M. Shestakova, I. Maev, A. S. Ametov, M. Antsiferov, D. S. Bordin, G. Galstyan, F. Dzgoeva, Y. Kucheryavyy, A. Mkrtumyan, T. Nikonova, E. Pashkova
Diabetes is disease of both the endo- and exocrine parts of the pancreas. Pancreatic exocrine insufficiency (PEI) can occur in every 2–3 patients with diabetes and affect not only the quality, but also life expectancy. At the same time, the diagnosis and treatment of PEI is not getting enough attention. The endocrinologist, as the main specialist leading patients with diabetes, can diagnose and treat patients with pancreatic exocrine insufficiency and diabetes using adequate doses of pancreatic enzyme replacement therapy (PERT).
{"title":"Pancreatic exocrine insufficiency in diabetes mellitus","authors":"M. Shestakova, I. Maev, A. S. Ametov, M. Antsiferov, D. S. Bordin, G. Galstyan, F. Dzgoeva, Y. Kucheryavyy, A. Mkrtumyan, T. Nikonova, E. Pashkova","doi":"10.14341/dm13027","DOIUrl":"https://doi.org/10.14341/dm13027","url":null,"abstract":"Diabetes is disease of both the endo- and exocrine parts of the pancreas. Pancreatic exocrine insufficiency (PEI) can occur in every 2–3 patients with diabetes and affect not only the quality, but also life expectancy. At the same time, the diagnosis and treatment of PEI is not getting enough attention. The endocrinologist, as the main specialist leading patients with diabetes, can diagnose and treat patients with pancreatic exocrine insufficiency and diabetes using adequate doses of pancreatic enzyme replacement therapy (PERT).","PeriodicalId":73708,"journal":{"name":"Journal of diabetes mellitus","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83927449","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. Antsiferov, G. Galstyan, T. Demidova, A. Zilov, T. Markova, А. M. Mkrtumyan, N. Petunina, I. S. Khalimov, M. Shamkhalova, M. Shestakova
Type 2 diabetes is characterized by increasing incidence and prevalence all-over the world. Current therapeutic management of type 2 diabetes is complex and is based not only on glycemic control, but also on cardiovascular and renal risks reduction. In previous years the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) increased in Russian Federation. Some manufacturers of the most widely used GLP-1 RA reported the supply decline in several countries. On Advisory board with participation of the Russian Endocrinology Association members the topics of SGLT2i and GLP-1 RA use in type 2 diabetes were discussed. The experts made conclusion that the decrease in access to GLP-1 RA does not pose serious risk for treatment of type 2 diabetes patients. SGLT2i show benefits in risk reduction of HF and CKD progression compering to GLP-1 RA, and in general show comparable efficacy in risk reduction of ACVD outcomes. SGLT2i show less glycemic efficacy in comparison with GLP-1 RA, and their replacement may need adding antidiabetic agents from other groups.
{"title":"The advisory board resolution on the use of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in type 2 diabetes","authors":"M. Antsiferov, G. Galstyan, T. Demidova, A. Zilov, T. Markova, А. M. Mkrtumyan, N. Petunina, I. S. Khalimov, M. Shamkhalova, M. Shestakova","doi":"10.14341/dm13034","DOIUrl":"https://doi.org/10.14341/dm13034","url":null,"abstract":"Type 2 diabetes is characterized by increasing incidence and prevalence all-over the world. Current therapeutic management of type 2 diabetes is complex and is based not only on glycemic control, but also on cardiovascular and renal risks reduction. In previous years the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) increased in Russian Federation. Some manufacturers of the most widely used GLP-1 RA reported the supply decline in several countries. On Advisory board with participation of the Russian Endocrinology Association members the topics of SGLT2i and GLP-1 RA use in type 2 diabetes were discussed. The experts made conclusion that the decrease in