D. Popovic, Ana Majić, Jovana Prodanovic-Simeunovic
Sexuality is a significant part of female life and is under the impact of various life events, factors related to reproduction, relationships and socio-cultural specifics, but is also affected by different chronic medical conditions and related treatments. Physiologically, women`s sexual functioning consists of desire, arousal, plateau, orgasm and resolution. Female sexual dysfunction (FSD) is a highly prevalent, age-related and progressive problem. It has multiple causes and dimensions including biological, psychological and interpersonal elements. Several disorders, encompassing issues with sexual desire and arousal, orgasm malfunctioning and sexual pain, can be differentiated within the FSD entity. Diabetes is considered to be a major cause of the impaired sexual function. Although women with diabetes have even frequency of cardiovascular and neurological complications as males, FSD has been paid rather less attention in research than the sexual dysfunction in men with diabetes, particularly exclusive in females with type 1 diabetes mellitus (T1DM). Usually, FSD is more related to the psychosocial issues, especially depression, than to cardiovascular, metabolic and other traditional risk factors, which are more characteristic for men. The sexual difficulties among T1DM women require much more attention. Their regular annual in-depth evaluation should routinely include queries regarding the presence of depressive symptoms and their sexual functioning. *Correspondence to: Djordje S POPOVIC, Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of Vojvodina Medical Faculty, University of Novi Sad, Hajduk Veljkova 1, 21000 Novi Sad, Serbia, Tel: +38163551606, +381214843758, Fax: +38121525081, E-mail: pitstop021@gmail. com; djordje.popovic@mf.uns.ac.rs; djordje.popovic@kcv.rs
性是女性生活的重要组成部分，受到各种生活事件、与生殖、关系和社会文化特征有关的因素的影响，但也受到不同慢性疾病和相关治疗的影响。从生理上讲，女性的性功能包括欲望、觉醒、平稳期、高潮和消退。女性性功能障碍(FSD)是一种高度普遍的、与年龄相关的进行性问题。它有多种原因和维度，包括生物因素、心理因素和人际因素。包括性欲和性唤起、性高潮功能障碍和性疼痛在内的几种障碍，可以在FSD实体中区分开来。糖尿病被认为是性功能障碍的主要原因。尽管女性糖尿病患者出现心血管和神经系统并发症的频率与男性相同，但FSD在研究中受到的关注远远少于男性糖尿病患者的性功能障碍，尤其是女性1型糖尿病(T1DM)患者。通常情况下，FSD与心理社会问题，尤其是抑郁症的关系更大，而与心血管、代谢和其他传统风险因素的关系更大，而这些因素在男性中更为常见。T1DM女性的性困难需要更多的关注。他们每年定期的深度评估应包括询问是否存在抑郁症状和性功能。*通讯:诺维萨德大学伏伊伏丁那医学院临床中心内分泌、糖尿病和代谢紊乱门诊Djordje S POPOVIC，塞尔维亚诺维萨德Hajduk Veljkova 1,21000，电话:+38163551606，+381214843758，传真:+38121525081,E-mail: pitstop021@gmail。com;djordje.popovic@mf.uns.ac.rs;djordje.popovic@kcv.rs
{"title":"The sexual dysfunction in females with type 1 diabetes: Still an underestimated issue?","authors":"D. Popovic, Ana Majić, Jovana Prodanovic-Simeunovic","doi":"10.15761/DU.1000119","DOIUrl":"https://doi.org/10.15761/DU.1000119","url":null,"abstract":"Sexuality is a significant part of female life and is under the impact of various life events, factors related to reproduction, relationships and socio-cultural specifics, but is also affected by different chronic medical conditions and related treatments. Physiologically, women`s sexual functioning consists of desire, arousal, plateau, orgasm and resolution. Female sexual dysfunction (FSD) is a highly prevalent, age-related and progressive problem. It has multiple causes and dimensions including biological, psychological and interpersonal elements. Several disorders, encompassing issues with sexual desire and arousal, orgasm malfunctioning and sexual pain, can be differentiated within the FSD entity. Diabetes is considered to be a major cause of the impaired sexual function. Although women with diabetes have even frequency of cardiovascular and neurological complications as males, FSD has been paid rather less attention in research than the sexual dysfunction in men with diabetes, particularly exclusive in females with type 1 diabetes mellitus (T1DM). Usually, FSD is more related to the psychosocial issues, especially depression, than to cardiovascular, metabolic and other traditional risk factors, which are more characteristic for men. The sexual difficulties among T1DM women require much more attention. Their regular annual in-depth evaluation should routinely include queries regarding the presence of depressive symptoms and their sexual functioning. *Correspondence to: Djordje S POPOVIC, Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of Vojvodina Medical Faculty, University of Novi Sad, Hajduk Veljkova 1, 21000 Novi Sad, Serbia, Tel: +38163551606, +381214843758, Fax: +38121525081, E-mail: pitstop021@gmail. com; djordje.popovic@mf.uns.ac.rs; djordje.popovic@kcv.rs","PeriodicalId":309709,"journal":{"name":"Diabetes Updates","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121203613","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}
