Impact Of Type 2 Diabetes Mellitus Research Articles

The relationship between pancreatic cancer and type 2 diabetes: cause and consequence.

Pancreatic cancer (PC) is a devastating and lethal malignant disease and it is well known that there is a complex bidirectional relationship between PC and type 2 diabetes mellitus (T2DM). In order to more deeply summarize the relationship between them, this article summarizes the epidemiological data on the relationship between PC and T2DM in the past 5 years, and further explains the mechanism of interaction between them. Meanwhile, it also summed up the effects of drug therapy for T2DM on PC and the impact of T2DM on surgical resection of PC. Epidemiological studies clearly indicate that the risk of PC is increased in patients with T2DM. But increasing epidemiological data points out that PC also acts as a cause of T2DM and new-onset T2DM is sign and consequence of PC. Insulin resistance, hyperinsulinemia, hyperglycemia, and chronic inflammation are the mechanisms of T2DM-Associated PC. Metformin decreases the risk of PC, while insulin therapy increases the risk of PC. Besides, studies have shown that T2DM decreases the survival in patients with PC resection.

Current status of dental implants survival and peri-implant bone loss in patients with uncontrolled type-2 diabetes mellitus.

The current review summarizes recent evidence on the impact of type-2 diabetes mellitus (T2DM) on implant dentistry, highlighting the behavior of peri-implant bone. There is no definitive information on the development and course of peri-implant bone loss associated with T2DM; however, poorly controlled T2DM patients present worse outcomes. Nevertheless, dental implants may be a successful therapy for these patients in a manner similar to healthy individuals, when glycemic levels and oral hygiene are strictly maintained. The most recent literature on the impact of T2DM on peri-implant bone loss was reviewed to evaluate the feasibility of dental implant therapy over the time for these patients.

Impact of Type 2 Diabetes Mellitus and Myocardial Perfusion on Long-Term Risk of Heart Failure and All-Cause Mortality following Interventional Treatment of ST-Elevation Myocardial Infarction

Patients with type 2 diabetes mellitus (T2DM) who undergo primary percutaneous coronary intervention (pPCI) for ST-elevation myocardial infarction (STEMI) have worse myocardial perfusion than normoglycemic patients. It is not known whether these factors combined influence prognosis in term of heart failure (HF) and/or all-cause mortality. We aimed to evaluate the impact of T2DM and myocardial perfusion on long-term risk of HF and/or all-cause mortality following interventional treatment of STEMI. 4STEMI patients (104 with T2DM) treated with pPCI were enrolled into the study. Myocardial perfusion was reassessed with: myocardial blush grade (MBG), Quantitative myocardial Blush Evaluator (QuBE), resolution of ST-segment elevation (STR). Follow-up data was collected during 6 years. 23.1% patients with T2DM developed HF vs. 16.9% without T2DM (P=NS). 34.6% of patients with T2DM have died vs. 14.9% patients without T2DM (P=0.000). Patients with T2DM and HF have had the highest mortality rate of 75%. Survival of patients with T2DM in relation to QuBe score is presented in the Figure. There was no difference in myocardial perfusion assessed by STR. T2DM and diminished myocardial perfusion increase the risk of HF and/or all cause death in 6 years follow-up. Disclosure A. Tomasik: None. K. Nabrdalik: None. H. Kwiendacz: None. T. Sawczyn: None. M. Kukla: None. E. Radzik: None. K. Pigon: None. T. Młyńczak: None. J. Gumprecht: Speaker's Bureau; Self; AstraZeneca. Consultant; Self; Bayer AG. Speaker's Bureau; Self; Bioton, Berlin-Chemie AG, Eli Lilly and Company, Merck Sharp & Dohme Corp., Boehringer Ingelheim GmbH, Novo Nordisk A/S, Polfa Tarchomin S.A., Polpharma. W. Grzeszczak: Speaker's Bureau; Self; Boehringer Ingelheim GmbH, Bioton, Merck & Co., Inc., Novo Nordisk A/S. Stock/Shareholder; Self; Eli Lilly and Company. Speaker's Bureau; Self; Bayer AG. E. Nowalany-Kozielska: None.

