaling pathway, and inhibiting downstream transcription factor AP-1- and ATF-2-mediated kidney damage. This research provides a new theoretical support for vitamin D3 treatment of diabetic nephropathy.
{"title":"Active Vitamin D3 Protects Against Diabetic Kidney Disease by Regulating the JNK Signaling Pathway in Rats","authors":"Xiao-fen Fan, Linlin Liu, W. Zhu, Yumei Zhao, Haowei Zhang, Yang Wu, Jia Fu, H. Liang, Rui Han","doi":"10.11648/J.IJDE.20210603.13","DOIUrl":"https://doi.org/10.11648/J.IJDE.20210603.13","url":null,"abstract":"Diabetic kidney disease (DKD) is an inflammatory disease caused by metabolic disorder. As an important signaling pathway in the inflammatory response, the JNK signaling pathway plays an crucial role in kidney injury in DKD. Vitamin D3 can reduce the inflammatory reaction and delay or even reverse DKD progression. Unfortunately, the mechanism by which vitamin D3 regulates DKD pathogenesis is unclear. This research established a DKD rat model and vitamin D3 and irbesartan were used as interventions. Then, urine and blood biochemistry; and inflammatory cytokine (IL-1 and IL-6), phosphorylated JNK pathway protein (MEK-4 and JNK1/2/3) and downstream factor (AP-1 and ATF-2) expression were assessed. We found that the DKD group showed body weight and insulin secretion were significantly decreased; significantly increased FPG, HOMA-IR and blood lipids; and significantly increased 24-h urinary protein (UPro) compared with normal group. Additionally, the levels of IL-1 and IL-6 and phosphorylated JNK pathway proteins were significantly elevated. These changes were improved by vitamin D3, especially at a low dosage. These results suggest that active vitamin D3 protects against DKD in rats by reducing IL-6 and IL-1 release, downregulating the JNK inflammatory signaling pathway, and inhibiting downstream transcription factor AP-1- and ATF-2-mediated kidney damage. This research provides a new theoretical support for vitamin D3 treatment of diabetic nephropathy.","PeriodicalId":13900,"journal":{"name":"International Journal of Diabetes and Endocrinology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90696545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-04DOI: 10.11648/J.IJDE.20210603.12
Qianghong Pu, Qiu-Ju Lyu
Background: The objective of this study was to identify the top 100 cited articles in primary aldosteronism, and examine their characteristics. Methods: Science Citation Index Expanded database was utilized to search for the top 100 cited articles published since 1900. Articles were evaluated for several characteristics, including the number of citations, authorship, country and institution of origin, publication year, journal, and study design. Results: The top 100 articles were cited between 88 and 762 times, with a median of 130. The articles were published between 1955 and 2012, with the majority of the primary aldosteronism publications (n=35) being published between 2000 and 2009. The biggest number of the top 100 cited articles (n=19) were published in the Journal of Clinical Endocrinology Metabolism, followed by Hypertension (n=9), Annals of Internal Medicine (n=6), and Archives of Internal Medicine (n=6). The United States and Italy had the most publications, whereas University of Michigan and University of Padua were the top two institutions. Observational studies were the most popular article type, followed by reviews and basic science. The impact factor of a journal was not correlated with the number of top-cited articles it published. Furthermore there was no correlation between the number of citations and the number of years since publication, authors, participating institutions, or countries involved. Conclusion: These findings will assist researchers in quickly identifying the most significant advances in the field of primary aldosteronism, as well as deciphering the characteristics of top-cited articles in this subject, and laying a basis for further research.
