Diabetes Mellitus最新文献

{"title":"Long-term results of transferring the patient from therapy with glucagon-like peptide-1 receptor agonists in combination with metformin to a dipeptidyl peptidase-4 inhibitor in combination with pioglitazone and inhibitor of type 2 sodium-glucose cotransporter in type 2 diabetes","authors":"V. Salukhov, D. A. Shipilova, A. A. Minakov","doi":"10.14341/dm13062","DOIUrl":"https://doi.org/10.14341/dm13062","url":null,"abstract":"The pioglitazone belongs to the class of antidiabetic medications and has various pleiotropic effects. The evidence base for this medication, based on the results of randomized clinical trials, demonstrates convincing cardio- and cerebroprotective efficacy of pioglitazone, comparable to innovative glucose-lowering drugs from the classes of GLP-1 agonists and SGLT-2 inhibitors. Currently, in Russia, a fixed combination of pioglitazone and alogliptin is available. However, it should be noted that there has been a recent lack of GLP-1 agonists on the domestic pharmaceutical market, which raises questions about the choice of further tactics for patients who have been taking them until recently.This clinical case presents an example of the transformation of glucose-lowering therapy from a combined treatment regimen with semaglutide and metformin to the combined use of a fixed combination of alogliptin and pioglitazone with empagliflozin. Against the background of therapy change, a stable and pronounced glucose-lowering effect was obtained and confirmed after six months, comparable to GLP-1 receptor agonists without the effect of escape and hypoglycemia. No edema or weight gain was observed, and no other adverse events were detected, which allowed continuing the chosen glucose-lowering therapy. Strategic perspectives of the prescribed therapy were determined — reducing cardio- and cerebrovascular risk and improving the patient’s prognosis.","PeriodicalId":11327,"journal":{"name":"Diabetes Mellitus","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140224841","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":"Binge eating disorder: epidemiological, clinical, pathophysiological, and treatment aspects","authors":"E. Starostina, M. V. Ananyan","doi":"10.14341/dm13122","DOIUrl":"https://doi.org/10.14341/dm13122","url":null,"abstract":"Binge eating disorder (BED) is the most prevalent type of eating disorders encountered in endocrinological practice, with 5 to 66% of obesity patients seeking for losing weight, 10 to 25% of patients with Type 2 diabetes mellitus, and above 70% of Type 2 patients with morbid obesity having BED. BED can seriously challenge the treatment for Type 2 diabetes and obesity, but remains underdiagnosed and undertreated in most cases. The review discussed diagnostic criteria of BED and their evolution during the last three decades, as well as neurochemical, genetic, and psychological components of its pathophysiology and potential role of BED as a new risk factor for Type 2 diabetes. We have also analyzed medical treatments available for an endocrinologist, including potential use of agonists of glucagone-like peptide 1 receptors.","PeriodicalId":11327,"journal":{"name":"Diabetes Mellitus","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140228799","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":"Use of the Guardian Connect glycemic monitoring system in patients after total duodenopancreatectomy in the early postoperative period on intravenous insulin therapy","authors":"A. G. Farmanov, E. V. Bublik, O. Vinogradskaya, O. V. Udovichenko, A. Zilov, S. M. Deunezheva, E. G. Ryzhkova, V. I. Egorov, V. Fadeev, A. V. Zhivov, I. E. Tobianskaya","doi":"10.14341/dm13055","DOIUrl":"https://doi.org/10.14341/dm13055","url":null,"abstract":"BACKGROUND: Among different subtypes of pancreatogenic diabetes mellitus the biggest difficulties of glycemic control arise in patients after total duodenopancreatectomy (TDPE), first of all due to the presence of absolute insulin insufficiency.AIM: Estimating safety and cost-effectiveness Guardian Connect CGM system in early postoperative period in hospitalized patients after TDPE on continuous intravenous insulin therapy (CIVIT).MATERIALS AND METHODS: Glucose measurement results of 26 patients in early postoperative period after TDPE were analyzed. In 12 of them, we used Guardian Connect CGM system. In this group 43 cycles (1 cycle — 6 days, 258 days total) of CGM and 971 glucometer measurements used for CGM calibration were analyzed; in other 14 patients in whom only glucometer was used we analyzed 2496 glycemic values.Cost-effectiveness was calculated over 6 days for CGM and only glucometer use (including cost of CGM, glucometers, disposable materials, clinic wage-costs to medical staff for time required for glucose control).RESULTS: Glucose levels of group #1 were in the target range 5.6 to 10.0 mmol/L (66.7 vs 61.2%, p=0.003) and the range 4.3–11.6 mmol/L (85.2% vs 82.2%, p=0.038) more than in comparison with group #2.The frequency of hypoglycemic episodes (<3.9 mmol/L) was statistically significantly lower in the CGM group (6 vs 54, p<0.001, RO 8.463 [3.579; 20.015], RR 1.746 [1.551; 1.966]).Cost analysis of glucose control using Guardian Connect CGM system for one cycle (6 days) and cost of glucose control using glucose meter for the same period showed that using Guardian Connect CGM system in patients after TDPE on intravenous insulin therapy reduced clinic costs by 21.7% in ICU and by 25.7% in the hospital department.CONCLUSION: Guardian Connect CGM have demonstrated its safety and cost-effectiveness during glucose control in patients in early postoperative period after TDPE on CIVIT.","PeriodicalId":11327,"journal":{"name":"Diabetes Mellitus","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230612","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":"Novel cardioprotective and nephroprotective combination in patients with type 2 diabetes and chronic kidney disease: perspectives of use","authors":"Y. Khalimov, G. V. Semikova, Yu. A. Shutova","doi":"10.14341/dm13113","DOIUrl":"https://doi.org/10.14341/dm13113","url":null,"abstract":"Chronic kidney disease (CKD) is a common complication of diabetes mellitus. It increases significantly cardiovascular risk and decreases the quality of life. CKD requires treatment, and the treatment paradigm for type 2 diabetes has shifted from a glucose-centric approach towards disease-modifying therapy. Attention is being paid to cardioprotective and nephroprotective effects. In patients with type 2 diabetes and CKD, drugs that affect the renin-angiotensin-aldosterone system, as well as sodium-glucose cotransporter type 2 inhibitors (iSGLT2) are widely used. Despite the proven positive effect of these drugs in preservation of renal functions, the pathogenesis of CKD contains links that have not yet been covered. In particular, the activity of fibrosis processes in the renal parenchyma is increased in patients with CKD due to high expression of mineracorticoid receptors. It may be a potential target for nephroprotective drugs. Thus, mineralocorticoid receptor antagonists (MCRA) may influence the residual risk of CKD progression. In particular, the effectiveness of the non-steroid selective AMCR finerenone has been proven in a number of large clinical studies, which confirmed its nephroprotective potential. In this regard, studies aimed at studying the joint effect of known nephroprotective drugs, as well as their combined effect on cardiovascular risk, are highly needed.This review marks the main mechanisms of the combined action of iSGLT2 and finerenone. Discussion of the results of main clinical studies with combined use of standard nephroprotective therapy, SGLT2 and finerenone is also presented.","PeriodicalId":11327,"journal":{"name":"Diabetes Mellitus","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230777","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":"Diagnosis of artificial hypoglycemia due to oral hypoglycemic drugs by high-performance liquid chromatography with tandem mass spectrometric detection","authors":"M. Yukina, E. A. Troshina, N. Nuralieva, V. A. Ioutsi, O. Rebrova, G. A. Mel’nichenko, N. G. Mokrysheva","doi":"10.14341/dm13119","DOIUrl":"https://doi.org/10.14341/dm13119","url":null,"abstract":"BACKGROUND: Artificial hypoglycemia (ArH) is a decrease of blood glucose levels less than 