Pub Date : 2020-11-25DOI: 10.31031/IOD.2020.04.000593
M. H. S. A. Dahr
Background: Non-insulin dependent diabetes (NIDDM) usually had high risk for vascular dysfunction. Objective: The target of this study is to measure the relationships between systemic inflammation, oxidative stress and glycemic control in non-insulin dependent diabetes. Material and Methods: Ninety obese patients with NIDDM (54 males and 36 females). Their age mean was 49.13±5.25 year, their body mass index (BMI) ranged from 31 to 36Kg/m 2 , and a control group included Nighty healthy volunteers, who was gender and age matched. Results: Our study results underscores that NIDDM patients had higher significant values of Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index, glycosylated hemoglobin(HBA1c), Malondialdehyde (MDA), Superoxide dismutase (SOD), Inter-Cellular Adhesion Molecule (ICAM-1), Vascular Cell Adhesion Molecule (VCAM-1), E-selectin, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α) and Interleukin-6 (IL-6) in addition to lower significant values of the quantitative insulin-sensitivity check index (QUICKI), Glutathione (GSH) and Glutathione peroxidase (GPX) levels in comparison to controls., in addition serum levels of ICAM-1, VCAM-1, E-selectin MDA ,SOD, CRP, TNF-α and IL-6 showed a direct relationship with HOMA-IR and HBA1c. However, serum levels of GSH and GPX showed an inverse relationship with HOMA-IR and HBA1c. However, serum levels of ICAM-1, VCAM-1, E-selectin MDA, SOD, CRP, TNF-α and IL-6 showed an inverse relationship with QUICKI. However, serum levels of GSH and GPX showed a direct relationship with QUICKI. dysfunction molecules and poor metabolic control in NIDDM.
{"title":"Relationships between Systemic Inflammation, Oxidative Stress, Endothelial Dysfunction Molecules and Glycemic Control in Non-Insulin Dependent Diabetes","authors":"M. H. S. A. Dahr","doi":"10.31031/IOD.2020.04.000593","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000593","url":null,"abstract":"Background: Non-insulin dependent diabetes (NIDDM) usually had high risk for vascular dysfunction. Objective: The target of this study is to measure the relationships between systemic inflammation, oxidative stress and glycemic control in non-insulin dependent diabetes. Material and Methods: Ninety obese patients with NIDDM (54 males and 36 females). Their age mean was 49.13±5.25 year, their body mass index (BMI) ranged from 31 to 36Kg/m 2 , and a control group included Nighty healthy volunteers, who was gender and age matched. Results: Our study results underscores that NIDDM patients had higher significant values of Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index, glycosylated hemoglobin(HBA1c), Malondialdehyde (MDA), Superoxide dismutase (SOD), Inter-Cellular Adhesion Molecule (ICAM-1), Vascular Cell Adhesion Molecule (VCAM-1), E-selectin, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α) and Interleukin-6 (IL-6) in addition to lower significant values of the quantitative insulin-sensitivity check index (QUICKI), Glutathione (GSH) and Glutathione peroxidase (GPX) levels in comparison to controls., in addition serum levels of ICAM-1, VCAM-1, E-selectin MDA ,SOD, CRP, TNF-α and IL-6 showed a direct relationship with HOMA-IR and HBA1c. However, serum levels of GSH and GPX showed an inverse relationship with HOMA-IR and HBA1c. However, serum levels of ICAM-1, VCAM-1, E-selectin MDA, SOD, CRP, TNF-α and IL-6 showed an inverse relationship with QUICKI. However, serum levels of GSH and GPX showed a direct relationship with QUICKI. dysfunction molecules and poor metabolic control in NIDDM.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115050332","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 : 2020-09-30DOI: 10.31031/IOD.2020.04.000592
Md. Nahian Rahman, Shaidaton Nisha, Syeda Saima Alam, A. Zobayed, M. Hasan, K. Islam
