Background: Research proved the importance of dosing apolipoprotein B (ApoB) over LDL cholesterol as a predictor of cardiovascular events. In this study, we aimed to observe the input apolipoprotein A1 (ApoA1) and ApoB, primarily if its ratio could provide in patients with type 2 diabetes mellitus (T2DM) without known atherosclerotic events regarding the coronary heart disease (CHD) risk.
Methods: We enrolled 83 patients with T2DM who attended the National Institute of Diabetes (Bucharest) between March 2022 and December 2022.
The increase in life expectancy without a decrease in the years lived without disability leads to the rise of the population aged over 65 years prone to polypharmacy. The novel antidiabetic drugs can improve this global therapeutic and health problem in patients with diabetes mellitus (DM). We aimed to establish the efficacy (A1c hemoglobin reduction) and safety of the newest antidiabetic drugs (considered so due to their novelty in medical practice use), specifically DPP-4i, SGLT-2i, GLP-1 Ra, and tirzepatide.
View Article and Find Full Text PDFFront Clin Diabetes Healthc
February 2023
Non-alcoholic fatty liver disease (NAFLD) has an important role in the pathogenesis of cardiovascular diseases in the population with diabetes and it is highly prevalent in end-stage renal disease (ESRD) patients. This case series describes NAFLD associated factors and survival in type 2 diabetes patients (T2DM) who have ESRD treated with hemodialysis. NAFLD prevalence in patients with T2DM and ESRD is 69.
View Article and Find Full Text PDFPeriodontitis is a chronic inflammatory disease caused by the presence of a bacterial biofilm known as dental plaque. This biofilm affects the supporting apparatus of the teeth, especially the periodontal ligaments and the bone surrounding the teeth. Periodontal disease and diabetes seem to be interrelated and in a bidirectional relationship, and have been increasingly studied in recent decades.
View Article and Find Full Text PDFIn obesity, the hormonal secretion of the thyroid gland switches from homeostasis to type 2 allostasis in order to adapt to persistent modifications of adipose tissue and inflammation. Previous meta-analyses have linked obesity with an increased risk of developing thyroid diseases, prediabetes, and type 2 diabetes mellitus. We designed an observational cross-sectional study including all female patients presenting consecutively in an ambulatory clinic for 16 months.
View Article and Find Full Text PDFAlthough it is well known that lifestyle changes can affect plasma glucose levels, there is little formal evidence for the sustained effectiveness of exercise and diet in diabetes mellitus (DM) management. Self-care in DM refers to the real-life application of the knowledge that the patient gained during the education programmes. The goals are to bring about changes in the patient's behaviour, thus improving glycaemic control.
View Article and Find Full Text PDFLongitudinal studies have indicated an association between thyroid function and insulin resistance (IR) or a neutral relationship. Both the lowest tertile of free thyroxine (fT4) and the highest tertile of free triiodothyronine (fT3) were found to be associated with IR in cross-sectional studies. The aim of the present study was to analyze the association between IR and subclinical hypothyroidism in a female adult population from Bucharest, Romania.
View Article and Find Full Text PDFTherapeutic inertia related to insulin treatment, i.e. delays in initiation, especially titration of basal insulin, is a significant problem in daily practice in Southeast European countries.
View Article and Find Full Text PDFVitamin D is involved in insulin resistance through genomic and non-genomic mechanisms. Several observational and randomized studies have discrepant results; some of them showed an improved insulin resistance (IR), and others a neutral effect after vitamin D deficiency is corrected. We designed a retrospective observational study that included all women who presented for 33 months in an outpatient clinic in Bucharest, Romania.
View Article and Find Full Text PDFCardiovascular risk (CVR) is a broad term that includes traditional factors like hypertension, hyper lipidemia, abdominal obesity, hyperinsulinemia or overt type 2 diabetes mellitus (T2DM), and emerging ones such as hypothyroidism or inflammatory diseases. In epidemiologic studies, all of these factors are associated with atherogenesis and have complex interactions between them. They have in common an increased prevalence in the general population beginning in childhood, and are correlated with endothelial damage as demonstrated by echocardiographic modifications of the left ventricle or carotid intima-media thickness.
View Article and Find Full Text PDFGestational diabetes mellitus is an important healthcare problem with serious implications both to the mother and to the foetus. The necessity of clear screening criteria for the pregnant woman and also identifying from an early stage the risk groups can be beneficial instruments for better management of gestational diabetes. The present report identify the main screening criteria for patients at risk for gestational diabetes and the therapeutic-nutritional therapy for women that have gestational diabetes.
View Article and Find Full Text PDFEvidence regarding the relation between SARS-CoV-2 mortality and the underlying medical condition is scarce. We conducted an observational, retrospective study based on Romanian official data about location, age, gender and comorbidities for COVID-19 fatalities. Our findings indicate that males, hypertension, diabetes, obesity and chronic kidney disease were most frequent in the COVID-19 fatalities, that the burden of disease was low, and that the prognosis for 1-year survival probability was high in the sample.
View Article and Find Full Text PDFThe disclosure of proven cardiorenal benefits with certain antidiabetic agents was supposed to herald a new era in the management of type 2 diabetes (T2D), especially for the many patients with T2D who are at high risk for cardiovascular and renal events. However, as the evidence in favour of various sodium-glucose transporter-2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) accumulates, prescriptions of these agents continue to stagnate, even among eligible, at-risk patients. By contrast, dipeptidyl peptidase-4 inhibitors (DPP-4i) DPP-4i remain more widely used than SGLT2i and GLP-1 RA in these patients, despite a similar cost to SGLT2i and a large body of evidence showing no clear benefit on cardiorenal outcomes.
