Group Of Non-diabetic Patients Research Articles

Comparative assessment of the impact of renal denervation on blood pressure values in resistant hypertensive patients with and without type 2 diabetes

Randomized clinical trial data confirm the effectiveness of renal artery denervation (RDN) not only among hypertensive patients, but also in other pathologies associated with increased SNS activity, such as type 2 diabetes, heart failure and others. Aim. Evaluation of the impact of RDN on blood pressure values in two categories of patients - resistant hypertension with and without type 2 diabetes. Materials and methods. The randomized prospective clinical study was designed that enrolled 250 resistant hypertensive patients divided into two equal groups of 125 patients depending to the presence of DM. The patients in the first two subgroups of each group were given standardized treatment supplemented with SNS blockers Moxonidine and Bisorpolol , while patients from subgroups III and VI underwent RDN. Patients were evaluated by dynamic ambulatory BP monitoring for a period of 3 years. Results. Authentic reduction of office SBP and DBP was noted starting from 6 months of assessment in all research groups, the comparative analysis of dynamics of office SBP at all stages of evaluation demonstrating a clear superiority of groups of minimally invasive treatment by RDN versus pharmacological treatment with the SNS blockers Moxonidine and Bisoprolol in improving these parameters. At the same time, a statistically significant reduction in the average values of SBP and DBP 24 hours was recorded in both the pharmacological and interventional treatment groups independent ofthe presence of type 2 diabetes, the maximum antihypertensive effect being expressed at 36 months of evaluation. Diabetic and non-diabetic patient groups undergoing RDN demonstrated superiority to both pharmacotherapeutic regimens at all follow-up stages.Conclusions. The obtained results demonstrated the comparable antihypertensive efficacy of RDN in resistant hypertensive patients with or without type 2 diabetes. At the same time, the groups of diabetic and non-diabetic patients undergoing RDN showed superiority over both pharmacotherapeutic regimens with SNS blockers in reducing blood pressure values, the beneficial effect being maintained for a three-year follow-up period.

Diabetes Mellitus and Obesity as Prognostic Factors in Arthroscopic Repair of Chronic Rotator Cuff Tears.

Metabolic diseases such as obesity and diabetes mellitus seem to have an influence on reoperation and long-term functional outcomes after arthroscopic repair of chronic rotator cuff tears. High prevalence of these pathologies can be found in the Canary Islands. A retrospective cohort study was carried out, in which 80 patients undergoing shoulder arthroscopic surgery for the repair of chronic rotator cuff tears were included, with a minimum follow up of 5 years, to study the occurrence of complications, reoperation, and functional outcomes. Functionality after surgery improved in 75% of patients with diabetes and remained the same or worsened in 25% (OR = 1.444). In the group of non-diabetic patients, 83.9% had improved function after surgery while it remained the same or worsened in 16.1% (OR = 0.830). Functionality after surgery improved in 76.6% of obese patients and remained the same or worsened in 23.4% (OR = 1.324). In the non-obese group, 87.9% had improved function after surgery, while it remained the same or worsened in 12.1% (OR = 0.598). Despite not obtaining statistically significant differences, the analysis of the results obtained suggests that obesity and diabetes could act by decreasing the subjective improvement in functionality after surgery, and, in the case of obesity, also increase the risk of reoperation.

Outcome of Renal Transplantation in Patients With Diabetes Mellitus: A Single-Center Experience

BackgroundAn increasing proportion of kidney recipients have diabetes mellitus (DM). Some concerns have been raised about the kidney transplantation results in diabetic patients. Therefore, we assessed the effect of DM on morbidity and mortality of diabetic patients with renal transplantation. MethodsWe retrospectively studied adult patients with and without DM who underwent living donor transplantation between 2007 and 2016. Information concerning demographic and clinical data were retrospectively analyzed by reviewing the patient files. ResultsOf the 1536 transplant recipients, 126 (8%) had diabetes mellitus (mean age 49.4 ± 11.8) and 525 patients were evaluated in the non-diabetic control group (mean age 36.2 ± 15.9). The diabetic and non-diabetic patient groups had a mean follow-up after kidney transplantation 42.5 months (0.27-101.7 months) and 58.8 ± 10.6 months, respectively. In the diabetic patient group, only 3 patients had lost graft and 13 patients were exitus. Three patients had lost graft and 5 patients were exitus in non-diabetic patient group. Cardiac death (54.5%) was the most common cause of mortality in diabetic group. The 6-year patient and graft survival rates are 84.9% and 95.3%; 97.5% and 97.2% in the diabetic and non-diabetic patient groups, respectively. ConclusionsBoth infection and cardiovascular diseases increase morbidity and mortality in renal transplant patients with diabetes mellitus. The mortality risk of diabetic patients after renal transplantation is higher than the non-diabetic kidney recipients. Therefore, diabetic patients need meticulous cardiac evaluation before renal transplantation and a close follow-up, in terms of infection, after transplantation.

