Diabetes Mellitus 2 Research Articles

Neurodegeneration in diabetic retinopathy: An insight on its main signalling pathways

Aims/Purpose: In the latest years neurodegeneration has been considered as one of the main pathological processes involved in proliferative diabetic retinopathy's (PDR) onset and progression. We aimed to increase the understanding on the role of the main signalling molecules that participate in this phenomenon, including apoptotic, excitotoxic and neurotrophic factor pathways.Methods: Participants of both sexes were selected and programmed for vitrectomy by its diabetes mellitus 2 (DM2)‐derived vitreoretinal complications (PDR group, PDRG; n = 20), or by suffering macular hole, epiretinal membrane or rhegmatogenous retinal detachment (as the surrogate control group, SCG; n = 26). Vitreous body (VIT) and plasma (PLS) samples were collected and processed to determine the glutamate, caspase‐3 (CAS‐3) and brain‐derived neurotrophic factor (BDNF) levels. Next‐Generation Sequencing (NGS) techniques were applied to characterize the miRNA expression pattern in both groups.Results: Significantly higher VIT glutamate (p < 0.05) and CAS‐3 (p < 0.05), and significantly lower BDNF (p < 0.05) levels were detected in the PDRG. Significantly higher PLS glutamate (p < 0.05) and CAS‐3 (p < 0.05) levels were found in diabetics. However, PLS levels of BDNF showed no differences between groups (p = 0.80). NGS analysis showed a different miRNA expression pattern between both groups.Conclusions: Diabetes‐induced changes in retinal neurons/glia may be the key to discover preclinical biomarkers for better managing diabetic eyes. Glutamate, caspase‐3 and BDNF, playing important roles in the neurodegenerative processes occurring in PDR, are pivotal candidates to identify diabetics at high risk of sight‐threatening complications. Additionally, certain miRNAs could be playing an important role in these signalling pathways, being involved in PDR's neurodegenerative phenomenon.

Prediction of COVID-19 course in patients with stage 3 chronic kidney disease and type 2 diabetes mellitus

BACKGROUND. Patients with Diabetes Mellitus 2 (DM2) and Chronic Kidney Disease (CKD) are at a high risk for severe clinical course of COVID-19. The high mortality rate due to COVID-19 and widespread distribution of DM2 and CKD all over the world make it necessary to determine the predictors of adverse outcome of novel coronavirus infection (NCI).AIM. The identification of predictors of NCI adverse outcome in patients with DM2 and CKD stage 3 due to diabetic kidney disease.Patients and Methods. The patients with NCI and CKD stage 3 were included in observational retrospective uncontrolled study during the follow-up period from 04.01. to 10.30.2020. The study endpoints were the outcome of NCI (survivors/nonsurvivors). Data were collected from electronic versions of case records. Demographic, DM2-related, CKD-related and NCI-related baseline parameters/signs were studied as independent variables.RESULTS. 90 patients with DM2 and CKD stages 3 (Me GFR 43[37; 49] ml/ min/1,73m2) were included, mean age 70 [69; 78] y, females – 56 %, the mortality rate – 21 %. The independent predictors of NCI adverse outcome were detected using a single factor analysis (odds ratio). Among them are: initial prandial glycemia ≥ 10 mmol/l (ОR 11,8; 95 % CI 3,13–44,9; р <0,001), albuminemia at admission ≤ 35 g/l (ОR 5,52; 95 % CI 1,85–16,55; р = 0,012), initial proteinuria ≥ 1 g/л (ОR 6,69; 95 % CI 1,95–23,00; р = 0,002), News2 ≥ 5 at admission (ОR 14,7; 95 % CI 3,15–48,8; р <0,001), lung damage CT 3–4 at admission (ОR 31,7; 95 % CI 6,59–52,85; р = 0,04). A prognostic model was constructed to determine the risk of lethal outcome using logistic regression method. The detected risk factors were used as variables. The predictive value of the model was 93 % according to ROC-analyses data.CONCLUSION. The detected predictors of adverse outcome are the part of routine screening available in pre-hospital setting and at hospital admission. Early identification of predictors allows optimizing patient routing and selecting the best treatment strategy for each patient.