Received: August 05, 2019; Accepted: August 26, 2019; Published: September 09, 2019 In Weimar, on the wall of Albert Schweitzer Museum, there is a memorial tablet which says: “The purpose of our life is to serve, to show solidarity and helpfulness.” The humanist medical doctor, theologian, philosopher, organist could not have expressed more clearly our confession. Behavioral therapy integrates the cure of body and soul, which occasionally show some duality and opposition.
{"title":"Behavioral therapy in diabetes mellitus and obesity","authors":"I. Sal","doi":"10.15761/du.1000132","DOIUrl":"https://doi.org/10.15761/du.1000132","url":null,"abstract":"Received: August 05, 2019; Accepted: August 26, 2019; Published: September 09, 2019 In Weimar, on the wall of Albert Schweitzer Museum, there is a memorial tablet which says: “The purpose of our life is to serve, to show solidarity and helpfulness.” The humanist medical doctor, theologian, philosopher, organist could not have expressed more clearly our confession. Behavioral therapy integrates the cure of body and soul, which occasionally show some duality and opposition.","PeriodicalId":309709,"journal":{"name":"Diabetes Updates","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116925137","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}
Sonila Alia, S. Pugnaloni, F. Borroni, L. Mazzanti, S. Giannubilo, A. Ciavattini, A. Vignini
In recent years, there has been an increased incidence of gestational diabetes (GDM), defined as any degree of glucose intolerance with the onset or first recognition during pregnancy with or without remission after the end of pregnancy. The most significant risk factors are: age >25 years, obesity, high parity, family history of DM, past history of GDM or macrosomic infant. GDM therapy should be based on a healthy diet, exercising and glycemic control, with or without insulin. The presence of GDM has important implications for both the baby and the mother. As regard baby complications, GDM is associated with a significantly increased risk of macrosomia, shoulder dystocia, birth injuries as well as neonatal hypo glycemia and hyperbilirubinemia, genetic risk for the development of obesity, diabetes and/or metabolic syndrome in childhood. As regard mother complications, GDM is a strong risk factor for the development of permanent diabetes later in life (40% in 10 subsequent years) and GDM in successive pregnancies (35%), stress urinary incontinence and mixed urinary incontinence, doubled risk for overactive bladder during premenopausal period, cardiovascular morbidity. This review briefly examine the risk factors, diagnostic criteria, best therapy and management, short and long term complications for the mother and the fetus associated with such pathology. *Correspondence to: Andrea Ciavattini, Department of Clinical Sciences, Unit of Obstetrics and Gynecology Università Politecnica delle Marche, Via Corridoni, 60124 Ancona, Italy, Tel: +39 071 596 2053; E-mail: a.ciavattini@univpm.it
{"title":"Impact of gestational diabetes mellitus in maternal and fetal health: An update","authors":"Sonila Alia, S. Pugnaloni, F. Borroni, L. Mazzanti, S. Giannubilo, A. Ciavattini, A. Vignini","doi":"10.15761/du.1000129","DOIUrl":"https://doi.org/10.15761/du.1000129","url":null,"abstract":"In recent years, there has been an increased incidence of gestational diabetes (GDM), defined as any degree of glucose intolerance with the onset or first recognition during pregnancy with or without remission after the end of pregnancy. The most significant risk factors are: age >25 years, obesity, high parity, family history of DM, past history of GDM or macrosomic infant. GDM therapy should be based on a healthy diet, exercising and glycemic control, with or without insulin. The presence