Early Complications Following Minimally Invasive Surgery for Hallux Valgus in Patients with and without Diabetes

Category: Diabetes; Bunion; Midfoot/Forefoot Introduction/Purpose: Diabetes mellitus (DM) is a chronic disease with a high worldwide prevalence. People with DM are more likely to develop complications compared to non-diabetic patients undergoing foot and ankle surgery. Currently, orthopedic surgery tends to use minimally invasive surgery (MIS), this resource is used to successfully solve forefoot deformities such as Hallux Valgus (HV). So far there is no evidence enough on this type of surgery and its complications in people with DM. The objective of this study is to determine the types and rates of early complications of elective MIS procedure for hallux valgus in a population of diabetic patients (DBT) compared to a control group of non-diabetic patients (NDBT). Methods: This retrospective study was carried out at our institution between October 2017 and August 2020. During the study period, 874 feet were operated on with MIS technique. All diabetic adults with a diagnosis of HV who underwent percutaneous correction surgery with distal metaphyseal osteotomy and a minimum follow-up of 6 months were included. All diabetic patients who underwent surgery had controlled diabetes with glycosylated hemoglobin less than 7%.For each DBT patient, we randomly selected two aged-matched patients +-1 year without DM as controls. In bilateral surgery, only the first operated foot was taken into account. Patients with previous foot surgery, open lesions or history of previous ulceration, Charcot's neuropathy, metatarsophalangeal osteoarthritis, peripheral vascular disease, and incomplete clinical history were excluded. Complications were recorded and defined as any deviation from the normal postoperative course. Results: A total of 75 patients were analyzed, 25 DBT and 50 NDBT. The follow-up was 10.8 months (6-48). There were no significant differences in demographic characteristics except for the body mass index and the Charlson comorbidity index, both of them were higher in the DBT group (p = <0.001). The complication rate was 18% (n = 9) in NDBT and 24% (n = 6) in DBT patients (p=0.553). There were also no significant differences in the different types of complications. Table 1. It is important to highlight that 7 of 9 complications of the NDBT group required a new surgical intervention (5 osteosynthesis extractions, 1 pseudarthrosis treatment and 1 toilette). In the DBT group, superficial infections were successfully treated with oral antibiotics. Conclusion: This would be the first study that specifically evaluates complications in diabetes patients with elective hallux valgus MIS correction. In our results, diabetic patients have not been associated with a higher rate of complications compared to non- diabetic patients.

The effect of diabetes on mid-term survival of open heart surgery patients aged over 70 years

Aim: To determine the effect of diabetes on mid-term survival rates of the patients over 70 years of age who underwent an open heart surgery.
 Material and Method: Patients who underwent an open heart surgery between November 2016 and May 2019 in our center included in this retrospective study. The patients younger than 70 years were excluded. Patients were divided into two groups: Group 1 included diabetic patients, Group 2 included non-diabetic patients. The patients who were followed-up for less than 24 months were excluded. 
 Results: A total 389 patients were evaluated and 93 (23.9%) patients aged over 70 years were included in this retrospective study. Group 1 included 36 (38.7%) type 2 diabetic patients and Group 2 included 57 (61.3%) non-diabetic patients. The general mean follow-up time was 48.25±10.42 months (range between 30.83-77.07 months). The number of emergency operations was significantly higher in non-diabetic patients group (p= 0.005). The mortality rates were similar in both groups (30.55% in Group1, 35.08% Group 2, p= 0.652). The survival times of the groups were also similar (63.49±3.42 months in diabetic patients, 59.40±2.67 months in non-diabetic patients group, p= 0.254).
 Conclusion: Diabetes mellitus has no effect on the mid-term survival rates of the older patients who underwent open heart surgery.

