The Lancet Diabetes & Endocrinology, Год журнала: 2023, Номер 11(12), С. 894 - 895
Опубликована: Ноя. 21, 2023
Язык: Английский
Cardiovascular Diabetology, Год журнала: 2024, Номер 23(1)
Опубликована: Фев. 9, 2024
Abstract Background Stress hyperglycemia and glycemic variability (GV) can reflect dramatic increases acute fluctuations in blood glucose, which are associated with adverse cardiovascular events. This study aimed to explore whether the combined assessment of stress ratio (SHR) GV provides additional information for prognostic prediction patients coronary artery disease (CAD) hospitalized intensive care unit (ICU). Methods Patients diagnosed CAD from Medical Information Mart Intensive Care-IV database (version 2.2) between 2008 2019 were retrospectively included analysis. The primary endpoint was 1-year mortality, secondary in-hospital mortality. Levels SHR stratified into tertiles, highest tertile classified as high lower two tertiles low. associations SHR, GV, their combination mortality determined by logistic Cox regression analyses. Results A total 2789 included, a mean age 69.6 years, 30.1% female. Overall, 138 (4.9%) died hospital, 404 (14.5%) at 1 year. superior (in-hospital mortality: 0.710 vs. 0.689, p = 0.012; 0.644 0.615, 0.007) 0.632, 0.004; 0.603, < 0.001) alone predicting receiver operating characteristic In addition, nondiabetic levels greatest risk both (odds [OR] 10.831, 95% confidence interval [CI] 4.494–26.105) (hazard [HR] 5.830, CI 3.175–10.702). However, diabetic population, (OR 4.221, 1.542–11.558) (HR 2.013, 1.224–3.311) observed but low GV. Conclusions simultaneous evaluation more stratification than alone, contributing developing individualized strategies glucose management admitted ICU.
Язык: Английский
Процитировано
18
European Heart Journal, Год журнала: 2024, Номер 45(38), С. 4099 - 4110
Опубликована: Сен. 6, 2024
Abstract Emerging evidence indicates that chemical exposures in the environment are overlooked drivers of cardiovascular diseases (CVD). Recent suggests micro- and nanoplastic (MNP) particles derived largely from or mechanical degradation plastics might represent a novel CVD risk factor. Experimental data preclinical models suggest MNPs can foster oxidative stress, platelet aggregation, cell senescence, inflammatory responses endothelial immune cells while promoting range metabolic alterations lead to disease premature death. In humans, various plastics, including polyethylene polyvinylchloride, have been detected atherosclerotic plaques other tissues, pericardia, epicardial adipose pericardial myocardia, left atrial appendages. measurable levels within thrombi seem accumulate preferentially areas vascular lesions. Their presence carotid is associated with subsequent increased incidence events. To further investigate possible causal role CVD, future studies should focus on large, prospective cohorts assessing exposure individuals plastic-related pollution, routes absorption, existence putative safety limit, correspondence between accumulation timing development, pathophysiological mechanisms instigated by pertinent concentrations MNPs. Data such would allow design preventive, even therapeutic, strategies. Meanwhile, existing reducing plastic production use will produce benefits for human health. This goal could be achieved through UN Global Plastics Treaty currently negotiation.
Язык: Английский
Процитировано
11
European journal of medical research, Год журнала: 2024, Номер 29(1)
Опубликована: Март 4, 2024
Type 2 diabetes mellitus (T2DM) poses a significant global health burden. This is particularly due to its macrovascular complications, such as coronary artery disease, peripheral vascular and cerebrovascular which have emerged leading contributors morbidity mortality. review comprehensively explores the pathophysiological mechanisms underlying these protective strategies, both existing emerging secondary preventive measures. Furthermore, we delve into applications of experimental models methodologies in foundational research while also highlighting current limitations future directions. Specifically, focus on literature published post-2020 concerning prevention complications patients with T2DM by conducting targeted studies supported robust evidence offer holistic perspective.
Язык: Английский
Процитировано
7
Diabetes Therapy, Год журнала: 2024, Номер 15(5), С. 1099 - 1124
Опубликована: Апрель 5, 2024
A substantial evidence base supports the use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in treatment type 2 diabetes mellitus (T2DM). This class medicines has demonstrated important benefits that extend beyond glucose-lowering efficacy to protective mechanisms capable slowing or preventing onset long-term cardiovascular, renal and metabolic (CVRM) complications, making their highly applicable for organ protection maintenance health outcomes. SGLT2is have shown cost-effectiveness T2DM management economic savings over other therapies due reduced incidence cardiovascular events. National international guidelines advocate SGLT2i early pathway, based upon a plethora supporting data from large-scale outcome trials, outcomes trials real-world studies. While most people with would benefit CVRM through use, prescribing hesitancy remains, potentially confusion concerning place complex therapeutic paradigm, variation licensed indications safety perceptions/misunderstandings associated historical since been superseded by robust clinical pharmacovigilance reporting. latest narrative review developed Improving Diabetes Steering Committee (IDSC) outlines within current evidence-informed guidelines, examines potential as standard care majority newly diagnosed sets into context perceived risks proven advantages terms sustained The authors discuss case provide user-friendly tools support healthcare professionals correct application these management. previously published IDSC Prescribing Tool Management undergone updates reformatting is now available Decision an interactive pdf format well abbreviated printable A4 poster/wall chart.
