History Of Diabetes Mellitus Type Research Articles

Correlation between Xerostomia, Hyposalivation, and Oral Microbial Load with Glycemic Control in Type 2 Diabetic Patients

ABSTRACT Aims and objectives The present study is an attempt to investigate prevalence of xerostomia and hyposalivation in type 2 diabetes mellitus using a modified Schirmer test (MST) and finding any association between xerostomia, hyposalivation, and oral microflora, namely, Streptococcus mutans, Lactobacillus spp., and Candida spp. with the glycemic control of individual. Background Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia and resulting in either lack or relative insufficiency of insulin. In addition to systemic alterations, oral manifestations of diabetes mellitus have been reported, such as xerostomia and hyposalivation, alteration in taste, caries, gingivitis, and periodontal disease. Materials and methods Thirty individuals with known history of diabetes mellitus type 2 were chosen as cases and 30 ageand sex-matched healthy controls were taken as control group. For assessment of hyposalivation, unstimulated salivary flow rate was measured using a MST with a commercially available Schirmer test strip having a millimeter scale (0—35 mm). Results In our study, we found that the difference in the wettability of Schirmer strip among diabetics and healthy controls was more significant at the end of the 1st minute due to decreased salivary flow in diabetics. Conclusion A n e arly a ssessment o f s alivary f low a nd xerostomia in type 2 diabetic patients and its treatment, along with routine oral hygiene and maintenance, may alter the clinical outcomes of diabetes. How to cite this article Ahmed J, Jindal R, Shenoy N, Denny C, Udayalakshmi J, Baliga S. Correlation between Xerostomia, Hyposalivation, and Oral Microbial Load with Glycemic Control in Type 2 Diabetic Patients. World J Dent 2016;7(2):83-86.

Glioblastoma multiforme of the optic chiasm: A rare case of common pathology.

Background:Malignant optic and chiasmatic gliomas are extremely rare, and are classified pathologically as anaplastic astrocytoma or glioblastoma multiforme (GBM). Approximately 40 cases of optic GBM in adults have been reported in the literature, and only five of them were described to originate from the optic chiasm.Case Description:An 82-year-old male patient with a past medical history of diabetes mellitus type 2, melanoma, and bladder cancer presented with gradual vision loss of the left eye in a period of 1 month. After neuro-ophthalmological examination, the decision of thither magnetic resonance imaging (MRI) studies was made. It showed a contrast enhancing mass in the region of the optic chiasm. In this case, imaging study was not enough to establish an accurate diagnosis and a left pterional craniotomy for biopsy and resection of the optic chiasmal mass was performed. After histological evaluation of the mass tissue, the diagnosis of GBM was made. Taking into account the patient's poor condition and unfavorable prognosis he was moved to inpatient hospice. The patient deceased within 2 months after surgery.Conclusion:Chiasmal GBM is an extremely rare condition where a biopsy is necessary for accurate diagnosis and optimal treatment. Differential diagnosis for such lesions can be very difficult and include demyelinating optic neuritis and non-demyelinating inflammatory optic neuropathy (e.g., sarcoid), vascular lesions (e.g., cavernoma), compressive lesions of the optic apparatus, metastatic malignancy, and primary tumors of the anterior optic pathway. The role of chemotherapy and radiotherapy including novel stereotaxic radiosurgery methods is still unclear and will need to be evaluated.

