NPY Levels In Type 1 Diabetic Men of Different Duration.

Background: The aim of the present study was to evaluate whether the different duration of type 1 diabetes mellitus influences basal NPY secretion. Design: The NPY concentrations were measured in sixty-eight men with insulin-dependent diabetes mellitus (IDDM) (duration: group 1 (n.21) <5 years (range 2-4 years); group 2 (n.24) >5 years and <10 years (range: 6-9 years); group 3 (n.29) >10 years (range: 11-14 years)) and in age matched normal control subjects (n. 30). Results: The NPY levels were significantly lower in group 3 than in group 2 and 1 and in the control group, in group 2 than in group 1 and in the control group and in group 1 than control group. Conclusion: These results support the view that the duration of diabetes may have a modulatory role in the decreased basal NPY secretion observed in diabetics

Relation between clinical features and gastric emptying time in diabetic patients

BACKGROUND: Gastroparesis is characterized by delayed gastric emptying. This pathology is usually observed in patients with diabetes. One standard approach to quantitative assessment of gastric emptying is scintigraphic study. The aim of present study was to perform scintigraphic study of gastric emptying time in patient with diabetes and to find its correlation with patients' characteristics. MATERIALS AND METHODS: Gastric emptying was assessed in 19 patients with type 2 diabetes (mean age of 61.04 ± 6.09 years) and 6 healthy volunteers. Characteristics of the patients were sex, age, duration of diabetes, blood sugar and serum HbA1c level. RESULTS: Results of present study revealed that gastric emptying half time was significantly larger in patients with type 2 diabetes as compared with healthy volunteers (P-value < 0.05). While correlation of sex, age, duration of diabetes and blood sugar with gastric emptying time was not statistically significant, HbA1c level had significant effect on gastric emptying time. CONCLUSION: Results of this prospective study indicated that level of serum HbA1c is an effecting factor on gastric emptying time in patients with type 2 diabetes; however, these preliminary findings should be validated in larger and well-designed studies. Copyright © 2015 Via Medica

Duration of type 2 diabetes is a predictor of elevated plantar foot pressure

AIMS: Elevated plantar pressure is considered a significant risk factor for ulceration in diabetes mellitus. The aim of this study was to determine whether duration of diabetes could affect plantar pressure in patients with no known significant comorbidity or foot pathology.METHODS: Participants with type 2 diabetes, but without known confounding factors that could alter peak pressure, were matched for age, weight, and gender and categorized into 3 groups of diabetes duration: group 1 (1-5 yr), group 2 (6-10 yr), and group 3 (11-15 yr). Plantar pressures were recorded utilizing a twostep protocol at a self-selected speed.RESULTS: One-way analysis of variance (ANOVA) revealed significant differences in mean peak plantar pressures between the three groups under the 2nd - 4th metatarsophalangeal joint (MPJ) region of interest (ROI) (p = 0.012 and p = 0.022, respectively) and left heel (p = 0.049). Also, a significant difference in mean pressure-time integral under the left 2nd - 4th MPJ ROI (p = 0.021) and right heel (p = 0.048) was observed. Regression analysis confirmed that mean peak plantar pressures in the first group (but not in the second group) were significantly lower than in the third group (p = 0.005).CONCLUSIONS: As the duration of diabetes increased, peak plantar pressure increased significantly under the 2nd - 4th MPJ ROIs. These findings suggest that clinicians should make more use of pressure mapping technology as part of their clinical management plan in patients with diabetes >10 yr, even if they have no complications or deformities, to preserve functional limbs in this high-risk population.peer-reviewe

Vascular changes in diabetic retinopathy-a longitudinal study in the Nile rat.