access to GLP-1 RA does not pose serious risk for treatment of type 2 diabetes patients. SGLT2i show benefits in risk reduction of HF and CKD progression compering to GLP-1 RA, and in general show comparable efficacy in risk reduction of ACVD outcomes. SGLT2i show less glycemic efficacy in comparison with GLP-1 RA, and their replacement may need adding antidiabetic agents from other groups.","PeriodicalId":73708,"journal":{"name":"Journal of diabetes mellitus","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75848715","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: Diabetes mellitus (DM) is an independent risk factor for low-traumatic fractures. On the other hand, hypoglycemic drugs can have both positive and negative effects on bone remodeling.THE AIM: Тo investigate bone metabolism parameters during surgical menopause and experimental DM under the treatment with glucagon-like peptide receptor agonist type 1 (arGLP-1) liraglutide (LIRA) and sodium-glucose cotransporter type 2 inhibitor (iSGLT-2) canagliflozin (CANA).MATERIALS AND METHODS: Female Wistar rats have been subjected to bilateral ovariectomy at the beginning of the experiment. Diabetes mellitus (DM) was modelled using a high-fat diet and streptozotocin+nicotinamide. Four weeks after the following groups were formed: “OE+DM” (females after ovariectomy with DM and without any therapy, n=4) «OE+DM+CANA» (females after ovariectomy with DM under treatment with CANA, n=4), «OE+DM+LIRA» (females after ovariectomy with DM under treatment LIRA, n=5). The treatment or observation period were continuing for 8 weeks. Calcium, phosphorus and bone turnover markers (fibroblast growth factor-23 (FGF-23), osteocalcin, sclerostin, osteoprotegerin (OPG), nuclear factor-kappa-B receptor activator ligand (RANKL), were measured in the end of experiment. Bone histomorphometry was performed after euthanasia.RESULTS: Treatment with both CANA and LIRA did not significantly affect the phosphorus-calcium metabolism, sclerostin and osteocalcin concentrations. At the same time, the level of OPG was the highest in «OE+DM ‘’ group (9.1 [7.81; 10.045] pmol/l). The differences were significant compared with «OE+DM+CANA’’ (2, 33 [1.84; 5.84] pmol/l, p = 0.003) and «OE+DM+LIRA» (1.7 [1; 2] pmol/l, p = 0.003) groups. There were no differences in OPG levels between animals treated with different drugs. Similarly, the OPG/RANKL ratio was similarly reduced with both types of treatment. In “OE+DM+CANA’’ group the bone trabeculae number of the femur epiphysis (p=0.042) were decreased in comparison to «OE+DM» group. LIRA did not change the histoarchitectonic parameters.CONCLUSION: Bone metabolism markers did not differ when using as canagliflozin as liraglutide. Besides, canagliflosin can lead to the activation of bone resorption, which is expressed in the femur epiphyseal trabeculae number decreasing.
背景:糖尿病(DM)是低创伤性骨折的独立危险因素。另一方面，降糖药物对骨重塑既有积极的影响，也有消极的影响。目的:Тo研究胰高血糖素样肽受体激动剂1型(arGLP-1)利拉脲肽(LIRA)和钠-葡萄糖共转运蛋白2型抑制剂(iSGLT-2)卡格列净(canagliflozin, CANA)治疗下手术绝经和实验性糖尿病期间的骨代谢参数。材料与方法:雌性Wistar大鼠在实验开始时进行双侧卵巢切除术。采用高脂肪饮食和链脲佐菌素+烟酰胺建立糖尿病模型。四周后分为以下组:“OE+DM”(卵巢切除合并DM且未接受任何治疗的女性，n=4)“OE+DM +CANA”(卵巢切除合并DM且接受CANA治疗的女性，n=4)，“OE+DM +LIRA”(卵巢切除合并DM且接受LIRA治疗的女性，n=5)。治疗或观察期均为8周。实验结束时测定钙、磷和骨转换标志物(成纤维细胞生长因子-23 (FGF-23)、骨钙素、硬化蛋白、骨保护素(OPG)、核因子- κ b受体激活剂配体(RANKL))。安乐死后进行骨组织形态学测定。结果:CANA和LIRA治疗对磷钙代谢、硬化蛋白和骨钙素浓度均无显著影响。同时，“OE+DM”组OPG水平最高，为9.1 [7.81;10.045] pmol / l)。与“OE+DM+CANA”相比，差异有统计学意义(2,33)[1.84;5.84] pmol/l, p = 0.003)和«OE+DM+LIRA»(1.7 [1;2] pmol/l, p = 0.003)组。不同药物治疗动物的OPG水平没有差异。同样，两种治疗方式的OPG/RANKL比值也同样降低。“OE+DM+CANA”组股骨骨骺骨小梁数较“OE+DM”组减少(p=0.042)。LIRA未改变组织结构参数。结论:卡格列净与利拉鲁肽使用时，骨代谢指标无显著差异。此外，卡格列素可导致骨吸收活化，表现为股骨骨骺小梁数量减少。
E. Koroleva, R. Khapaev, A. Lykov, A. Korbut, V. Klimontov