A Rare Case of Emphysematous Pyelonephritis

Background: This case illustrates the potential for class 3A emphysematous pyelonephritis with the presence of nephrolithiasis to be initially treated solely by relieving the hindered urinary outflow and with systemic antibiotics if diagnosed early with appropriate imaging studies. Case Presentation: 64-year-old Caucasian female with history of diabetes mellitus type 2, hyperlipidemia, hypertension, coronary artery disease and diastolic congestive heart failure presented to the emergency department with respiratory distress of 2 days duration. Her chief complaint was associated with anuria for two days, abdominal pain, generalized weakness, and loss of appetite. The patient was admitted to the medical intensive care unit (MICU) for hypotension, severe mixed respiratory and metabolic acidosis, and uremia. She was intubated for pending respiratory failure and underwent emergency hemodialysis for acute renal failure. She received hemodynamic support and was also started on systemic antibiotics. A computerized tomography (CT) scan of the abdomen/pelvis revealed class 3A emphysematous pyelonephritis (EPN) of the left kidney and an 8 mm nonobstructing calculus in the left proximal ureter. Subsequently a left ureteral stent was placed to relieve the obstruction. In addition, blood cultures revealed bacteremia with Klebsiella pneumoniae. Although she had thrombocytopenia, acute renal failure and shock, the intra-renal emphysema improved with the stent and she was eventually weaned off of vasopressors, extubated and showed marked clinical improvement. Conclusion: Rare cases of class 3A EPN precipitated by any degree of urinary tract obstruction may be treated initially with relief of outflow hindrance and aggressive supportive care if an early diagnosis can be made with appropriate imaging studies.

Analysis of selected glutathione S-transferase gene polymorphisms in Malaysian type 2 diabetes mellitus patients with and without cardiovascular disease.

Type 2 diabetes mellitus (T2DM) is believed to be associated with excessive production of reactive oxygen species. Glutathione S-transferase (GST) polymorphisms result in decreased or absent enzyme activity and altered oxidative stress, and have been associated with cardiovascular disease (CVD). The present study assessed the effect of GST polymorphisms on the risk of developing T2DM in individuals of Malaysian Malay ethnicity. A total of 287 subjects, consisting of 87 T2DM and 64 CVD/T2DM patients, as well as 136 healthy gender- and age-matched controls were genotyped for selected polymorphisms to evaluate associations with T2DM susceptibility. Genomic DNA was extracted using commercially available kits, and GSTM1, GSTT1, and α-globin sequences were amplified by multiplex polymerase chain reaction. Biochemical parameters were measured with a Hitachi autoanalyzer. The Fisher exact test, the chi-square statistic, and means ± standard deviations were calculated using the SPSS software. Overall, we observed no significant differences regarding genotype and allele frequencies between each group (P = 0.224 and 0.199, respectively). However, in the combined analysis of genotypes and blood measurements, fasting plasma glucose, HbA1c, and triglyceride levels, followed by age, body mass index, waist-hip ratio, systolic blood pressure, and history of T2DM significantly differed according to GST polymorphism (P ˂ 0.05). Genetically induced absence of the GSTT1 enzyme is an independent and powerful predictor of premature vascular morbidity and death in individuals with T2DM, and might be triggered by cigarette smoking's oxidative effects. These polymorphisms could be screened in other ethnicities within Malaysia to determine further possible risk factors.

A cross-sectional assessment of health-related quality of life among type 2 diabetic patients in Pakistan.

Objective:This study aims to describe the health-related quality of life (HRQoL) profile of Type 2 diabetes mellitus (T2DM) population attending outpatient clinics in Sargodha City, Pakistan.Methods:The study was designed as a cross-sectional descriptive survey. T2DM patients attending a tertiary care institute in Sargodha, Pakistan were targeted for the study. The EuroQol EQ-5D was used for the assessment of HRQoL and was scored using values derived from the UK general population survey. Descriptive statistics were used for the elaboration of sociodemographic characteristics. The Chi-square test was used to depict the possible association between study variables and HRQoL. Where significant associations were noted, Phi/Cramer's V was used for data interpretation accordingly. SPSS version 21 (SPSS Inc., Chicago, IL, USA) was used for data analysis and P < 0.05 was taken as significant.Results:Three hundred and ninety-two patients were approached for the study. The cohort was dominated by males (n = 222, 56.60%) with 5.58 ± 4.09 years of history of T2DM. The study highlighted poor HRQoL among the study participants (0.471 ± 0.336). Gender, marital status, education, monthly income, occupation, location and duration of the disease were reported to be significantly associated with HRQoL (P < 0.001).Conclusion:T2DM imposes a negative effect on HRQoL of the patients. Attention is needed to highlight determinants of HRQoL and to implement policies for better management of T2DM, particularly in early treatment phases where improving HRQoL is still possible.

