Mark B Zimering, Tanzila Razzaki, Tiffany Tsang, John J Shin
Advanced age and medical co-morbidity are strong predictors of mortality in COVID-19 infection. Yet few studies (to date) have specifically addressed risk factors associated with COVID-19 mortality in a high-risk subgroup of older US adults having one or more chronic diseases. Our hypothesis is that medications having 'off-target' anti-inflammatory effects may play a role in modulating the immune response in COVID-19 infection. We analyzed baseline risk factors associated with respiratory failure or death in 55 older adult US military veterans hospitalized for COVID-19 infection during (March-June 2020) the peak of the pandemic in New Jersey. Fifty-three percent (29/55) of patients experienced respiratory failure and thirty-one percent (17/55) died. In adjusted logistic regression analysis, baseline neutrophil to lymphocyte ratio (NLR) (P=0.0035) and body mass index (P=0.03) were significant predictors of the risk for respiratory failure. Age (P=0.05) and non-use (vs. use) of psychotropic medications having serotonin 2A receptor antagonist properties (odds ratio 5.06; 95% confidence intervals 1.18-21.7; P= 0.029) was each a significant predictor of an increased risk of death. There was a significant interaction effect of age and non-use (vs.. use) of psychotropic serotonin 2A receptor antagonist medications on the odds ratio (OR) for death (P=0.011). In selected, ventilator-dependent COVID-19 pneumonia patients treated with psychotropic serotonin 2A receptor antagonist medications to control agitation and ICU delirium, there was an apparent positive association between medication use and significant rise in the absolute lymphocyte count and decrease in the neutrophil: lymphocyte ratio. Taken together, these data are the first to suggest that certain psychotropic medications used in the treatment of chronic psychiatric illness and/or for acute delirium are inversely associated with mortality in severe COVID-19 infection by unknown mechanism which may involve (in part) immunomodulatory effects.
{"title":"Inverse Association between Serotonin 2A Receptor Antagonist Medication Use and Mortality in Severe COVID-19 Infection.","authors":"Mark B Zimering, Tanzila Razzaki, Tiffany Tsang, John J Shin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Advanced age and medical co-morbidity are strong predictors of mortality in COVID-19 infection. Yet few studies (to date) have specifically addressed risk factors associated with COVID-19 mortality in a high-risk subgroup of older US adults having one or more chronic diseases. Our hypothesis is that medications having 'off-target' anti-inflammatory effects may play a role in modulating the immune response in COVID-19 infection. We analyzed baseline risk factors associated with respiratory failure or death in 55 older adult US military veterans hospitalized for COVID-19 infection during (March-June 2020) the peak of the pandemic in New Jersey. Fifty-three percent (29/55) of patients experienced respiratory failure and thirty-one percent (17/55) died. In adjusted logistic regression analysis, baseline neutrophil to lymphocyte ratio (NLR) (P=0.0035) and body mass index (<i>P</i>=0.03) were significant predictors of the risk for respiratory failure. Age (<i>P</i>=0.05) and non-use (vs. use) of psychotropic medications having serotonin 2A receptor antagonist properties (odds ratio 5.06; 95% confidence intervals 1.18-21.7; P= 0.029) was each a significant predictor of an increased risk of death. There was a significant interaction effect of age and non-use (vs.. use) of psychotropic serotonin 2A receptor antagonist medications on the odds ratio (OR) for death (<i>P</i>=0.011). In selected, ventilator-dependent COVID-19 pneumonia patients treated with psychotropic serotonin 2A receptor antagonist medications to control agitation and ICU delirium, there was an apparent positive association between medication use and significant rise in the absolute lymphocyte count and decrease in the neutrophil: lymphocyte ratio. Taken together, these data are the first to suggest that certain psychotropic medications used in the treatment of chronic psychiatric illness and/or for acute delirium are inversely associated with mortality in severe COVID-19 infection by unknown mechanism which may involve (in part) immunomodulatory effects.</p>","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":"4 4","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590925/pdf/nihms-1637199.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38539628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Zimering, Tanzila S Razzaki, Tiffany Tsang, John J. Shin