Continuous Glucose Monitoring in Transient Neonatal Diabetes Mellitus-2 Case Reports and Literature Review.

Neonatal diabetes mellitus is a rare genetic disease that affects 1 in 90,000 live births. The start of the disease is often before the baby is 6 months old, with rare cases of onset between 6 months and 1 year. It is characterized by low or absent insulin levels in the blood, leading to severe hyperglycemia in the patient, which requires temporary insulin therapy in around 50% of cases or permanent insulin therapy in other cases. Two major processes involved in diabetes mellitus are a deformed pancreas with altered insulin-secreting cell development and/or survival or faulty functioning of the existing pancreatic beta cell. We will discuss the cases of two preterm girls with neonatal diabetes mellitus in this research. In addition to reviewing the literature on the topic, we examined the different mutations, patient care, and clinical outcomes both before and after insulin treatment.

Recent trends in the patterns of dyslipidemia and management strategy in newly diagnosed patients of type 2 diabetes mellitus-2

Background: Objective of the study was to evaluate the patterns of dyslipidaemia in newly diagnosed type 2 diabetes mellitus-2 (T2DM) patients and to understand the initial management options utilised by the treating physician.Methods: The real world, retrospective, observational REcent trends in the patterns of dyslipidemia and Management strategy in newly diAgnosed Patients of type 2 diabetes mellitus-2 (REMAP-2) study was conducted at various centers including hospitals, clinics, and health care institutes across India between Apr-2021 and Mar-2022. Clinicians at the respective center captured the data in REMAP-2 study data capture form. Dyslipidemia was considered as: total cholesterol >200 mg/dl, low density lipoprotein cholesterol (LDL-C) >100 mg/dl, high density lipoprotein cholesterol (HDL-C) <40 mg/dl, or triglyceride >150 mg/dl.Results: Of 9605 newly diagnosed T2DM patients with dyslipidemia, 68.94% (n=6622) had mixed dyslipidemia. The mean age was 53.8 years. Majority of the patients were males (63.3%), had family history of diabetes (52.5%), physical activity category of ‘not very active’ or ‘lightly active’ (79.33%), and were overweight or obese (58.9%). About 25.9% of the patients were smokers. Hypertension (72.33%) was the most common comorbidity followed by coronary artery disease (23.44%). The mean glycated hemoglobin (HbA1c) was 8.3%. The most commonly prescribed antidiabetic medication was metformin (87.71%), while lipid lowering therapy was atorvastatin (77.79%).Conclusions: This study on newly diagnosed T2DM patients with dyslipidemia found that majority of the patients had hypertriglyceridemia, family history of diabetes and were physically inactive. More than half of T2DM patients were either overweight or obese. More than 2/3rd of the patients had mixed dyslipidemia. Statins were prescribed to the majority of these patients and atorvastatin was the most commonly prescribed statin in Indian T2DM patients with dyslipidemia.

HUBUNGAN STATUS GIZI DAN INDEKS GLIKEMIK PANGAN DENGAN KADAR GLUKOSA DARAH PASIEN DIABETES MELITUS TIPE 2 DI UPTD RSUD dr. H. BOB BAZAR, SKM TAHUN 2021