of GDM has important implications for both the baby and the mother. As regard baby complications, GDM is associated with a significantly increased risk of macrosomia, shoulder dystocia, birth injuries as well as neonatal hypo glycemia and hyperbilirubinemia, genetic risk for the development of obesity, diabetes and/or metabolic syndrome in childhood. As regard mother complications, GDM is a strong risk factor for the development of permanent diabetes later in life (40% in 10 subsequent years) and GDM in successive pregnancies (35%), stress urinary incontinence and mixed urinary incontinence, doubled risk for overactive bladder during premenopausal period, cardiovascular morbidity. This review briefly examine the risk factors, diagnostic criteria, best therapy and management, short and long term complications for the mother and the fetus associated with such pathology. *Correspondence to: Andrea Ciavattini, Department of Clinical Sciences, Unit of Obstetrics and Gynecology Università Politecnica delle Marche, Via Corridoni, 60124 Ancona, Italy, Tel: +39 071 596 2053; E-mail: a.ciavattini@univpm.it","PeriodicalId":309709,"journal":{"name":"Diabetes Updates","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116328885","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}
The clinical and practical consideration of GLP1RAs has risen incredibly to treat T2DM since the development of Dulaglutide- a once-weekly formulation with the combined positive effects on both glucose control and weight management, along with the potential reduction in cardio-renal outcomes.
{"title":"Dulaglutide For effective diabetes management","authors":"C. Khan","doi":"10.15761/DU.1000123","DOIUrl":"https://doi.org/10.15761/DU.1000123","url":null,"abstract":"The clinical and practical consideration of GLP1RAs has risen incredibly to treat T2DM since the development of Dulaglutide- a once-weekly formulation with the combined positive effects on both glucose control and weight management, along with the potential reduction in cardio-renal outcomes.","PeriodicalId":309709,"journal":{"name":"Diabetes Updates","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120952726","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}
M. Iwanishi, C. Azuma, Y. Tezuka, Yuji Yamamoto, J. Ito-Kobayashi, M. Washiyama, A. Shimatsu, A. Mizuno, Y. Osafune
We experienced the case that a Japanese female diabetic patient with partial lipodystrophy continued liraglutide monotherapy for a long period on her will. At first examination, she had poor glycemic control and body weight reduction with decreased fat mass had been caused by uncontrolled diabetes. She had severe non-proliferative diabetic retinopathy and nephropathy with microalbuminuria. When she had weight gain after her glycemic control was improved, she still had fat loss in the lower limbs with abdominal fat excess. She had insulin deficiency and relatively severe insulin resistance. According to the clinical findings and genetic analysis, she might fit the category of familial partial lipodystrophy (FPLD)1. We administered liraglutide for her diabetes care, as previous report suggested the effectiveness of liraglutide in patients with FPLD1 for about three months. We assessed changes in fat distribution and insulin resistance during liraglutide therapy using dual energy X-ray absorptiometry (DEXA) and the oral glucose tolerance test (OGTT). Liraglutide effectively has achieved favorable glycemic and body weight control for a long period. The DEXA showed that fat mass in the upper limbs and trunk was increased, but we could speculate no further increase as her body weight was stable. The OGTT showed the amelioration of insulin resistance and insulin secretory capacity adjusted for insulin sensitivity. We thought that this might be caused by the blood-glucose-reducing effects of liraglutide and preventive effects on obesity through increasing the fat storage capacity of adipocytes. The intensified multifactorial intervention with liraglutide, anti-hypertensive drugs, and statin attenuated diabetic microangiopathies. The present case suggests that liraglutide might be as an efficient therapeutic option through its pleiotropic effects in diabetic patients with FPLD1.