Advanced age and medical co-morbidity are strong predictors of mortality in COVID-19 infection. Yet few studies (to date) have specifically addressed risk factors associated with COVID-19 mortality in a high-risk subgroup of older US adults having one or more chronic diseases. Our hypothesis is that medications having 'off-target' anti-inflammatory effects may play a role in modulating the immune response in COVID-19 infection. We analyzed baseline risk factors associated with respiratory failure or death in 55 older adult US military veterans hospitalized for COVID-19 infection during (March-June 2020) the peak of the pandemic in New Jersey. Fifty-three percent (29/55) of patients experienced respiratory failure and thirty-one percent (17/55) died. In adjusted logistic regression analysis, baseline neutrophil to lymphocyte ratio (NLR) (P=0.0035) and body mass index (P=0.03) were significant predictors of the risk for respiratory failure. Age (P=0.05) and non-use (vs. use) of psychotropic medications having serotonin 2A receptor antagonist properties (odds ratio 5.06; 95% confidence intervals 1.18-21.7; P= 0.029) was each a significant predictor of an increased risk of death. There was a significant interaction effect of age and non-use (vs.. use) of psychotropic serotonin 2A receptor antagonist medications on the odds ratio (OR) for death (P=0.011). In selected, ventilator-dependent COVID-19 pneumonia patients treated with psychotropic serotonin 2A receptor antagonist medications to control agitation and ICU delirium, there was an apparent positive association between medication use and significant rise in the absolute lymphocyte count and decrease in the neutrophil: lymphocyte ratio. Taken together, these data are the first to suggest that certain psychotropic medications used in the treatment of chronic psychiatric illness and/or for acute delirium are inversely associated with mortality in severe COVID-19 infection by unknown mechanism which may involve (in part) immunomodulatory effects.
{"title":"Inverse Association between Serotonin 2A Receptor Antagonist Medication Use and Mortality in Severe COVID-19 Infection.","authors":"M. Zimering, Tanzila S Razzaki, Tiffany Tsang, John J. Shin","doi":"10.31038/edmj.2020443","DOIUrl":"https://doi.org/10.31038/edmj.2020443","url":null,"abstract":"Advanced age and medical co-morbidity are strong predictors of mortality in COVID-19 infection. Yet few studies (to date) have specifically addressed risk factors associated with COVID-19 mortality in a high-risk subgroup of older US adults having one or more chronic diseases. Our hypothesis is that medications having 'off-target' anti-inflammatory effects may play a role in modulating the immune response in COVID-19 infection. We analyzed baseline risk factors associated with respiratory failure or death in 55 older adult US military veterans hospitalized for COVID-19 infection during (March-June 2020) the peak of the pandemic in New Jersey. Fifty-three percent (29/55) of patients experienced respiratory failure and thirty-one percent (17/55) died. In adjusted logistic regression analysis, baseline neutrophil to lymphocyte ratio (NLR) (P=0.0035) and body mass index (P=0.03) were significant predictors of the risk for respiratory failure. Age (P=0.05) and non-use (vs. use) of psychotropic medications having serotonin 2A receptor antagonist properties (odds ratio 5.06; 95% confidence intervals 1.18-21.7; P= 0.029) was each a significant predictor of an increased risk of death. There was a significant interaction effect of age and non-use (vs.. use) of psychotropic serotonin 2A receptor antagonist medications on the odds ratio (OR) for death (P=0.011). In selected, ventilator-dependent COVID-19 pneumonia patients treated with psychotropic serotonin 2A receptor antagonist medications to control agitation and ICU delirium, there was an apparent positive association between medication use and significant rise in the absolute lymphocyte count and decrease in the neutrophil: lymphocyte ratio. Taken together, these data are the first to suggest that certain psychotropic medications used in the treatment of chronic psychiatric illness and/or for acute delirium are inversely associated with mortality in severe COVID-19 infection by unknown mechanism which may involve (in part) immunomodulatory effects.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":"4 4 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46339424","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}