Diabetes mellitus is a disease of glucose metabolism disorders in which the body fails or is not good at controlling the glucose that enters from food so that blood glucose levels are high. The prevalence of diabetes mellitus in Lampung province based on doctor's diagnosis increased from 0.8% in 2013 to 0.99% in 2018. Type 2 Diabetes mellitus patients who were hospitalized at UPTD dr. H. Bob Bazar, SKM South Lampung in 2020 ranks first of the 10 most diseases with a total of 552 patients. The purpose of this study was to determine the relationship between nutritional status and food glycemic index with blood glucose levels in type 2 diabetes mellitus patients at UPTD RSUD dr. H. Bob Bazar, SKM 2021. This study uses a Cross Sectional approach with a sample of 40 people. The test used is the Pearson correlation test. Based on the results of the study, it is known that the distribution of the characteristics of respondents with the most gender is female (62.5%), the age of the most
 respondents is 46-55 years (45%). The results of the univariate analysis showed that the average blood glucose level (GDS) of 40 respondents was 240.58 mg/dl, the average Body Mass Index (BMI) of 40 respondents was 22.98 kg/m2 and the average glycemic index of food was 40. respondents was 53.56. The results of the bivariate analysis showed that there was a relationship between nutritional status and blood glucose levels with p-value = 0.001, there was no significant relationship between food glycemic index and blood glucose levels with p-value = 0.301.
 Keywords: Food Glycemic Index1, Diabetes Mellitus2, Blood Glucose Level3.

High Prevalence of Primary Aldosteronism in Patients with Type 2 Diabetes Mellitus and Hypertension.

Primary aldosteronism (PA) is the most common cause of endocrine hypertension. The prevalence of hypertension is higher in patients with diabetes mellitus-2 (DM-2). Following the limited existing data, we prospectively investigated the prevalence of aldosterone excess either as autonomous secretion (PA) or as a hyper-response to stress in hypertensive patients with DM-2 (HDM-2). A total of 137 HDM-2 patients and 61 non-diabetics with essential hypertension who served as controls (EH-C) underwent a combined, overnight diagnostic test, the Dexamethasone–captopril–valsartan test (DCVT) used for the diagnosis of PA and an ultralow dose (0.3 μg) ACTH stimulation test to identify an exaggerated aldosterone response to ACTH stimulation. Twenty-three normotensive individuals served as controls (NC) to define the normal response of aldosterone (ALD) and aldosterone-to-renin ratio (ARR) to the ultralow dose ACTH test. Using post-DCVTALD and ARR from the EH-C, and post-ACTH peak ALD and ARR from the NC, 47 (34.3%) HDM-2 patients were found to have PA, whereas 6 (10.4%) HDM-2 patients without PA (DCVT-negative) exhibited an exaggerated aldosterone response to stress—a prevalence much higher than ever reported. Treatment with mineralocorticoid receptor antagonists (MRAs) induced a significant and permanent reduction of BP in all HDM-2 patients. Early diagnosis and targeted treatment of PA is crucial to prevent any aggravating effect on chronic diabetic complications.

Diabetic foot salvage: breaking paradigms through a case report

Diabetic foot (DF) is one of the most frequent and disabling complications of diabetes mellitus 2 (DM2). This study presents the case of a 66-year-old female patient with DM2 and DF complicated by extensive infected necrosis involving more than 50% of the foot. She was not a candidate for revascularization and, due to the poorly controlled septic focus and the extent of necrosis, infracondylar amputation was indicated. However, as the patient refused to undergo amputation, the case was re evaluated at another health institution and a multidisciplinary therapeutic plan for DF salvage was proposed. The protocol included antibiotic therapy, surgical debridement, periodic outpatient dressing, and negative pressure wound therapy (NPWT). After ten months of treatment, the limb showed almost complete healing, and amputation was not necessary. Management of complicated DF is currently one of the greatest clinical-surgical challenges, requiring a highly trained multidisciplinary team to propose an optimal limb salvage program. Level of Evidence V; Case Report; Expert Opinion.

Insulin and Melatonin Modulates the Histo Architecture, Cellular Biochemistry and Receptor Expression During Injury of Hepatic in Diabetic individuals and its treatment