背景:本研究的目的是确定原发性醛固酮增多症的前100篇被引文章，并研究其特征。方法:利用科学引文索引扩展数据库检索自1900年以来发表的前100位被引文章。评估文章的几个特征，包括引用次数、作者、原产国家和机构、出版年份、期刊和研究设计。结果:排名前100位的文章被引次数在88 ~ 762次之间，中位数为130次。这些文章发表于1955年至2012年之间，大多数醛固酮增多症的主要出版物(n=35)发表于2000年至2009年之间。前100名中，发表在《Journal of Clinical Endocrinology Metabolism》的文章最多(n=19)，其次是《Hypertension》(n=9)、《Annals of Internal Medicine》(n=6)、《Archives of Internal Medicine》(n=6)。美国和意大利发表的论文最多，而密歇根大学和帕多瓦大学排名前两。观察性研究是最受欢迎的文章类型，其次是综述和基础科学。期刊的影响因子与其发表的被引次数无关。此外，引用次数与发表年数、作者、参与机构或涉及国家之间没有相关性。结论:这些发现将有助于研究者快速识别原发性醛固酮增多症领域最重要的进展，并解读该学科高被引文章的特征，为进一步的研究奠定基础。
{"title":"Top-cited Articles in Primary Aldosteronism: A Bibliometric Analysis","authors":"Qianghong Pu, Qiu-Ju Lyu","doi":"10.11648/J.IJDE.20210603.12","DOIUrl":"https://doi.org/10.11648/J.IJDE.20210603.12","url":null,"abstract":"Background: The objective of this study was to identify the top 100 cited articles in primary aldosteronism, and examine their characteristics. Methods: Science Citation Index Expanded database was utilized to search for the top 100 cited articles published since 1900. Articles were evaluated for several characteristics, including the number of citations, authorship, country and institution of origin, publication year, journal, and study design. Results: The top 100 articles were cited between 88 and 762 times, with a median of 130. The articles were published between 1955 and 2012, with the majority of the primary aldosteronism publications (n=35) being published between 2000 and 2009. The biggest number of the top 100 cited articles (n=19) were published in the Journal of Clinical Endocrinology Metabolism, followed by Hypertension (n=9), Annals of Internal Medicine (n=6), and Archives of Internal Medicine (n=6). The United States and Italy had the most publications, whereas University of Michigan and University of Padua were the top two institutions. Observational studies were the most popular article type, followed by reviews and basic science. The impact factor of a journal was not correlated with the number of top-cited articles it published. Furthermore there was no correlation between the number of citations and the number of years since publication, authors, participating institutions, or countries involved. Conclusion: These findings will assist researchers in quickly identifying the most significant advances in the field of primary aldosteronism, as well as deciphering the characteristics of top-cited articles in this subject, and laying a basis for further research.","PeriodicalId":13900,"journal":{"name":"International Journal of Diabetes and Endocrinology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90753405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-22DOI: 10.46715/ijde2021.08.1000118
Jesús Rocca
Background: Since cardiovascular (CV) disease is one of the principal causes of mortality among Peruvian population, especially in people with type 2 diabetes (T2D), patient´s CV risk factors evaluation should be done as homogenously as possible. The aim of this study was to determinate what was the perception of different specialists in Peru, of CV risk factors in patients with and without T2D. Methods: An on-line questionnaire on a convenient sample of physicians, from different medical specialties, was answered. The questionnaire assessed the physicians’ perception of fourteen CV risk factors in patients with and without T2D, according to three ratings: very important, moderately important, and slightly important. We assessed the differences between medical specialties through graphs and chi-square tests, and also identified the risk factors considered as “very important” with the highest (≥90%) consensus amongst each specialty. Results: A total of 156 physicians responded to the questionnaire, composed by endocrinologists (30%), cardiologists (26%), internists (18%), nephrologists (13%) and general practitioners (13%). In patients with T2D the importance of BMI ≥30, high LDL cholesterol level, triglycerides ≥ 150 mg/dL, and hyperuricemia were statistically different across medical specialties. Likewise In patients without T2D; triglycerides ≥150 mg/dL, hyperuricemia, pre diabetes, and hepatic steatosis. With the exception of general practitioners, consensus on at least one risk factor was attained in all specialties, albeit these risk factors were heterogeneous amongst them. The only risk factor that reached consensus across all specialties was high blood pressure. Conclusion: Hypertension and smoking were the most important CV risk factors in T2D patients valued by the surveyed physicians, followed by levels of LDL-c and albuminuria. Cardiologists as well as endocrinologists, gave the same assessment to CV risk factors. For people without T2D, smoking was recognized as the most important CV risk factor, followed by hypertension and albuminuria.