Arun Raghavan, A. Nanditha, Krishnamoorthy Satheesh, Priscilla Susairaj, R. Vinitha, C. Snehalatha
Aim: To study the clinical and metabolic characteristics of newly diagnosed type 2 diabetes (T2DM) in urban clinics (CDD) and also to compare with the screen detected new diabetes cases (SDD) during an urban population survey. Methods: Newly diagnosed T2DM (aged 20-60 years, n=741), based on blood glucose and Glycosylated haemoglobin (HbA1c) of ≥6.5% (48 mmol/mol) were selected. Demography, anthropometry, blood pressure, glycaemic and lipids profiles were analysed. Relevant statistical tests were used for group comparisons. Results: Both groups had young age (45.0 ± 8.6 years) at diagnosis. Fasting blood glucose (p<0.05) and HbA1c (p<0.0001) were higher in CDD. Mean values of HbA1c were 9.1 ± 2.3% (76 ± 20 mmol/mol) in CDD and 8.3 ± 2.4% (67 ± 19 mmol/mol) in SDD (p<0.0001). Values of HbA1c were higher than ≥9.0% (75 mmol/mol) in 44.6% of CDD versus 26.4% of SDD (z=4.60, p<0.0001). SDD had higher body mass index (p<0.0001), abdominal obesity (p<0.005), hypertension (p<0.0001), cholesterol (p<0.005) and low density lipoprotein cholesterol (p<0.05) than CDD. Conclusion: Both groups had young age at diagnosis. CDD had more severe glycaemia than SDD, probably suggesting that the clinic visits were delayed and therefore had longer period of undiagnosed diabetes. In comparison to CDD, SDD had higher metabolic abnormalities although the HbA1c values were lower.
{"title":"The Profile of Clinically Diagnosed New Type 2 Diabetes among Asian Indians","authors":"Arun Raghavan, A. Nanditha, Krishnamoorthy Satheesh, Priscilla Susairaj, R. Vinitha, C. Snehalatha","doi":"10.31038/edmj.2020434","DOIUrl":"https://doi.org/10.31038/edmj.2020434","url":null,"abstract":"Aim: To study the clinical and metabolic characteristics of newly diagnosed type 2 diabetes (T2DM) in urban clinics (CDD) and also to compare with the screen detected new diabetes cases (SDD) during an urban population survey. Methods: Newly diagnosed T2DM (aged 20-60 years, n=741), based on blood glucose and Glycosylated haemoglobin (HbA1c) of ≥6.5% (48 mmol/mol) were selected. Demography, anthropometry, blood pressure, glycaemic and lipids profiles were analysed. Relevant statistical tests were used for group comparisons. Results: Both groups had young age (45.0 ± 8.6 years) at diagnosis. Fasting blood glucose (p<0.05) and HbA1c (p<0.0001) were higher in CDD. Mean values of HbA1c were 9.1 ± 2.3% (76 ± 20 mmol/mol) in CDD and 8.3 ± 2.4% (67 ± 19 mmol/mol) in SDD (p<0.0001). Values of HbA1c were higher than ≥9.0% (75 mmol/mol) in 44.6% of CDD versus 26.4% of SDD (z=4.60, p<0.0001). SDD had higher body mass index (p<0.0001), abdominal obesity (p<0.005), hypertension (p<0.0001), cholesterol (p<0.005) and low density lipoprotein cholesterol (p<0.05) than CDD. Conclusion: Both groups had young age at diagnosis. CDD had more severe glycaemia than SDD, probably suggesting that the clinic visits were delayed and therefore had longer period of undiagnosed diabetes. In comparison to CDD, SDD had higher metabolic abnormalities although the HbA1c values were lower.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47576332","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}
Aims: Circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor were increased in older adult type 2 diabetes in association with certain neurodegenerative complications. The male Zucker diabetic fatty (ZDF) rat is a model system for studies of obese, type 2 diabetes mellitus. The aim of the current study was to test for (and compare) circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor in the Zucker diabetic fatty rat and age-matched lean Zucker rat strains.
Methods: Plasma from lean and Zucker diabetic fatty rat (obtained at different developmental stages) was subjected to protein G affinity chromatography. The resulting immunoglobulin G fraction was tested for neurotoxicity (acute neurite retraction, accelerated neuron loss) in N2A mouse neuroblastoma cells and for binding to a linear synthetic peptide corresponding to the second extracellular loop of the 5-hydroxytryptamine 2A receptor.
