Renin-Angiotensin-Aldosterone System, Glucose Metabolism and Incident Type 2 Diabetes Mellitus: MESA.

Background Mechanistic studies suggest that aldosterone impairs glucose metabolism. We investigated the cross-sectional associations of aldosterone and plasma renin activity with fasting plasma glucose, insulin resistance ( IR ), β-cell function, and longitudinal association with incident diabetes mellitus among adults in MESA (the multiethnic study of atherosclerosis) prospective cohort study. Methods and Results Homeostatic model assessment of IR ( HOMA 2- IR ) and HOMA 2-β were used to estimate IR and β-cell function, respectively. Incident diabetes mellitus was defined as fasting plasma glucose ≥126 mg/dL or anti-diabetic medication use at follow-up. Linear regression was used to examine cross-sectional associations of aldosterone with fasting plasma glucose, HOMA 2- IR and HOMA 2-β; Cox regression was used to estimate hazard ratios ( HR ) for incident diabetes mellitus with multivariable adjustment. There were 116 cases of incident diabetes mellitus over 10.5 years among 1570 adults (44% non-Hispanic white, 13% Chinese American, 19% Black, 24% Hispanic American, mean age 64±10 years, 51% female). A 100% increase in log-aldosterone was associated with a 2.6 mg/dL higher fasting plasma glucose, 15% higher HOMA 2- IR and 6% higher HOMA 2-β ( P<0.01). A 1- SD increase in log-aldosterone was associated with a 44% higher risk of incident diabetes mellitus ( P<0.01) with the greatest increase of 142% ( P<0.01) observed in Chinese Americans ( P for interaction=0.09 versus other ethnicities). Similar cross-sectional findings for log-plasma renin activity existed, but log-plasma renin activity was not associated with incident diabetes mellitus after full adjustment. Conclusions Aldosterone is associated with glucose homeostasis and diabetes mellitus risk with graded associations among Chinese Americans and blacks, suggesting that pleiotropic effects of aldosterone may represent a modifiable mechanism in diabetes mellitus pathogenesis with potential racial/ethnic variation

Obesity and diabetes mellitus association in rural community of Katana, South Kivu, in Eastern Democratic Republic of Congo : Bukavu Observ Cohort study results

Background: Factual data exploring the relationship between obesity and diabetes mellitus prevalence from rural areas of sub-Saharan Africa remain scattered and are unreliable. To address this scarceness, this work reports population study data describing the relationship between the obesity and the diabetes mellitus in the general population of the rural area of Katana (South Kivu in the Democratic Republic of the Congo). Methods: A cohort of three thousand, nine hundred, and sixty-two (3962) adults (>15 years old) were followed between 2012 and 2015 (or 4105 person-years during the observation period), and data were collected using the locally adjusted World Health Organization's (WHO) STEPwise approach to Surveillance (STEPS) methodology. The hazard ratio for progression of obesity was calculated. The association between diabetes mellitus and obesity was analyzed with logistic regression. Results: The diabetes mellitus prevalence was 2.8 % versus 3.5 % for obese participants and 7.2 % for those with metabolic syndrome, respectively. Within the diabetes group, 26.9 % had above-normal waist circumference and only 9.8 % were obese. During the median follow-up period of 2 years, the incidence of obesity was 535/100,000 person-years. During the follow-up, the prevalence of abdominal obesity significantly increased by 23 % (p < 0.0001), whereas the increased prevalence of general obesity (7.8 %) was not significant (p = 0.53). Finally, diabetes mellitus was independently associated with age, waist circumference, and blood pressure but not body mass index. Conclusion: This study confirms an association between diabetes mellitus and abdominal obesity but not with general obesity. On the other hand, the rapid increase in abdominal obesity prevalence in this rural area population within the follow-up period calls for the urgent promoting of preventive lifestyle measures

Facilitators and barriers of adaptation to diabetes: experiences of Iranian patients

Background: Diabetes mellitus is one of the most challenging and burdensome chronic diseases of the 21st century and More than 1% of the Iranian urban population older than 20 years develops Type 2 diabetes each year. Living with diabetes mellitus has been described as a dynamic personal transitional adaptation, based on restructuring of the illness perceived experience and management of the self. Adaptation to Type 2 Diabetes mellitus is an integral part of diabetes care.This study explored the experiences of facilitators and barriers adaptation to Type 2 Diabetes by Iranian patients.Methods: This study was conducted by using qualitative content analysis. Data were collected via in-depth, semi-structured and face to face interviews with 15 patients with type2 diabetes.Results: Three themes emerged from collected data, including a) individual context with Beliefs, personal background, and previous experience subthemes. b) supportive system with Family, Society and Health organizations subthemes and c) self-comparison with comparison with other diabetes and comparison with other diseases subthemes.Conclusions: Identifying and managing Facilitators and Barriers adaptation to Type 2 Diabetes mellitus are an integral part of diabetes care. This study provides a better understanding of the factors from perspective of patients and it can be utilized by health care providers to adapt their health care and education contents to better meet the needs of people with diabetes. © 2014 Karimi Moonaghi et al.; licensee BioMed Central Ltd

Rastreio da Diabetes em Doentes com Doença Macrovascular Coronária: As Novas Guidelines Europeias são um Retrocesso?