Heart rate variability in nondiabetic dyslipidemic young Saudi adult offspring of type 2 diabetic patients

Background: Autonomic imbalance has been described in first-degree relatives of diabetic patients, and dyslipidemia has been reported to induce sympathovagal imbalance (SVI). Aims and Objective: To assess the contribution of dyslipidemia to SVI in adults with positive family history of type 2 diabetes mellitus (T2DM). Materials and Methods: This is a cross-sectional study involving 150 male Saudi adults aged 19–30 years, recruited from students of College of Applied Medical Sciences in Taif University, Taif, Saudi Arabia. Lipid profile, atherogenic index (AI), body mass index (BMI), waist circumference (WC), basal heart rate (BHR), blood pressure (BP), spectral indices of heart rate variability (HRV), and homeostatic model of insulin resistance (HOMA-IR) were measured and analyzed in study groups (control subjects with no family history of T2DM, n = 50; positive family history of T2DM, nondyslipidemic subjects, n = 50 and dyslipidemic subjects n = 50). Result: In the dyslipidemic group, lipid profile, LF-HF (ratio of low-frequency to high-frequency power of HRV, a precise indicator of SVI) was significantly increased (P˂ 0.05) when compared with non dyslipidemic and the control groups. Increased SVI was owing to simultaneous sympathetic motivation and vagal inhibition. LF-HF ratio was positively correlated with the WC, SBP, DBP, BHR, total cholesterol (TC), low-density lipoprotein (LDL) and AI. Significant contribution of WC, DBP, BHR, TC, and AI to the LF-HF ratio in the dyslipidemic group was observed by multiple regression analysis. Conclusion: SVI in dyslipidemic subjects with family history of T2DM occurs owing to sympathetic activation and vagal depression. Dyslipidemia contributes to the SVI in these subjects.

Exposures to road traffic, noise, and air pollution as risk factors for type 2 diabetes: A feasibility study in Bulgaria

Type 2 diabetes mellitus (T2DM) is a growing public health problem in Bulgaria. While individual and lifestyle determinants have been researched; till date there has been no study on environmental risks such as road traffic, noise, and air pollution. As a first step toward designing a large-scale population-based survey, we aimed at exploring the overall associations of prevalent T2DM with exposures to road traffic, noise, and air pollution. A total of 513 residents of Plovdiv city, Bulgaria were recruited. Individual data on self-reported doctor-diagnosed T2DM and confounding factors were linked to objective and self-rated exposure indicators. Logistic and log-link Poisson regressions were conducted. In the fully adjusted logistic models, T2DM was positively associated with exposures to Lden 71-80 dB (odds ratio (OR) = 4.49, 95% confidence interval (CI): 1.38, 14.68), fine particulate matter (PM)2.5 25.0-66.8 μg/m3 (OR = 1.32, 95% CI: 0.28, 6.24), benzo alpha pyrene 6.0-14.02 ng/m3 (OR = 1.76, 95% CI: 0.52, 5.98) and high road traffic (OR = 1.40, 95% CI: 0.48, 4.07). Lden remained a significant risk factor in the: Poisson regression model. Other covariates with consistently high multivariate effects were age, gender, body mass index, family history of T2DM, subjective sleep disturbance, and especially bedroom location. We concluded that residential noise exposure might be associated with elevated risk of prevalent T2DM. The inferences made by this research and the lessons learned from its limitations could guide the designing of a longitudinal epidemiological survey in Bulgaria.

Is type 2 diabetes mellitus in mechanically ventilated adult trauma patients potentially related to the occurrence of ventilator-associated pneumonia?

