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Prevalence and Correlates of macrovascular complications at Type 2 Diabetes Diagnosis in a Tertiary Hospital in Yaoundé, Cameroon

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Journal of Diabetes Mellitus 2023年第4期13卷 269-283页

作者： Francine Mendane Ekobena Martine Claude Etoa Etoga Mesmin Dehayem Carole Laurence Ngo Yon Pauline Ngo Balôgôg Guy Dieudonné Mvogo André Pascal Kengne Eugène Sobngwi Jean Claude Mbanya Internal Medicine Unit Essos Hospital Center Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Endocrinology and Metabolic Diseases Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Medicine and pharmaceutical Sciences University of Douala Douala Cameroon Medical Analysis Laboratory Essos Hospital Center Yaoundé Cameroon Department of Public Health Kesmonds International University Ngaoundéré Cameroon Department of Medicine University of Cape Town Cape Town South Africa Non-Communicable Diseases Research Unit South African Medical Research Council Cape Town South Africa

Introduction: The presence of vascular complications at type 2 diabetes (T2D) diagnosis is a heavy burden for developing countries. We aimed to determine the prevalence and correlates of macrovascular complications at T2D diagnosis in Yaoundé, Cameroon. Materials and Methods: We conducted a cross-sectional study at the Essos Hospital Center in Yaoundé from January 2017 to June 2021. We recruited patients newly diagnosed with T2D who, simultaneously, with assessed macrovascular complications including stroke, myocardial infarction (MI) and arterial foot ulcer (AFU). Correlates were investigated using Chi square test and logistic regressions. The significance level was set at 5%. Results: In all, 286 newly diagnosed diabetic patients (51.7% being men) were included. The mean age was 52.6 ± 12.3 years. Prevalent cardiovascular risk factors at diabetes diagnosis were a dyslipidemia (63.6%), sedentary lifestyle (57.7%) and family history of type 2 diabetes (51.6%). The prevalence of macrovascular complications was 17.5% with 8.4% stroke, 5.6% myocardial infarction and 3.4% arterial foot ulcer. Hypertension was associated with all macrovascular complications (p Conclusion: macrovascular complications are frequent at type 2 diabetes diagnosis and are represented by stroke and myocardial infarction in our study, highlighting the importance of cardiovascular risk evaluation and reduction in people with diabetes right from diagnosis.

关键词： Diabetes Mellitus macrovascular complications Cameroon

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Genetics of macrovascular complications in type 2 diabetes

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World Journal of Diabetes 2021年第8期12卷 1200-1219页

作者： Ziravard N Tonyan Yulia A Nasykhova Maria M Danilova Andrey S Glotov Department of Genomic Medicine D.O.Ott Research Institute of ObstetricsGynecology and ReproductologySaint-Petersburg 199034Russia Laboratory of Biobanking and Genomic Medicine of Institute of Translation Biomedicine St.Petersburg State UniversitySaint-Petersburg 199034Russia

Type 2 diabetes mellitus(T2DM)is a metabolic disorder that currently affects more than 400 million worldwide and is projected to cause 552 million cases by the year ***-term vascular complications,such as coronary artery disease,myocardial infarction,stroke,are the leading causes of morbidity and mortality among diabetic *** recent advances in genome-wide technologies have given a powerful impetus to the study of risk markers for multifactorial *** date,the role of genetic and epigenetic factors in modulating susceptibility to T2DM and its vascular complications is being successfully studied that provides the accumulation of genomic *** the future,this will provide an opportunity to reveal the pathogenetic pathways in the development of the disease and allow to predict the macrovascular complications in T2DM *** review is focused on the evidence of the role of genetic variants and epigenetic changes in the development of macrovascular pathology in diabetic patients.

关键词： Type 2 diabetes Epigenetics Genetics macrovascular complications

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Visit-to-visit glycated hemoglobin A1c variability in adults with type 2 diabetes: a systematic review and meta-analysis

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Chinese Medical Journal 2022年第19期135卷 2294-2300页

作者： Furong Qu Qingyang Shi Yang Wang Yanjao Shen Kaixin Zhou Ewan R.Pearson Sheyu Li Department of Endocrinology and Metabolism West China HospitalSichuan UniversityChengduSichuan 610041China Department of Guideline and Rapid Recommendation Chinese Evidence-Based Medicine CenterCochrane China Center and MAGIC China CenterWest China HospitalSichuan UniversityChengduSichuan 610041China School of Life Science University of Chinese Academy of ScienceBejing 100101China Divson of Population Health and Genomics Ninewells Hospital and School of MedicineUniversity of DundeeDundee DD19SYScotlandUnited Kingdom.