{"title":"Beneficial effects of long-term liraglutide monotherapy on glycemic control and diabetic microangiopathies in a female Japanese diabetic patient with familial partial lipodystrophy 1","authors":"M. Iwanishi, C. Azuma, Y. Tezuka, Yuji Yamamoto, J. Ito-Kobayashi, M. Washiyama, A. Shimatsu, A. Mizuno, Y. Osafune","doi":"10.15761/du.1000150","DOIUrl":"https://doi.org/10.15761/du.1000150","url":null,"abstract":"We experienced the case that a Japanese female diabetic patient with partial lipodystrophy continued liraglutide monotherapy for a long period on her will. At first examination, she had poor glycemic control and body weight reduction with decreased fat mass had been caused by uncontrolled diabetes. She had severe non-proliferative diabetic retinopathy and nephropathy with microalbuminuria. When she had weight gain after her glycemic control was improved, she still had fat loss in the lower limbs with abdominal fat excess. She had insulin deficiency and relatively severe insulin resistance. According to the clinical findings and genetic analysis, she might fit the category of familial partial lipodystrophy (FPLD)1. We administered liraglutide for her diabetes care, as previous report suggested the effectiveness of liraglutide in patients with FPLD1 for about three months. We assessed changes in fat distribution and insulin resistance during liraglutide therapy using dual energy X-ray absorptiometry (DEXA) and the oral glucose tolerance test (OGTT). Liraglutide effectively has achieved favorable glycemic and body weight control for a long period. The DEXA showed that fat mass in the upper limbs and trunk was increased, but we could speculate no further increase as her body weight was stable. The OGTT showed the amelioration of insulin resistance and insulin secretory capacity adjusted for insulin sensitivity. We thought that this might be caused by the blood-glucose-reducing effects of liraglutide and preventive effects on obesity through increasing the fat storage capacity of adipocytes. The intensified multifactorial intervention with liraglutide, anti-hypertensive drugs, and statin attenuated diabetic microangiopathies. The present case suggests that liraglutide might be as an efficient therapeutic option through its pleiotropic effects in diabetic patients with FPLD1.","PeriodicalId":309709,"journal":{"name":"Diabetes Updates","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132112600","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}
Objective: This pilot studied assessed the effects of the GOLO Weight Management Program with Release supplement on weight and glycemic control in subjects with type 2 diabetes mellitus and obesity. Methods: 26 subjects with type 2 diabetes mellitus and obesity were recruited into an open-label study of the GOLO Weight Management System with Release supplement at a single clinical site. 16 subjects completed the study over a 13-week treatment period. Results: After 13 weeks of open-label treatment, subjects lost an average of -3.3 kg (SD 2.47; p<0.001) which represented an average of -3.53% (SD 0.02) weight loss and was statistically significant. Statistically significant reductions in several body measurement parameters were demonstrated including BMI -1.17 kg/m2 (0.75, p<0.001), waist circumference -6.41 cm (4.22; p<0.001), hip circumference -3.81 cm (3.68, p<0.001), and body fat mass -2.34 kg (2.29, p<0.001). Reductions in Hemoglobin A1C averaged -0.61% (0.86; p=0.01) and reductions in HOMA-IR, a measure of insulin resistance, averaged -2.25 (3.33; p=0.02) both statistically significant. Positive trends were observed in reductions of fasting blood glucose [-24.19 mg/dl (52.31), p=0.08] and insulin levels [-2.91 uIU/dl (5.75); p=0.06] that were not statically significant. Conclusions: Treatment with the GOLO Weight Management Program and Release supplement for 13 weeks resulted in weight loss and improvements in glycemic control and insulin resistance in patients with type 2 diabetes mellitus and obesity. *Correspondence to: Robert J Buynak, MD, 55 University Suite 106, Valparaiso, IN 46385, USA, Tel: 219-464-8302, E-mail: rbuynak@att.net