Background:Ventilator-associated pneumonia (VAP) is a type of lung infection that typically affects critically ill patients undergoing mechanical ventilation (MV) in the intensive care unit (ICU). Patients with type 2 diabetes mellitus (T2DM) are considered to be more susceptible to several types of infections including community-acquired pneumonia. However, it is not clear whether T2DM is a risk factor for the development of VAP. The purpose of this study was to determine the risk of VAP for diabetic and nondiabetic mechanically ventilated trauma patients.Materials and Methods:This study is a secondary analysis of a prospective observational study of the history of T2DM in the ICU over a period of 1 year at Imam Khomeini Hospital in Iran. A total of 186 critically ill trauma patients who required at least 48 h of MV were monitored for the occurrence of VAP by their clinical pulmonary infection score (CPIS) until ICU discharge, VAP diagnosis, or death.Results:Forty-one of the 186 patients developed VAP. The median time from hospitalization to VAP was 29.09 days (95% CI: 26.27–31.9). The overall incidence of VAP was 18.82 cases per 1,000 days of intubation (95% CI: 13.86-25.57). Risk of VAP in diabetic patients was greater than nondiabetic patients after adjustments for other potential factors [hazard ratio (HR): 10.12 [95% confidence interval (CI): 5.1–20.2); P < 0.0001)].Conclusion:The findings show that T2DM is associated with a significant increase in the occurrence of VAP in mechanically ventilated adult trauma patients.

Gastrin Secretion After Bariatric Surgery-Response to a Protein-Rich Mixed Meal Following Roux-En-Y Gastric Bypass and Sleeve Gastrectomy: a Pilot Study in Normoglycemic Women.

Recent investigations have linked elevated gastrin levels to the improvement of type 2 diabetes mellitus (T2DM). Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are effective treatments for T2DM, but it is not known if this is related to postoperative alterations of gastrin secretion. Twenty women previously operated with RYGB or SG and 13 female controls were enrolled and evaluated for body mass index, lipids, C-peptide, HbA1c, and anti-H. pylori IgG. Glucose, gastrin, insulin, and glucagon-like peptide 1 (GLP-1) concentrations were measured before and 30, 60, 90, and 120min after ingestion of a protein-rich mixed meal. Six participants primarily selected were excluded due to usage of proton pump inhibitors, positive H.pylori IgG, or history of T2DM, yielding the following groups: RYGB (n = 9), SG (n = 8), and controls (n = 10). There were no differences in age, body mass index, HbA1c, or C-peptide levels between groups. RYGB had significantly lower area under the curve (AUC) for glucose during the test compared to controls (p = 0.013). RYGB showed lower serum gastrin levels compared to SG and controls (p < 0.05 for all). There was a non-significant increased gastrin release in SG compared to controls (p = 0.091). For SG and controls, there was a negative correlation between glucose and gastrin response (p = 0.0043). Gastrin secretion is diminished after RYGB. Hypergastrinemia was not present after SG, but a tendency of enhanced gastrin secretion was observed. These findings require further investigation in prospective studies.

Fıbroblast growth factor 21 and ıts relatıonshıp wıth ınsulın sensıtıvıty ın fırst-degree relatıves of patıents wıth type 2 dıabetes mellıtus.

Fibroblast growth factor 21 (FGF 21) has been suggested as a predictor for the development of type 2 diabetes mellitus (T2DM). We aimed to determine FGF 21 levels in normoglycaemic (Group 1) and prediabetic (Group 2) first-degree relatives (FDR) of patients with T2DM in comparison with normoglycaemic subjects without a history of T2DM in their FDR (Group 3). There was a significant difference between Group 1, 2, and 3 with respect to plasma FGF 21 concentrations (143.3 ± 93.8, 221.9 ± ± 171.7 and 121.2 ± 119.8 pg/mL, respectively, p = 0.01). FGF 21 levels were significantly increased in prediabetic FDR of patients with T2DM compared to normoglycaemic subjects without a history of T2DM in their FDR (p = 0.02). FGF 21 levels did not differ between normoglycaemic FDR of patients with T2DM and normoglycaemic subjects without a history of T2DM in their FDR (p > 0.05). In the whole group, FGF 21 correlated positively with age (r = 0.31, p = 0.003), BMI (r = 0.38, p < 0.001), systolic blood pressure (r = 0.38, p = 0.001), diastolic blood pressure (r = 0.26, p = 0.02), fasting blood glucose (r = 0.24, p = 0.02), HOMA-IR (r = 0.23, p = 0.03), AUC glucose (r = 0.35, p = 0.001), and AUC insulin (r = 0.32, p = 0.003) and negatively with HDL cholesterol (r = -0.24, p = 0.02) and Matsuda ISI (r = -0.33, p = 0.002). In the regression analysis, BMI was the most predictive factor for FGF 21 levels (beta = 0.41, r2 = 0.17, p < 0.001). We showed that FGF 21 concentrations are increased in prediabetic FDR of patients with T2DM and that there is a significant association between FGF 21 and obesity and insulin sensitivity. (Endokrynol Pol 2016; 67 (3): 260-264).