Objective: The purpose of this research was to examine the effects of exogenous melatonin and insulin on the biochemical, serological, histological, and receptor expression architecture of liver tissues in response to hepatic damage. Study Design: Observational study Place and Duration: This study was carried out at Hayatabad Medical Complex from November 2021 to March 2022 Methods: Total 72 patients of diabetes mellitus had age 19-78 years were presented in this study. All the patients had hepatic injury and admitted to outpatient department. After obtaining informed written consent detailed demographics of enrolled cases were recorded. Patients received melatonin and insulin therapy and continuous follow up was taken. Outcomes among all patients were recorded in terms of effectiveness. SPSS 23.0 was used to analyze all data. Results: Mean age of the patients was 42.13±16.42 years and had mean BMI 28.11±8.38 kg/m2.Most of the patients were from rural areas and were not educated. 45 (62.5%) were married and remaining 27 (37.5%) were not married. Majority patients 50 (69.4%) had diabetes mellitus-2. Other diseases were hypertension, pulmonary disease, respiratory and cardiac disease. As per liver function test, significant increased values were obtained in ALT, AST, ALP, serum cholesterol, LDL, VLD but decrease in HDL level. We found recovery of hepatic injury in 64 (88.9%) cases. Biochemical, cellular structure of liver cells, and the expression pattern of MT1, MT2, and IR receptors were all shown to have significantly recovered and restored. Conclusion: We concluded in this study that combine therapy of melatonin and insulin among diabetic patients of hepatic injury resulted significantly good results in terms of efficacy and disease recovery. Keywords: Diabetes Mellitus, Insulin, Melatonin, Efficacy, Hepatic Injury

Understanding of front of package nutrition labels: Guideline daily amount and warning labels in Mexicans with non-communicable diseases.

One strategy for the prevention and treatment of non-communicable diseases (NCDs) is the implementation of the front-of-pack labeling (FoPL) in foods and beverages. In 2020, Mexico adopted the warning label system (WL) as a new public health policy, whose aim is to help consumers make healthier food choices. Previously, the Guideline Daily Amount (GDA) was the labelling used it. This paper aims to compare the understanding of two FoPL, the GDA and the WL, through the identification of unhealthy products in Mexicans with NCDs. We analyzed data from 14,880 Mexican adults older than 20 years old with NCDs (overweight-obesity (OW/O), self-reported diabetes mellitus 2 (DM2), or/and hypertension (HT), or/and dyslipidemia (Dys)). Participants were randomly assigned to one of two groups: the GDA labeling or WL. Each group had to respond to a survey and had to classify food products images as healthy or unhealthy according to the labelling system to which they were assigned. The correct classification was determined according to the criteria of Chile’s labeling nutrient profile stage 3. To evaluate the correct classification in each one of the groups we evaluated the differences in proportions. Logistic regression models were used to assess the likelihood to correctly classify the product according to participants’ number of diseases and WL information, taking GDA label as a reference. Participants who used the information contained in the GDA label misclassified food product labels in greater proportion (70%), mostly participants with three or more NCDs (participants with OW/O+ HT+ Dys, represent 42.3% of this group); compared with those who used WL (50%). The odds of correct classification of food products using WL image were two times greater compared to GDA image in participants with NCDs; being greater in participants with three or more NCDs. The study results highlight the usefulness of WL as it helps Mexicans with NCDs to classify unhealthy food products more adequately compared with GDA.

THE STATE OF TOXIN-RELEASING FUNCTION OF THE KIDNEYS IN THE SYNDROME OF ENDOGENOUS INTOXICATION OF PURULENT-SEPTIC ORIGIN IN PATIENTS WITH DIABETES MELLITUS.

The aim: To investigate the state of renal toxin excretory function in EIS of purulent-septic genesis in patients with diabetes mellitus-2 under the condition of infusion load with low-volume Ringer's solution. Materials and methods: The research belongs to the opened, randomized, prospective and controlled studies. The study group was consisted of patients with diabetes mellitus-2 complicated syndrome of endogenous intoxication of purulent-septic origin (CDSEI). Results: However, their activity is different. In particular, renal toxin excretory function in patients with CDSEI by STPC clearance is characterized by an increase in activity by 165% (control - 282%; p <0.05), and by MMM clearance - by 137% (control - 171%; p <0.05). These data indicate the degree of depression of renal toxin function in patients with CDSEI and its compensatory capabilities. Conclusions: The depression of the clearance of total blood plasma toxicity is a predictor of the predominance of toxin formation over the elimination of toxic substances in patients with diabetes mellitus 2 complicated by purulent-septic pathology. The low-volume infusion loads with Ringer's solution in terms of clearance of total blood plasma toxicity is a sensitive indicator of the degree of depression of toxin-releasing function of the kidneys and compensatory capabilities in diabetes mellitus 2 complicated by purulent-septic pathology.