BACKGROUND: Carotid atherosclerosis (CA) and lower extremity peripheral artery disease (PAD) is a common and potentially life-threatening comorbidity in diabetes.AIM: to determine risk factors and biomarkers of the association of CA and PAD in patients with type 2 diabetes.MATERIALS AND METHODS: A single-center cross-sectional comparative study was carried out. Three hundred ninety one patients with type 2 diabetes were included. Duplex ultrasound of carotid and low limb arteries, screening/monitoring of diabetic complications and associated diseases, and assessment of glycemic control, biochemical and coagulation parameters were performed. Factors involved in vascular wall remodeling, including calponin-1, relaxin, L-citrulline, matrix metalloproteinase-2 and -3, were measured in blood serum by ELISA.RESULTS: The signs of CA and PAD were observed in 330 and 187 patients respectively. In 178 patients, both CA and PAD were revealed. The risk of combined involvement of carotid and lower extremity arteries was higher in patients with diabetic retinopathy (OR=2.57, p<0.001), chronic kidney disease (OR=4.48, p<0.001), history of myocardial infarction (OR=5.09, p<0.001), coronary revascularization (OR=4.31, p<0.001) or cerebrovascular accident (OR=3.07, p<0.001). In ROC-analysis, age ≥65.5 years (OR=3.43, p<0.001), waist-to-hip ratio ≥0.967 (OR=3.01, p=0.001), diabetes duration ≥12.5 years (OR=3.7, p<0.001), duration of insulin therapy ≥4.5 years (OR=3.05, p<0.001), duration of arterial hypertension ≥16.5 years (OR=1.98, p=0.002), serum L-citrulline ≥68 µmol/l (OR=3.82, p=0.003), and mean amplitude of glucose excursions ≥3.72 mmol/l (OR=1.79, p=0.006) were the risk factors for atherosclerosis of two vascular beds. In multivariate logistic regression analysis, age, diabetes duration and waist-to-hip ratio were independent risk factors for association of CA and PAD (p=0.005, p=0.0003, and p=0.004 respectively).CONCLUSION: In subjects with type 2 diabetes, carotid and lower extremity atherosclerotic disease is associated with age, diabetes duration, abdominal obesity, microvascular and macrovascular complications, glucose variability, and high serum levels of L-citrulline.
{"title":"Association of carotid atherosclerosis and peripheral artery disease in patients with type 2 diabetes: risk factors and biomarkers","authors":"E. Koroleva, R. Khapaev, A. Lykov, A. Korbut, V. Klimontov","doi":"10.14341/dm12915","DOIUrl":"https://doi.org/10.14341/dm12915","url":null,"abstract":"BACKGROUND: Carotid atherosclerosis (CA) and lower extremity peripheral artery disease (PAD) is a common and potentially life-threatening comorbidity in diabetes.AIM: to determine risk factors and biomarkers of the association of CA and PAD in patients with type 2 diabetes.MATERIALS AND METHODS: A single-center cross-sectional comparative study was carried out. Three hundred ninety one patients with type 2 diabetes were included. Duplex ultrasound of carotid and low limb arteries, screening/monitoring of diabetic complications and associated diseases, and assessment of glycemic control, biochemical and coagulation parameters were performed. Factors involved in vascular wall remodeling, including calponin-1, relaxin, L-citrulline, matrix metalloproteinase-2 and -3, were measured in blood serum by ELISA.RESULTS: The signs of CA and PAD were observed in 330 and 187 patients respectively. In 178 patients, both CA and PAD were revealed. The risk of combined involvement of carotid and lower extremity arteries was higher in patients with diabetic retinopathy (OR=2.57, p<0.001), chronic kidney disease (OR=4.48, p<0.001), history of myocardial infarction (OR=5.09, p<0.001), coronary revascularization (OR=4.31, p<0.001) or cerebrovascular accident (OR=3.07, p<0.001). In ROC-analysis, age ≥65.5 years (OR=3.43, p<0.001), waist-to-hip ratio ≥0.967 (OR=3.01, p=0.001), diabetes duration ≥12.5 years (OR=3.7, p<0.001), duration of insulin therapy ≥4.5 years (OR=3.05, p<0.001), duration of arterial hypertension ≥16.5 years (OR=1.98, p=0.002), serum L-citrulline ≥68 µmol/l (OR=3.82, p=0.003), and mean amplitude of glucose excursions ≥3.72 mmol/l (OR=1.79, p=0.006) were