Evaluating the impact of type 2 diabetes mellitus on CYP450 metabolic activities: protocol for a case–control pharmacokinetic study

IntroductionDiabetes affects more than 9% of the adult population worldwide. Patients with type 2 diabetes mellitus (T2DM) show variable responses to some drugs which may be due, in part, to...

Impact of type 2 diabetes mellitus on the prognosis of early stage triple-negative breast cancer in People's Republic of China.

BackgroundType 2 diabetes mellitus (T2DM) is one of the most common chronic metabolic diseases. Increased cause-specific mortality and decreased disease-free survival (DFS) have been reported among cancer patients with T2DM compared with patients without T2DM, even after adjustments of other comorbidities. However, less is known about the impact of T2DM and other comorbidities on DFS in Chinese patients with early stage triple-negative breast cancer (TNBC).Patients and methodsWe assessed patients who were newly diagnosed with early stage primary TNBC at the Department of Breast Surgery, Fudan University, from 2003 to 2011. Of the 1,100 TNBC patients, 865 female patients had invasive and early stage TNBC. The association of the variables in the T2DM and non-T2DM groups was compared using the Pearson’s chi-square and independent t-tests. DFS was estimated using the Kaplan–Meier method. The effects of T2DM and other possible risk factors on DFS were assessed by Cox proportional hazards regression using univariate or multivariate analysis.ResultsA total of 865 early stage primary TNBC cases were studied, including 104 (12.02%) subjects with T2DM. Metastatic or recurrent disease was detected in 24 (23.08%) patients in the T2DM group and 35 (4.60%) patients in the non-T2DM group. Patients with T2DM exhibited a significantly lower DFS than patients without T2DM (log-rank P<0.001). Similar results were observed when patients with positive lymph nodes were compared with patients with negative lymph nodes (log-rank P=0.003). T2DM was independently associated with a lower DFS after adjustments of other variables (adjusted hazard ratio, 7.719; 95% confidence interval, 4.304–13.843; P<0.001) and adjustments of lymph node positivity (adjusted hazard ratio, 2.407; 95% confidence interval, 1.391–4.166; P=0.002). The DFS rates at 2 years for the T2DM group and the non-T2DM group were 78% and 97%, respectively. The prognostic influence of T2DM was consistent across the subgroups, including subgroups by age (>50 or ≤50), menopausal status (post- or premenopausal), tumor size (>5 cm or ≤5 cm), lymph node involvement (positive or negative), and adjuvant chemotherapy (received or not) using the Kaplan–Meier method (log-rank P<0.05).ConclusionIn the People’s Republic of China, T2DM is an independent prognostic risk factor that indicates an increased likelihood of recurrence and metastasis in patients with early stage TNBC. The presence of T2DM should be taken into account when evaluating the risk for an early stage TNBC patient. More effective therapeutic regimens are needed for early stage TNBC patients with T2DM.

Quality of life and fear for hypoglycemia in patients with type 2 diabetes mellitus