Risk of type 2 diabetes mellitus in female breast cancer patients treated with morphine: A retrospective population-based time-dependent cohort study

AimsWe aimed to examine whether morphine treatment is associated with type 2 diabetes mellitus (T2DM) in female breast cancer patients. MethodsWe conducted a retrospective cohort analysis of the Longitudinal Health Insurance Database for Catastrophic Illness Patients in Taiwan. A total of 31,112 women with breast cancer without T2DM history during the period 2000–2005 were identified, divided into morphine and non-morphine users (8071 and 23,041 patients, respectively), and the hazard ratios of newly diagnosed T2DM during the period 2005–2010 were calculated. We used a Cox proportional hazard model with time-dependent exposure covariates to estimate the risk of T2DM. The dosage of morphine was counted as defined daily dose and its effect was assessed by multivariable Cox proportional hazard regression controlling age, Charlson comorbidity index, outpatient department visits, antipsychotics, and breast cancer drugs. ResultsMorphine users were 1.24 times more likely to suffer from T2DM than non-morphine users (95% CI=1.04–1.49). Risk increased slightly with the morphine dosage, in patients aged 35–49 years, and with tamoxifen, aromatase inhibitors, and antipsychotics treatment. ConclusionsThe incidence of T2DM is associated with morphine treatment in female breast cancer patients. A higher risk was observed in patients aged 35–49 years using higher dose of morphine, and may be increased by tamoxifen and aromatase inhibitors.

Cardiorespiratory fitness and risk of type 2 diabetes mellitus: A 23-year cohort study and a meta-analysis of prospective studies

AimsTo investigate the association between cardiorespiratory fitness (CRF) and type 2 diabetes mellitus (T2DM) in a cohort of middle-age Finnish men and to summarise the current evidence in a meta-analysis of prospective studies. MethodsCRF was measured at baseline in a random population-based sample of 2520 subjects by assessing oxygen uptake during maximal exercise. Cox regression analysis was used to estimate the association between CRF, expressed as metabolic equivalents (METs), and the risk of T2DM adjusted for potential confounders; this estimate was then pooled with the results of other prospective studies in a meta-analysis. ResultsMean (SD) baseline age and CRF were 53 (5) years and 8.7 (2.1) METs, respectively. During 23 years of follow-up, 153 (6.1%) participants developed T2DM. The hazard ratio per 1-MET higher CRF, adjusted for age, body mass index, systolic blood pressure, serum HDL-cholesterol, and family history of T2DM, was 0.93 (95% confidence interval (CI): 0.84, 1.02; p = 0.109); further adjustment for smoking, education, and socioeconomic status did not materially change the estimate. In a random-effects meta-analysis of eight studies (92,992 participants and 8564 T2DM cases) combining maximally adjusted estimates, the pooled risk ratio of T2DM per 1-MET higher CRF level was 0.95 (95% CI: 0.93, 0.98; p = 0.003; I2 = 81%), corresponding to 23 fewer cases per 100,000 person-years based on the assumption of a causal link between CRF and T2DM. ConclusionsThese data suggest that there is an inverse relationship between CRF and T2DM that is largely independent of other risk factors.