Prognostic value of myocardial perfusion scintigraphy in diabetic patients and without coronary lesion

ObjectiveTo determine the prognostic value of myocardial perfusion scintigraphy-gated SPECT in patients with diabetes mellitus and without obstructive coronary artery disease. Materials and methodsThis retrospective study included consecutive patients undergoing adenosine stress-rest myocardial perfusion imaging (MPI) by 99mTc-tetrofosmin between 2009 and 2011. The patients had diabetes mellitus and coronary angiography without significant coronary lesions. In total, 37 diabetic patients (female/male: 20/17; mean age: 65.2 (range: 40−78). 29 non-diabetic patients were included wich are matched with the group of diabetic patients with positive MPI. The group of non-diabetic patients had scintigraphy with myocardial ischemia and without angiographic lesions. A 36-month clinical follow-up was performed, and major cardiac events were recorded. ResultsIn 78.3% (29/37) of diabetic patients the scintigraphic study showed myocardial ischemia, while it was negative in the 21.7%. The cardiac event rate in both groups was 6%. In diabetics with a myocardial perfusion study with myocardial ischemia, there were 3 major cardiac events. In diabetic patients with negative study had no cardiac event. In the non-diabetic control group the cardiac events rate was 3.4% (1/29). ConclusionIn diabetic patients without obstructive coronary disease, myocardial perfusion study can be predictor of cardiac events. A negative study can be an indicator of a better cardiovascular prognosis.

Diabetes Status Affects Odds of Body Mass Index-dependent Adverse Outcomes After Total Hip Arthroplasty.

Obesity and diabetes have independently been shown to predispose to adverse outcomes after total hip arthroplasty (THA). These may have a coupled effect on perioperative risks. The purpose of this study was to evaluate the effect of body mass index (BMI) on adverse outcomes in nondiabetic (ND), non-insulin-dependent diabetes mellitus (NIDDM), and insulin-dependent diabetes mellitus (IDDM) patients. Patients undergoing primary THA were selected from the National Surgical Quality Improvement Program Database from 2012 to 2016 and categorized as ND, NIDDM, and IDDM. BMI, demographics, and 30-day perioperative outcomes were assessed for each group. Multivariate logistic regressions controlling for demographics, functional status, and American Society of Anesthesiologists were used to determine the odds ratio of serious adverse event (SAE) in each diabetes group for patients with BMI ≥ 40 kg/m compared with a control group of ND patients with a normal BMI (18.5 to 24.9 kg/m). A total of 108,177 patients were included. The results demonstrate that ND (odds ratio 1.65; P < 0.001) and NIDDM (odds ratio 1.75; P = 0.007) patients have similar risks of SAE, whereas IDDM (odds ratio 2.79; P < 0.001) patients have a greater risk of adverse events, particularly at BMIs greater than 40 kg/m. Consistent with previous reports, ND (odds ratio 1.65; P < 0.001) and NIDDM (odds ratio 1.75; P = 0.007) morbidly obese patients (BMI > 40 kg/m) had an increased odds of SAEs after THA, but for IDDM (odds ratio 2.79; P < 0.001) patients this increased odds was notably higher. Although patients with IDDM have increased rates of adverse events compared with ND and NIDDM patients, these findings should not be used to establish strict BMI cutoffs in patients with IDDM. Nonetheless, the results suggest additional factors, such as patient medical history and diabetes control, should be considered when evaluating patients with IDDM for THA. Level III.

Valor pronóstico de la gammagrafía de perfusión miocárdica en pacientes diabéticos sin lesiones coronarias

ObjectiveTo determine the prognostic value of myocardial perfusion scintigraphy-gated SPECT in patients with diabetes mellitus and without obstructive coronary artery disease. Materials and methodsThis retrospective study included consecutive patients undergoing adenosine stress-rest myocardial perfusion imaging (MPI) by 99mTc-tetrofosmin between 2009 and 2011. The patients had diabetes mellitus and coronary angiography without significant coronary lesions. In total, 37 diabetic patients (female/male: 20/17; mean age: 65.2 (range: 40-78). 29 non-diabetic patients were included wich are matched with the group of diabetic patients with positive MPI. The group of non-diabetic patients had scintigraphy with myocardial ischemia and without angiographic lesions. A 36-month clinical follow-up was performed, and major cardiac events were recorded. ResultsIn 78.3% (29/37) of diabetic patients the scintigraphic study showed myocardial ischemia, while it was negative in the 21.7%. The cardiac event rate in both groups was 6%. In diabetics with a myocardial perfusion study with myocardial ischemia, there were 3 major cardiac events. In diabetic patients with negative study had no cardiac event. In the non-diabetic control group the cardiac events rate was 3.4% (1/29). ConclusionIn diabetic patients without obstructive coronary disease, myocardial perfusion study can be predictor of cardiac events. A negative study can be an indicator of a better cardiovascular prognosis.

