Risk of type 1 diabetes at 3 years is high for initially multiple and single Ab+ IT and multiple Ab+ NT. Genetic predisposition, age, and male sex are significant risk factors for development of Ab+ in twins.
Inflammatory bowel disease (IBD) is associated with extra-intestinal manifestations (EIMs) that tend to parallel intestinal activity and have a debilitating effect on the quality of life. EIMs primarily affect the joints, skin, and eyes with less frequent involvement of the liver, kidney, and pancreas. This article reviews the prevalence of musculoskeletal, dermatological, ocular, and other manifestations in IBD and their coalition with underlying intestinal inflammation. EIMs occurring independently of intestinal activity are managed by targeted therapies, categorical regimens, and specific treatments. On the other hand, EIMs paralleling the bowel activity are carefully monitored while the IBD is brought under control. Since the etiology of the disease is responsible for the development of the EIMs, the research scrutinizes the identified pathogenic mechanisms that tend to involve genetic susceptibility, aberrant self-recognition, and autoantibodies directed against organ-specific antigens shared by intestinal and extra-intestinal organs. This article also provides an overview of the epidemiology, clinical features, diagnostic modalities, and management of the EIMs associated with IBD.
Diabetes mellitus is a leading cause of morbidity and mortality and a significant risk factor for the early onset of chronic kidney disease and heart disease. Hyperglycemia and insulin resistance are key factors that play a role in the pathogenesis of type 2 diabetes. Renal glucose reabsorption is a critical component of glycemic regulation. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, commonly known as gliflozins, lower blood sugar levels by inhibiting glucose absorption in the proximal tubule of the kidney. SGLT2 inhibitors are currently used primarily as antidiabetic medications; however, their advantages go well beyond just glycemic control. This article has reviewed the mechanisms behind cardiac and renal involvement in type 2 diabetes and their inseparable interconnections. This article has also discussed the pharmacokinetic and pharmacodynamic profile of different SGLT2 inhibitors available in the market. Finally, this review has provided a perspective on the outcome trials, which provide evidence supporting a potential benefit of SGLT2 inhibitors in reducing cardiovascular and renal risks and possible mechanisms that mediate the renal and cardiovascular protection conferred.
Proton pump inhibitors (PPIs) are among the most extensively prescribed medications internationally for gastroesophageal reflux disease treatment and the prevention of gastrointestinal bleeding. Their efficiency, ease of availability, and low side effect profile offer several advantages over other treatment modalities. Long-term use and inappropriate prescribing habits have increased the presence of this class of drugs, prompting several studies to reassess their adverse effects. This article explored the possibility of a relationship between PPIs and cardiovascular adverse effects while highlighting the current prescription guidelines for PPIs. We further examined the need for more research into the etiology of PPI-related cardiovascular adverse effects and strategies to alleviate these risks.
Background: Type 2 Diabetes (T2D) with microalbuminuria have increased risk of progression to overt proteinuria, and after some time, renal failure. It is the leading cause of end-stage renal disease as a sequalae of Diabetic Nephropathy (DN) and an independent risk factor for Cardio-Vascular Diseases (CVD). Initial finding for microalbuminuria can prevent long-term complications. The objective of the present investigation was to study the relation between microalbuminuria and with other biochemical parameters related to complications of T2D.Methods: This observational study was conducted among 150 T2D patients attending to the OPD, Department of General Medicine during the time period March 2018 to April 2019. The patients were interviewed for socio-demographic details, history and clinical examination and subjected to blood investigations and Electrocardiogram (ECG).Results: Microalbuminuria was present in 47(31.3%) of the diabetics. The age group 48-63 years 18(38.3%), male gender 33(70.2%) duration of diabetes >5 years 11(23.4%). The smokers, Diabetic Retinopathy, Peripheral Neuropathy, Ischemic Heart Disease, SBP 160-170 mmHg, DBP 95-100 mmHg and 100-105 mmHg, BMI 30-35 Kg/m2, TG >250 mg/dl, LDL >110 mg/ dl and HbA1c 7.5-9 % showed a greater odds ratio and significant association (p<0.001) with microalbuminuria.Conclusions: There was an increased prevalence of microalbuminuria among patients with T2D. It also showed a significant association of major microvascular and macrovascular complications of T2D and microalbuminuria.
Systemic sclerosis (SSc) is an autoimmune disease that leads the patient to have a diverse clinical presentation encompassing several systems and a worse prognosis, mainly when complications arise. Most SSc-related deaths are caused by pulmonary hypertension (PH) and interstitial lung disease (ILD). This article focuses on pulmonary artery hypertension (PAH) and ILD as pulmonary consequences of SSc. We examined the grave effects regarding SSc's respiratory complications, which are concealed by the disease's clinical heterogeneity. In this article, we briefly reviewed the discussion of clinical features and management and the mortality associated with the sequelae. We further addressed the benefits and significance of screening for the disease and associated respiratory complications in SSc patients in this study.
Background: The prevalence of chronic kidney disease (CKD) and Type 2 diabetes (T2D) is increasing worldwide, information on Indian populations regarding the CKD patients with T2D is lacking. In this study, we examined the association of gender and age on the prevalence of other complications in CKD with T2D patients.Methods: A cross-sectional study was conducted at Sri Aurobindo Medical College, from March 2018 to April 2019. Source populations were all patients who came our medicine department for routine check-up.Results: A total of 163 CKD patients were included in the study. All the patients were randomly divided in two groups 61(37.4%) patients in CKD with T2D case group and 102 (62.5%) patients in CKD control group. Out of this 107 were males (65.6%) and 56 were females (34.3%). Male-to-female ratio and mean age were higher in the CKD with T2D group. The clinicopathological characteristics of CKD patients with T2D are even more complicated and severe disease in many ways.Conclusions: A male presents was higher as compare to female in CKD with T2D and control group. In present study there is significant difference in older and younger age in CKD with T2D and control group. Age, HNT, CVD, smoking, BMI, and 24-h urinary protein level were identified as possible contributors’ factors of CKD patients with T2D.
Background: Diabetes mellitus, a leading cause of death worldwide, is the most common endocrine disorder. Type 2 Diabetes (T2D) and Thyroid Dysfunction (TD) often present together and complicate each other at many levels. Recent studies find out the prevalence of TD in T2D in Malwa Region. Objective of the purpose of this study was to find out the prevalence of TD in patients with T2D.Methods: A match cross-sectional study design was conducted at Department of Medicine, Sri Aurobindo Medical College, from March 2018 to April 2019. Source populations were all patients who live in Malwa Region, Indore. A total of 150 cases were enrolled in this study, 75 cases (TD in T2D) and 75 controls were taken into study.Results: There was no significant difference in age and body mass index (BMI) between groups. The average duration of diabetes was 7.76±5.57 years and mean Hemoglobin A1c (HBA1c) was 8.17±1.66%. Only 29(38.6%) of patients had HbA1c below 7%. There was significant difference (p=0.001) in HbA1c. Prevalence of TD in T2D was significantly more in females. Out of TD in T2D patients, sub-clinical hypothyroid was present in 14.6% hypothyroidism was present in 8% patients and sub-clinical hyperthyroidism and hyperthyroidism was present in 1.3% patients.Conclusions: This study reveals about one in four people living with T2D are suffering from TD in Malwa Region. TD is common in T2D patients and can produce significant metabolic disturbances.
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