Obesity is becoming the most common health problem of the 21st century, as it will contribute significantly to the high prevalence of cardiovascular disease in developing countries. This study aims to estimate the prevalence of overweight and obesity and determine potential influencing factors among adults in selected areas in Bangladesh. A cross-sectional survey was conducted in4 districts of Bangladesh (Dhaka, Mymensing, Khulna and Sylhet) in 2018. A total of 400 respondents aged 18-93 years from the general population were included using a multistage stratified random cluster sampling design. Data were obtained from face-to-face interview and physical examination. After being weighted according to a complex sampling scheme, the sample was used to estimate the prevalence of overweight (body mass index (BMI) 23-27.49kg/m2) and obesity (BMI ≥27.5kg/m2).The overall prevalence of overweight was 23.25% (male 25.11%; female 20.61%), and the prevalence of obesity was 6.75% (male 6.81%; female 6.67%). The prevalence of both overweight and obesity were higher in men than women (p<0.001). The prevalence of overweightwas higher inrespondents aged 36 to50 years than others age group .The prevalence of obesitywas higher inrespondents aged 51 to 65 yearsthan others age group (p<0.05). The results of this study will be helpful to policy makers in developing education and publicity to prevent and control the occurrence of overweight and obesity
{"title":"Prevalence of Overweight and Obesity among Adult in Selected Areas of Bangladesh","authors":"Md. Nahian Rahman, Shaidaton Nisha, Syeda Saima Alam, A. Zobayed, M. Hasan, K. Islam","doi":"10.31031/IOD.2020.04.000592","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000592","url":null,"abstract":"Obesity is becoming the most common health problem of the 21st century, as it will contribute significantly to the high prevalence of cardiovascular disease in developing countries. This study aims to estimate the prevalence of overweight and obesity and determine potential influencing factors among adults in selected areas in Bangladesh. A cross-sectional survey was conducted in4 districts of Bangladesh (Dhaka, Mymensing, Khulna and Sylhet) in 2018. A total of 400 respondents aged 18-93 years from the general population were included using a multistage stratified random cluster sampling design. Data were obtained from face-to-face interview and physical examination. After being weighted according to a complex sampling scheme, the sample was used to estimate the prevalence of overweight (body mass index (BMI) 23-27.49kg/m2) and obesity (BMI ≥27.5kg/m2).The overall prevalence of overweight was 23.25% (male 25.11%; female 20.61%), and the prevalence of obesity was 6.75% (male 6.81%; female 6.67%). The prevalence of both overweight and obesity were higher in men than women (p<0.001). The prevalence of overweightwas higher inrespondents aged 36 to50 years than others age group .The prevalence of obesitywas higher inrespondents aged 51 to 65 yearsthan others age group (p<0.05). The results of this study will be helpful to policy makers in developing education and publicity to prevent and control the occurrence of overweight and obesity","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114645895","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 : 2020-08-17DOI: 10.31031/IOD.2020.04.000591
H. Verkoelen, E. Govers, H. Maas, Koek Gh
A low carbohydrate diet is suggested to be effective in type 2 diabetes to reduce or stop glucose lowering medication. To prove the effectiveness of this dietary change, a low carbohydrate diet was studied in patients with type 2 diabetes on the amount of insulin, HbA1c values and weight loss. Methods An observational study in one dietitian practice on the treatment of patients with type 2 diabetes, all on an insulin regimen, with a low carbohydrate diet. Two HbA1c values prior to, and after six months of the dietary intervention were measured. All patients received a dietary advice to consume 30 grams carbohydrates per day in a day menu schedule. Patients visited the outpatient clinic to discuss their results, experiences, and questions. The online treatment group received feedback every week and extra support per mail. Results We included 37 overweight type 2 diabetes patients on insulin treatment and evaluated 35 patients after 6 months. The consumption of carbohydrates was 31±10 grams per day. Insulin use was reduced significantly (p<0.001) from 62.6±46.4 IU to 1.4±6.4 IU per day. For 92% of the participants, insulin injections could be stopped completely. Patients lost a mean of 13.3±6.3 kg of weight and the mean HbA1c level declined from 63.4±11.0mmol/mol to 56.9±13.0mmol/mol (p<0.001). Conclusion A low carbohydrate dietary lifestyle is effective in improving HbA1c and weight loss and leads to a significant reduction of insulin need.