Assessment of the efficacy of endovascular treatment in chronic limb-threatening ischemia in diabetic and non-diabetic patients

Aim: Peripheral artery diseases are a very common manifestation of atherosclerosis. We assessed the clinical outcomes of diabetic versus non-diabetic patients with chronic limb-threatening leg ischemia who underwent Peripheral Transluminal Angioplasty (PTA). Methods: The patients (84 diabetic/66 non-diabetic) who underwent percutaneous transluminal angioplasty (PTA) in the lower extremity arterial lesions (stenosis/occlusion) because of chronic limb-threatening leg ischemia (Rutherford class 4 and above) between June 2013 and March 2020 were included in the study. Results: Six-month primary patency rates were 86.5% and 93.3% in the diabetic and non-diabetic group, respectively. The 12-month primary patency rates were 73.0% and 73.3%; and 12-month secondary patency rates were 66.7% and 77.8%. No differences were detected between the groups in terms of patency rates. Major amputation and total amputation rates were higher at statistically significant levels in the diabetic patient group (%16.7% vs. 6.1%; P=0.003) (34.6% vs. 22.8%); P=0.004) Conclusion: When patency and amputation rates are evaluated in diabetic and non-diabetic patient groups with limb-threatening chronic leg ischemia after endovascular treatment, good clinical results were reported in these two groups. Current results suggest that endovascular treatment can be used safely and effectively in both patient groups.

P0421STUDY OF DIFFERENT EXPRESSION PROFILES OF “TRANSIENT RECEPTOR POTENTIAL ION CHANNEL (TRPC) GENE FAMILY” IN PATIENTS UNDERGOING RENAL BIOPSY WITH CLINICAL SUSPECTED GLOMERULONEPHRITIS

Abstract Background and Aims The transient receptor potential ion channels (TRPC) are non-selective Ca+ 2 permeable cation channels and are widely expressed in the tissues of vertebrates. They become active in response to signal transduction pathways associated with phospholipase C stimulation. TRPC6 is expressed in podocytes and is a component of the slit diaphragm. In genetic and acquired glomerular kidney diseases, TRPC6 overactivation causes podocyte damage by pathological Ca+ 2 entry. TRPC1, TRPC2, TRPC4, and TRPC5 interact with a protein called stromal-interacting molecule 1 (STIM 1), which is susceptible to intracellular calcium storage content. As a result of binding with this protein, TRPC channels bind to calcium-releasing zone in endosomes. The aim of the study was to investigate different expression profiles of TRPC family members in renal biopsy specimens in patients with clinically considered glomerulonephritis. Method This study was conducted with 108 patients admitted to Ege University Faculty of Medicine Nephrology Clinic who underwent a kidney biopsy with a preliminary diagnosis of glomerulonephritis and 37 patients who underwent a nephrectomy in urology clinic with a diagnosis of primary kidney tumour as a control case. PKD2, NPHS2, TRPC1, TRPC3, TRPC6, STIM-1 and Orai-1 mRNA levels were studied in the biopsy samples. Results When we compared the patient and the control group, the gender distribution of both groups was similar. The frequency of diabetes and hypertension was similar. The control group was statistically significantly older and glomerular filtration rates were higher than the patient group. In pathological examination, glomerulonephritis (57.5%) was diagnosed in the majority of patients. The most common etiologic factors were membranous nephropathy 23.1%, IgA nephropathy 13%, Amyloidosis 11.2%, focal segmental glomerulosclerosis 7.1%, proliferative glomerulonephritis 4.6%, minimal change disease 2.8% and membranoproliferative glomerulonephritis was 1.9%. 7.4% of the patients were diagnosed with diabetic nephropathy by renal biopsy. When we compared the TRPC expression profiles of the patient and the control group, the TRPC1, TRPC6, PKD2, NPHS2, STIM-1 and ORAi-1 mRNA levels of the patient group were statistically significantly higher than those of the control group (Figure). In contrast, TRPC3 mRNA levels were significantly lower in the patient group compared to the control group. When we performed subgroup analysis, the TRPC1, TRPC6 and STIM1 levels of the diabetic group were statistically significantly higher compared to the non-diabetic group of patients. We could not find any difference between TRPC expression profiles between the patients according to pathological diagnosis. Similarly, there was no difference between the amount of proteinuria (nephrotic level versus nephritic level). In correlation analysis, there was a negative correlation with TRPC6 and STIM1 levels with positive C4d staining of glomeruli in renal biopsy. Positive correlation was found between ORAI and glomerular sclerosis rate. Conclusion As a result, we found that other than TRPC3 mRNA level, other TRPC and related protein channels mRNA levels were statistically significantly increased in proteinuric kidney patients compared to healthy kidney tissue. We did not find a positive relationship between proteinuria severity and TRPC expression profiles. We found that TRPC6 and STIM1 expression levels were increased in diabetic patients, which supports the knowledge that intracellular calcium pathways were activated in podocyte damage. In our study, there were significantly increased STIM1 and ORAi-1 expression levels in proteinuric patients compared to the control group and their increase was closely related to TRPC6. From this we can conclude that these proteins play an important role in proteinuric kidney damage.