View Article and Find Full Text PDFUnlabelled: The aims were to assess the prevalence and characteristics of dyslipidemia phenotypes in a Romanian population-based sample from the PREDATORR study.
Methods: PREDATORR was an epidemiological study with a cross-sectional, cluster random sampling design. Participants were classified into four dyslipidemia phenotypes based on the NCEP ATP III criteria: isolated hypertrigliceridemia, isolated hypoHDL-C, isolated hyperLDL-C and mixed dyslipidemia (≥2 standard lipid abnormalities).
Background: The impact of smoking on morbidity is well known, but in Romania, limited data are available regarding the smoking prevalence and relationship with cardiometabolic profile and kidney function.
Objectives: To assess the association of smoking with cardiometabolic traits and kidney function, in a Romanian population-based sample from the PREDATORR study.
Methods: PREDATORR was an epidemiological cross-sectional study.
Purpose: We aimed to analyze the impact of basal insulin analogues on glucose variability (GV) in patients with type 2 diabetes (DM) undergoing renal replacement therapy.
Methods: Fourteen subjects on insulin therapy for at least 6 months (detemir, n = 7 vs. glargine, n = 7) were sequentially enrolled in this prospective study.
Purpose: PREDATORR is the first national study analyzing the prevalence of chronic kidney disease and its prognosis and association with socio-demographic, cardio-metabolic and lifestyle risk factors in the adult Romanian population.
Methods: Chronic kidney disease was defined according to the KDIGO 2012 criteria as an estimated glomerular filtration rate <60 mL/min/1.73 m(2) and/or urinary albumin-to-creatinine ratio ≥30 mg/g.
Background: The PREDATORR (PREvalence of DiAbeTes mellitus, prediabetes, overweight, Obesity, dyslipidemia, hyperuricemia and chronic kidney disease in Romania) study is the first national study analyzing the prevalence of diabetes mellitus (DM) and prediabetes, and their association with cardiometabolic, sociodemographic, and lifestyle risk factors in the Romanian population aged 20-79 years.
Methods: This was an epidemiological study with a stratified, cross-sectional, cluster random sampling design. Sociodemographic, lifestyle, and anamnestic data were collected through self- and interviewer-administered questionnaires, and biochemical assays and oral glucose tolerance tests were performed.
Objectives: To assess the prevalence of metabolic syndrome and evaluate proinflammatory status in patients with type 1 diabetes, and to analyse the relationship between inflammation, metabolic control and insulin resistance in these patients.
Methods: Patients with type 1 diabetes were stratified according to the presence or absence of metabolic syndrome. Serum adiponectin, leptin, tumour necrosis factor (TNF)-α, interleukin (IL)-6 and high-sensitivity C-reactive protein (hsCRP) were quantified.
Background: We investigated the l-arginine (l-Arg)-nitric oxide (NO) metabolic pathway in the erythrocytes (RBCs) and plasma of subjects with type 2 diabetes at first clinical onset.
Methods: RBCs and plasma were collected from 26 patients with type 2 diabetes at first clinical onset and 19 age-matched non-diabetes subjects as controls. l-Arg content was assayed by capillary electrophoresis.
Objectives: To investigate paraoxonase-1 (PON1) lactonase activity, myeloperoxidase (MPO) activity (as a marker of inflammation) and antioxidant status in plasma of patients with type 1 diabetes mellitus.
Methods: Whole blood and plasma samples were collected from patients with diabetes and healthy control subjects. PON1 lactonase and MPO activities and total antioxidant capacity (TEAC) were determined in plasma.
Objectives: We studied erythrocyte (RBC) caspase-3 activity and oxidative status in plasma and RBCs of 33 patients with type 2 diabetes at first clinical onset and 23 age-matched non-diabetes control subjects.
Methods: Caspase-3 activity was assayed during the life span of RBCs; lipid peroxides and total antioxidant capacity (TEAC) were assessed in plasma and RBCs as indicators of oxidative stress and non-enzymatic antioxidant defense; and superoxide dismutase, catalase, and glutathione peroxidase activity were measured in RBCs as enzymatic antioxidants.
Results: We found that, compared to controls, RBCs caspase-3 is activated early in type 2 diabetes (P < 0.
Diabetic kidney disease, or diabetic nephropathy (DN), is a major complication of diabetes and the leading cause of end-stage renal disease (ESRD) that requires dialysis treatment or kidney transplantation. In addition to the decrease in the quality of life, DN accounts for a large proportion of the excess mortality associated with type 1 diabetes (T1D). Whereas the degree of glycemia plays a pivotal role in DN, a subset of individuals with poorly controlled T1D do not develop DN.
View Article and Find Full Text PDFThe insulin -23Hph and IGF2 Apa polymorphisms were genotyped in Romanian patients with T1DM (n = 204), T2DM (n = 215) or obesity (n = 200) and normoponderal healthy subjects (n = 750). The genotypes of both polymorphisms were distributed in concordance with Hardy-Weinberg equilibrium in all groups. The -23Hph AA genotype increased the risk for T1DM (OR: 3.
View Article and Find Full Text PDF