Язык: Английский
Процитировано
7
Cells, Год журнала: 2024, Номер 13(19), С. 1662 - 1662
Опубликована: Окт. 8, 2024
Low-grade inflammation (LGI) represents a key driver of type 2 diabetes (T2D) and its associated cardiovascular diseases (CVDs). Indeed, inflammatory markers such as hs-CRP IL-6 predict the development T2D complications, suggesting that LGI already increases before diagnosis remains elevated even after treatment. Overnutrition, unhealthy diets, physical inactivity, obesity, aging are all recognized triggers LGI, promoting insulin resistance sustaining pathogenesis T2D. Once developed, frank appearance, people with undergo pathological metabolic remodeling, an alteration multiple CVD risk factors, i.e., glycemia, lipids, blood pressure, renal function. In turn, variables foster range pathways mechanisms, e.g., immune cell stimulation, accrual senescent cells, long-lasting epigenetic changes, trained immunity, which held to chronically fuel at systemic tissue levels. Targeting factors partially ameliorates LGI. However, some unaffected by common therapies, burden is still increased in many patients, phenomenon possibly underlying residual (i.e., having > mg/dL despite optimal LDL cholesterol control). On other hand, selected disease-modifying drugs, GLP-1RA, seem also act on T2D, curbing trajectory disease preventing it if introduced early. addition, trials demonstrated potential canonical anti-inflammatory therapies reducing rate CVDs patients this condition or high for it, whom had Since colchicine, inhibitor activation, now approved prevention CVDs, might be worth exploring possible therapeutic paradigm identify subjects treat them drug. Upcoming studies will reveal whether drugs reverse early suppressing sources colchicine has broad benefit condition.
Язык: Английский
Процитировано
5
Ageing Research Reviews, Год журнала: 2024, Номер 99, С. 102405 - 102405
Опубликована: Июль 4, 2024
Diabetes mellitus, a metabolic condition affecting around 537 million individuals worldwide, poses significant challenges, particularly among the elderly population. The etiopathogenesis of type 2 diabetes (T2D) depends on combination effects driven by advancing age, genetic background, and lifestyle habits, e.g. overnutrition. These factors influence development T2D differently in men women, with an obvious sexual dimorphism possibly underlying diverse clinical features disease different sexes. More recently, environmental pollution, estimated to cause 9 deaths every year, is emerging as novel risk factor for T2D. Indeed, exposure atmospheric pollutants such PM2.5, O3, NO2, Persistent Organic Pollutants (POP)s, along their bioaccumulation, associated obesity, 15 % excess case very high levels PM2.5. Similar data are available plasticizer molecules, bisphenol A phthalates, endocrine-disrupting chemicals. Even though causality still debated at this stage, preclinical evidence sustains ability multiple affect pancreatic function, promote insulin resistance, alter lipid metabolism, contributing onset progression. In addition, findings suggest possible role also plastic itself pioneeristic studies evidenced that micro- or nanoplastics (MNP)s, particles nano- range, cellular damage, senescence, inflammation, disturbances, leading resistance impaired glucose metabolism animal and/or vitro models. Here we synthesize recent knowledge relative association between air-related plastic-derived incidence T2D, discussing mechanistic links suggested literature. We then anticipate need future field candidate therapeutic strategies limiting pollution-induced damage models, SGLT-2 inhibitors. finally postulate guidelines prevention should consider pollution sex additional limit pandemic.
Язык: Английский
Процитировано
4
The Lancet, Год журнала: 2025, Номер 405(10472), С. 28 - 28
Опубликована: Янв. 1, 2025
Язык: Английский
Процитировано
0
Ibnosina Journal of Medicine and Biomedical Sciences, Год журнала: 2025, Номер unknown
Опубликована: Март 3, 2025
Abstract Sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as a groundbreaking class of oral antihyperglycemic agents for managing type diabetes mellitus (T2DM), offering dual benefits in glycemic control and cardiovascular protection. These work by inhibiting glucose reabsorption the kidneys, leading to excretion through urine effectively lowering blood levels. Beyond their capabilities, SGLT2 also reduce sodium reabsorption, contributing pressure reduction natriuresis diuresis. Remarkably, extend renal outcomes, showing significant improvements patients with diabetic kidney disease chronic disease, even without diabetes. The nephroprotective mechanisms are multifaceted, including glomerular hyperfiltration, alleviation intraglomerular pressure, attenuation inflammatory fibrotic pathways kidneys. This comprehensive review illustrates diverse functions inhibitors, emphasizing influence on management T2DM increasing importance treatment diseases. become an integral part current therapeutic strategies its associated complications.
Язык: Английский
Процитировано
0
Biomedicines, Год журнала: 2025, Номер 13(3), С. 728 - 728
Опубликована: Март 17, 2025
Atherosclerosis is a closely related complication of diabetes mellitus (DM), driven by endothelial dysfunction, inflammation, and oxidative stress. The progression atherosclerosis accelerated hyperglycemia, insulin resistance, hyperlipidemia. Novel antidiabetic agents, SGLT2 inhibitors, GLP-1 agonists improve glycemic control offer cardiovascular protection, reducing the risk major adverse events (MACEs) heart failure hospitalization. These along with nonsteroidal mineralocorticoid receptor antagonists (nsMRAs), promise to mitigate metabolic disorders their impact on function, stress, inflammation. This review explores potential molecular mechanisms through which these drugs may prevent development disease (CVD), supported summary preclinical clinical evidence.
Язык: Английский
Процитировано
0
Diabetes Research and Clinical Practice, Год журнала: 2025, Номер unknown, С. 112109 - 112109
Опубликована: Март 1, 2025
Язык: Английский
Процитировано
0