Higher Odds of Type 2 Diabetes for Some Blood Groups

Background: Diabetes is one of the most common metabolic diseases in humans that cause disruption in glucose and fat metabolism. The determination of the ABO blood group system is hereditary and both diabetes and blood groups have a genetic basis. Objectives: The aim of this study was to investigate the odds of type 2 diabetes for some blood groups. Methods: This case-control study was conducted in hospitals of Kermanshah in 2018. The case group consisted of patients with diabetes admitted to hospital and the control group of nondiabetic patients hospitalized in the surgical ward. Information such as age, sex, BMI, family history of diabetes and blood group is collected and analyzed by the univariate and multivariate logistic regression method. Results: A total of 750 patients were enrolled in this study. The number of participants in both groups was 375. The average ages of the participants were 50.51 and 51.62 years, respectively. 67.5% of the patients in the case group were female in comparison with 73.6% of those in the control group. The value of Rh⁺ in the case and control groups was 94.4 and 93.6%, respectively (p = 0.645). The chance of having diabetes for patients with blood group A was 76% higher than for those with blood group O (p = 0.006). Conclusion: According to the results of this study, the odds of type 2 diabetes for people in blood group A was higher than for those in other blood groups. It is recommended that blood group A be considered as a risk factor in the screening of type 2 diabetes.

Ciprofloxacin is not a better choice in the patients with diabetes suffering urinary tract infection

Objective: The aim of this study is to determine antibacterial susceptibilities of Gram-negative bacteria isolated from diabetic and non-diabetic patients as infectious agents of community-acquired urinary tract infections (UTI) and to compare their rates of resistance to the antibiotics frequently used in empirical treatment. Methods: Ninety-six diabetic and sixty-eight non-diabetic (total n=164) patients’ data were evaluated retrospectively who diagnosed as community-acquired urinary system infection and consulted to outpatient clinics of Department of Endocrinology and Infectious Diseases of Firat University School of Medicine between January 1st , 2014 and December 31st, 2014 whose urine cultures demonstrated Gram-negative bacteria were included in the study. Antibiotic susceptibilities of the isolated bacteria were determined using Vitek 2 automated system and the results were evaluated as sensitive and resistant. Results: In both diabetic and non-diabetic patient groups, most frequently Escherichia coli (88.5% in diabetic and 85.3% in non-diabetic groups) were isolated. In the diabetic group, microorganisms mostly demonstrated the highest rates of resistance against ampicillin, cephalosporins, ciprofloxacin, amoxicillin-clavulanic acid and in the non-diabetic group ampicillin, amoxicillin-clavulanic acid, cefuroxime and trimethoprim-sulfamethoxazole. Conclusion: Resistance to ciprofloxacin was at a significantly higher rate in the diabetic group. In diabetic patients, it will be more appropriate to give antibiotherapy in urinary system infections based on the antibacterial susceptibility test results.