3 mmol/l due to the deliberate use of hypoglycemic drugs by a patient outside of medical appointments. Timely diagnosis of this kind of hypoglycemia avoids unnecessary numerous examinations and hospitalizations. However, the detection of ArH still remains an extremely difficult task for both the healthcare facility and the attending physician. The foreign literature describes cases of successful detection of deliberate intake of oral hypoglycemic drugs (OHD) using high-performance liquid chromatography with tandem mass spectrometric detection (HPLC-MS/MS). Thus, it is relevant to develop and validate a method for determining OHD using HPLC-MS/MS.AIM: To optimize the diagnosis of ArH due to the use of OHD.MATERIALS AND METHODS: A total of 92 patients were examined. The development of the HPLC-MS/MS method for the detection of the studied OHD (sOHD; n=1-glibenclamide, n=1-gliquidone, n=1-gliclazide, n=1-glimepiride, n=1-glipizide, n=1-nateglinide and n=1-repaglinide) in the blood was carried out in a group of patients with diabetes mellitus type 2 (n=7) who received sOHD, and a group of conditionally healthy people who did not receive any medications (n= 7). To validate the method, the determination of sOHD substances was carried out on groups of patients with hyperinsulinemic nondiabetic hypoglycemia (NDH) of unknown origin (n=11) and with insulinoma (n=67).RESULTS: In the study of blood samples by HPLC-MS/MS in the group of patients with diabetes mellitus type 2, was confirmed in 100% of the cases the use of the drug that the patient received, in the group of conditionally healthy — sOHD were not detected. A false positive result was not obtained in any conditionally healthy and in any patient with insulinoma. ArH was diagnosed in 5 out of 11 patients in the group with hyperinsulinemic NDH of unknown origin, the method identified sOHD glibenclamide and gliclazide in the patients’ blood samples. In the remaining 6 patients of this group, examinations were continued and other causes of NDH were diagnosed. The sensitivity of the method was 100% [74%; 100%], specificity — 100% [95%; 100%].CONCLUSION: The HPLC-MS/MS method has high diagnostic accuracy in the detection and identification of sOHD (glibenclamide, gliquidone, gliclazide, glimepiride, glipizide, nateglinide and repaglinide) in blood samples of patients receiving these drugs. Currently, due to the low availability of the method, this study is advisable to use in patients with hyperinsulinemic hypoglycemia with negative results of first-line insulinoma imaging methods (computed tomography with contrast enhancement, ultrasound and magnetic resonance imaging of the abdominal cavity).","PeriodicalId":11327,"journal":{"name":"Diabetes Mellitus","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230495","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":"Automated analysis of retinal microcirculation in type 1 diabetes mellitus","authors":"Y. Yusef, M. Durzhinskaya, V. Pavlov, D. Petrachkov, I. Gurevich, V. Yashina, A. Tleubaev, V. V. Fadeyev, I. Poluboyarinova, A. E. Goldsmid, R. A. Karamullina, D. Lipatov, M. Budzinskaya","doi":"10.14341/dm12931","DOIUrl":"https://doi.org/10.14341/dm12931","url":null,"abstract":"BACKGROUND: The paper is dedicated to the assessment of the retinal microvasculature in patients with type 1 diabetes mellitus (DM) with various features of the clinical course and different stages of diabetic retinopathy (DR). Automatic analysis of optical coherence tomogram angiograms (OCT-A) was carried out with specially developed software that provides the ability to estimate quantitative vascular parameters.AIM: The purpose of the study was to assess diagnostic accuracy of clinical parameters and imaging biomarkers in type 1 diabetes using a new algorithm for OCT-A analysis.MATERIALS AND METHODS: The study involved 186 people (365 eyes) with type 1 diabetes. The analysis of the OCT-A parameters was performed with a specially developed software. The range of studied parameters included: foveal avascular zone (FAZ), vessel area density (VAD), skeletonized vessel density (VSD), vessel diameter index (VDI), vascular curvature index (VCI) at the level of superficial (SCP) and deep (DCP) retinal capillary plexuses in the macular region. A correlation between the involvement of OCT-A biomarkers and age, degree of DM, increased glycated hemoglobin (HbA1c) level, stage of DR, and maximally corrected visual acuity (BCVA) was analysed.RESULTS: A significant dependence of all quantitative OCT-A parameters on the age of and duration of diabetes (p<0.05) was revealed. An increase in FAZ SCP (K=0.788, p=0) and DCP (K=0.764, p=0.03); decrease in VAD SCP (K=-0.476, p=0) and DCP (K=-0.485, p=0); VSD SCP (K=0.692, p=0) and DCP (K=0.713, p=0); an increase in VDI SCP (K=0.698, p=0) and DCP (K=787, p<0.01), as well as an increase in the VCI SCP (K=0.735, p=0) and DCP (K=0.694, p p=0). An inverse relationship was found between HbA1c level and VAD SCP (K=-0.636, p=0) and DCP (K=-0.619, p=0.05) were identified as well as a direct relationship with VDI DCP (K=0.717, p<0.05). The influence of the HbA1c level on other parameters was not confirmed (p>0.05). The presence of correlation between BCVA and FAZ DCP (K=-0.728, p=0), as well as VSD DCP (K=-0.754, p=0) was proved.CONCLUSION: As a result of a comprehensive analysis of clinical data and imaging biomarkers, a number of patterns that have diagnostic value in diabetic retinopathy were identified.","PeriodicalId":11327,"journal":{"name":"Diabetes Mellitus","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140229093","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":"Prevalence of heart failure among hospitalized patient with T2D: results of a prospective observational multicenter study (CREDO)","authors":"M. Antsiferov, Z. Kobalava, T. Demidova, T. N. Markova, V. V. Tolkacheva, L. Morgunov, A. V. Andreeva, Е. Y. Pashkova, M. R. Khaziakhmetova, E. S. Samburova, S. G. Vedyashkina, A. Mkrtumyan, N. Petunina, A. N. Serebrov, T. M. Deeva, A. Y. Karaeva","doi":"10.14341/dm13124","DOIUrl":"https://doi.org/10.14341/dm13124","url":null,"abstract":"BACKROUND: Heart failure (HF) is in the first place in the structure of cardiovascular death in patients with type 2 diabetes mellitus (T2D). One of the factors determining the prognosis of patients with this pathology is hospitalization. The difficulties of managing patients are related to the heterogeneity of the population. In some cases, HF in patients with T2D remains undiagnosed, and data on the true frequency of HF in patients with T2D and their clinical and laboratory characteristics in real clinical practice remain limited.AIM: To assess the prevalence of HF, clinical and demographic characteristics and therapy profile in patients with T2D admitted to multidisciplinary hospitals.MATERIALS AND METHODS: A prospective observational multicenter study was conducted at the city clinical hospitals of the Moscow. For the period from August 2022 to April 2023, data from patients with T2D were analyzed. Data collection was carried out at one visit. The study design did not involve any intervention in routine clinical practice, including the choice of diagnostic method or treatment.RESULTS: The study included 445 patients in accordance with the main inclusion criteria - T2D, age over 50 years, duration of T2D more than 3 years. The incidence of HF in patients with type 2 diabetes at discharge was 76.6%. The diagnosis of HF was confirmed in 48.7% (n=217), newly diagnosed HF occurred in 27.9% (n=124) of cases, in 12.6% of patients (n=56) the diagnosis of HF was withdrawn, in 10.8% (n=48) of cases the diagnosis of HF was not established. The frequency of prescribing drugs at discharge was iSGLT-2 — 77.3% (n=344), statins — 86.7% (n= 386), MRAs — 23.1% (n=103), diure­tics — 46.1% (n=205).CONCLUSION: 76.6% of patients with T2D admitted to multidisciplinary Moscow hospitals were diagnosed with HF at discharge. The results obtained confirm the possibility of detecting HF and initiating cardioprotective therapy at the hospital stage, using inpatient clinical diagnostic examination, and patients with type 2 diabetes lasting more than 3 years and aged over 50 years can be classified as a high risk group for developing HF.","PeriodicalId":11327,"journal":{"name":"Diabetes Mellitus","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140234938","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":"Serum