The impact of PNPLA3 and JAZF1 on hepatocellular carcinoma in non-viral hepatitis patients with type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is an established independent risk factor for hepatocellular carcinoma (HCC). T2DM is associated with non-alcoholic steatohepatitis (NASH), which is a major cause of non-HBV and non-HCV-related HCC; nevertheless, it has been difficult to identify those patients with T2DM who have a high risk of developing HCC. The aim of this study was to identify genetic determinants that predispose T2DM patients to HCC by genotyping T2DM susceptibility loci and PNPLA3. We recruited 389 patients with T2DM who satisfied the following three criteria: negative for HBs-Ag and anti-HCV Ab, alcohol intake <60 g/day, and history of T2DM >10 years. These patients were divided into two groups: T2DM patients with HCC (DM-HCC, n = 59) or those without HCC (DM-non-HCC, n = 330). We genotyped 51 single-nucleotide polymorphisms (SNPs) previously reported as T2DM or NASH susceptibility loci (PNPLA3) compared between the DM-HCC and DM-non-HCC groups with regard to allele frequencies at each SNP. The SNP rs738409 located in PNPLA3 was the greatest risk factor associated with HCC. The frequency of the PNPLA3 G allele was significantly higher among DM-HCC individuals than DM-non-HCC individuals (OR 2.53, p = 1.05 × 10(-5)). Among individuals homozygous for the PNPLA3 G allele (n = 115), the frequency of the JAZF1 rs864745 G allele was significantly higher among DM-HCC individuals than DM-non-HCC individuals (OR 3.44, p = 0.0002). PNPLA3 and JAZF1 were associated with non-HBV and non-HCV-related HCC development among Japanese patients with T2DM.

Cells to Surgery Quiz: June 2015

1 Journal of Investigative Dermatology (2015), Volume 135 © 2015 The Society for Investigative Dermatology QUESTIONS 1. A 37-year-old man with history of diabetes mellitus type 1 presented for evaluation of the lesions pictured above. They are asymptomatic and have been slowly increasing in size and number over the past few years. What is your diagnosis? a. Tinea versicolor. b. Vitiligo. c. Nevus depigmentosus. d. Postinflammatory hypopigmentation. Cells to Surgery Quiz: June 2015 Leyre Falto-Aizpurua1, Mohammad-Ali Yazdani Abyaneh1, Brian J. Simmons1, Fleta N. Bray1, Mohammed Alsaidan1 and Keyvan Nouri1 Journal of Investigative Dermatology (2015) 135, e14. doi:10.1038/jid.2015.136

Logistic regression analysis of risk factors of Type 2 diabetes mellitus complicated with cardiovascular disease factors

Objective To explore the main risk factors of type 2 diabetes mellitus(T2DM)complicated with cardiovascular disease(CVD). Methods The T2DM of 128 cases of CVD associated with CVD group were selected, the patients with T2DM 107 cases were selected as control group, used Logistic regression method for the analysis of the risk factors of concurrent CVD. Results The risk of CVD in patients with a family history of T2DM was 1.535 times of that of the other patients(OR=1.535,95%CI=1.145,2.057,P=0.036), the vegetarian diet patients was 41.3%(OR=0.413,95%CI=0.210,0.815,P=0.024),in patients with hypertension was 2.077 times(OR=2.077,95%CI=1.301,2.813,P=0.010).T2DM patients with TG,PBG,LDL-C,HDL-C per 1mmol/L rise,the risk of concurrent CVD was 1.192 times of that of the other patients(OR=1.192,95% CI 1.012,1.372,P=0.023),1.125 times(OR=1.125,95%CI=1.043,1.218,P=0.028),1.712 times(OR=1.712,95%CI=1.203,2.231,P=0.009)and 42.6%(OR=0.426,95%CI=0.239,0.776,P=0.011);Hb A1c increased every 1%,the risk of concurrent CVD was 1.284 times of that of theother patients(OR=1.284,95% CI=1.132,1.413,P=0.013);BMI increased by 1kg/m2,the risk of concurrent CVD was 1.508 times of that of the other patients(OR=1.508,95%CI=1.143,1.825,P=0.026);C2 increased by 1m L/mm Hg×100,the risk was the other patient's 33.9%(OR=1.508,95%CI=1.143,1.825,P=0.026). Conclusion Family history of T2DM, hypertension, TG,PBG,LDL-C,Hb A1c and BMI are major risk factors for T2DM with CVD;vegetarian diet,HDL-C and C2 are protective factors. Key words: Diabetes mellitus, type 2; Cardiovascular disease; Risk factors; Concurrent

Association between direct measurement of active serum calcium and risk of type 2 diabetes mellitus: A prospective study