100.52 Primary Percutaneous Transluminal Coronary Angioplasty in Diabetic Versus Non-Diabetic Patients. Independent Predictors of Suvival and Event-Free Survival

Some studies showed that the diabetic patients (D) group (DG) had worse outcomes when compared to the nondiabetic (ND) patients group (NDG) after primary percutaneous coronary intervention (PCI). We aimed to compare mortality and major adverse coronary events (MACE) at 30 days and 1 year in DG and

Pulse Wave Velocity and Augmentation Index in Renal Transplant Recipients - 4.6 Years Follow Up

Introduction Chronic kidney disease (CKD) is a risk factor for cardiovascular diseases leading to rapid progression of arteriosclerosis. After renal transplantation some of the traditional and CKD-specific risk factors disappear, however, new risk factors emerge, such as metabolic effects of immunosuppression therapy and new onset diabetes mellitus (NODAT). Arterial properties can be evaluated by measuring pulse wave velocity (PWV) and augmentation index (AI). The aim of the study was to define the long-term impact of renal transplantation on arterial stiffness. Another goal of the study was to evaluate effects of diabetes mellitus on PWV and AI. Materials and Methods The study was conducted on renal graft recipients, who had successful kidney transplantation in the years between 2011 and 2013. PWV and AI were evaluated noninvasively by applanation tonometry using SphygmoCor™ (AtCor Medical Pty. Ltd., Sydney, Australia) immediately after transplantation and four to five years thereafter. Clinical and biochemical data were obtained from the hospital's database. Results and Discussion 44 graft recipients (17 women, 27 men, age 49.1±11.5 years) were included in the study. The average follow-up period between the first and the second measurement was 55.7±6.9 months. PWV did not change significantly during the follow-up period (9.1±1.8m/s vs. 8.7±1.8m/s; p=0.137). PWV in the group of non-diabetic patients decreased in the follow-up period by 0.62±1.23 m/s, while it increased for 0.43±2.1m/s in the group of diabetic patients. However, the difference between the two was not significant (p=0.057). At the second measurement the difference in PWV between diabetic and nondiabetic patients was significant (10.2±1.8 vs. 8.3±1.23m/s; p=0.02). Duration of smoking before transplantation correlated significantly with PWV (p=0.012). AI in the whole group increased significantly (from 18.3±10.3% to 25.9±9.4%; p<0.01), whereas a significant difference in AI between diabetic and nondiabetic patients was not found. Conclusion PWV of the whole group did not change significantly during the follow-up period, possibly due to stabilization of the process of arteriosclerosis after renal transplantation. In the subgroup of patients without diabetes we observed a trend of PWV reduction, whereas in the subgroup of patients with diabetes we observed the opposite. Diabetes mellitus and duration of smoking before transplantation are important risk factors for arteriosclerosis progression after renal transplantation.

Fractional excretion of magnesium and kidney function parameters in nondiabetic chronic kidney disease

Elevated fractional excretion of magnesium (FEMg) is a noninvasive biomarker of kidney damage, but its association with kidney functional parameters in nondiabetic chronic kidney disease (CKD) patients has not been sufficiently explored thus far. We enrolled 111 adult patients with nondiabetic CKD and 30 controls. To precisely investigate kidney function, the following parameters were assessed measured glomerular filtration rate (mGFR), effective renal plasma flow (ERPF), Cystatin C, albuminuria, and fractional excretion of magnesium (FEMg). All the CKD patients were divided into two groups according to the values of mGFR (mL/min/1.73m2): the first group consisted of those with GFR≥ 60mL/min/1.73m2, whereas the second group included those with GFR< 60mL/min/1.73m2. FEMg (%) was significantly higher in the group of nondiabetic patients with CKD compared to the healthy subjects [6.3 vs. 5.3 %, P=0.013]. There was also significant difference in the value of FEMg between the first and second groups of CKD patients. Increased FEMg was significantly correlated with all the investigated kidney function parameters, mGFR, ERPF, Cystatin C and albuminuria (r=-0.62; r=-0.60; r=0.77; r=0.39; p<0.01 for all). In multiple regression analyses based on observed parameters of kidney function, only cystatin C was independently and significantly associated with FEMg (multiple correlation coefficients: 0.738, p < 0.001)). Nondiabetic CKD patients with GFR< 60mL/min/1.73m2 have increased FEMg above 6.1% with 78.7 % specificity and 83.7% sensitivity. Highly significant association between kidney functional parameters and FEMg may indicate significance of this parameter in clinical practice.