biomarkers associated with liver fibrosis in patients with type 2 diabetes","authors":"Y. A. Krasner, V. Romanov, O. N. Fazullina, M. F. Osipenko, V. Klimontov","doi":"10.14341/dm13059","DOIUrl":"https://doi.org/10.14341/dm13059","url":null,"abstract":"BACKGROUND: The diagnosis of liver fibrosis is an important task in the management of patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes. The currently used diagnostic methods have a number of disadvantages such as invasiveness and high cost, or insufficient sensitivity and specificity. Therefore, the search for new non-invasive markers of liver fibrosis remains an actual challenge.AIM: To assess a diagnostic value of serum growth differentiation factor-15 (GDF-15), microfibril-associated glycoprotein 4 (MFAP-4), collagen type IV alpha1 (COL4alpha1), Mac-2 binding protein (M2BPGI) and chitinase-3-like protein 1 (YKL-40) as markers of liver fibrosis in patients with type 2 diabetes and NAFLD.MATERIALS AND METHODS: A single center cross-sectional observational study was performed. The study included 74 patients, 23 men and 51 women, aged 18 to 74 years. Liver elastography was used as reference method for the fibrosis evaluation. APRI and fib-4, non-invasive fibrosis indices, were assessed. Serum concentrations of GDF-15, MFAP-4, COL4alpha1, M2BPGI, and YKL-40 were determined by ELISA. ROC analysis was used to evaluate the sensitivity and specificity of serum markers for the diagnosis of the liver fibrosis.RESULTS: Liver fibrosis stage 1 was verified in 16 subjects, stage 2 in 12, stage 3 in 7, and stage 4 in 19. Patients with advanced liver fibrosis (stages 3–4), compared with those without severe fibrosis (stages 0–2), had higher levels of GDF-15 (p=0.003), COL4alpha1 (p=0.007), and YKL-40 (p=0.04). Patients with stage 1-2 liver fibrosis had higher levels of COL4alpha compared to those without any signs of fibrosis (p=0.02). There were no significant differences in the level of MFAP-4 and M2BPGI between patients with different severity of fibrosis. According to the ROC analysis, GDF-15, COL4alpha1 and YKL-40 have diagnostic value in the detection of severe liver fibrosis comparable to that of the APRI and fib-4 indices.CONCLUSION: GDF-15, COL4alpha1 and YKL-40 could be considered as promising non-invasive markers of liver fibrosis in patients with type 2 diabetes and NAFLD.","PeriodicalId":11327,"journal":{"name":"Diabetes Mellitus","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140232188","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":"Metabolic biomarkers in patients with type 2 diabetes mellitus and heart failure with preserved ejection fraction","authors":"T. Sveklina, S. B. Shustov, S. N. Kolyubayeva, A. N. Kuchmin, V. A. Kozlov, E. V. Smirnova, A. V. Zharkov","doi":"10.14341/dm13028","DOIUrl":"https://doi.org/10.14341/dm13028","url":null,"abstract":"BACKGROUND: Half of all patients with chronic heart failure (CHF) have preserved ejection fraction (CHF-nEF). The drug’s use effective for treatment of CHF with reduced ejection fraction (CHF-nFV) reduces the hospitalization incidence but does not affect the cardiovascular incidence or overall mortality in patients with CHF-nFV. Finding differences between CSN-SFV and CSN-nFV biomarkers is a pressing scientific problem.AIM: To study the metabolic disorders biomarkers intergenic relationships, myocardial damage, and to evaluate their role in the CHF development in patients with DM2.MATERIALS AND METHODS: We studied the lipid and carbohydrate metabolism disorder genes polymorphisms frequencies in patients with CHF-CFV and DM2 (48 patients), CHF-NFV and DM2 (46) and patients with metabolic syndrome (MS) without CHF (68), mean age of patients was 69,7±5,3 yo. DNA was isolated from venous blood according to the manufacturer’s methodology. Gene polymorphisms were determined by real time PCR. The studied polymorphisms correlations with clinical and laboratory data and associations between clinical and laboratory tests were identified by regression analysis.RESULTS: In the control group, PPARG, APOC3 C3238G rs5128, LIPC -250 G>A rs2070895, APOA1 G-75A rs670, FABP2 