Background and aimsPrevious prospective studies showing a positive association between serum calcium and incidence of type 2 diabetes mellitus (T2DM) have relied on total calcium or an indirect estimate of active, ionized calcium (iCa). We aimed to assess this relationship using a direct measurement of iCa. Methods and resultsiCa and cardiometabolic risk factors were measured in a population-based sample of 2350 men without a known history of T2DM at baseline. Associations between iCa levels and incident cases of T2DM (self-reported, ascertained with a glucose tolerance test, or determined by record linkage to national registers) were estimated using Cox regression analyses adjusted for potential confounders. At baseline, mean (standard deviation) age was 53 (5) years and mean iCa 1.18 (0.05) mmol/L. During a median follow-up of 23.1 years, 140 new cases of T2DM were recorded. In a multivariable analysis adjusted for age, body mass index, systolic blood pressure, serum HDL-cholesterol, and family history of T2DM, there was no association comparing second (hazard ratio 0.84; 95% confidence interval 0.59–1.18), third (0.77; 0.52–1.14), or fourth (0.98; 0.69–1.39) vs first quartile of iCa (p for trend 0.538); further adjustment for C-reactive protein, physical activity level, and triglycerides did not change the estimates (p for trend 0.389). ConclusionIn this study, we did not find evidence of an association between direct measurement of active calcium and risk of T2DM. Further studies are needed to confirm our findings and define the relationship between factors influencing indirect calcium estimation and incident T2DM.

Risk factors of incident type 2-diabetes mellitus over a 3-year follow-up: Results from a large Australian sample

AimsTo describe the incidence of type 2 diabetes mellitus (T2DM) among middle-aged and older Australian adults and to examine a broad range of risk factors of T2DM. MethodsA large cohort of Australian adults aged 45 and up was sampled from the general population and was followed up for approximately 3 years (n=60,404). Physician-diagnosed T2DM was self-reported at baseline (2006–2008) and follow-up (2010). Incident T2DM was determined as not reporting T2DM at baseline, but reporting T2DM at follow-up. A broad range of risk factors, including socio-demographic characteristics, health status, family history, and lifestyle behaviors were examined at baseline. Multiple logistic regression was used for selecting potential predictors of incident T2DM, and age and reported family history of T2DM were tested as potential effect modifiers. ResultsOf the 54,997 without T2DM at baseline, 888 reported T2DM at follow-up (cumulative incidence 1.6% over 3.4 years, annual incidence rate 0.44%). Adjusted for other risk factors, being male, older age, higher relative socio-economic disadvantage, being born in Asia, lower educational attainment, medical history of hypertension and dyslipidemia, family history of T2DM, overweight/obese, smoking, long sleeping hours, and psychological distress were significantly associated with higher odds of developing T2DM. Particularly, hypertension, dyslipidemia, and overweight/obesity were stronger predictors of T2DM among middle-aged than older adults (≥60 years). ConclusionsUnderstanding risk factors for incident T2DM could help identify at-risk populations and develop upstream preventive strategies to combat the epidemic of diabetes.

The Impact of the eNOS Glu298→Asp Polymorphisms on Endothelial and Diastolic Function in Non-Diabetic Offspring of Diabetic Parents

Objective: The aim of the present study was to investigate the relationship of the eNOS Glu298→Asp polymorphisms with impaired flow mediated dilatation (FMD) and diastolic dysfunction in Egyptian children with family history of type-2 diabetes Mellitus (DM). Materials and methods: Brachial artery FMD and echocardiographic study were performed in 80 (mean age, 11.5 ± 2.2 years) Egyptian non-diabetic offspring of patients with DM, and 80 (mean age, 10.6+2.4 years) Egyptian non-diabetic offspring of non-diabetic parents. Analysis of the endothelial nitric oxide synthase gene polymorphism using polymerase chain reaction and restriction fragment length polymorphism. for detection of different genotype variants (Glu/Glu (GG), Glu/Asp (GT) and Asp/Asp (TT) genotype). Results: Offspring of diabetic parents showed an increase in the frequency of Glu298Asp polymorphisms, significantly higher compared with controls (P<0.0001). The FMD% was significantly correlated with impaired diastolic dysfunction in offspring of diabetic patients (r=0.435 for IVRT and r=462 for E/Em). The Glu298Asp was significantly associated with impaired FMD and elevated E/Em among non-diabetic offspring of diabetic patients (P<0.001 and <0.005). Conclusion: Glu298Asp polymorphism in the endothelial nitric oxide synthase gene was significantly associated with impaired FMD and diastolic dysfunction in non-diabetic children with family history of diabetes.