the risk factors for atherosclerosis of two vascular beds. In multivariate logistic regression analysis, age, diabetes duration and waist-to-hip ratio were independent risk factors for association of CA and PAD (p=0.005, p=0.0003, and p=0.004 respectively).CONCLUSION: In subjects with type 2 diabetes, carotid and lower extremity atherosclerotic disease is associated with age, diabetes duration, abdominal obesity, microvascular and macrovascular complications, glucose variability, and high serum levels of L-citrulline.","PeriodicalId":73708,"journal":{"name":"Journal of diabetes mellitus","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90784223","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}
In the modern world the prevalence of obesity and type 2 diabetes mellitus (T2DM) significantly increases. In this light the risks of obesity-associated complications also grow up. The crucial linkage between obesity and its complications is inflammation, which is a convenient target for potential anti-diabetic therapy. There are some anti-inflammatory therapy strategies: action on secreted cytokines, circulating lipids or intracellular signaling cascades. Canakinumab (antibody to IL-1b receptor) and colchicine (IL-6 secretion blocker) have the most balanced anti-diabetic and cardioprotective action among cytokine anti-inflammatory therapy. Lipid-lowering therapy is very diverse, but bempedoic acid nowadays has the best combination of anti-inflammatory and cardioprotective effects. Salicylate is an inhibitor of IKK-dependent inflammatory signaling cascade and significantly lowers glycated hemoglobin and C-reactive protein levels among obese patients. The future of anti-inflammatory T2DM therapy can be related with anti-inflammatory cytokines (IL-4, IL-37), chimeric engineered cytokines (IC7Fc), novel inhibitors of inflammatory and cytokines signaling cascades (imatinib, CC90001) and cell-based therapy (mesenchymal stem cells). In summary, despite on the limitations of current clinical trials, anti-inflammatory drugs have a potential to become a part of modern combined T2DM therapy with anti-diabetic and cardioprotective properties. Novel findings in potential anti-inflammatory T2DM therapy have great perspectives in protection against T2DM and related complication prevention.
BACKGROUND: the effect of diabetes mellitus on the long-term patency of autovenous femoro-popliteal bypass has not been definitively determined AIM: to determine the effect of diabetes mellitus on the long-term outcomes of autovenous femoral-popliteal bypass.MATERIALS AND METHODS: the results of treatment of 648 patients who underwent autovenous femoral-popliteal bypass were analyzed. The patients were divided into 2 clinical groups: the first group included 367 patients with diabetes mellitus, the second — 281 patients without the named disease. The groups did not differ significantly in the incidence of concomitant pathology.RESULTS: occlusion of the autovenous conduit within a 5-year period after surgical treatment was observed in 218 patients of the first group (59.4%) and 72 patients of the second group (25.6%) (p <0.01, χ2 = 39.05, RR = 1.78; CI = 1.53–2.12). The average service life of the autovenous femoral-popliteal bypass was 63.49 months in patients of the first group, and 107.46 months in the second. The decompensated course of diabetes mellitus was observed in 203 patients (55.2%). Among patients with decompensated diabetes mellitus, occlusion of the autovenous femoral-popliteal bypass was observed in 95 patients (46.8%), in 104 patients the autovenous conduit was passable (51.2%; p = 0.449, χ2 = 0.57). Decompensated course of diabetes mellitus may contribute to a decrease in the service life of autovenous femoro-popliteal bypass.CONCLUSION: the presence of diabetes mellitus, and especially its decompensated course, can negatively affect the patency of autovenous femoro-popliteal bypass in the long term.