Results: The male Zucker diabetic fatty rat (fa/fa) and two Zucker lean strains (+/?) and (fa/+) harbored autoantibodies to the 5-hydroxytryptamine 2A receptor which appeared spontaneously around 7-8.5 weeks of age. The circulating autoantibodies persisted until at least 25 weeks of age in the Zucker diabetic fatty rat and in the Zucker heterozygote (fa/+), but were no longer detectable in 25-week-old lean (+/?) Zucker rats. Autoantibody-induced acute neurite retraction and accelerated loss in mouse neuroblastoma N2A cells was dose-dependently prevented by selective antagonists of the 5-hydroxytryptamine 2A receptor. It was also substantially prevented by co-incubation with antagonists of RhoA/Rho kinase-mediated signaling (Y27632) or Gq11/phospholipase C/inositol triphosphate receptor-coupled signaling.
Conclusions: These data suggest that neurotoxic 5-hydroxytryptamine 2A receptor-targeting autoantibodies increase in the aging male Zucker diabetic fatty rat and in male Zucker lean rats harboring a heterozygous mutation, but not in age-matched, older Zucker lean rats lacking a known leptin receptor mutation. The Zucker genetic strain may be useful in studies of the role of humoral and/or innate immunity in late neurodegeneration.
{"title":"Circulating Agonist Autoantibody to 5-Hydroxytryptamine 2A Receptor in Lean and Diabetic Fatty Zucker Rat Strains.","authors":"M B Zimering, M Grinberg, J Burton, Kch Pang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aims: </strong>Circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor were increased in older adult type 2 diabetes in association with certain neurodegenerative complications. The male Zucker diabetic fatty (ZDF) rat is a model system for studies of obese, type 2 diabetes mellitus. The aim of the current study was to test for (and compare) circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor in the Zucker diabetic fatty rat and age-matched lean Zucker rat strains.</p><p><strong>Methods: </strong>Plasma from lean and Zucker diabetic fatty rat (obtained at different developmental stages) was subjected to protein G affinity chromatography. The resulting immunoglobulin G fraction was tested for neurotoxicity (acute neurite retraction, accelerated neuron loss) in N2A mouse neuroblastoma cells and for binding to a linear synthetic peptide corresponding to the second extracellular loop of the 5-hydroxytryptamine 2A receptor.</p><p><strong>Results: </strong>The male Zucker diabetic fatty rat (<i>fa/fa</i>) and two Zucker lean strains (+/?) and (<i>fa</i>/+) harbored autoantibodies to the 5-hydroxytryptamine 2A receptor which appeared spontaneously around 7-8.5 weeks of age. The circulating autoantibodies persisted until at least 25 weeks of age in the Zucker diabetic fatty rat and in the Zucker heterozygote (<i>fa</i>/+), but were no longer detectable in 25-week-old lean (+/?) Zucker rats. Autoantibody-induced acute neurite retraction and accelerated loss in mouse neuroblastoma N2A cells was dose-dependently prevented by selective antagonists of the 5-hydroxytryptamine 2A receptor. It was also substantially prevented by co-incubation with antagonists of RhoA/Rho kinase-mediated signaling (Y27632) or Gq11/phospholipase C/inositol triphosphate receptor-coupled signaling.</p><p><strong>Conclusions: </strong>These data suggest that neurotoxic 5-hydroxytryptamine 2A receptor-targeting autoantibodies increase in the aging male Zucker diabetic fatty rat and in male Zucker lean rats harboring a heterozygous mutation, but not in age-matched, older Zucker lean rats lacking a known leptin receptor mutation. The Zucker genetic strain may be useful in studies of the role of humoral and/or innate immunity in late neurodegeneration.</p>","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":"4 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7550200/pdf/nihms-1629599.