A Benign Ovarian Tumour developing an Endometrial Cancer? Sertoliform Ovarian Cystoadenoma getting together with an Endometrioid Adenocarcinoma

Introduction: Sertoli cells tumours are neoplasms with a very low incidence, being sertoliform cystoadenomae extremely unusual. Its first description was made on 1982 by Young and Roth, with very few cases published after them. This is a neoplasm only described on postmenopausal women, with an average age of presentation of 68 year old, and they could suffer virilization symptoms in different degrees. Histologically, it is a well differentiated neoplasm, with a low malignancy degree, and good prognosis if it is confined to ovaries. In other way, the finding of this ovarian tumour getting together with an endometrioid adenocarcinoma is an extremely rare case. Medical Case: A 66 year old woman, who attended our office relating postmenopausal metrorrhage, is presented. The patient had a medical history of diabetes mellitus type II, arterial hypertension, dyslipidemia, liver steatosis, glaucoma and appendectomy. She got three deliveries and had her menopause at the age of 53. An outpatient hysteroscopy was carried on, finding three endometrial polyps, two of them appeared as normal, and the bigger one had a glandular appearance with atypical vascularization, taking biopsy of it that was informed as endometrioid type adenocarcinoma with mucus-secreting pattern. Ultrasoud scanning, magnetic resonance and serum Ca 125 were carried on, finding a 2,5cm left ovarian nodule with negative Ca 125. An abdominal total hysterectomy with double adnexectomy, was carried on, with intraoperative biopsy, informed as a borderline tumour. Due to this finding, the operation was completed with omentectomy, lymphadenectomy and peritoneal washing. Last histological analysis identifies the ovarian tumour as sertoliform adenoma from rete ovarii, with hepatocyte multifocal metaplasia. This tumour is suspected of being estrogenic functioning one, probably was the inductor of low degree and moderatedly differentiated G2 endometrioid adenocarcinoma. There was no lymphatic or omental metastases. FIGO staging IA, TNM staging T1aN0M0. Conclusions: Sertoliform cystoadenoma is a very rare finding, with only few cases reported. It could be an estrogenic functioning tumour and due to this characteristic could induce endometrial hyperplasia, and at last, could be the reason for appearance of low malignancy degree endometrial neoplasms.

Signature biomarkers in Diabetes Mellitus and associated Cardiovascular diseases

Platelet signatures indicating differential dysfunction, hyperactivation, aggregation or adhesion are capable of expressing their characters during the journey of a disease process, and can be utilized as cost effective biomarkers with immense clinical value. Type 2 diabetes mellitus (T2DM) is a major lifestyle disease of contemporary world with progression to diabetes associated cardiovascular diseases (DM-CVD). We identified a few potential biomarkers in platelets of T2DM to analyze the thrombotic risk in diabetes subjects by utilizing flow cytometric quantification with different flurochrome conjugated monoclonal antibodies. Our study describes interesting correlations (p<0.0001) for different clinical parameters of concurrent threat for vessel occlusion and the status of indices like reactive oxygen species, von Willebrand factor and mitochondrial membrane potential using western blotting and fluorescence techniques. Our study involved 32 T2DM, and 31 T2DM-CVD subjects compared to 29 healthy controls without any history of T2DM or CVD. An altered expression of platelet surface markers P-selectin (CD62p) and GpIIb/IIIa (CD 41/61, PAC1) along with changes in the platelet size due to agonist induced activation contributed to the enhanced thrombotic potential in the patients. This work elucidates the prospect of platelet biomarkers as diagnostic tool to predict cardiovascular risk in DM subjects.