{"title":"Diabetes mellitus and long-time outcomes of autovenous femoro-popliteal bypass","authors":"A. Artemova, M. Chernyavskiy","doi":"10.14341/dm12858","DOIUrl":"https://doi.org/10.14341/dm12858","url":null,"abstract":"BACKGROUND: the effect of diabetes mellitus on the long-term patency of autovenous femoro-popliteal bypass has not been definitively determined AIM: to determine the effect of diabetes mellitus on the long-term outcomes of autovenous femoral-popliteal bypass.MATERIALS AND METHODS: the results of treatment of 648 patients who underwent autovenous femoral-popliteal bypass were analyzed. The patients were divided into 2 clinical groups: the first group included 367 patients with diabetes mellitus, the second — 281 patients without the named disease. The groups did not differ significantly in the incidence of concomitant pathology.RESULTS: occlusion of the autovenous conduit within a 5-year period after surgical treatment was observed in 218 patients of the first group (59.4%) and 72 patients of the second group (25.6%) (p <0.01, χ2 = 39.05, RR = 1.78; CI = 1.53–2.12). The average service life of the autovenous femoral-popliteal bypass was 63.49 months in patients of the first group, and 107.46 months in the second. The decompensated course of diabetes mellitus was observed in 203 patients (55.2%). Among patients with decompensated diabetes mellitus, occlusion of the autovenous femoral-popliteal bypass was observed in 95 patients (46.8%), in 104 patients the autovenous conduit was passable (51.2%; p = 0.449, χ2 = 0.57). Decompensated course of diabetes mellitus may contribute to a decrease in the service life of autovenous femoro-popliteal bypass.CONCLUSION: the presence of diabetes mellitus, and especially its decompensated course, can negatively affect the patency of autovenous femoro-popliteal bypass in the long term.","PeriodicalId":73708,"journal":{"name":"Journal of diabetes mellitus","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72690484","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. Saprina, N. N. Musina, T. S. Prokhorenko, Ya. S. Slavkina, A. P. Zima
BACKGROUND: High prevalence of anemia in diabetes mellitus (DM) determines the relevance of studying its pathogenetic aspects, the role of anemia in DM complications development and the issue of differential diagnosis between iron deficiency anemia (IDA) and anemia of chronic disease (ACD)).AIM: To establish the diagnostic value of classical parameters for diagnosing anemia in DM and propose an optimized algorithm for the differential diagnosis of ACD and IDA in DM type 1 and 2 using new markers.MATERIALS AND METHODS: The observational, single-centre, comparative, controlled, single-stage study. Patients underwent assessment of glycated hemoglobin, creatinine, microalbuminuria; indicators of iron metabolism — hematocrit, the number of erythrocytes, reticulocytes, hemoglobin, serum iron, transferrin, ferritin, the level of soluble transferrin receptors (sTfR), sTfR/logFerpitin index, and inflammation markers — erythrocyte sedimentation rate (ESR), leukocyte count, high sensitive CRP and TNF-α. ROC-analysis was used to assess the differential diagnosis markers informative content.RESULTS: We examined 135 patients: 51 with DM 1 and 84 with DM 2. The patients were stratified into groups based on anemia type: 1) ACD 2) IDA 3) latent iron deficiency 4) without ferrokinetics disorders. According to the ROC-analysis in DM patients, the following parameters had high information content in ACD. ESR — sensitivity 92%, specificity 85%, diagnostic threshold 26.5 mm/h (area under the curve (AUC) 0.943; p<0.0001); leukocyte count — sensitivity 69%, specificity 64%, diagnostic threshold 7.50x109/l (AUC 0.727; p=0.007), microalbuminuria — sensitivity 71%, specificity 72%, diagnostic threshold 29.5 mg/l (AUC 0.744; p=0.003). In DM sTfR and the sTfR /logFerritin index had high information content in IDA at diagnostic thresholds different from those for general population. The sensitivity of sTfR 71%, the specificity 71%, diagnostic threshold 1.42 ng/mL (2.9 ng/mL for general population) (AUC 0.765; p=0.024). The sensitivity of sTfR/logFerritin index 100%, the specificity 97%, diagnostic threshold 1.48 (2.0 for general population) (AUC 0.983; p=0.024).CONCLUSION: In differential diagnosis of IDA and ACD in DM, ESR, leukocyte count, microalbuminuria, sTfR and sTfR/logFerritin index have a high diagnostic value. This allows proposing them as additional markers for differential diagnosis of anemia in DM.