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38484320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims Circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor were increased in older adult type 2 diabetes in association with certain neurodegenerative complications. The male Zucker diabetic fatty (ZDF) rat is a model system for studies of obese, type 2 diabetes mellitus. The aim of the current study was to test for (and compare) circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor in the Zucker diabetic fatty rat and age-matched lean Zucker rat strains. Methods Plasma from lean and Zucker diabetic fatty rat (obtained at different developmental stages) was subjected to protein G affinity chromatography. The resulting immunoglobulin G fraction was tested for neurotoxicity (acute neurite retraction, accelerated neuron loss) in N2A mouse neuroblastoma cells and for binding to a linear synthetic peptide corresponding to the second extracellular loop of the 5-hydroxytryptamine 2A receptor. Results The male Zucker diabetic fatty rat (fa/fa) and two Zucker lean strains (+/?) and (fa/+) harbored autoantibodies to the 5-hydroxytryptamine 2A receptor which appeared spontaneously around 7-8.5 weeks of age. The circulating autoantibodies persisted until at least 25 weeks of age in the Zucker diabetic fatty rat and in the Zucker heterozygote (fa/+), but were no longer detectable in 25-week-old lean (+/?) Zucker rats. Autoantibody-induced acute neurite retraction and accelerated loss in mouse neuroblastoma N2A cells was dose-dependently prevented by selective antagonists of the 5-hydroxytryptamine 2A receptor. It was also substantially prevented by co-incubation with antagonists of RhoA/Rho kinase-mediated signaling (Y27632) or Gq11/phospholipase C/inositol triphosphate receptor-coupled signaling. Conclusions These data suggest that neurotoxic 5-hydroxytryptamine 2A receptor-targeting autoantibodies increase in the aging male Zucker diabetic fatty rat and in male Zucker lean rats harboring a heterozygous mutation, but not in age-matched, older Zucker lean rats lacking a known leptin receptor mutation. The Zucker genetic strain may be useful in studies of the role of humoral and/or innate immunity in late neurodegeneration.
{"title":"Circulating Agonist Autoantibody to 5-Hydroxytryptamine 2A Receptor in Lean and Diabetic Fatty Zucker Rat Strains.","authors":"M. Zimering, M. Grinberg, J. Burton, Kch Pang","doi":"10.31038/edmj.2020435","DOIUrl":"https://doi.org/10.31038/edmj.2020435","url":null,"abstract":"Aims\u0000Circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor were increased in older adult type 2 diabetes in association with certain neurodegenerative complications. The male Zucker diabetic fatty (ZDF) rat is a model system for studies of obese, type 2 diabetes mellitus. The aim of the current study was to test for (and compare) circulating neurotoxic autoantibodies to the 5-hydroxytryptamine 2A receptor in the Zucker diabetic fatty rat and age-matched lean Zucker rat strains.\u0000\u0000\u0000Methods\u0000Plasma from lean and Zucker diabetic fatty rat (obtained at different developmental stages) was subjected to protein G affinity chromatography. The resulting immunoglobulin G fraction was tested for neurotoxicity (acute neurite retraction, accelerated neuron loss) in N2A mouse neuroblastoma cells and for binding to a linear synthetic peptide corresponding to the second extracellular loop of the 5-hydroxytryptamine 2A receptor.\u0000\u0000\u0000Results\u0000The male Zucker diabetic fatty rat (fa/fa) and two Zucker lean strains (+/?) and (fa/+) harbored autoantibodies to the 5-hydroxytryptamine 2A receptor which appeared spontaneously around 7-8.5 weeks of age. The circulating autoantibodies persisted until at least 25 weeks of age in the Zucker diabetic fatty rat and in the Zucker heterozygote (fa/+), but were no longer detectable in 25-week-old lean (+/?) Zucker rats. Autoantibody-induced acute neurite retraction and accelerated loss in mouse neuroblastoma N2A cells was dose-dependently prevented by selective antagonists of the 5-hydroxytryptamine 2A receptor. It was also substantially prevented by co-incubation with antagonists of RhoA/Rho kinase-mediated signaling (Y27632) or Gq11/phospholipase C/inositol triphosphate receptor-coupled signaling.