Anemia in Diabetic Patients without Underlying Nephropathy. a Retrospective Cohort Study

Background: Anemia (defined by the World Health Organization as a hemoglobin level of less than 13 mg/dl in men and less than 12 mg/dl in women) is common in diabetic patients, particularly in those with reduced renal function. Most studies attribute anemia in diabetic patients to kidney function impairment. There are no controlled systematic studies of the prevalence and predictors of anemia in patients with diabetes in the absence of overt nephropathy. Objective: This retrospective cohort study was designed to measure the prevalence of anemia in diabetic patients with normal kidney function (estimated glomerular filtration rate (EGFR) greater than 90 ml/min/1.73 m2 and negative micro albuminuria) and compare it to a control group of non-diabetic patients. The study was designed to investigate diabetes as an independent risk for causing anemia. Methods: We undertook a retrospective review of medical records of 400 patients (older than 18 years old) visiting the outpatient clinic in our institution between January and June 2015. 200 patients with diabetes (glycosylated hemoglobin (HgA1C) greater than 7) were compared to 200 non-diabetic patients (HgA1C level below 5.6), to identify the prevalence of anemia, with and without kidney disease and any other associated factors. Results:The prevalence of anemia in all diabetic patients was 22% vs. 9% in non-diabetic group (OR: 2.69, 95% CI; 1.49 to 4.86, P = 0.001). Out of the 22% (n = 44) anemic patients, 18 patients had anemia with normal kidney function, out of those; 5 had iron deficiency anemia and one had autoimmune disease, while the remaining 12 patients (6%) did not have any obvious cause of anemia other than diabetes vs. 2 patients (1%) in non-diabetic patients who we did not find any explanation for the their anemia (OR: 6.6, 95% CI; 1.45 to 30, P &lt; 0.015). Conclusion: Most studies have highlighted an association between anemia and nephropathy in diabetic patients. This retrospective cohort study suggests a high incidence of anemia with unidentified pathology in the diabetic population. The mechanism of this anemia is not well understood, although direct glucose toxicity to erythrocyte precursors in the bone marrow or oxidative stress to mature erythrocytes are both possibilities. Prospective study of hemoglobin levels in patients with diabetes may help elucidate the precise mechanism of anemia in this group. Disclosures No relevant conflicts of interest to declare.

Comparison of chondral defects in diabetic patients and matched controls undergoing hip arthroscopy

Purpose To review the role of hip arthroscopy to diagnose and assess intraoperative hip pathology in diabetic patients compared to matched nondiabetic patients. Methods In our institutional review board-approved study, we retrospectively reviewed 791 consecutive hip arthroscopies performed by a single surgeon between 2010 and 2015. Patients under 18 years of age or who had previous ipsilateral hip surgery were excluded, leaving 321 patients who met inclusion criteria. Eleven diabetic patients were matched by age, sex, and body mass index to a control, nondiabetic group ( n = 310). Clinical symptoms, preoperative evaluations, radiographic and intraoperative findings were compared. Primary outcomes included the acetabular and femoral head chondromalacia index (CMI), calculated as a product of the Outerbridge chondromalacia grade and surface area (mm 2 *severity). Results On physical exam, diabetics had significantly less terminal hip flexion (83° vs. 92°, P = 0.011) and internal rotation (0.5° vs. 6.4°, P > 0.001) on the operative side compared to controls. More diabetics demonstrated evidence of femoral head chondromalacia compared to controls (57% vs. 8%, P = 0.05; 100% vs. 71%, P > 0.001, respectively) on MRI and intraoperative findings. Acetabular chondromalacia prevalence and grade were similar between the groups on operative findings. Acetabular (369 vs. 389, P = 0.842) and femoral head CMI (510 vs. 354, P = 0.081) did not vary significantly between diabetics and controls. Femoral head CMI positively correlated with acetabular CMI ( r = 0.398, P > 0.001). Conclusions Hip chondral pathology is more prevalent in diabetics compared to a similar group of nondiabetic patients. However, this difference did not translate to severity of the defect between the groups. The deficits in range of motion exhibited by diabetic patients may be due to pincer-type impingement but also suggest soft tissue involvement about the hip joint. Further, histological and molecular studies may better delineate the pathologic process that leads to hip pain in diabetic patients.