{"title":"Physicians’ Perception of the Relevance of Cardiovascular Risk Factors in Patients with and without Type 2 Diabetes in Peru","authors":"Jesús Rocca","doi":"10.46715/ijde2021.08.1000118","DOIUrl":"https://doi.org/10.46715/ijde2021.08.1000118","url":null,"abstract":"Background: Since cardiovascular (CV) disease is one of the principal causes of mortality among Peruvian population, especially in people with type 2 diabetes (T2D), patient´s CV risk factors evaluation should be done as homogenously as possible. The aim of this study was to determinate what was the perception of different specialists in Peru, of CV risk factors in patients with and without T2D. \u0000\u0000Methods: An on-line questionnaire on a convenient sample of physicians, from different medical specialties, was answered. The questionnaire assessed the physicians’ perception of fourteen CV risk factors in patients with and without T2D, according to three ratings: very important, moderately important, and slightly important. We assessed the differences between medical specialties through graphs and chi-square tests, and also identified the risk factors considered as “very important” with the highest (≥90%) consensus amongst each specialty.\u0000\u0000Results: A total of 156 physicians responded to the questionnaire, composed by endocrinologists (30%), cardiologists (26%), internists (18%), nephrologists (13%) and general practitioners (13%). In patients with T2D the importance of BMI ≥30, high LDL cholesterol level, triglycerides ≥ 150 mg/dL, and hyperuricemia were statistically different across medical specialties. Likewise In patients without T2D; triglycerides ≥150 mg/dL, hyperuricemia, pre diabetes, and hepatic steatosis. With the exception of general practitioners, consensus on at least one risk factor was attained in all specialties, albeit these risk factors were heterogeneous amongst them. The only risk factor that reached consensus across all specialties was high blood pressure.\u0000\u0000Conclusion: Hypertension and smoking were the most important CV risk factors in T2D patients valued by the surveyed physicians, followed by levels of LDL-c and albuminuria. Cardiologists as well as endocrinologists, gave the same assessment to CV risk factors. For people without T2D, smoking was recognized as the most important CV risk factor, followed by hypertension and albuminuria.","PeriodicalId":13900,"journal":{"name":"International Journal of Diabetes and Endocrinology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84838079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-11DOI: 10.46715/IJDE2021.07.1000117
J. Burd
Obesity and type 2 diabetes are related worldwide epidemics which could be erased with the help of governments and medical communities using tools that are readily available today. Prevailing diet recommendations, which are clearly wrong, are a significant cause of both obesity and type 2 diabetes and have led to the current dire situation. According to the CDC, in the United States alone there are currently 34.2 million people with diabetes of which 30 million have type 2 diabetes. In addition, 88 million Americans have prediabetes (defined as an A1c above 5.7%) which will almost certainly progress to type 2 diabetes if not treated and reversed. The cause of insulin resistance, prediabetes and type 2 diabetes is “glucose toxicity” as explained below, and understanding this medical term is paramount to the case against using insulin for type 2 diabetes. Glucose reacts with all the proteins in the body leading to insulin resistance and type 2 diabetes. Unfortunately, nearly 20% of adults with type 2 diabetes are prescribed insulin injections often in conjunction with oral pharmaceutical medications. Because people with with type 2 diabetes have insulin resistance, prescribing insulin is a very bad idea, since they will need an ever-increasing dosage of insulin as time passes, leading to a lifetime of insulin injections. There is only one product, Lysulin (www.lysulin.com), that targets the cause of insulin resistance and has been proven in double blind, placebo controlled clinical studies to improve insulin resistance and better cell function. The recommend initial treatment for type 2 diabetes should be moderate exercise, intermittent fasting, a low calorie, low carbohydrate ketrogenic diet combined with Lysulin before instituting insulin therapy for type 2 diabetes. By adhering to a ketogenic diet that includes moderate exercise, intermittent fasting and nutritional supplementation with Lysulin, diabetes can be halted and quite possibly reversed. Lysulin is a patented nutritional supplement that contains lysine, zinc, and vitamin C [1]. Double-blind placebo-controlled clinical studies have shown the effectiveness of this nutritional supplement [2, 3].