\u0000\u0000\u0000Conclusions\u0000These data suggest that neurotoxic 5-hydroxytryptamine 2A receptor-targeting autoantibodies increase in the aging male Zucker diabetic fatty rat and in male Zucker lean rats harboring a heterozygous mutation, but not in age-matched, older Zucker lean rats lacking a known leptin receptor mutation. The Zucker genetic strain may be useful in studies of the role of humoral and/or innate immunity in late neurodegeneration.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":"4 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44367474","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}
COVID19 is regarded as a lifethreatening infection for most people, but especially certain risk-groups including diabetes, and has caused lock-down of societies which may have deleterious consequences. Many countries have taken steps to shut down schools, companies and businesses, and entire countries have been isolated. These drastic measures will have serious consequences for economy, psychosocial situation and health. There is a risk that people with other diseases like diabetes do not get ordinary adequate care. have eg serious lung disease och extreme obesity. For everybody physical distancing, increased hygiene, at home when symptoms of COVID19, crowds < 50 people etc Otherwise open shops, open restaurants, open schools. In the care of children and adolscents with Type 1 diabetes has some ordinary visits to the diabetesteam been replaced by telemedicine. Quality has remained the same as 2018 and 2019 with national mean HbA1c 53.8 mmol/mol ( 95% CI 53-5- 54.1) during Jan 1- April 28, 2020 and the proportion of patients with HbA1c < 57 mmol/l was 67.3% ( 95% CI 66-68.6%). Type 1 diabetes has not been a risk factor for severe COVID19, and no children with T1D are among those who have needed Intensive Care or who have died.
{"title":"COVID-19 and Type 1 diabetes in Sweden","authors":"J. Ludvigsson","doi":"10.31038/edmj.2020424","DOIUrl":"https://doi.org/10.31038/edmj.2020424","url":null,"abstract":"COVID19 is regarded as a lifethreatening infection for most people, but especially certain risk-groups including diabetes, and has caused lock-down of societies which may have deleterious consequences. Many countries have taken steps to shut down schools, companies and businesses, and entire countries have been isolated. These drastic measures will have serious consequences for economy, psychosocial situation and health. There is a risk that people with other diseases like diabetes do not get ordinary adequate care. have eg serious lung disease och extreme obesity. For everybody physical distancing, increased hygiene, at home when symptoms of COVID19, crowds < 50 people etc Otherwise open shops, open restaurants, open schools. In the care of children and adolscents with Type 1 diabetes has some ordinary visits to the diabetesteam been replaced by telemedicine. Quality has remained the same as 2018 and 2019 with national mean HbA1c 53.8 mmol/mol ( 95% CI 53-5- 54.1) during Jan 1- April 28, 2020 and the proportion of patients with HbA1c < 57 mmol/l was 67.3% ( 95% CI 66-68.6%). Type 1 diabetes has not been a risk factor for severe COVID19, and no children with T1D are among those who have needed Intensive Care or who have died.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43867764","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}
T. D. Frydman, Natalie Madeline Atkinson-Ginsburg, M. Alpízar-Salazar
Endocrinol Diabetes Metab J, Volume 4(2): 1–3, 2020 No one single mechanism is responsible for disease progression into severity in COVID-19 cases as in almost all diseases -chronic or not, transmissible or not-. We as scientists are trained to observe, identify differences and similarities between cases and arrive at possible explanations called hypothesis that can help the scientific community to develop effective strategies to combat the illness.