{"title":"Low Carbohydrate Lifestyle Reduces Significantly Insulin Need in Type 2 Diabetes Patients","authors":"H. Verkoelen, E. Govers, H. Maas, Koek Gh","doi":"10.31031/IOD.2020.04.000591","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000591","url":null,"abstract":"A low carbohydrate diet is suggested to be effective in type 2 diabetes to reduce or stop glucose lowering medication. To prove the effectiveness of this dietary change, a low carbohydrate diet was studied in patients with type 2 diabetes on the amount of insulin, HbA1c values and weight loss. Methods An observational study in one dietitian practice on the treatment of patients with type 2 diabetes, all on an insulin regimen, with a low carbohydrate diet. Two HbA1c values prior to, and after six months of the dietary intervention were measured. All patients received a dietary advice to consume 30 grams carbohydrates per day in a day menu schedule. Patients visited the outpatient clinic to discuss their results, experiences, and questions. The online treatment group received feedback every week and extra support per mail. Results We included 37 overweight type 2 diabetes patients on insulin treatment and evaluated 35 patients after 6 months. The consumption of carbohydrates was 31±10 grams per day. Insulin use was reduced significantly (p<0.001) from 62.6±46.4 IU to 1.4±6.4 IU per day. For 92% of the participants, insulin injections could be stopped completely. Patients lost a mean of 13.3±6.3 kg of weight and the mean HbA1c level declined from 63.4±11.0mmol/mol to 56.9±13.0mmol/mol (p<0.001). Conclusion A low carbohydrate dietary lifestyle is effective in improving HbA1c and weight loss and leads to a significant reduction of insulin need.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121833417","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 : 2020-07-07DOI: 10.31031/IOD.2020.04.000589
M. Kamil, F. Ahmad, A. Et
Although earlier work on the hypoglycemic effect of Fenugreek ( Trigonella foenum-graecum L. seed) extract have been carried out in many studies [1-9]. The present paper is a collective scientific study on Trigonella Foenum Graecum starting from its description, habitat, traditional and medicinal uses, pharmacognostic, physico-chemical and phytochemical protocols along with preclinical study of antidiabetic effect of Trigonella Foenum Graecum aqueous using animals.
{"title":"Scientific Study on Trigonella Foenum-Graecum (Fenu Greek) with Special Reference to its Preclinical Study on Antidiabetic Effect","authors":"M. Kamil, F. Ahmad, A. Et","doi":"10.31031/IOD.2020.04.000589","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000589","url":null,"abstract":"Although earlier work on the hypoglycemic effect of Fenugreek ( Trigonella foenum-graecum L. seed) extract have been carried out in many studies [1-9]. The present paper is a collective scientific study on Trigonella Foenum Graecum starting from its description, habitat, traditional and medicinal uses, pharmacognostic, physico-chemical and phytochemical protocols along with preclinical study of antidiabetic effect of Trigonella Foenum Graecum aqueous using animals.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121833032","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 : 2020-07-07DOI: 10.31031/IOD.2020.04.000590
W. F. Elbossaty
There are two ways for glucose uptake depending on metabolic needs and glucose availability. These ways included passive (facilitated diffusion) and secondary active transport. Passive transport is movement of substances from high to low concentration. On the other hand active transport is movement of substances against its concentration gradient, unlike passive transport, the cell expends energy. In passive process, as a result of impermeability of plasma membrane for polar substance as glucose, the cellular uptake of glucose is accomplished by special carrier proteins called glucose transporters. The most significant carrier proteins are GLUT1-4. GLUT1 and GLUT3 are located in the plasma membrane, and they are responsible for maintaining rate of glucose uptake. GLUT2 is located in the plasma membranes of hepatocytes, pancreatic beta cells and it responsible for glucose sensing. GLUT4 transporters are insulin sensitive, they found in muscle and adipose tissue. During carbohydrate breakdown high level of glucose concentration according to absorption. This means there is a concentration gradient allowing the diffusion of glucose into the cells. Active transport can be divided into two categories. Primary active transport uses ATP as source of chemical energy to move molecules across a membrane against their gradient as sodiumpotassium pump.