Screening for diabetes and prediabetes: the newest communication opportunities

Type 2 diabetes mellitus (DM-2) and prediabetes are serious diseases that can lead to early disability and death. DM-2 can remain undiagnosed for many years; therefore, screening is one of the main assistants of a doctor in establishing a diagnosis, allowing to start treatment as early as possible.Research objective: early identification of patients with prediabetes and DM-2 using an online questionnaire.Materials and methods. The study was carried out online using the Google Forms platform, where a questionnaire was created based on Appendix 3 “Form of risk assessment of diabetes mellitus-2” of the Unified clinical protocol of primary and secondary (specialized) medical care “Type 2 diabetes mellitus”, approved by order of the Ministry of Health of Ukraine No. 1118 dated 12.21.2012, as well as additional questions on nutrition and physical activity. As of June 2021, the study involved 209 patients (151 women and 58 men) who did not have a documented diagnosis of DM-2 or prediabetes.Results. Most of the respondents (89 people) were overweight. 51 respondents had grade I obesity, 31 respondents had grade II, and 7 patients had a body mass index &gt; 40 kg/m2, which corresponds to grade III obesity. Only 49 respondents had a healthy weight, which corresponds to a body mass index 18.5–24.9 kg/m2. 29 (19.21%) women had a history of childbirth with a child weighing more than 4 kg. The diagnosis of polycystic ovary disease (a risk factor for the DM-2) was in 34 (22.52%) women. Upon receipt of laboratory tests, we established a diagnosis of prediabetes in 28 (13.40%) patients, and a diagnosis of DM-2 in 17 (8.13%) people.Conclusions. It is necessary to search for new opportunities in communicating with patients during the COVID-19 pandemic, one of which is online questionnaires based on regulatory documents.

Dendritic Cells and T Cell Subsets in the Development of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis

Abstract Nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are associated with steatosis, inflammation and fibrosis. Liver dendritic cells (DCs) are usually tolerogenic in the sinusoidal milleu composed of immunosuppressive cytokines. In NAFLD and NASH, DCs become pro-inflammatory and modulate hepatic immune response. Murine liver DCs are three major subtypes: classical (lymphoid) cDC1 or the crosspresenters (CD8α+CD103+), classical (myeloid) cDC2 (CD11b+) and plasmacytoid pDCs (PDCA-1+Siglec-H+) and two additional subtypes or lymphoid + myeloid DCs and NKDCs. Similarly, human liver DCs are three subtypes or CD141+CLEC9A+, CD1c+ (BDCA1+) and pDCs (CD303+BDCA2+). Compared to blood human hepatic DCs are less immature and predominantly induce regulatory T cells (Tregs) and IL-4 secreting T cells (Th2). DCs polarize T cells into different Th types that are in interrelations in NAFLD/NASH. T helper 1 (Th1) (T-bet) cells are associated with adipose tissue inflammation. The differentiation of Th2 (GATA3) cells is induced by IL-4 DCs, increased in NAFLD. Similarly, Th17 cells (RORγt/ RORc) are increased in NAFLD and NASH. Tregs (FoxP3) are increased in the liver in steatosis and Th22 cells (AHR) are elevated in diabetes mellitus 2 (DM2) and adiposity. CD8+ T cells γδT cells and MAIT cells also contribute to liver inflammation.