{"title":"When two pandemics meet","authors":"T. D. Frydman, Natalie Madeline Atkinson-Ginsburg, M. Alpízar-Salazar","doi":"10.31038/edmj.2020423","DOIUrl":"https://doi.org/10.31038/edmj.2020423","url":null,"abstract":"Endocrinol Diabetes Metab J, Volume 4(2): 1–3, 2020 No one single mechanism is responsible for disease progression into severity in COVID-19 cases as in almost all diseases -chronic or not, transmissible or not-. We as scientists are trained to observe, identify differences and similarities between cases and arrive at possible explanations called hypothesis that can help the scientific community to develop effective strategies to combat the illness.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48630966","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}
Tito Cardoso de Almeida Mafra, Christiane Salum Machado Simões, Marcus Vinicius Gomes Cezar Vieira, Lı́via Ribeiro Borges, Lazzarotto, Juliana Cristina de Abreu Teixeira, Marco Aurelio Lopes Miranda, Adriana Antunes Vieira, André Abrantes Maciel, Ferreira, Marcos Renato Corrêa, Ismael Porto Bomfim, D. R. Lacerda, W. Pereira
Obesity is a Chronic Non-Transmissible Disease (CNCD), understood as a multifactorial disorder that assumes the condition of an epidemic, affecting individuals of different age groups and with great prevalence in different countries of the world, having a great relationship with the emergence of several other diseases and high rates of morbidity and mortality [1,2]. The terms overweight and obesity are used to describe an excess of adiposity (or fat) above the ideal for good health. The use of anthropometric indicators, assist in the classification of cutoff points of the Body Mass Index (BMI), being used in the prediction of the weight status [3]. It is possible to point out several factors that can contribute to the development of obesity, among them are diets with positive caloric balance, physical inactivity, reduced basal metabolic rate, genetic and hereditary factors [4]. The interaction of these factors is complex and has been the focus of several studies. The increase in consumption of foods rich in sugars and fat and the decrease in the practice of physical exercises are the main factors related to the development of obesity [5]. The impacts that overweight and obesity have on the quality of life of children, adults and the elderly are the targets of several studies. The data found in the literature demonstrate significant reductions in quality of Review Article
肥胖是一种慢性非传染性疾病(Chronic non -传染性疾病，CNCD)，是一种多因素疾病，具有流行病的特征，影响不同年龄组的个体，在世界不同国家都有很高的患病率，与其他几种疾病的出现和高发病率和死亡率有很大的关系[1,2]。超重和肥胖这两个术语用来描述超过理想健康水平的过度肥胖(或脂肪)。人体测量指标的使用，有助于身体质量指数(BMI)分界点的分类，被用于体重状况的预测。可以指出几个因素可以促进肥胖的发展，其中包括正热量平衡的饮食，缺乏体育活动，基础代谢率降低，遗传和遗传因素[4]。这些因素的相互作用是复杂的，已经成为几个研究的焦点。多吃含糖和脂肪的食物和少做体育锻炼是导致肥胖的主要因素。超重和肥胖对儿童、成人和老年人生活质量的影响是几项研究的目标。在文献中发现的数据表明综述文章的质量显著降低
{"title":"Obesity and Inflammatory Profile: Is Physical Exercise Able to Reverse This Process? A Mini Review","authors":"Tito Cardoso de Almeida Mafra, Christiane Salum Machado Simões, Marcus Vinicius Gomes Cezar Vieira, Lı́via Ribeiro Borges, Lazzarotto, Juliana Cristina de Abreu Teixeira, Marco Aurelio Lopes Miranda, Adriana Antunes Vieira, André Abrantes Maciel, Ferreira, Marcos Renato Corrêa, Ismael Porto Bomfim, D. R. Lacerda, W. Pereira","doi":"10.31038/edmj.2020422","DOIUrl":"https://doi.org/10.31038/edmj.2020422","url":null,"abstract":"Obesity is a Chronic Non-Transmissible Disease (CNCD), understood as a multifactorial disorder that assumes the condition of an epidemic, affecting individuals of different age groups and with great prevalence in different countries of the world, having a great relationship with the emergence of several other diseases and high rates of morbidity and mortality [1,2]. The terms overweight and obesity are used to describe an excess of adiposity (or fat) above the ideal for good health. The use of anthropometric indicators, assist in the classification of cutoff points of the Body Mass Index (BMI), being used in the prediction of the weight status [3]. It is possible to point out several factors that can contribute to the development of obesity, among them are diets with positive caloric balance, physical inactivity, reduced basal metabolic rate, genetic and hereditary factors [4]. The interaction of these factors is complex and has been the focus of several studies. The increase in consumption of foods rich in sugars and fat and the decrease in the practice of physical exercises are the main factors related to the development of obesity [5]. The impacts that overweight and obesity have on the quality of life of children, adults and the elderly are the targets of several studies. The data found in the literature demonstrate significant reductions in quality of Review Article","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42526217","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}