Diabetic retinopathy is the most common microvascular complication of diabetes and is a major cause of blindness, but an understanding of the pathogenesis of the disease has been hampered by a lack of accurate animal models. Here, we explore the dynamics of retinal cellular changes in the Nile rat (Arvicanthis niloticus), a carbohydrate-sensitive model for type 2 diabetes. The early retinal changes in diabetic Nile rats included increased acellular capillaries and loss of pericytes that correlated linearly with the duration of diabetes. These vascular changes occurred in the presence of microglial infiltration but in the absence of retinal ganglion cell loss. After a prolonged duration of diabetes, the Nile rat also exhibits a spectrum of retinal lesions commonly seen in the human condition including vascular leakage, capillary non-perfusion, and neovascularization. Our longitudinal study documents a range and progression of retinal lesions in the diabetic Nile rat remarkably similar to those observed in human diabetic retinopathy, and suggests that this model will be valuable in identifying new therapeutic strategies

Diabetes Alters Diurnal Rhythm of Electroretinogram in db/db Mice

Diabetic retinopathy (DR) is the most common complications of diabetes and a leading cause of blindness in the United States. The retinal neuronal changes precede the vascular dysfunction observed in DR. The electroretinogram (ERG) determines the electrical activity of retinal neural and non-neuronal cells. The retinal ERG amplitude is reduced gradually on the progression of DR to a more severe form. Circadian rhythms play an important role in the physiological function of the body. While ERG is known to exhibit a diurnal rhythm, it is not known whether a progressive increase in the duration of diabetes affects the physiological rhythm of retinal ERG. To study this, we determined the ERG rhythm of db/db mice, an animal model of type 2 diabetes at 2, 4, and 6 months of diabetes under a regular light-dark cycle and constant dark. Our studies demonstrate that the diurnal rhythm of ERG amplitude for retinal a-wave and b-wave was altered in diabetes. The implicit time was increased in db/db mice while the oscillatory potential was reduced. Moreover, there was a progressive decline in an intrinsic rhythm of ERG upon an increase in the duration of diabetes. In conclusion, our studies provide novel insights into the pathogenic mechanism of DR by showing an altered circadian rhythm of the ERG

Attitudes to food and lifestyle choices in women with well-controlled and poorly-controlled type 2 diabetes mellitus from different ethnic groups : a pilot study : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition at Massey University

Type 2 diabetes has reached epidemic proportions in New Zealand, as it has globally. There has also been a dramatic rise in numbers from different ethnic groups attending the Auckland Diabetes Centre, with interpreters in approximately 60 different languages being employed. Research indicates that good glycaemic control in people with diabetes can dramatically reduce the risk of complications. However there are many barriers to achieving this. This thesis, by a dietician working at the Auckland Diabetes Centre, examines the research pertaining to the ethnic groups with the highest prevalence of type 2 diabetes, these being Maori, Pacific, Chinese and Indian, along with European groups. It investigates some of the socio-cultural and psychological issues which may be barriers to lifestyle and dietary modification for optimal diabetes control. A total of 232 women attending the Auckland Diabetes Centre took part in this study, aged from 24 to 78 years, the average being 56 years. Duration of diabetes ranged from one to 44 years, with an average of seven years. A questionnaire, designed to obtain their views on diabetes, how it affects their lifestyle, and their perceptions of food and health, was completed at their follow up visit. All had received dietary and lifestyle advice and questionnaire responses indicated a good dietary knowledge. It was evident from comments made that most felt the information given by the dietician was practical, focused on normal food; it was easy to understand and gave them confidence. Most agreed that not smoking, regular meals, daily physical activity, and taking medication (if prescribed) were very important. No statistical association was found between diabetes control and age, income, marital status, education, weight, blood pressure or lipid profile. However duration was significant, with more of those with poorly controlled diabetes likely to have diabetes longer; there was also evidence of an ethnic difference (p=0.02). This was to be expected given that diabetes is a progressive disease, but could indicate frustration and loss of motivation. Psychological issues were significant. The number of ethnic differences found in this study suggest that a more holistic approach and a wider knowledge of cultural and psychological issues is required in diabetes education. Health professionals need to be cognisant of the individual's health beliefs, cultural practices, and any psychological issues, to better assist people of different ethnic groups in management of their diabetes, in order that they may live full and normal lives and avoid complications. At present only 26 (8%) practising dieticians are from minority ethnic groups and not all of these are bilingual. There are only 192 (60%) dieticians employed by District Health Boards, for a population of four million people, 115,000 of whom have diagnosed diabetes. This pilot has identified more precisely the requirements for effective counselling

Duration of diabetes and the risk of major cardiovascular events in women and men: A prospective cohort study of UK Biobank participants