ObjectivesHypoglycemia can negatively impact many aspects of type 2 diabetes mellitus (T2DM) management. The aim was to determine the impact of hypoglycemia and the fear for hypoglycemic episodes on HRQoL in T2DM patients in Spain, as well as healthcare professionals’ attitudes and knowledge of these issues. Patients and methodsAn observational, cross-sectional study, with consecutive recruitment of T2DM patients in 661 healthcare centers, between September 2010 and May 2011. Sociodemographic and clinical variables were recorded. HRQoL (ADDQoL questionnaire) and fear for hypoglycemia (HFS-II) were evaluated. Two groups were compared: with and without reported hypoglycemia in the previous 6 months. Physicians responded 4 questions (visual analog scales). Results4.054 patients participated, of which 3812 were selected [mean age (SD)=64 (11) years; male=54%; 10 (7) years for diagnostic of T2DM]. Patients with hypoglycemia (45%) expressed higher fear for hypoglycemia [31.32 (15.71) vs. 18.85 (16.03); p<.0001] and the overall impact of T2DM on their HRQoL was more negative [−2.48 (1.61) vs. −1.64 (1.36); p<.001]. Respondent physicians occasionally used HRQoL questionnaires, knew about hypoglycemia risk, explored fear for hypoglycemia and modified treatments accordingly. ConclusionsT2DM patients with hypoglycemia show an increase of fear for them, negatively affecting T2DM patients HRQoL. However physicians know the risk of hypoglycemia, they explore the fear for hypoglycemic episodes occasionally.

Calidad de vida y grado de preocupación por las hipoglucemias en pacientes con diabetes mellitus tipo 2

ObjectivesHypoglycaemia can negatively impact many aspects of type 2 diabetes mellitus (T2DM) management. The aim was to determine the impact of hypoglycaemia and the fear for hypoglycemic episodes on HRQoL in T2DM patients in Spain, as well as healthcare professionals’ attitudes and knowledge of these issues. Patients and methodsAn observational, cross-sectional study, with consecutive recruitment of T2DM patients in 661 healthcare centers, between September 2010 and May 2011. Sociodemographic and clinical variables were recorded. HRQoL (ADDQoL questionnaire) and fear for hypoglycaemia (HFS-II) were evaluated. Two groups were compared: with and without reported hypoglycaemia in the previous 6 months. Physicians responded 4 questions (visual analogue scales). Results4.054 patients participated, of which 3,812 were selected [mean age (SD)=64 (11) years; male=54%; 10 (7) years for diagnostic of T2DM]. Patients with hypoglycaemia (45%) expressed higher fear for hypoglycemia [31.32 (15.71) vs. 18.85 (16.03); p<0.0001] and the overall impact of T2DM on their HRQoL was more negative [–2.48 (1.61) vs. –1.64 (1.36); p<0.001]. Respondent physicians occasionally used HRQoL questionnaires, knew about hypoglycaemia risk, explored fear for hypoglycaemia and modified treatments accordingly. ConclusionsT2DM patients with hypoglycaemia show an increase of fear for them, negatively affecting T2DM patients HRQoL. However physicians know the risk of hypoglycaemia, they explore the fear for hypoglycemic episodes occasionally.

Bipolar disorder and comorbidity: Increased prevalence and increased relevance of comorbidity for hospital-based mortality during a 12.5-year observation period in general hospital admissions

BackgroundBipolar disorder (BD) is associated with an increase of psychiatric and physical comorbidities, but the effects of these disorders on general hospital-based mortality are unclear. Consequently, we investigated whether the burden of comorbidity and its relevance on hospital-based mortality differed between individuals with and without BD during a 12.5-year observation period in general hospital admissions. MethodsDuring 1 January 2000 and 30 June 2012, 621 individuals with BD were admitted to three General Manchester Hospitals. All comorbidities with a prevalence ≥1% were compared with those of 6210 randomly selected and group-matched hospital controls of the same age and gender, regardless of priority of diagnoses. Comorbidities that increased the risk for hospital-based mortality (but not mortality outside of the hospitals) were identified using multivariate logistic regression analyses. ResultsIndividuals with BD had a more severe course of disease than controls that was associated with a higher total number of in-hospital deaths. Individuals with BD compared to controls had a substantial higher burden of comorbidities, the most frequent comorbidities included asthma, type-2 diabetes mellitus (T2DM), and alcohol dependence. 18 other diseases with a surplus of diabetes related complications were also increased. Fourteen comorbidities contributed to the prediction of hospital-based mortality in univariate analyses. Risk factors for hospital-based mortality in multivariate analyses were ischemic stroke, pneumonia, bronchitis, chronic obstructive pulmonary disease, T2DM, and hypertension. The impact of T2DM on hospital-based mortality was higher in individuals with BD than in controls. LimitationsThe study design was not assigned to assess the type of BD, the current bipolar status, and if individuals with BD were treated with medication. It was neither possible to compare drug effects, nor to compare the adherence to treatment between samples. ConclusionIn one of the largest samples of individuals with BD in general hospitals, the excess comorbity in individuals with BD compared to controls is in particular caused by asthma and T2DM. T2DM and its complications cause significant excess hospital-based mortality in individuals with BD.