PP.10.03] SUCCESSFUL RENAL DENERVATION FOR RESISTANT HYPERTENSION FAILS TO IMPROVE INSULIN RESISTANCE AS ASSESSED BY HYPERINSULINEMIC EUGLYCEMIC STEP-CLAMP AND GLUCOSE TRACER INFUSION

Objective: The purpose of this study was to determine whether insulin sensitivity is improved after successful renal denervation (RDN) treatment for resistant hypertension. Design and method: Non-randomized, prospective study of 23 non-diabetic patients with resistant hypertension undergoing a two-step hyperinsulinemic euglycemic clamp with glucose tracer and labeled glucose infusion (HEC) as well as an oral glucose tolerance test (OGTT) before and 6 months after RDN. Whole body glucose disposal (WGD) and endoogenous glucose release (EGR) were calculated. Results: Eighteen of the 23 patients had metabolic syndrome at baseline, and body mass index (32 ± 5 kg/m2 at baseline) was stable during the study. At baseline, fasting plasma glucose was 5.9 ± 0.7 mmol/L, plasma insulin was 147 ± 93 pmol/L and plasma c-peptide was 1456 ± 502 pmol/L. No significant changes in these parameters were observed after 6 months. Basal glu-cose turnover rate and glucose infusion rate during two-step clamping remained unchanged. Suppression of endogenous glucose release during low-dose insulin infusion decreased from 0.9 ± 0.4 to 0.8 ± 0.4 mg/kg/min (p = 0.02), but remained unchanged during high insulin infu-sion. Area under the curve 0–120 min for glucose and insulin during OGTT, homeostasis model assessment-insulin resistance (HOMA-IR), Quantitative Insulin Sensitivity Check Index (ISQUICKI), the Simple Index assessing Insulin Sensitivity oral glucose tolerance (SIisOGTT) did not change significantly. Whole body glucose disposal did not change from basal levels at follow-up (Figure 1).Conclusions: Despite a significant effect on blood pressure, RDN treatment did not improve peripheral or hepatic insulin sensitivity, in this group of non-diabetic patients with resistant hypertension, as assessed by two-step HEC with glucose tracer infusion as well as indices derived from OGTT and fasting blood samples 6 months after RDN.

CRT-200.80 Primary Percutaneous Coronary Intervention in Diabetic Patients. Independents Predicitors of Survival and Event-free Survival

Some studies showed that diabetic patients (D) group (DG) had a worse outcome when compared to nondiabetic (ND) patients group (NDG), after primary percutaneous coronary intervention (PCI). The objectives were to compare mortality and major coronary events (MACE) at 30 days and 1 year of DG and NDG

The Difference of Gastric pH in Dyspepsia Patients With or Without Type 2 Diabetes Mellitus

Background: Dyspepsia syndrome often experienced by patients with diabetes mellitus (DM). Gastric acid is one of the aggressive factors of syndrome dyspepsia and peptic ulcers. This study aims to find the difference of gastric pH in dyspepsia patients with DM and without DM, and also to determine whether there is any correlation between gastric pH with proteinuria and hemoglobin A1c (HbA1c).Method: Two groups of patients consisted of 30 patients with DM and 30 patients without DM. Basal gastric pH of each group counted. Basal gastric pH was measured by inserting electrode catheter into the stomach for 30 minutes and then recorded on PH Metri brand Digitrapper pH-Z. Complication of DM was measured by microalbuminuria, while blood sugar control was measured by HbA1c. Chi-square test was done to look for difference of gastric pH between the diabetic patients group and non-diabetic patients group, by first determining the point of intersection with receiver operating characteristic (ROC) analysis. Correlation test between basal gastric pH with microalbuminuria and HbA1c were done.Results: Basal gastric pH in dyspepsia patients with DM vs. dyspepsia patients without DM was 2.30 ± 0.83 vs. 2.19 ± 0.52. With the Chi-square test, there is a significant difference between the diabetic patients group and non-diabetic patients group. With the correlation test between gastric pH and microalbuminuria was found r = 0.47 and p 0.05, whereas the correlation test between gastric pH and HbA1c was found r = 0.59 and p 0.05.Conclusion: There is a significant difference between basal gastric pH in diabetic dyspepsia patients and non-diabetic dyspepsia patients. There is a correlation between basal gastric pH and microalbuminuria, whereas there is no correlation between basal gastric pH and HbA1c.