The influence of hydrogen ions on coagulation in traumatic brain injury, explored by molecular dynamics

ABSTRACT Background: Patients in intensive care units with traumatic brain injuries (TBI) frequently present acid-base abnormalities and coagulability disorders, which complicate their condition. Objective: To identify protonation through in silico simulations of molecules involved in the process of coagulation in standard laboratory tests. Materials and methods: Ten patients with TBI were selected from the intensive care unit in addition to ten “healthy control subjects”, and another nine patients as “disease control subjects”; the latter being a comparative group, corresponding to subjects with diabetes mellitus 2 (DM2). Fibrinogen, FVII, FVIII, FIX, FX, and D-dimer in the presence of acidification were evaluated in 20 healthy subjects in order to compare clinical results with molecular dynamics (MD), and to explain proton interactions and coagulation molecules. Results: The TBI group presented a slight, non-significant increase in D-dimer; but this was not present in “disease control subjects”. Levels of fibrinogen, FVII, FIX, FX, and D-dimer were affected in the presence of acidification. We observed that various specific residues of coagulation factors “trap” ions. Conclusion: Protonation of tissue factor and factor VIIa may favor anticoagulant mechanisms, and protonation does not affect ligand binding sites of GPIIb/IIIa (PAC1) suggesting other causes for the low affinity to PAC1.

Acute myocarditis in COVID19 patients. Clinical features, severity and outcomes. Results from Spanish multicenter registry Car-COVID19

Funding AcknowledgementsType of funding sources: Foundation. Main funding source(s): Fundacion del CorazonIntroductionCOVID19 has emerged as a new disease, spreading around the world, leading to a complete lockdown. It is known that other infectious diseases can affect the heart inducing myocarditis. As a new entity, it was unknown if SARS-COV2 could provoke that cardiovascular manifestation. This national registry was created to describe COVID19 cardiac affection and its severity.Methods and resultsA multicenter registry was conducted, including 28 centers in Spain. Patients with COVID19 diagnosis presenting an acute cardiovascular event between March 1st and May 30th were included. Eighty-two patients were included. Of them, 9 (14,1%, excluding missing data) presented with acute myocarditis; the rest were diagnosed of acute myocardial infarction or stress cardiomyopathy. Baseline characteristics of these patients are summarised in Table 1. The 83,3% of patients with myocarditis presented with heart failure and 25% simulating an acute coronary syndrome.According to severity, 5 patients (62,5%) were admitted in the Intensive Care Unit, requiring orotracheal intubation 4 patients (57,1%). Left ventricle was affected in 66,7% of patients, whereas the remaining 33,3% presented biventricular failure. Mean left ventricle ejection fraction was 46% [30,0%-52%]. One patient developed refractory cardiogenic shock requiring implantation of both intra-aortic balloon pump and VA- ECMO. Three patients died during hospitalization.Cardiac magnetic resonance was conducted in 2 patients (28,6%), showing oedema and subepicardial enhacement in postero-lateral segments. Cardiac biopsy was performed in one patient showing significant lymphoid infiltration and intersticial oedema.ConclusionsPatients with COVID 19 who develop acute myocarditis usually present with heart failure secondary to ventricular failure. This entity has a bad prognosis with high in-hospital mortality rate. Table 1. Baseline characteristics.n (%)Age65,0[47,0-77,0]Sex (female)3 (42,9%)Hypertension3 (42,9%)Dyslipidemia3 (42,9%)Diabetes mellitus2 (28,6%)Chronic coronary disease1 (14,3%)Previous stroke1 (14,3%)Cancer1 (14,3%)

Variability of peripheral pulse wave velocity in patients with diabetes mellitus type 2 during orthostatic challenge.