Ala54Thr G>A rs1799883, ADRB2 5318 C>G rs1042714 genes polymorphisms, along with co-dependent ADRB3, FTO, FABP2 genes polymorphic form a gene network regulating plasma concentrations of LDL, uric acid and CAD. Gene polymorphisms have been found to be associated with clinical and/or laboratory parameters in patients with CHF-CFV: PPARGC1AGly482Ser G>A rs8192678 with CAD; PPARGT-2821C rs12497191 with glycated hemoglobin level; FTO A>T rs9939609 (α-ketoglutarate dependent dioxygenase gene) with waist circumference; LEPR A>G rs1137101 (leptin receptor gene) with MAP. The following polymorphisms were found to be associated in patients with CHF-nFV: LIPC-250 G>A rs2070895 (liver triglyceride lipase gene) with MAP; PPARGC1A Gly482Ser G>A rs8192678 with MAP; FTO A>T rs9939609 with waist volume.CONCLUSIONS: From the study results, it is evident that patients with DM2 having CHF with different PV differ significantly among themselves by the presence of polymorphic genes prone to network interactions. The greatest number of such interactions is observed in the group of CHF-sFV, which determines a more complex course of this variant of CHF than in patients with CHF-nFV.","PeriodicalId":11327,"journal":{"name":"Diabetes Mellitus","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140232651","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":"Hypoglycemic episodes among type 1 diabetic patients in Unaizah, Saudi Arabia: causes, management, and associated factors","authors":"S.K.S. Aldekheel, M.A. Shahin","doi":"10.14341/dm13112","DOIUrl":"https://doi.org/10.14341/dm13112","url":null,"abstract":"BACKGROUND: Diabetes mellitus is a prevalent condition in Saudi Arabia, with approximately 20% of the adult population affected, ranking sixth highest in the world. This disease is associated with both acute and chronic complications. Among these complications, hypoglycemia is particularly dangerous and can occur during diabetes treatment. Individuals diagnosed with type 1 diabetes may experience multiple episodes of asymptomatic or symptomatic hypoglycemia per week.AIM: To assess the frequency of hypoglycemic episodes and identify associated factors among individuals with type 1 diabetes in Unaizah City, Saudi Arabia.MATERIALS AND METHODS: A quantitative, cross-sectional, descriptive research design was employed in April and May of 2023. A convenience sample of 280 type 1 diabetic clients living in the Qassim region of Unaizah City was selected. Participants completed an electronic structured questionnaire that collected information on sociodemographic factors and hypoglycemia-related data. Descriptive statistics and a Chi-square test were used for data analysis, utilizing SPSS version 23. Ethical considerations were strictly adhered to throughout the study.RESULTS: The findings revealed that over two-thirds of the participants (72.1%) reported experiencing hypoglycemic episodes within the past week. Furthermore, more than one-fifth of these individuals attributed the cause of the episodes to high insulin doses (21%). Seeking medical assistance to change medications for hypoglycemia was reported by more than half of the participants (55.4%), while less than half received help from others during hypoglycemic episodes (42.9%). It was observed that adherence to diabetic medication was higher than adherence to diabetic diet and exercise regimens. Males, as well as single or divorced participants, reported a higher frequency of hypoglycemic episodes. Additionally, patients with higher levels of education and those residing in rural regions reported a higher exposure to hypoglycemic episodes.CONCLUSION: The effective management of hypoglycemia necessitates patient education and awareness regarding its causes and symptoms. Targeted interventions are required to improve adherence to therapeutic regimens and lifestyle modifications. Furthermore, when managing hypoglycemia, it is important to consider the gender, marital status, educational level, and residence of diabetic patients.","PeriodicalId":11327,"journal":{"name":"Diabetes Mellitus","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140416220","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}