The impact of type 2 diabetes mellitus on cancer‐specific survival

Earlier studies have suggested that type 2 diabetes mellitus (T2DM) alters the risk of developing a variety of cancers, but little has been known about the impact of T2DM on cancer prognosis. On the basis of nationwide population-based Swedish registries, the authors of this report compared the cause-specific survival among cancer patients with and without T2DM. Patients with T2DM were identified from the nationwide Swedish Hospital Discharge Register, and cancers were recorded from the Swedish Cancer Registry. Hazard ratios (HRs) were calculated using Cox regression models to compare variations in cause-specific survival between cancer patients with and without T2DM. Of the 1016,105 cancer patients, 16,123 had been hospitalized with T2DM before their diagnosis of cancer. The mortality rate was significantly higher among cancer patients with T2DM than among those without T2DM (cause-specific HR, 1.38; 95% confidence interval, 1.35-1.41). There were no differences in TNM stage distribution among cancer patients with or without T2DM for the main cancers, with an exception of tumor and metastatic classifications for breast cancer and prostate cancer, respectively. The current results indicated that patients with T2DM who are diagnosed with a subsequent cancer are at an increased risk for cause-specific mortality compared with patients who have cancer without T2DM.

Preserving insulin secretion in Type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a complex disease characterized by insulin resistance and a progressive decline in β-cell function and mass. Current evidence suggests that β-cell dysfunction is present early in the course of the disease and that this dysfunction, rather than insulin resistance, is primarily responsible for the progression of T2DM. β-cell dysfunction can be accelerated by glucose toxicity, lipotoxicity, oxidative stress, chronic increases in inflammatory mediators and, potentially, the use of sulfonylureas. This review suggests that future efforts to limit the impact of T2DM must focus on strategies to preserve β-cell function. Several interventions have shown promise in this regard, including lifestyle modifications, thiazolidinediones, potassium channel openers, incretin mimetics, cytokine antagonists, bariatric surgery and dipeptidyl peptidase IV inhibitors, although therapeutic insulin remains the most robust and physiological approach.

Impacto de la diabetes mellitus tipo 2 en la calidad de vida de los pacientes tratados en las consultas de atención primaria en España

To evaluate the impact of type-2 diabetes mellitus (DM2) on the health-related quality of life (HRQL) of patients and to analyse the impact of social-demographic and clinical variables and of resource use. Cross-sectional study with retrospective and prospective information gathering (HRQL questionnaire). Setting. 29 primary care centres from the whole of Spain. 1041 patients diagnosed with DM2 after the age of 30, chosen at random from patients' records at participating centres. Main measurements. HRQL evaluated through the general questionnaire EQ-5D, which enabled HRQL of patients to be compared with that of the general Spanish population, obtained from a sample of 8963 people. Patients with DM2 had worse HRQL (mean EVA index of 0.71) than people in the general population of the same age and gender (mean EVA index of 0.81). Women, older patients and obese patients had worse HRQL. In clinical terms, patients with some DM2-related complication, deficient glycaemic control and in receipt of insulin treatment had worse HRQL than patients without complications, acceptably controlled patients or those receiving non-pharmacological or oral anti-diabetes treatment. DM2 is associated with worse HRQL for patients, and more so for patients with complications, poor control of glucaemia or under insulin treatment.