Assessment of metabolic syndrome components in newly diagnosed type 2 diabetes

Metabolic syndrome (MS) consists of multiple cardiometabolic risk factors that tend to aggregate in an individual more often than only by chance. It frequently coexists with type 2 diabetes mellitus (T2DM). The aim of the present study is to characterize the prevalence of MS and its traits, as well as the modalities of clustering of the components, in 1111 (49.6% female, 50.4% male; mean age of 59 years) newly diagnosed T2DM patients from an outpatient diabetes clinic. According to the International Diabetes Federation (IDF)'s definition, the abdominal obesity is one of "any three of five characteristics" in a person with MS. As all our patients were diabetics, in order to be defined as having MS they must have had a waist circumference ≥ 94 cm for men and ≥80 cm for women and at least one of any of the following factors: elevated triglycerides: ≥150 mg/dL or specific treatment for this lipid abnormality; decreased HDL-cholesterol: 100 mg/dL. Metabolic syndrome incidence was high, no matter what definition was used: 89.7% (IDF's definition), 92.3% (the 2009 harmonized definition with a cut-off value for waist of 80 cm in women and 94 cm in men) and 88.6% (the 2009 harmonized definition with a cut-off value for waist of 88 cm in women and 102 cm in men). The concordance between the three definitions was 85.3% (higher in women). Most of the patients with MS fulfilled four of the criteria. Beside hyperglycemia, the decreasing frequency of MS traits was: increased waist circumference (96.4%), high blood pressure (84.8%), low HDL cholesterol (63.9%) and high triglycerides (57.9%). Among patients with MS, the increased waist and low HDL cholesterol were more frequent findings in women than in men, while hypertriglyceridemia was more frequent in men. Mean value for both systolic and diastolic pressure were higher in women. In sum, the results underline the high prevalence of MS among subjects with newly diagnosed T2DM and in majority of cases, four components are clustering. The clustering appears to be dependent on excess of visceral adipose tissue and has a different pattern depending on gender.Adipobiology 2012; 4: 91-96

A short observational study regarding the lifestyle intervention in newly diagnosed type 2 diabetic patients - cohort 2010

To evaluate the results in metabolic control at newly discovered type 2 diabetic mellitus (T2DM) patients regarding the lifestyle optimization only. In this short (1 year) observational study we included a number of 1855 newly discovered T2DM patients. We compared body mass index (BMI), fasting blood glucose (FBG), HbA1c, triglycerides (TG), high density level cholesterol (HDLc) all these recorded initially at the diagnosis and then 1 year later. At baseline 52.91% males and 52.41% females were recommended only lifestyle and the rest was treated with metformin, sulfonylurea or insulin. After one year the patients who remained on lifestyle only decreased with only 5%, demonstrating that lifestyle optimization remains one of the most important "therapeutic" tools in the metabolic control of T2DM patients studied.Adipobiology 2012; 4: 103-106

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049