Diabetes mellitus 2 (DM2) is the seventh cause of death worldwide. One of the reasons is late diagnosis of vascular damage. Pulse wave velocity (PWV) has become an independent marker of arterial stiffness and cardiovascular risk. Moreover, the previous studies have shown the importance of beat-to-beat PWV measurement due to its variability among the heart cycle. However, variability of PWV (PWVv) of the whole body hasn't been examined yet. We have studied a group of DM II and heathy volunteers, to investigate the beat-to-beat mean PWV (PWVm) and PWVv in the different body positions. PWV of left lower and upper extremities were measured in DM2 (7 m/8 f, age 68+/-10 years, BP 158/90+/-19/9 mm Hg) and healthy controls (5 m/6 f, age 23+/-2 years, BP 117/76+/-9/5 mm Hg). Volunteers were lying in the resting position and of head-up-tilt in 45° (HUT) for 6 min. PWVv was evaluated as a mean power spectrum in the frequency bands LF and HF (0.04-0.15 Hz, 0.15-0.5 Hz). Resting PWVm of upper extremity was higher in DM2. HUT increased lower extremity PWVm only in DM2. Extremities PWVm ratio was significantly lower in DM2 during HUT compared to controls. LF and HF PWVv had the same response to HUT. Resting PWVv was higher in DM2. Lower extremity PWVv increased during HUT in both groups. PWVm and PWVv in DM2 differed between extremities and were significantly influenced by postural changes due to hydrostatic pressure. Increased resting PWVm and PWVv in DM2 is a marker of increased arterial stiffness.

Association between Angiotensin-Converting Enzyme- Insertion/Deletion Polymorphism and Diabetes Mellitus-2 in Saudi Population.

Objectives:The association of angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and the development of type 2 diabetes mellitus (T2DM) has been debated vigorously but still remains controversial. Therefore, the current study was designed to determine the possible association between ACE I/D polymorphism and T2DM and hypertension (HTN) in a population of Saudi Arabian participants. Methods:A total of 143 individuals were recruited for the study, consisting of 74 controls and 69 patients with T2DM. Genotyping was performed via polymerase chain reaction. Results:The genotype frequencies for DD, ID and II in controls were 52.7%, 39.2% and 8.1%, whereas in T2D patients it was 52.2%, 40.6% and 7.2% respectively. The DD frequency was highest out of the three genotypes in both the controls and the T2DM patients. Conclusion:There was no significant difference found in the genotype and allele frequencies between cases and controls, suggesting that insertion/deletion polymorphism in the ACE gene may not be associated with an increased susceptibility to type 2 diabetes in our study population.

P26 Asociación entre diabetes y depresión en una población con diabetes mellitus 2 tratada en un centro de referencia

Introducción: la diabetes mellitus 2 (DM2) es considerada una de las enfermedades crónicas más psicológicamente demandantes. La presencia de síntomas depresivos son una comorbilidad conocida en los pacientes con diabetes mellitus 1 y 2, siendo hasta tres veces mayor que en la población no diabética. La depresión se asocia a peores resultados sobre el control metabólico, adherencia al tratamiento,mayor morbilidad y mayores costos de atención médica.Objetivos: conocer la prevalencia de síntomas depresivos y su relación con el control metabólico, complicaciones crónicas, factores socioculturales y adherencia al tratamiento.Materiales y métodos: se realizó un estudio descriptivo, observacional en el período mayo-julio 2020. Se incluyeron pacientes con diagnostico de DM2 mayores de 15 años que se asisten en la UDA de diabetes del HP. Para evaluar síntomas depresivos, se aplicó el inventario de depresión de Beck II(BDI-II) que consta de 21 preguntas y cuya puntuación va de 0 a 63, considerándose depresión puntajes iguales o mayores a 14 puntos.Se dividió en síntomas leves 14-19,moderados 20-28 y severos 29-63.Para evaluar adherencia al tratamiento se utilizó el test de Morisky Green. Este estudio se realizó en un período de pandemia por COVID-19.