目的:本试验研究评估了GOLO体重管理计划加释放补充剂对2型糖尿病和肥胖症患者体重和血糖控制的影响。方法:招募26名2型糖尿病和肥胖症患者，在单一临床地点进行GOLO体重管理系统与释放补充剂的开放标签研究。16名受试者在13周的治疗期内完成了研究。结果:经过13周的开放标签治疗，受试者平均减轻-3.3 kg (SD 2.47;p<0.001)，平均体重减轻-3.53% (SD 0.02)，具有统计学意义。BMI -1.17 kg/m2 (0.75, p<0.001)、腰围-6.41 cm (4.22;P <0.001)，臀围-3.81 cm (3.68, P <0.001)，体脂质量-2.34 kg (2.29, P <0.001)。血红蛋白A1C平均降低-0.61% (0.86;p=0.01)， HOMA-IR(胰岛素抵抗指标)平均下降-2.25 (3.33;P =0.02)均具有统计学意义。空腹血糖[-24.19 mg/dl (52.31)， p=0.08]和胰岛素水平[-2.91 uIU/dl(5.75)]降低呈阳性趋势;P =0.06]，差异无统计学意义。结论:采用GOLO体重管理方案和释放补充剂治疗13周后，2型糖尿病合并肥胖患者体重减轻，血糖控制和胰岛素抵抗得到改善。*通讯:Robert J Buynak, MD, 55 University Suite 106, Valparaiso, IN 46385, USA, Tel: 219-464-8302, E-mail: rbuynak@att.net
{"title":"Pilot study on the Effects of the GOLO Weight Management Program and RELEASE Supplement on Weight and Glycemic Control in Patients with Type 2 Diabetes Mellitus and Obesity","authors":"Buynak Rj","doi":"10.15761/du.1000125","DOIUrl":"https://doi.org/10.15761/du.1000125","url":null,"abstract":"Objective: This pilot studied assessed the effects of the GOLO Weight Management Program with Release supplement on weight and glycemic control in subjects with type 2 diabetes mellitus and obesity. Methods: 26 subjects with type 2 diabetes mellitus and obesity were recruited into an open-label study of the GOLO Weight Management System with Release supplement at a single clinical site. 16 subjects completed the study over a 13-week treatment period. Results: After 13 weeks of open-label treatment, subjects lost an average of -3.3 kg (SD 2.47; p<0.001) which represented an average of -3.53% (SD 0.02) weight loss and was statistically significant. Statistically significant reductions in several body measurement parameters were demonstrated including BMI -1.17 kg/m2 (0.75, p<0.001), waist circumference -6.41 cm (4.22; p<0.001), hip circumference -3.81 cm (3.68, p<0.001), and body fat mass -2.34 kg (2.29, p<0.001). Reductions in Hemoglobin A1C averaged -0.61% (0.86; p=0.01) and reductions in HOMA-IR, a measure of insulin resistance, averaged -2.25 (3.33; p=0.02) both statistically significant. Positive trends were observed in reductions of fasting blood glucose [-24.19 mg/dl (52.31), p=0.08] and insulin levels [-2.91 uIU/dl (5.75); p=0.06] that were not statically significant. Conclusions: Treatment with the GOLO Weight Management Program and Release supplement for 13 weeks resulted in weight loss and improvements in glycemic control and insulin resistance in patients with type 2 diabetes mellitus and obesity. *Correspondence to: Robert J Buynak, MD, 55 University Suite 106, Valparaiso, IN 46385, USA, Tel: 219-464-8302, E-mail: rbuynak@att.net","PeriodicalId":309709,"journal":{"name":"Diabetes Updates","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131605299","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}
Received: February 28, 2021; Accepted: March 15, 2021; Published: March 22, 2021 Traditionally, the secondary complications of type 2 diabetes are considered to be caused by chronic hyperglycemia existing over a number of years and involve primarily microvascular disease of eyes, kidneys, and nerves as well as macrovascular disease of large arteries. The cause of progressive hyperglycemia is attributed to the continuing deterioration of pancreatic islet beta cell function. However, this formulation does not directly address why the beta cell continues to deteriorate over the course of the disease.