BACKGROUND: The new European guidelines on diabetes mellitus and cardiovascular diseases propose that the FINnish Diabetes RIsk SCore should be used to evaluate the risk of diabetes mellitus and that diabetes mellitus screening in coronary artery disease patients should be based on fasting glucose and HbA1c. The 2 hour oral glucose tolerance test, recommended for all pts in the previous guidelines, is now only recommended for 'inconclusive' cases. We aimed to evaluate this new strategy. MATERIAL AND METHODS: Fasting glucose, HbA1c and glucose tolerance test (75 g, 2h) were prospectively evaluated in a consecutive group of pts with coronary artery disease. ADA criteria (both glucose tolerance test and HbA1c) were used to define diabetes mellitus and pre-diabetes mellitus. Diabetes mellitus risk was evaluated according to the FINnish Diabetes RIsk SCore. RESULTS: A total of 135 patients were included (mean age 62.3 +/- 13.1 years, 99 males). Glucose tolerance test and HbA1c together diagnosed 18 (13.3%) new cases of diabetes mellitus and 77 (57.0%) patients with pre-diabetes mellitus. Fasting glucose + HbA1c (guidelines strategy) identified 12/18 patients with diabetes mellitus (Sens 66.7%; negative predictive value 95.1%; Kappa 0.78; p < 0.0001) and 83/95 patients with glucose anomalies (pre- diabetes mellitus + diabetes mellitus) (Sens 87.4%; negative predictive value 76.9%). Performing glucose tolerance test in the 29 patients with an elevated FINnish Diabetes RIsk SCore would allow identifying 15/18 patients with diabetes mellitus (Sens 83.3%; negative predictive value 97.5%; Kappa 0.85; p < 0.0001) and 86/95 patients with glucose anomalies (Sens 90.5%; negative predictive value 81.6%). DISCUSSION: Although this strategy improved the screening accuracy, one in each six patients with diabetes mellitus would still remain undiagnosed, as compared to measuring HbA1c and performing an glucose tolerance test in all patients. CONCLUSION: Using the FINnish Diabetes RIsk SCore to select candidates to additional glucose tolerance test improves the accuracy for identifying diabetic patients, as compared with fasting glucose + HbA1c alone. However, 1/6 patients diabetes mellitus is still left undiagnosed with this strategy proposed by the current guidelines.info:eu-repo/semantics/publishedVersio

The prevalence of diabetes mellitus and its effect in elderly subjects in Hong Kong

The prevalence of non-insulin-dependent diabetes mellitus in 1467 ambulatory elderly subjects aged from 60 to 90 years was determined using fasting plasma glucose as a screening test. A questionnaire survey on the history of diabetes and related complications was performed. The results showed that 10.7% had already been diagnosed as having diabetes mellitus. Screening revealed a further 5% who had diabetes mellitus but were asymptomatic. The prevalence of non-insulin-dependent diabetes mellitus was 15% (95% confidence interval 9-21) among the 60- to 80-year-old age group and 17% confidence interval (3 to 30) in those older than 80 years. Obesity and advancing age were adverse risk factors associated with diabetes. The diabetic subjects had significantly more coronary and cerebrovascular atherosclerosis, hypertension, and adverse lipid profiles. Even in the non-diabetic elderly subjects, fasting blood glucose was positively correlated with body weight and body mass index, confirming the importance in the aetiology of non-insulin-dependent diabetes mellitus. This is a common disease in the elderly and is associated with significant cardiovascular morbidity.published_or_final_versio

Evaluasi Kerasionalan Pengobatan Diabetes Melitus Tipe 2 Pada Pasien Rawat Inap Di Rumah Sakit Bhakti Wira Tamtama Semarang Tahun 2006

ASTRACTDiabetes melitus is metabolic disease characterized hiperglikemia that caused disparity of insulin secretion, insulin activity or both. WHO had predicted there were increasing of diabetes mellitus patients in next time, included in Indonesia. This study aim to know and evaluate the rational of in patients diabetes mellitus type 2 medication in Bhakti Wira Tamtama Hospital Semarang at 2006. This study is non experimental research that analyzed by non analytical descriptive method. Data were collected retrospectively from medical record comprised patient identity, diabetes melitus type 2 medication, and rational antidibetic USAge. Data obtained were analysed with Standard of Perkeni 2006. The result of this study showed that 34 in-patient diabetes mellitus type 2 in Bhakti Wira Tamtama Hospital Semarang at 2006 were 40-50 years old (47,06%). Diabetes mellitus type 2 patients comprised 18 men and 16 women, 8 cases (23,52 %) were diabetes mellitus type 2 without additional diseases and 26 cases (76,47%) diabetes mellitus type 2 with additional diseases. Patients had diagnosis appropriate were 94,12 %, drug choise appropriate were 100 %, which biguanid metformin USAge were 15 patients (46,87%). Dosis appropiate 100%, patient appropriate 100%, while drug interaction had happened to 1 case, that was antidiabetic and thiazid diuretic