{"title":"Sodium/Glucose Cotransport and Treatment of Diabetes","authors":"W. F. Elbossaty","doi":"10.31031/IOD.2020.04.000590","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000590","url":null,"abstract":"There are two ways for glucose uptake depending on metabolic needs and glucose availability. These ways included passive (facilitated diffusion) and secondary active transport. Passive transport is movement of substances from high to low concentration. On the other hand active transport is movement of substances against its concentration gradient, unlike passive transport, the cell expends energy. In passive process, as a result of impermeability of plasma membrane for polar substance as glucose, the cellular uptake of glucose is accomplished by special carrier proteins called glucose transporters. The most significant carrier proteins are GLUT1-4. GLUT1 and GLUT3 are located in the plasma membrane, and they are responsible for maintaining rate of glucose uptake. GLUT2 is located in the plasma membranes of hepatocytes, pancreatic beta cells and it responsible for glucose sensing. GLUT4 transporters are insulin sensitive, they found in muscle and adipose tissue. During carbohydrate breakdown high level of glucose concentration according to absorption. This means there is a concentration gradient allowing the diffusion of glucose into the cells. Active transport can be divided into two categories. Primary active transport uses ATP as source of chemical energy to move molecules across a membrane against their gradient as sodiumpotassium pump.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134641325","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 : 2020-07-07DOI: 10.31031/IOD.2020.04.000588
B. King
Obesity is a modifiable risk factor for poor health outcomes including cardiovascular disease (CVD). A trend for elevated body weight in children with type 1 diabetes (T1D) compared to the general population is clearly evident. This trend is pronounced in teenage girls with T1D and increases with age. Teenage boys with T1D more closely resemble the population norms for overweight and obesity. Given that individuals with T1D are at an increased risk of early CVD related morbidity and mortality, early weight management intervention could potentially improve CVD outcomes. Further investigation of mechanisms of weight gain in T1D is required to inform interventions.
{"title":"Overweight and Obesity in Youth with Type 1 Diabetes: What is Known?","authors":"B. King","doi":"10.31031/IOD.2020.04.000588","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000588","url":null,"abstract":"Obesity is a modifiable risk factor for poor health outcomes including cardiovascular disease (CVD). A trend for elevated body weight in children with type 1 diabetes (T1D) compared to the general population is clearly evident. This trend is pronounced in teenage girls with T1D and increases with age. Teenage boys with T1D more closely resemble the population norms for overweight and obesity. Given that individuals with T1D are at an increased risk of early CVD related morbidity and mortality, early weight management intervention could potentially improve CVD outcomes. Further investigation of mechanisms of weight gain in T1D is required to inform interventions.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114989302","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 : 2020-06-29DOI: 10.31031/IOD.2020.04.000587
R. Hegazi
Diabetes-specific nutrition could play an important role in the overall management of diabetes. Diabetes-specific nutritional formulas (DSNF) could be beneficial for the management of people with diabetes (PWD) who are malnourished or at risk. The role of primary care physicians as drivers of DSNF recommendations was assessed via phone surveys in community-dwelling PWD at malnutrition risk participating in a home-based nutrition focused quality improvement program (QIP). Of patients surveyed, 93.2% were still using DSNF within 30-45 days of enrollment in QIP and 238 of 266 (89%) were “very-” or “somewhat-” likely to continue DSNF if they were recommended by a physician. In PWD receiving home healthcare, patient education, and professional recommendation of DSNF by physicians could reinforce utilization and better adherence. Hospitalization rates were also reduced for patients enrolled in the QIP as compared to at-risk/malnourished pre-QIP historical PWD controls; relative risk reductions were 21.7% at 30 days (12.6% vs. 16.1%, p=0.053), 28.1% at 60 days (17.9% vs. 24.9%, p=0.001), and 28.3% at 90 days (21.8% vs. 30.4%, p<0.001). Nutrition-focused QIPs and physician driven recommendations for DSNF can improve patient engagement in nutrition therapy and decrease hospitalization rates.