{"title":"Perspective: Inexorable beta cell deterioration via oxidative stress as a secondary complication of Type 2 Diabetes","authors":"R. Robertson","doi":"10.15761/du.1000153","DOIUrl":"https://doi.org/10.15761/du.1000153","url":null,"abstract":"Received: February 28, 2021; Accepted: March 15, 2021; Published: March 22, 2021 Traditionally, the secondary complications of type 2 diabetes are considered to be caused by chronic hyperglycemia existing over a number of years and involve primarily microvascular disease of eyes, kidneys, and nerves as well as macrovascular disease of large arteries. The cause of progressive hyperglycemia is attributed to the continuing deterioration of pancreatic islet beta cell function. However, this formulation does not directly address why the beta cell continues to deteriorate over the course of the disease.","PeriodicalId":309709,"journal":{"name":"Diabetes Updates","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123426752","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}
Introduction: Neuropathy is an agonizing debility seen commonly in diabetic patients. Statins can also lead to similar neuropathic symptoms independent of diabetic status. When statins are prescribed in patients of diabetes, it is not possible to distinguish whether neuropathic pain is secondary to diabetes or to statin therapy. This review analyzes the molecular mechanisms involved in etio pathogenesis of neuropathy caused either by diabetes or by statin therapy. ATP deficiency and ion channel abnormalities may be responsible for the symptoms of neuropathy in diabetes, and a similar mechanism is at play in statin induced neuropathy. This is seen to occur independent of blood sugar levels. Areas covered: Literature published between 1980 and 2019 on the etio pathogenesis of neuropathy, insulin receptor defects, cholesterol biosynthesis, action of statins and of Coenzyme Q, KATP and calcium channels was reviewed. A comprehensive search on PubMed, Embase and Cochrane databases was carried out. Expert opinion: Statins activate KATP channels and directly affect neurons. Activation of KATP channels inhibits calcium channels which should theoretically be beneficial in neuropathic symptoms. However, statins lead to a simultaneous deficiency in levels of ubiquinone because of their inhibitory action on cholesterol biosynthesis pathway, This leads to neuropathy. Insulin receptor defects in diabetes may be leading to a similar pathogenesis in the causation of diabetic neuropathy. *Correspondence to: Devindra Sehra MD, DTCD, Sehra Medical Center ,Punjabi Bagh, New Delhi -110026 , India, E-mail: sehradev@yahoo.com Received: August 01, 2019; Accepted: August 26, 2019; Published: August 28, 2019 Introduction Statins are prescribed widely for both primary and secondary prevention of coronary artery disease. They act by their lipid lowering action, as well as by their pleiotropic effects. The number of patients who are on statin therapy is gradually and steadily increasing [1,2] Statins have been found to be generally safe; but they may be responsible for the side effects which so far have been attributed to the disease process per se for which they are being prescribed; and long term trials specifically exploring this aspect would unravel their real safety [3,4] That statins lead to increasing incidence of new onset diabetes has recently been reported in literature [5]. Since a large number of patients who have been prescribed statins are already suffering from diabetes, it is practically not possible to evaluate whether the worsening of diabetes in these patients is because of diabetes per se or because of statin therapy. Statin therapy per se may be causing polyneuropathy, which itself is a common complication of diabetes. It is difficult to interpret whether the reported polyneuropathy is because of statin therapy in a diabetic patient, or because of disease process of diabetes per se. This becomes significant because statins are prescribed very commonly in
{"title":"A review of the molecular mechanisms leading to diabetic and statin induced neuropathies: exploring the similarities between the two and the role of coenzyme Q in its treatment","authors":"Sehra D, Sehra S, Sharma Jk","doi":"10.15761/du.1000131","DOIUrl":"https://doi.org/10.15761/du.1000131","url":null,"abstract":"Introduction: Neuropathy is an agonizing debility seen commonly in diabetic patients. Statins can also lead to similar neuropathic symptoms independent of diabetic status. When statins are prescribed in patients of diabetes, it is not possible to distinguish whether neuropathic pain is secondary to diabetes or to statin therapy. This review analyzes the molecular mechanisms involved in etio pathogenesis of neuropathy caused either by diabetes or by statin therapy. ATP deficiency and ion channel abnormalities may be responsible for the symptoms of neuropathy in diabetes, and a similar mechanism is at play in statin induced neuropathy. This is seen to occur independent of blood sugar levels. Areas covered: Literature published between 1980 and 2019 on the etio pathogenesis of neuropathy, insulin receptor defects, cholesterol