Faktor-faktor yang Mempengaruhi Ketidak Patuhan Pasien Diabetes Mellitus dalam Kontrol Ulang di Ruangan Penyakit dalam Rumah Sakit Santa Elisaebth Medan Tahun 2018

Penyakit Diabetes Mellitus (DM) adalah penyakit seumur hidup dan tidak dapat disembuhkan, akan tetapi kadar glukosa darah dapat dikendalikan sedemikian rupa. Salah satu cara untuk mengatasi akibat lebih lanjut dari diabetes mellitus adalah dengan penerapan kontrol diabetes mellitus. Namun sampai saat ini banyak ditemukan penderita diabetes mellitus yang tidak patuh dalam pelaksanaan kontrol ulang. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang mempengaruhi ketidakpatuhan pasien diabetes mellitus dalam kontrol ulang di ruangan penyakit dalam Rumah Sakit Santa Elisabeth Medan 2018. Jenis penelitian yang digunakan adalah penelitian deskriptif dengan jenis pendekatan cross sectional. Populasi pada penelitian ini adalah pasien DM yang di rawat di Rumah Sakit Santa Elisabeth Medan yang berjumlah 243 orang. Teknik pengambilan sampel menggunakan purposive sampling, peneliti menggunakan 15% dari jumlah populasi. Sehingga pada penelitian ini dengan menggunakan sampel 36 orang. Hasil penelitian ini adalah faktor ketidakpatuhan yang paling besar adalah pemahaman instruksi 21 responden dengan persentase 58.3%, kualitas insteraksi 20 responden 55.6%, dan keluarga 14 responden 38.9%. Disimpulkan bahwa ketaatan terhadap pendidikan kesehatan mendapat nilai tertinggi dan dukungan keluarga dalam nilai terendah, ini adalah situasi kritis dalam pengendalian ulang di Rumah Sakit Dalam untuk rumah sakit. Saran kepada manajemen rumah sakit dan para-medis tersebut harus memperbaiki interaksi mereka dalam memberikan instruksi kepada penderita diabetes mellitus

The prevalence of Type 2 diabetes and its associated health problems in a community-dwelling elderly population.

AIMS: Prevalence estimates of Type 2 diabetes and its associated health problems in elderly populations are rare, especially in the very elderly. METHODS: A sample of 15 095 community-dwelling older people aged > or = 75 years were assessed. Type 2 diabetes and associated health problems were identified using self-reporting, general practitioner records, drug histories, and blood and urine measurements. RESULTS: There were 1177 people identified as having Type 2 diabetes mellitus, giving an overall prevalence of 7.8% (95% confidence interval 7.1, 8.5), 9.4% (8.4, 10.5) for men and 6.8% (6.1, 7.6) for women. The age, sex and smoking adjusted odds ratios for various health problems, comparing people with and without diabetes were: low vision 1.6 (1.3, 1.9), proteinuria 1.7 (1.4, 2.1), chronic kidney disease stage 4 or 5 1.5 (1.0, 2.1), angina 1.3 (1.1, 1.6), myocardial infarction 1.5 (1.2, 1.8), cerebrovascular event 2.0 (1.8, 2.1) and foot ulceration 1.7 (1.2, 2.4). CONCLUSIONS: The prevalence of Type 2 diabetes is not high in community-dwelling older people, but diabetes was a contributory factor to a number of health problems

Pengaruh Senam Diabetes Melitus Terhadap Kadar Gula Darah Penderita Diabetes Melitus Tipe 2 Di Sanggar Senam Persadia Kabupaten Gorontalo

: Diabetes mellitus is a group of metabolic disorders characterized by elevated level of blood glucose due to damage in insulin secretion, insulin action or both. Control of diabetes mellitus become an important goal in controling blood sugar levels. One of the efforts to control diabetes mellitus is the diabetes mellitus gymnastics. The research objective was to determine the effect of exercise on reducing blood sugar levels. Research design is Quasi Eksperimental, consisting of 15 samples of the intervention group and 15 samples control group. Gimnastics diabetes mellitus held 3 times a week for 2 weeks, with examination of blood sugar levels pretest and posttest. Using a T-test at significance level of 95% (á 0,05). Results of the study the characteristics of the sexes are mostly women, age range 44-70 years and most education is high school level, pretest sugar levels above normal and posttest results has decreased. Conclusion of the study is that gymnastics effect on blood sugar levels of diabetes patients with type 2 diabetes mellitus. Suggestions research, for futher research would be to develop research by adding the variables such us diet patterns, length of study 4-6 weeks and begins with mild intensity gimnastic