糖尿病特定营养在糖尿病的整体管理中可能发挥重要作用。糖尿病专用营养配方(DSNF)可能对营养不良或有风险的糖尿病患者(PWD)的管理有益。通过电话调查评估初级保健医生作为DSNF建议推手的作用，这些社区居住的有营养不良风险的PWD参与了以家庭为基础的营养质量改善计划(QIP)。在接受调查的患者中，93.2%的患者在QIP登记后的30-45天内仍在使用DSNF, 266名患者中有238名(89%)在医生的建议下“非常”或“有些”可能继续使用DSNF。在残疾患者中，接受家庭保健、患者教育和医生的专业推荐可以提高对DSNF的利用率和依从性。与QIP前有风险/营养不良的历史PWD对照组相比，参加QIP的患者住院率也有所降低;相对危险度在30天降低21.7% (12.6% vs. 16.1%， p=0.053)， 60天降低28.1% (17.9% vs. 24.9%， p=0.001)， 90天降低28.3% (21.8% vs. 30.4%， p<0.001)。以营养为重点的qip和医生驱动的DSNF建议可以提高患者对营养治疗的参与度，降低住院率。
{"title":"Utilization of Diabetes-Specific Nutrition among Community-Dwelling Malnourished People with Diabetes: Results of a Quality Improvement Program","authors":"R. Hegazi","doi":"10.31031/IOD.2020.04.000587","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000587","url":null,"abstract":"Diabetes-specific nutrition could play an important role in the overall management of diabetes. Diabetes-specific nutritional formulas (DSNF) could be beneficial for the management of people with diabetes (PWD) who are malnourished or at risk. The role of primary care physicians as drivers of DSNF recommendations was assessed via phone surveys in community-dwelling PWD at malnutrition risk participating in a home-based nutrition focused quality improvement program (QIP). Of patients surveyed, 93.2% were still using DSNF within 30-45 days of enrollment in QIP and 238 of 266 (89%) were “very-” or “somewhat-” likely to continue DSNF if they were recommended by a physician. In PWD receiving home healthcare, patient education, and professional recommendation of DSNF by physicians could reinforce utilization and better adherence. Hospitalization rates were also reduced for patients enrolled in the QIP as compared to at-risk/malnourished pre-QIP historical PWD controls; relative risk reductions were 21.7% at 30 days (12.6% vs. 16.1%, p=0.053), 28.1% at 60 days (17.9% vs. 24.9%, p=0.001), and 28.3% at 90 days (21.8% vs. 30.4%, p<0.001). Nutrition-focused QIPs and physician driven recommendations for DSNF can improve patient engagement in nutrition therapy and decrease hospitalization rates.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131720389","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 : 2020-06-22DOI: 10.31031/IOD.2020.04.000585
B. Irons
In 2013 the Food and Drug Administration (FDA) approved the first sodium glucose cotransporter 2 inhibitor (SGLT2i), canagliflozin, for the treatment of hyperglycemia in patients with type 2 diabetes (T2D). This was followed a year later by the approvals of two other SGLT2is, empagliflozin and dapagliflozin. The last currently FDA approved agent in this class, ertugliflozin, was approved in late 2017. Following approval each agent had to also undergo further evaluation of their cardiovascular safety as mandated by the FDA at that time for all new agents used in the treatment of T2D hyperglycemia. The first cardiovascular outcome trial (CVOT) appeared in 2015 and showed that empagliflozin not only showed no increased cardiovascular risk but actually decreased cardiovascular and all-cause mortality in patients with both diabetes and established cardiovascular disease [1]. Subsequently in 2017 the CVOT of canagliflozin showed a 14% relative risk reduction in the combined outcome of nonfatal stroke, myocardial infarction (MI), or cardiovascular death in subjects with established cardiovascular disease or at high risk for such but did not show a reduction in cardiovascular mortality [2]. Last year, dapagliflozin’s CVOT failed to demonstrate a cardiovascular benefit in the same combined outcome as the canagliflozin study [3]. No CVOT of these agents showed a significant reduction in MI or stroke but each showed a significant reduction in hospital admissions for heart failure. The CVOT for ertugliflozin was completed in late 2019 and results should be published in the near future. As a result of the CVOT for empagliflozin the FDA approved a new indication for the agent late in 2016 for the reduction of cardiovascular death in patients with T2D and cardiovascular disease. In the fall of 2018, the FDA approved dapagliflozin with a new indication to reduce MI, stroke, or cardiovascular death in patients with T2D and cardiovascular disease. The CVOTs have also led to updates in clinical practice guidelines recommending the use of agents within this class that have demonstrated reduced cardiovascular outcomes in patients with T2D and cardiovascular disease [4,5].