{"title":"The question of differential diagnosis of anemia in diabetes mellitus","authors":"T. Saprina, N. N. Musina, T. S. Prokhorenko, Ya. S. Slavkina, A. P. Zima","doi":"10.14341/dm12979","DOIUrl":"https://doi.org/10.14341/dm12979","url":null,"abstract":"BACKGROUND: High prevalence of anemia in diabetes mellitus (DM) determines the relevance of studying its pathogenetic aspects, the role of anemia in DM complications development and the issue of differential diagnosis between iron deficiency anemia (IDA) and anemia of chronic disease (ACD)).AIM: To establish the diagnostic value of classical parameters for diagnosing anemia in DM and propose an optimized algorithm for the differential diagnosis of ACD and IDA in DM type 1 and 2 using new markers.MATERIALS AND METHODS: The observational, single-centre, comparative, controlled, single-stage study. Patients underwent assessment of glycated hemoglobin, creatinine, microalbuminuria; indicators of iron metabolism — hematocrit, the number of erythrocytes, reticulocytes, hemoglobin, serum iron, transferrin, ferritin, the level of soluble transferrin receptors (sTfR), sTfR/logFerpitin index, and inflammation markers — erythrocyte sedimentation rate (ESR), leukocyte count, high sensitive CRP and TNF-α. ROC-analysis was used to assess the differential diagnosis markers informative content.RESULTS: We examined 135 patients: 51 with DM 1 and 84 with DM 2. The patients were stratified into groups based on anemia type: 1) ACD 2) IDA 3) latent iron deficiency 4) without ferrokinetics disorders. According to the ROC-analysis in DM patients, the following parameters had high information content in ACD. ESR — sensitivity 92%, specificity 85%, diagnostic threshold 26.5 mm/h (area under the curve (AUC) 0.943; p<0.0001); leukocyte count — sensitivity 69%, specificity 64%, diagnostic threshold 7.50x109/l (AUC 0.727; p=0.007), microalbuminuria — sensitivity 71%, specificity 72%, diagnostic threshold 29.5 mg/l (AUC 0.744; p=0.003). In DM sTfR and the sTfR /logFerritin index had high information content in IDA at diagnostic thresholds different from those for general population. The sensitivity of sTfR 71%, the specificity 71%, diagnostic threshold 1.42 ng/mL (2.9 ng/mL for general population) (AUC 0.765; p=0.024). The sensitivity of sTfR/logFerritin index 100%, the specificity 97%, diagnostic threshold 1.48 (2.0 for general population) (AUC 0.983; p=0.024).CONCLUSION: In differential diagnosis of IDA and ACD in DM, ESR, leukocyte count, microalbuminuria, sTfR and sTfR/logFerritin index have a high diagnostic value. This allows proposing them as additional markers for differential diagnosis of anemia in DM.","PeriodicalId":73708,"journal":{"name":"Journal of diabetes mellitus","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73496544","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}
S. T. Magerramova, A. Odarchenko, Y. A. El-Taravi, D. K. Erikenova, M. Shestakova
The condition known today as diabetes mellitus was described as early as 1550 B.C. in the papyrus of Ebers, when Ayurvedic physicians noted the sweet taste of urine in patients with polyuria. This fact allows diabetes to be considered as one of the most well-known antiquity diseases. During all these thousands of years scientists have been trying to «unravel» this «mysterious» condition, and to find the cause and ways to cure the disease. Therefore, the long history of the diabetes existence is rich in discoveries, which often had a tremendous impact on all medicine. Insulin discover and investigation has become a key moment in diabetes history. A lot of scientists who have worked on the study of the insulin structure and developed new methods have been honored with the Nobel Prize. In our opinion, this review highlights the most important works of the 20th century, which played a key role in the discovery of a drug for the treatment of diabetes mellitus patients.
{"title":"On the 100th anniversary of the Nobel Prize «For the Discovery of Insulin»","authors":"S. T. Magerramova, A. Odarchenko, Y. A. El-Taravi, D. K. Erikenova, M. Shestakova","doi":"10.14341/dm13012","DOIUrl":"https://doi.org/10.14341/dm13012","url":null,"abstract":"The condition known today as diabetes mellitus was described as early as 1550 B.C. in the papyrus of Ebers, when Ayurvedic physicians noted the sweet taste of urine in patients with polyuria. This fact allows diabetes to be considered as one of the most well-known antiquity diseases. During all these thousands of years scientists have been trying to «unravel» this «mysterious» condition, and to find the cause and ways to cure the disease. Therefore, the long history of the diabetes existence is rich in discoveries, which often had a tremendous impact on all medicine. Insulin discover and investigation has become a key moment in diabetes history. A lot of scientists who have worked on the study of the insulin structure and developed new methods have been honored with the Nobel Prize. In our opinion, this review highlights the most important works of the 20th century, which played a key role in the discovery of a drug for the treatment of diabetes mellitus patients.","PeriodicalId":73708,"journal":{"name":"Journal of diabetes mellitus","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78697824","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}
I. Dedov, M. Shestakova, O. Vikulova, A. Zheleznyakova, M. A. Isakov, D. Sazonova, N. Mokrysheva