biosynthesis, action of statins and of Coenzyme Q, KATP and calcium channels was reviewed. A comprehensive search on PubMed, Embase and Cochrane databases was carried out. Expert opinion: Statins activate KATP channels and directly affect neurons. Activation of KATP channels inhibits calcium channels which should theoretically be beneficial in neuropathic symptoms. However, statins lead to a simultaneous deficiency in levels of ubiquinone because of their inhibitory action on cholesterol biosynthesis pathway, This leads to neuropathy. Insulin receptor defects in diabetes may be leading to a similar pathogenesis in the causation of diabetic neuropathy. *Correspondence to: Devindra Sehra MD, DTCD, Sehra Medical Center ,Punjabi Bagh, New Delhi -110026 , India, E-mail: sehradev@yahoo.com Received: August 01, 2019; Accepted: August 26, 2019; Published: August 28, 2019 Introduction Statins are prescribed widely for both primary and secondary prevention of coronary artery disease. They act by their lipid lowering action, as well as by their pleiotropic effects. The number of patients who are on statin therapy is gradually and steadily increasing [1,2] Statins have been found to be generally safe; but they may be responsible for the side effects which so far have been attributed to the disease process per se for which they are being prescribed; and long term trials specifically exploring this aspect would unravel their real safety [3,4] That statins lead to increasing incidence of new onset diabetes has recently been reported in literature [5]. Since a large number of patients who have been prescribed statins are already suffering from diabetes, it is practically not possible to evaluate whether the worsening of diabetes in these patients is because of diabetes per se or because of statin therapy. Statin therapy per se may be causing polyneuropathy, which itself is a common complication of diabetes. It is difficult to interpret whether the reported polyneuropathy is because of statin therapy in a diabetic patient, or because of disease process of diabetes per se. This becomes significant because statins are prescribed very commonly in ","PeriodicalId":309709,"journal":{"name":"Diabetes Updates","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122119848","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}
Background: Living successfully with diabetes mellitus requires the very large task of managing a serious chronic condition. The tasks associated with diabetes can be complex and demanding and most people in their life journey with diabetes report great frustration with the burden of the disease. Aim: Study of the effect of Glycemic Control on the Diabetes-Related Distress in a sample of Egyptian patients with Diabetes mellitus. Patients and methods: this a cross sectional study conducted on 350 patients with T2DM attending the outpatient clinic of endocrinology of El Agouza Police Hospital. Fasting blood glucose, Post prandial blood glucose, HbA1c, hs-CRP, Creatinine, BUN, SGPT and SGPT were assessed, BMI, Waist /Hip Ratio, also Diabetes Distress Screening Scale Questionnaire was completed by the patients. Results: There is a statistically significant positive relationship between HbA1c and Total DDS score, Emotional burden, Physician related distress, Regimen related distress, and Interpersonal distress with P-value 0.000, 0.000, 0.000, 0.032, and 0.001 respectively. Conclusion: Diabetes related Distress is associated with poor glycemic control and also inflammation. *Correspondence to: Mohamed Saad Hamed, Professor of Internal Medicine & Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt, E-mail: hanan.mahmoud29@yahoo.com
{"title":"Study of the effect of glycemic control on the diabetes-related distress in a sample of Egyptian patients with diabetes mellitus","authors":"Hamed Ms, Ibrahim Na, Ali Hm, Kheir Cg","doi":"10.15761/du.1000134","DOIUrl":"https://doi.org/10.15761/du.1000134","url":null,"abstract":"Background: Living successfully with diabetes mellitus requires the very large task of managing a serious chronic condition. The tasks associated with diabetes can be complex and demanding and most people in their life journey with diabetes report great frustration with the burden of the disease. Aim: Study of the effect of Glycemic Control on the Diabetes-Related Distress in a sample of Egyptian patients with Diabetes mellitus. Patients and methods: this a cross sectional study conducted on 350 patients with T2DM attending the outpatient clinic of endocrinology of El Agouza Police Hospital. Fasting blood glucose, Post prandial blood glucose, HbA1c, hs-CRP, Creatinine, BUN, SGPT and SGPT were assessed, BMI, Waist /Hip Ratio, also Diabetes Distress Screening Scale Questionnaire was completed by the patients. Results: There is a statistically significant positive relationship between HbA1c and Total DDS score, Emotional burden, Physician related distress, Regimen related distress, and Interpersonal distress with P-value 0.000, 0.000, 0.000, 0.032, and 0.001 respectively. Conclusion: Diabetes related Distress is associated with poor glycemic control and also inflammation. *Correspondence to: Mohamed Saad Hamed, Professor of Internal Medicine & Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt, E-mail: hanan.mahmoud29@yahoo.com","PeriodicalId":309709,"journal":{"name":"Diabetes Updates","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121318680","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}