Aims: Diabetes has been associated with a greater excess risk of cardiovascular disease (CVD) in women than men. We investigated whether there are also sex differences in the association of diabetes duration and the risk of CVD. Methods: Data were used from 18,961 (40% women) individuals with type 2 diabetes, without a history of CVD, in the UK Biobank. Sex-specific incidence rates were calculated by diabetes duration. Cox proportional hazards analyses estimated multiple-adjusted sex-specific hazard ratios (HR) and women-to-men ratio of HRs (RHR). Results: Over a median follow-up of 11 years, 1,506 (29% women) CVD events were documented. Compared with men, women had lower multiple-adjusted incidence rates of CVD per 10,000 person-years for all categories of diabetes duration. Duration of diabetes was associated with an increased risk of CVD in both sexes. A 5-year increase in diabetes duration was associated with an approximately similar excess risk of about 20% for each of the three endpoints, in both sexes. Conclusions/Interpretation: The increased risk of CVD associated with longer duration of diabetes is similar in women and men, and thus cannot explain the higher excess risk from diabetes in women in this study population

Electrophysiological Changes of Sensory Nerves in Patients with Type-2 Diabetes Mellitus of Different Duration

Background: Peripheral neuropathy is a common complication of diabetes mellitus. Among the diabetic neuropathies symmetrical sensory polyneuropathy is the most common one. Abnormalities of sensory nerve conduction are features of diabetic nerve damage. Significant association has been found between electrophysiological parameters of sensory nerves and duration of metabolic derangement in patients with diabetic neuropathy. Objectives: The present study was designed to characterize nerve conduction abnormalities of sensory nerves in subjects with type 2 diabetes mellitus of different duration and also to assess whether duration of diabetes has any influence on the sensory nerve function. Methods: Forty-four type 2 diabetic subjects were included in two groups:- Group B1 consisted of 23 diabetic subjects having duration of diabetes for 5-10 years (shorter duration) and Group B2 consisted of 21 diabetic subjects having duration of diabetes for 10-15 years (longer duration). Twenty-five age and BMI matched healthy subjects without family history of diabetes were included as Group A (control) subjects. Sensory nerve conduction velocities, action potential amplitudes and latencies of ulnar and sural nerves were measured by a standard NCV-EMG equipment. Result: No significant changes in sensory nerve conduction parameters were observed in the group of diabetic subjects having shorter duration of diabetes. In the diabetic group with relatively longer duration of diabetes some of the sensory nerve conduction parameters were affected. Among them S SNAP and S NCV were significantly (P<0.01 and <0.05 respectively) reduced in diabetic group with relatively longer duration of diabetes. Conclusion: The results of the study indicated that neuronal dysfunction for sensory nerves appears after a prolonged exposure to hyperglycemia; there may also be some genetic and biochemical basis (other than hyperglycemia) for early sensory sparing in type 2 diabetic population of Bangladesh. DOI: 10.3329/bsmmuj.v3i1.5507 BSMMU J 2010; 3(1): 9-1

Role of HbA1c and duration of diabetes in predicting mortality in patients of diabetic ketoacidosis in type II diabetes mellitus

Background: Previous studies have reported the presence of diabetes ketoacidosis in patients of type 2 diabetes mellitus (T2DM). India reported that up to 30% of hospitalized DKA cases result in inpatient death. Aims and objectives of the study was to study the role of HbA1c and duration of diabetes in outcome of patients of diabetic ketoacidosis in type 2 diabetes mellitus.Methods: Hundred T2DM patients having DKA admitted in the Department of Medicine, Gandhi Medical College and Hamidia Hospital, Bhopal, were included. Data on demography (age, sex and diabetes duration, random blood sugar (RBS) and glycated hemoglobin (HbA1c) were recorded for each patients. Outcome was also recorded and compared with duration of diabetes and HbA1c level.Results: DKA was more common in age group of51-55 years (21%) with mean age of 56.10±10.40 years. Male preponderance was observed. Mean duration of diabetes, hemoglobin, random blood sugar (RBS) and HbA1c were 7.28±3.81 years, 9.8±1.42 gm%, 351.72±22.32 mg/dl, and 7.14±0.10 respectively. Mortality was higher among the patients with longer duration of diabetes (23.1%; p=0.012) and higher HbA1c (25%, p>0.05).Conclusions: Duration of diabetes play a significant role in deciding mortality in T2DM patients with DKA however HbA1c has no role in that