BACKGROUND. The clinical and epidemiological characteristics of diabetes mellitus (DM) and the quality of its therapy are the key prognostic dominant that determines the organizational aspects of the diabetic service. The continuous dynamic monitoring of DM has been carried out in the Russian Federation (RF) since 1996 through the activities of the Federal Register of Diabetes Mellitus (FDR).AIMS. The aim of our study was to analyze the epidemiological characteristics of DM in the RF (prevalence, morbidity, mortality), the prevalence diabetic of complications, the state of carbohydrate metabolism (level of HbA1c) and the dynamics of the structure of glucose-lowering therapy (GLT) according to the FDR.MATERIALS AND METHODS. The database of FRD (https://www.diaregistry.ru/), 85 regions of the RF. The data are presented as of 01.01.2023 and in dynamics for the period 2010–2022.RESULTS. The total number of DM patients in the RF as of 01.01.2023 was 4 962 762 (3.31% of the population), including: Type 1 (T1) — 5.58% (277.1 ths), T2 — 92.33% (4.58 million), other DM types —2.08% (103 ths). The dynamics of prevalence over the 13-year period (2010→2022) was 146.0→191.0/100 ths people with T1, and 2036.2→3158.8/100 ths people with T2; morbidity in T1 12.3→8.2/100 ths population, in T2 260.1→191.4/100 ths population; мortality: T1 2.1→2.4/100 ths population, T2 41.2→86.1/100 ths of the population. The main cause of death was cardiovascular: in T1 38.6% cases, in T2 — 50.9%. Life expectancy (average age of death of patients): T1 was 52.7 years, the dynamics in males 50.9 → 50.7 years, females 62.1→56.0 years; in T2 — 74.2 years, males 69.5→70.4 years, females 74.2→76.1 years. The dynamic of DM duration from onset to the death: in T1 15.4→19.9 years; in T2 11→11.4 10.2→11.8 years. The proportion of patients with laboratory-measured HbA1c <7% in the dynamics of 2010–2022: with DM1 24.4%→29%, with DM2 41.5%→42.2%, with HbA1c ≥9.0%: with DM1 29, 4% → 20.4%, with DM2 13.8 → 9.0%.The incidence of diabetic complications as of 01.01.2023 in T1 and T2 patients: neuropathy 41.3% and 23.7%, nephropathy (CKD) 22.8% and 19.1%, retinopathy 28.9% and 12.3%, respectively. The structure GLT in T2 patients as of 01.01.2023: monotherapy — 41.6%; combination of 2 GLM — 30.0%, 3 GLM — 5.8%, insulin therapy in 18.3%.CONCLUSIONS. The information-analytical system FDR is a key tool for systematizing the most important epidemiological and clinical characteristics of DM based on data from real clinical practice, which allows optimizing the algorithm of patient management and improving the quality of care for diabetes.
{"title":"Diabetes mellitus in the Russian Federation: dynamics of epidemiological indicators according to the Federal Register of Diabetes Mellitus for the period 2010–2022","authors":"I. Dedov, M. Shestakova, O. Vikulova, A. Zheleznyakova, M. A. Isakov, D. Sazonova, N. Mokrysheva","doi":"10.14341/dm13035","DOIUrl":"https://doi.org/10.14341/dm13035","url":null,"abstract":"BACKGROUND. The clinical and epidemiological characteristics of diabetes mellitus (DM) and the quality of its therapy are the key prognostic dominant that determines the organizational aspects of the diabetic service. The continuous dynamic monitoring of DM has been carried out in the Russian Federation (RF) since 1996 through the activities of the Federal Register of Diabetes Mellitus (FDR).AIMS. The aim of our study was to analyze the epidemiological characteristics of DM in the RF (prevalence, morbidity, mortality), the prevalence diabetic of complications, the state of carbohydrate metabolism (level of HbA1c) and the dynamics of the structure of glucose-lowering therapy (GLT) according to the FDR.MATERIALS AND METHODS. The database of FRD (https://www.diaregistry.ru/), 85 regions of the RF. The data are presented as of 01.01.2023 and in dynamics for the period 2010–2022.RESULTS. The total number of DM patients in the RF as of 01.01.2023 was 4 962 762 (3.31% of the population), including: Type 1 (T1) — 5.58% (277.1 ths), T2 — 92.33% (4.58 million), other DM types —2.08% (103 ths). The dynamics of prevalence over the 13-year period (2010→2022) was 146.0→191.0/100 ths people with T1, and 2036.2→3158.8/100 ths people with T2; morbidity in T1 12.3→8.2/100 ths population, in T2 260.1→191.4/100 ths population; мortality: T1 2.1→2.4/100 ths population, T2 41.2→86.1/100 ths of the population. The main cause of death was cardiovascular: in T1 38.6% cases, in T2 — 50.9%. Life expectancy (average age of death of patients): T1 was 52.7 years, the dynamics in males 50.9 → 50.7 years, females 62.1→56.0 years; in T2 — 74.2 years, males 69.5→70.4 years, females 74.2→76.1 years. The dynamic of DM duration from onset to the death: in T1 15.4→19.9 years; in T2 11→11.4 10.2→11.8 years. The proportion of patients with laboratory-measured HbA1c <7% in the dynamics of 2010–2022: with DM1 24.4%→29%, with DM2 41.5%→42.2%, with HbA1c ≥9.0%: with DM1 29, 4% → 20.4%, with DM2 13.8 → 9.0%.The incidence of diabetic complications as of 01.01.2023 in T1 and T2 patients: neuropathy 41.3% and 23.7%, nephropathy (CKD) 22.8% and 19.1%, retinopathy 28.9% and 12.3%, respectively. The structure GLT in T2 patients as of 01.01.2023: monotherapy — 41.6%; combination of 2 GLM — 30.0%, 3 GLM — 5.8%, insulin therapy in 18.3%.CONCLUSIONS. The information-analytical system FDR is a key tool for systematizing the most important epidemiological and clinical characteristics of DM based on data from real clinical practice, which allows optimizing the algorithm of patient management and improving the quality of care for diabetes.","PeriodicalId":73708,"journal":{"name":"Journal of diabetes mellitus","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91277049","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: Diabetes Mellitus is a rapidly growing and challenging health issue of the 21st century. Type 2 diabetes (T2D) is a major risk factor for obesity and hypertension (HTN). The prevalence of HTN and obesity in T2D patients is not well documented in the country of Yemen. AIM: The focus of this study was to assess the prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in Yemen.METHODS: A cross-sectional study was carried out in Dhamar city hospitals. Patients diagnosed with diabetes (300 males and females: 30 years old and/or above) visiting an endocrinology and diabetes clinic in Dhamar city hospital for the first time were examined and evaluated for blood glucose levels, mode of treatment, duration of the disorder and body mass index. Socio-demographic and clinical data were collected using pretested questionnaires. Ethical approval was obtained from corresponding ethical committees from Dhamar University and hospitals. Data were analyzed using SPSS 23 version.RESULTS: The prevalence of overweight and/or obesity in T2D was 60.67%, and hypertension was 35.66%. The occurrence of T2D was predominant in females (56.33%), patients with an age over 50 years (61%), and rural dwellers (74%). The mode of treatment was mainly through oral antihyperglycemic and hypoglycemic agents (79.3%). A large population (66.3%) showed poor control of blood glucose levels ranging from more than 131 to 500 mg/dL and the type of work these patients were involved in was mostly physically inactive (64%). The body mass index revealed that more than 35% were found to be overweight and 23% to be obese. Patients with hypertension and undergoing treatment for the same showed a significant (P < 0.001) increase in blood glucose level compared to those who were not diagnosed with HTN.CONCLUSION: The prevalence of obesity, HTN, and poor glycemic control in patients with T2D is high, especially in females.
{"title":"Type 2 diabetes with obesity and hypertension: prevalence and sociodemographic risk factors in Yemen","authors":"S. Mareai, K. Gawli","doi":"10.14341/dm12960","DOIUrl":"https://doi.org/10.14341/dm12960","url":null,"abstract":"BACKGROUND: Diabetes Mellitus is a rapidly growing and challenging health issue of the 21st century. Type 2 diabetes (T2D) is a major risk factor for obesity and hypertension (HTN). The prevalence of HTN and obesity in T2D patients is not well documented in the country of Yemen. AIM: The focus of this study was to assess the prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in Yemen.METHODS: A cross-sectional study was carried out in Dhamar city hospitals. Patients diagnosed with diabetes (300 males and females: 30 years old and/or above) visiting an endocrinology and diabetes clinic in Dhamar city hospital for the first time were examined and evaluated for blood glucose levels, mode of treatment, duration of the disorder and body mass index. Socio-demographic and clinical data were collected using pretested questionnaires. Ethical approval was obtained from corresponding ethical committees from Dhamar University and hospitals. Data were analyzed using SPSS 23 version.RESULTS: The prevalence of overweight and/or obesity in T2D was 60.67%, and hypertension was 35.66%. The occurrence of T2D was predominant in females (56.33%), patients with an age over 50 years (61%), and rural dwellers (74%). The mode of treatment was mainly through oral antihyperglycemic and hypoglycemic agents (79.3%). A large population (66.3%) showed poor control of blood glucose levels ranging from more than 131 to 500 mg/dL and the type of work these patients were involved in was mostly physically inactive (64%). The body mass index revealed that more than 35% were found to be overweight and 23% to be obese. Patients with hypertension and undergoing treatment for the same showed a significant (P < 0.001) increase in blood glucose level compared to those who were not diagnosed with HTN.CONCLUSION: The prevalence of obesity, HTN, and poor glycemic control in patients with T2D is high, especially in females.","PeriodicalId":73708,"journal":{"name":"Journal of diabetes mellitus","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79270857","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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