{"title":"The Scientific Case against Prescribing Insulin for Treatment of Type 2 Diabetes","authors":"J. Burd","doi":"10.46715/IJDE2021.07.1000117","DOIUrl":"https://doi.org/10.46715/IJDE2021.07.1000117","url":null,"abstract":"Obesity and type 2 diabetes are related worldwide epidemics which could be erased with the help of governments and medical communities using tools that are readily available today. Prevailing diet recommendations, which are clearly wrong, are a significant cause of both obesity and type 2 diabetes and have led to the current dire situation. According to the CDC, in the United States alone there are currently 34.2 million people with diabetes of which 30 million have type 2 diabetes. In addition, 88 million Americans have prediabetes (defined as an A1c above 5.7%) which will almost certainly progress to type 2 diabetes if not treated and reversed. The cause of insulin resistance, prediabetes and type 2 diabetes is “glucose toxicity” as explained below, and understanding this medical term is paramount to the case against using insulin for type 2 diabetes.\u0000\u0000Glucose reacts with all the proteins in the body leading to insulin resistance and type 2 diabetes. Unfortunately, nearly 20% of adults with type 2 diabetes are prescribed insulin injections often in conjunction with oral pharmaceutical medications. Because people with with type 2 diabetes have insulin resistance, prescribing insulin is a very bad idea, since they will need an ever-increasing dosage of insulin as time passes, leading to a lifetime of insulin injections. There is only one product, Lysulin (www.lysulin.com), that targets the cause of insulin resistance and has been proven in double blind, placebo controlled clinical studies to improve insulin resistance and better cell function. The recommend initial treatment for type 2 diabetes should be moderate exercise, intermittent fasting, a low calorie, low carbohydrate ketrogenic diet combined with Lysulin before instituting insulin therapy for type 2 diabetes. By adhering to a ketogenic diet that includes moderate exercise, intermittent fasting and nutritional supplementation with Lysulin, diabetes can be halted and quite possibly reversed. Lysulin is a patented nutritional supplement that contains lysine, zinc, and vitamin C [1]. Double-blind placebo-controlled clinical studies have shown the effectiveness of this nutritional supplement [2, 3].","PeriodicalId":13900,"journal":{"name":"International Journal of Diabetes and Endocrinology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79086530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-30DOI: 10.11648/J.IJDE.20210603.11
Afjal Hossain, M. Barua, M. Sharifuzzaman, F. Amin, Lutful Kabir, N. Mahmud, F. Afsana, F. Pathan, M. Kabir, Mahmudul Islam Talukder, Aman Ullah
Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with various phenotypic expressions. Aims: This study was conducted to observe and compare various metabolic components in different phenotypes of PCOS and to find out the frequency of insulin resistance (IR) among them. Materials and Methods: Eighty (80) patients diagnosed as case of PCOS as per inclusion and exclusion criteria were recruited in this cross sectional observational study. Patients were categorized in 4 different phenotypes based on the presence of oligo/anovulation (O), hyperandrogenism (H) and polycystic ovarian morphology (P): (i) Phenotype A (O+ H+ P), Phenotype B (O+H), (iii) Phenotype C (H+P) and (iv) Phenotype D (O+P). Demographic, anthropometric, biochemical and metabolic parameters were recorded and compared by ANOVA & Chi Square test using SPSS software version 22.0. Results: Most prevalent