{"title":"The New and Evolving Roles of Sodium Glucose Co-Transporter 2 Inhibitors","authors":"B. Irons","doi":"10.31031/IOD.2020.04.000585","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000585","url":null,"abstract":"In 2013 the Food and Drug Administration (FDA) approved the first sodium glucose cotransporter 2 inhibitor (SGLT2i), canagliflozin, for the treatment of hyperglycemia in patients with type 2 diabetes (T2D). This was followed a year later by the approvals of two other SGLT2is, empagliflozin and dapagliflozin. The last currently FDA approved agent in this class, ertugliflozin, was approved in late 2017. Following approval each agent had to also undergo further evaluation of their cardiovascular safety as mandated by the FDA at that time for all new agents used in the treatment of T2D hyperglycemia. The first cardiovascular outcome trial (CVOT) appeared in 2015 and showed that empagliflozin not only showed no increased cardiovascular risk but actually decreased cardiovascular and all-cause mortality in patients with both diabetes and established cardiovascular disease [1]. Subsequently in 2017 the CVOT of canagliflozin showed a 14% relative risk reduction in the combined outcome of nonfatal stroke, myocardial infarction (MI), or cardiovascular death in subjects with established cardiovascular disease or at high risk for such but did not show a reduction in cardiovascular mortality [2]. Last year, dapagliflozin’s CVOT failed to demonstrate a cardiovascular benefit in the same combined outcome as the canagliflozin study [3]. No CVOT of these agents showed a significant reduction in MI or stroke but each showed a significant reduction in hospital admissions for heart failure. The CVOT for ertugliflozin was completed in late 2019 and results should be published in the near future. As a result of the CVOT for empagliflozin the FDA approved a new indication for the agent late in 2016 for the reduction of cardiovascular death in patients with T2D and cardiovascular disease. In the fall of 2018, the FDA approved dapagliflozin with a new indication to reduce MI, stroke, or cardiovascular death in patients with T2D and cardiovascular disease. The CVOTs have also led to updates in clinical practice guidelines recommending the use of agents within this class that have demonstrated reduced cardiovascular outcomes in patients with T2D and cardiovascular disease [4,5].","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114860181","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 : 2020-06-15DOI: 10.31031/IOD.2020.04.000584
K. Kubát
High mortality from COVID-19 is in the group of patients suffering from malnutrition. People with severe diseases such as tumors, patients with heart failure, kidney failure, liver and other organ damage are at risk. COVID-19 was a particular problem for older people, and a resistance to social distancing and sheltering [1]. However, people with obesity and people with obesity and diabetes mellitus are also at risk. In the May issue of the prestigious Lancet magazine, the authors Kass DA, et al. [2] bring irrefutable data obtained by monitoring a large number of patients [2]. It has been shown that the unfavorable course of the disease surprisingly affected “good-looking” young people, young obese patients. How are the possible causes? Obesity can restrict ventilation by impeding diaphragm excursion [2], impairs immune responses to viral infection [3], is pro-inflammatory, and induces diabetes and oxidant stress to adversely affect cardiovascular function [4]. Data were obtained using univariate and multivariate linear regression models. The pharmacotherapy can solve problem of oxidative stress or pro-inflammatory factors. There will certainly be effective medicines in the future. Today, they are still tested for efficacy, safety and other clinical trials. We are not talking now about drugs that act directly on the virus (so-called antivirals). Many of them have already shown an excellent effect [5]. But back to obesity. It has also been found to be dangerous in view of the current viral infection. Is it possible to improve the condition without the help of drugs?
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Pub Date : 2020-06-15DOI: 10.31031/IOD.2020.04.000583
Y. Arzu
When ongoing research established the relationship between Covid-19 infection and diabetes mellitus, the interest of the clinicians and the anxiety of the patients increased. This evidence-based mini-review aims to determine whether or not patients with diabetes are more prone to getting infected with Covid-19 and how this affects their clinical outcomes. Among the reported Covid-19 cases, 6-14% outpatients, 16-25% inpatients, 32-58% ICU patients, and 31-42% cases with a mortal course had diabetes mellitus. The latest meta-analysis did not consider diabetes as a risk factor contributing to the increase in mortality of Covid-19 cases.
{"title":"Relationship of COVID-19 and Diabetes Mellitus","authors":"Y. Arzu","doi":"10.31031/IOD.2020.04.000583","DOIUrl":"https://doi.org/10.31031/IOD.2020.04.000583","url":null,"abstract":"When ongoing research established the relationship between Covid-19 infection and diabetes mellitus, the interest of the clinicians and the anxiety of the patients increased. This evidence-based mini-review aims to determine whether or not patients with diabetes are more prone to getting infected with Covid-19 and how this affects their clinical outcomes. Among the reported Covid-19 cases, 6-14% outpatients, 16-25% inpatients, 32-58% ICU patients, and 31-42% cases with a mortal course had diabetes mellitus. The latest meta-analysis did not consider diabetes as a risk factor contributing to the increase in mortality of Covid-19 cases.","PeriodicalId":170669,"journal":{"name":"Interventions in Obesity & Diabetes","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131844115","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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