Background:Current practice uses the latest measure of glycated hemoglobin(HbAlc)to facilitate clinical *** have demonstrated that HbAlc variability links the risk of death and complications of ***,the role of HbAlc variability is unclear in clinical *** systematic review summarized the evidence of visit-to-visit HbAlc variability regarding different metrics in micro-and macro-vascular complications and death in people with type 2 ***:We searched PubMed,EMBASE(via OVID),and Cochrane Central Register(CENTRAL,via OVID)for studies investigating the association between HbAlc variability and adverse outcomes in patients with type 2 diabetes and performed random-effects meta-analysis stratified by HbAlc variability metrics in terms of standard deviation(SD),coefficient of variation(CV),and HbAlc variability score(HVS).Results:In people with type 2 diabetes,the highest quantile of all three HbAlc variability metrics(HbAlc-standard deviation[HbAlc-SD],HbAlc-coefficient of variance[HbAlc-CV],and HVS)is associated with increased risks of all-cause mortality,cardiovascular events,progression to chronic kidney disease,amputation,and peripheral *** example,the hazard ratio of HbAlc-SD on all-cause mortality was 1.89 with 95%confidence interval(95%CI)1.46–2.45(HbAlc-CV 1.47,95%CI 1.26-1.72;HVS 1.67,95%CI 1.34–2.09).Conclusions:High HbAlc variability leads to micro-and macro-vascular complications of type 2 diabetes and related *** with type 2 diabetes and high HbAlc variability need additional attention and care for the potential adverse outcomes.

关键词： Visit-to-visit HbAlc variability Type 2 diabetes macrovascular complications All-cause mortality Glycated hemoglobin

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Diabetic foot ulcers: A devastating complication of diabetes mellitus continues non-stop in spite of new medical treatment modalities

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World Journal of Diabetes 2022年第12期13卷 1106-1121页

作者： Gamze Akkus Murat Sert Department of Endocrinology Cukurova UniversityAdana 33170Turkey Department of Internal Medicine Cukurova University Medical FacultyAdana 33170Turkey

Diabetic foot ulcer is a devastating complication of diabetes mellitus and significant cause of mortality and morbidity all over the world and can be complex and *** development of foot ulcer in a diabetic patient has been estimated to be 19%-34%through their *** pathophysiology of diabetic foot ulcer consist of neuropathy,trauma and,in many patients,additional peripheral arterial *** particular,diabetic neuropathy leads to foot deformity,callus formation,and insensitivity to trauma or *** standard algorithms in diabetic foot ulcer management include assessing the ulcer grade classification,surgical debridement,dressing to facilitate wound healing,offloading,vascular assessment(status and presence of a chance for interventional vascular correction),and infection and glycemic *** especially surgical procedures are sometimes inevitable,they are poor predictive factors for the prognosis of diabetic foot *** novel treatment modalities such as nonsurgical debridement agents,oxygen therapies,and negative pressure wound therapy,topical drugs,cellular bioproducts,human growth factors,energy-based therapies,and systematic therapies have been available for patients with diabetic foot ***,it is uncertain whether they are effective in terms of promoting wound healing related with a limited number of randomized controlled *** review aims at evaluating diabetic foot ulcer with regard to all *** will also focus on conventional and novel adjunctive therapy in diabetic foot management.

关键词： Diabetic foot ulcer Peripheric artery disease macrovascular complications Neuropathy Wagner classification Intralesionar growth factor treatment

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Effects of phlorizin on vascular complications in diabetes db/db mice

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Chinese Medical Journal 2012年第20期125卷 3692-3696页

作者： SHEN Lin YOU Bei-an GAO Hai-qing LI Bao-ying YU Fei PEI Fei Department of Geriatrics Qilu Hospital of Shandong UniversityJinanShandong 250012China

Background Diabetic macrovascular complications are important causes of cardiovascular and cerebrovascular diseases and also one of the major causes of morbidity and mortality in patients with type 2 diabetes mellitus （T2DM）. Phlorizin has been reported to be effective in reducing the blood glucose level in diabetic mellitus, while little is known about its effects on vascular complications. This study aimed to observe the effects of phlorizin on the aorta of diabetes db/db mice and explore its mechanism. Methods Diabetic db/db mice （n=16） and age-matched db/m mice （n=8） were divided into three groups： normal control group （CC group, db/m mice, n=8）, untreated diabetic group （DM group, db/db mice, n=8） and diabetic group treated by phlorizin （DMT group, db/db mice, n=8）. Phlorizin （20 mg/kg body weight） was given in normal saline solution intragastrically for 10 weeks. Animals were weighed weekly. At the 10th weekend, all mice were fasted overnight and then sacrificed. Fasting blood was collected, and the aortas were dissected. The blood samples were analyzed for fasting blood glucose （FBG）, serum advanced glycation end products （AGEs）, malondialdehyde （MDA） and superoxide dismutase （SOD） activity, the aortic ultrastructure was studied. Results The weight and serum concentration of FBG, AGEs, and MDA in the DM group were higher than that in the CC group （P 〈0.01 ）, and they were significantly lower in the DMT group （P 〈0.05）. Serum SOD activity was lower than that in the CC group （P 〈0.01）, and it is significantly higher in the DMT group （P 〈0.05）. The severity of aorta damage in the DMT group was less than that in the DM group. Conclusions Phlorizin protected the db/db mice from diabetic macrovascular complications, attributed to the decreasing of blood glucose and AGEs level, and its antioxidant potential. This study may provide a new natural medicine for treating diabetic macrovascular complications.

关键词： diabetes mellitus, type 2," phlorizin macrovascular complications db/db mice," oxidative stress

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