Gebreegziabhier G, Mekonnen Ms, Wtsadik Da, Nigus G
Background: Diabetes mellitus is the predominant risk factor for erectile dysfunction due to vascular and neurological complications. It affects the patient's quality of life by imposing psychological and emotional consequences including depression, anxiety, low self-esteem, and lack of self-confidence. Hence, this study aimed to scrutinize the prevalence of impotence and its associated factors among diabetic patients. Methods: Institutional based cross-sectional study was employed on 330 systematically selected male diabetic patients in tertiary hospitals, Northern Ethiopia from March 2019 to January 2020. Data were collected using a structured questionnaire through face-to-face interviews, entered to Epi data version 4.4.2.1, and exported to SPSS version 25 for analysis. Binary logistic regression was used for analysis. Variables with p< 0.25 in the bi-variable analysis were fitted to multivariate analysis. Then, the adjusted odds ratio with 95% CI was used to report the association whereas statistical significances declared at P≤0.05. Finally, the findings were presented using texts and frequency tables. Results: This study was conducted on 330 male diabetic patients with an overall response rate of 97.1%. The prevalence of erectile dysfunction among men with diabetes mellitus was found to be 87%. Having average monthly income above poverty line [AOR=5.6; 95%CI: 2.08-15.08], long duration on diabetic follow-up [AHR=1.67; 95% CI: 1.40-2.00], not engaging in daily physical exercise [AOR=4.73; 95%CI: 1.83-12.23], and using oral medications for diabetes mellitus [AHR= 6.27; 95% CI: 2.01-19.58] were significantly associated with erectile dysfunction among male diabetic patients. Conclusion: Erectile dysfunction is highly prevalent among diabetic patients. Moreover, prolonged diabetic follow-up, family monthly-income above the poverty line, using oral hypoglycemic agents, and lack of daily physical exercise were independent risk factors of impotence. Thus, it is advisable to conduct universal screening for this population group with open discussion during diabetic visits to enable timely detection and management.
{"title":"Prevalence of erectile dysfunction and associated factors among men with diabetes mellitus, Northern Ethiopia, 2020","authors":"Gebreegziabhier G, Mekonnen Ms, Wtsadik Da, Nigus G","doi":"10.15761/du.1000148","DOIUrl":"https://doi.org/10.15761/du.1000148","url":null,"abstract":"Background: Diabetes mellitus is the predominant risk factor for erectile dysfunction due to vascular and neurological complications. It affects the patient's quality of life by imposing psychological and emotional consequences including depression, anxiety, low self-esteem, and lack of self-confidence. Hence, this study aimed to scrutinize the prevalence of impotence and its associated factors among diabetic patients. Methods: Institutional based cross-sectional study was employed on 330 systematically selected male diabetic patients in tertiary hospitals, Northern Ethiopia from March 2019 to January 2020. Data were collected using a structured questionnaire through face-to-face interviews, entered to Epi data version 4.4.2.1, and exported to SPSS version 25 for analysis. Binary logistic regression was used for analysis. Variables with p< 0.25 in the bi-variable analysis were fitted to multivariate analysis. Then, the adjusted odds ratio with 95% CI was used to report the association whereas statistical significances declared at P≤0.05. Finally, the findings were presented using texts and frequency tables. Results: This study was conducted on 330 male diabetic patients with an overall response rate of 97.1%. The prevalence of erectile dysfunction among men with diabetes mellitus was found to be 87%. Having average monthly income above poverty line [AOR=5.6; 95%CI: 2.08-15.08], long duration on diabetic follow-up [AHR=1.67; 95% CI: 1.40-2.00], not engaging in daily physical exercise [AOR=4.73; 95%CI: 1.83-12.23], and using oral medications for diabetes mellitus [AHR= 6.27; 95% CI: 2.01-19.58] were significantly associated with erectile dysfunction among male diabetic patients. Conclusion: Erectile dysfunction is highly prevalent among diabetic patients. Moreover, prolonged diabetic follow-up, family monthly-income above the poverty line, using oral hypoglycemic agents, and lack of daily physical exercise were independent risk factors of impotence. Thus, it is advisable to conduct universal screening for this population group with open discussion during diabetic visits to enable timely detection and management.","PeriodicalId":309709,"journal":{"name":"Diabetes Updates","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121676914","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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