CHANGES OF COGNITIVE FUNCTION IN PATIENTS WITH HYPERTENSION WITH CONCOMITANT DIABETES MELLITUS TYPE 2

Relevance. Till now there is no clear clinical trial understanding of the relationship between hypertension (AH) and the patient's cognitive function.&#x0D; Objective: the investigation of changes in cognitive function in patients with hypertension with concomitant type 2 diabetes mellitus (DM2).&#x0D; Materials and methods. 215 people were examined: Group I (n = 131) – stage II hypertensive disease (HD); Group II (n = 46) – HD, combined with diabetes mellitus2; Group III, control (n = 38) – without a diagnosis of HD and diabetes mellitus2. All examined blood pressure (BP), echocardiogram. Clinical complaints, anamnestic data, and neuropsychiatric testing data were used to diagnose moderate cognitive impairment (MCI). Used modified diagnostic criteria J. Touchon, R. Petersen. To assess cognitive function used: Short scale of assessment of mental state (Mini-Mental State Examination - MMSE); Frontal Assessment Battery (FAB); clock drawing test; test for literal and categorical associations; Schulte tables; the Global Deterioration Scale (GDS) and the Clinical Dementia Rating (CDR).&#x0D; Result. In patients with HD, the most significant risk factors for moderate cognitive impairment are hypercholesterolemia and overweight (with OR 1.8), obesity (OR 1.6), the presence of concomitant diabetes mellitus2, which, especially in overweight, significantly impairs cognitive function ( OR 2.56). Deterioration of cognitive function correlates with the duration of HD, cholesterol levels. Concomitant diabetes mellitus2 in patients with HD creates a statistically significant additional negative effect on the results of cognitive function. In patients with HD with a distorted daily blood pressure profile, the neurodynamic component of cognitive function is first of all affected - conceptualization, repetition, the reaction of choice. The relationship between cognitive function and daily monitoring of blood pressure often have a U-shaped relationship, where the maximum indicators of cognitive function are at the level of the optimal recommended blood pressure figures (130-139 mm Hg for SBP, and 75-85 mm Hg for DBP, and the daily index within 10%).&#x0D; Conclusions. There is a dependence on changes in cognitive function on the presence of risk factors and signs of subclinical damage to target organs. The nonlinear U-shaped character of the relationship between the average daily, average night, and average daily blood pressure and the results of screening tests and scales for assessing cognitive function are shown.

Cross sectional study of sensorineural hearing loss in type 2 diabetes mellitus

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The objective of the study was to evaluate the prevalence of sensorineural hearing loss in type 2 diabetes mellitus and to figure out a relation between age, sex, duration of diabetes and diabetic control.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A cross-sectional study was conducted at Geetanjali Medical College and Hospital for 1.5 years. Patients were known case of diabetes mellitus type 2 without any other systemic illness included in the study. A total of 115 patients were involved in the study and the informed consent was taken. A detailed examination and history related to hearing loss and diabetes status with treatment was elicited. All basic blood investigations were performed on all the patients. All the patients were subjected to pure tone audiometry and impedance audiometry in a sound proof room. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The total prevalence of sensorineural hearing loss in the study subjects was found to be 80% with most of them having mild degree of sensorineural deafness. Increase in age, longer duration and uncontrolled diabetes are the factors which had higher risk of developing sensorineural hearing loss in the study subjects.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; There is a strong association between sensorineural hearing loss and duration of diabetes mellitus-2. The threshold of hearing loss is increased mainly at the higher frequencies with diabetes.&lt;/p&gt;

Yogasana in management of diabetes mellitus-2- A Critical Review

Background: -Yoga is group of physical, mental and spiritual practices or discipline which originated in ancient India. In today’s world, lifestyle has been changed, lack of regular exercise, eating of junk food or fast food, etc. give rise to many lifestyle disorders. Diabetes mellitus 2 is one of them. In diabetes mellitus 2 cells of pancreas doesn’t make enough insulin or cell can’t use the insulin. Hence with the help of asanas management of Diabetes Mellitus2 can be effectively helpful. Objectives:-Objective is to study the Yogasana in the management of DM2. Methods: -Literature review, databases, Ayurvedic and Yoga classical texts were reviewed with focus to assess relation between Yogasana and Diabetes Mellitus2. Results: -Studies state that Yogasana helps to decrease blood glucose level and increase utilization and metabolisation of glucose in peripheral tissues by regeneration/rejuvenation of cells of pancreas. Conclusion: So in this study, it can be concluded that we can use Yogasana in the day to day practice as effective management in DM2.