Rapid accumulation of clinical Abstract The correct differentiation of diabetes types is still a problem. This is especially true for groups of young adult patients between 20 and 55 years old. In this group of patients Type 2 diabetes is still routinely diagnosed, without a thorough analysis of the patient’s history, phenotype, as well as disregarding the need to perform all necessary laboratory tests. Such diagnostic irregularities lead to taking wrong therapeutic decisions. As far as the patient’s history is concerned, attention should be paid to the incidence or non-incidence of a positive history of diabetes in the patient’s family. In the autoimmune diabetes such incidence usually does not occur. In Type 2 diabetes it is usually high, whereas most often it occurs on the patient’s mother’s and well as father’s side. A feature that is usually very characteristic is high incidence on one side of the family, typical for monogenic diabetes. A very important indicator is the occurrence or non-occurrence of obesity. Clear obesity suggests the diagnosis of Type 2 diabetes, whereas in patients without obesity LADA or MODY diabetes needs to be taken into account. Conclusive in this respect are the results of tests checking the levels of C-peptide and the titre of autoantibodies, predominantly of a/GAD. When MODY diabetes is suspected, it is necessary to run genetic tests. It is extremely important to undertake efforts aiming at a correct diagnosis of the etiological cause of diabetes, i.e. determining whether we deal with the autoimmunization process, insulin resistance, or with a genetic defect, as it influences therapeutic decisions. In the presence of the autoimmunization process, it is recommended to provide the insulin therapy at an early stage. In patients with clearly marked insulin resistance an early onset of the insulin therapy should be avoided. The first choice drugs in this condition are metformin, incretin drugs, as well as drugs from the group of SGLT-2 inhibitors. In monogenic diabetes therapeutic decisions depend on the type of the genetic defect.
{"title":"Errors in Diagnosing Types of Diabetes in Young Adult Patients – Constantly Valid Topic","authors":"A. Chwalba, A. Dudek","doi":"10.31038/edmj.2020421","DOIUrl":"https://doi.org/10.31038/edmj.2020421","url":null,"abstract":"Rapid accumulation of clinical Abstract The correct differentiation of diabetes types is still a problem. This is especially true for groups of young adult patients between 20 and 55 years old. In this group of patients Type 2 diabetes is still routinely diagnosed, without a thorough analysis of the patient’s history, phenotype, as well as disregarding the need to perform all necessary laboratory tests. Such diagnostic irregularities lead to taking wrong therapeutic decisions. As far as the patient’s history is concerned, attention should be paid to the incidence or non-incidence of a positive history of diabetes in the patient’s family. In the autoimmune diabetes such incidence usually does not occur. In Type 2 diabetes it is usually high, whereas most often it occurs on the patient’s mother’s and well as father’s side. A feature that is usually very characteristic is high incidence on one side of the family, typical for monogenic diabetes. A very important indicator is the occurrence or non-occurrence of obesity. Clear obesity suggests the diagnosis of Type 2 diabetes, whereas in patients without obesity LADA or MODY diabetes needs to be taken into account. Conclusive in this respect are the results of tests checking the levels of C-peptide and the titre of autoantibodies, predominantly of a/GAD. When MODY diabetes is suspected, it is necessary to run genetic tests. It is extremely important to undertake efforts aiming at a correct diagnosis of the etiological cause of diabetes, i.e. determining whether we deal with the autoimmunization process, insulin resistance, or with a genetic defect, as it influences therapeutic decisions. In the presence of the autoimmunization process, it is recommended to provide the insulin therapy at an early stage. In patients with clearly marked insulin resistance an early onset of the insulin therapy should be avoided. The first choice drugs in this condition are metformin, incretin drugs, as well as drugs from the group of SGLT-2 inhibitors. In monogenic diabetes therapeutic decisions depend on the type of the genetic defect.","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45371942","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":"Current and Emerging Technologies for Diabetes Care","authors":"","doi":"10.31038/edmj.2020414","DOIUrl":"https://doi.org/10.31038/edmj.2020414","url":null,"abstract":"","PeriodicalId":72911,"journal":{"name":"Endocrinology, diabetes and metabolism journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48581722","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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