phenotype was phenotype A (55%) followed by phenotype D (22.5%), phenotype B (15%) & phenotype C (7.5%). Phenotype A & B had higher mean body mass index (BMI), waist circumference (WC), waist hip ratio (WHR), total testosterone (TT), fasting insulin, triglycerides (TG) & lower HDL-cholesterol in comparison to phenotype C & D (P value 0.001, 0.000, 0.000, 0.003, 0.000, 0.005 & 0.046 respectively). Fasting plasma glucose (FPG), plasma glucose 2 hours after 75 grams oral glucose load (AG), total cholesterol & LDL-cholesterol were comparable among the phenotypes (P value 0.636, 0.829, 0.143 & 0.201 respectively). Overall frequency of IR as defined by HOMA-IR≥3.8 was 61.25%. Highest frequency of IR was found in phenotype B followed by phenotype A and least in phenotype D (IR in A, B, C & D were 72.73%, 83.33%, 33.33% & 27.28%, P 0.002). Conclusion: Phenotype A & B had higher degree of deranged metabolic parameters than other phenotypes. Insulin resistance is mostly associated with phenotype A & B and least in normoandrogenic phenotype (phenotype D).
{"title":"Metabolic Profile and Insulin Resistance in Different Phenotypes of Polycystic Ovary Syndrome Attending in a Tertiary Care Hospital of Bangladesh","authors":"Afjal Hossain, M. Barua, M. Sharifuzzaman, F. Amin, Lutful Kabir, N. Mahmud, F. Afsana, F. Pathan, M. Kabir, Mahmudul Islam Talukder, Aman Ullah","doi":"10.11648/J.IJDE.20210603.11","DOIUrl":"https://doi.org/10.11648/J.IJDE.20210603.11","url":null,"abstract":"Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with various phenotypic expressions. Aims: This study was conducted to observe and compare various metabolic components in different phenotypes of PCOS and to find out the frequency of insulin resistance (IR) among them. Materials and Methods: Eighty (80) patients diagnosed as case of PCOS as per inclusion and exclusion criteria were recruited in this cross sectional observational study. Patients were categorized in 4 different phenotypes based on the presence of oligo/anovulation (O), hyperandrogenism (H) and polycystic ovarian morphology (P): (i) Phenotype A (O+ H+ P), Phenotype B (O+H), (iii) Phenotype C (H+P) and (iv) Phenotype D (O+P). Demographic, anthropometric, biochemical and metabolic parameters were recorded and compared by ANOVA & Chi Square test using SPSS software version 22.0. Results: Most prevalent phenotype was phenotype A (55%) followed by phenotype D (22.5%), phenotype B (15%) & phenotype C (7.5%). Phenotype A & B had higher mean body mass index (BMI), waist circumference (WC), waist hip ratio (WHR), total testosterone (TT), fasting insulin, triglycerides (TG) & lower HDL-cholesterol in comparison to phenotype C & D (P value 0.001, 0.000, 0.000, 0.003, 0.000, 0.005 & 0.046 respectively). Fasting plasma glucose (FPG), plasma glucose 2 hours after 75 grams oral glucose load (AG), total cholesterol & LDL-cholesterol were comparable among the phenotypes (P value 0.636, 0.829, 0.143 & 0.201 respectively). Overall frequency of IR as defined by HOMA-IR≥3.8 was 61.25%. Highest frequency of IR was found in phenotype B followed by phenotype A and least in phenotype D (IR in A, B, C & D were 72.73%, 83.33%, 33.33% & 27.28%, P 0.002). Conclusion: Phenotype A & B had higher degree of deranged metabolic parameters than other phenotypes. Insulin resistance is mostly associated with phenotype A & B and least in normoandrogenic phenotype (phenotype D).","PeriodicalId":13900,"journal":{"name":"International Journal of Diabetes and Endocrinology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87787910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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