The Pathophysiology of Cardiovascular Disease and Diabetes: Beyond Blood Pressure and Lipids

Dokken, Betsy B.

doi:10.2337/diaspect.21.3.160

Cited by 241 publications

(225 citation statements)

References 60 publications

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“…A good history should include the duration of DM, neuropathic and peripheral vascular disease symptoms, previous ulcers or amputations and any other complication of DM like retinopathy or nephropathy [37]. A complete history will aid in assessing the severity vasodilators and nitric oxide are decreased hence leading to constriction of the blood vessels [18] and propensity for atherosclerosis [19], eventually leading to ischemia. Ischemia can also occur even in the presence of palpable pedal pulses [13].…”

Section: Diagnosis History and Physical Examinationmentioning

confidence: 99%

Diabetic Foot Ulcer – Diagnosis and Management

Pai¹

2013

Clin Res Foot Ankle

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Diabetes Mellitus is known to have many complications and one of the most distressing is diabetic foot ulcer which affects 15% of people with diabetes. It puts enormous financial burden on the patient and the health care services, even though it is preventable. Diabetic foot ulcer is characterized by a classical triad of neuropathy, ischemia, and infection. Each of these has a multifactorial aetiopathogenesis. These factors are compounded by mechanical stress created by foot deformities. The most commonly used classification systems are the Wagner-Ulcer Classification system and the University of Texas Wound Classification. These classifications help to predict the outcome of this condition. Prevention of this condition is paramount to prevent long term morbidity and sometimes mortality. This can be achieved by patient self-awareness and emphasis on regular foot examinations during follow-up. Care of the diabetic foot should be multidisciplinary. Debridement, dressings and offloading are the pillars of local management. Simultaneous glycemic and infection control is also essential. Amputations are usually the treatment of last resort but occasionally can be considered early to allow for faster mobilization and rehabilitation. Causative factors like peripheral vasculopathy and neuropathy must also be appropriately treated.

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Section: Diagnosis History and Physical Examinationmentioning

confidence: 99%

Diabetic Foot Ulcer – Diagnosis and Management

Pai¹

2013

Clin Res Foot Ankle

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“…The combining factor in the development of diabetic complications is oxidative stress. 1 Oxidized LDL results in atherosclerotic plaque 2 formation that leads to vascular complications. It is a fact that among diabetics some develop vascular complications but not seen in others.This may be due to some gene polymorphism in those developing complications.…”

Section: Introductionmentioning

confidence: 99%

Susceptibility of diabetics with superoxide dismutase gene 2 polymorphism to cardiovascular complications

2020

IJCBR

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Introduction: Diabetes mellitus is the most important cause for vascular diseases of heart and brain. The major factor in the development of diabetic complications is oxidative stress. Superoxide dismutases (SODs) are the enzymes which play a primary role against oxidative stress. A polymorphism C/T substitution producing TT genotype in superoxide dismutase 2 gene causes impaired targeting of the SOD 2 enzyme, resulting in reduced activity of the enzyme inside mitochondria. This can lead to increased oxidative stress in these patients making them susceptible to cardiovascular complications Aim: Our study is performed to analyse if there is increased susceptibility of diabetics with SOD2 gene polymorphism to cardiovascular complications and to assess if this SOD2 polymorphism causes reduced SOD activity. Materials and Methods: 30 cases of diabetics with cardiovascular disease, 30 cases of diabetics without cardiovascular disease and 30 healthy controls are included in the study. Genotype analysis by PCR and RFLP and serum superoxide dismutase activity is measured by spectrophotometer. Results: TT genotype is more frequently distributed and Serum SOD activity is reduced among diabetics with CVD compared to diabetics without CVD and controls ,which shows an increased risk of cardiovascular complications among diabetics with SOD2(GCT/GTT) gene polymorphism. Conclusion: TT genotype is an independent risk factor for the development of cardiovascular complications in diabetes. Patients with TT genotype have reduced level of serum superoxide dismutase that may cause increased oxidative stress, the main mechanism for development of cardiovascular complications in diabetes.

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“…The relationship between metabolic syndrome and inflammation may still remain unclear, but available evidence suggests that inflammation may play a major role in mediating both insulin resistance in vascular endothelium, and may contribute to the link between conditions such as metabolic syndrome, type 2 diabetes and CVD [13] [14]. Inflammatory markers that may be increased in response to increase in adipose tissue include tumour necrosis factor α (TNF-α), interleukin 6 (IL-6) and C-reactive protein (CRP).…”

Section: Introductionmentioning

confidence: 99%

Relationship between C-Reactive Protein, White Blood Cell Count and Metabolic Syndrome in Nigerians with Type 2 Diabetes Mellitus

Soyoye¹,

Ikem²,

Kolawole³

et al. 2017

JDM

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Background: Presence of metabolic syndrome (MS) in people with diabetes confers increased cardiovascular and diabetes-specific micro-and macrovascular complications. The pathogenic pathways for metabolic syndrome are still issues for discussion especially in some special groups like those with type 2 diabetes mellitus (T2DM). Recent evidences suggest that inflammation may play a key role in MS. This study assessed the relationship between MS (and its component risks) and markers of inflammation (high-sensitivity C-reactive protein {hs-CRP} and white blood cells {WBC}). Methods: A cross-sectional study involving 108 patients with T2DM. Anthropometric measurements and clinical examination were conducted. Blood sample was collected for hs-CRP, WBC, glycated haemoglobin etc. Metabolic syndrome was defined using the International Diabetes Federation criteria. Ethical approval was granted and informed consent was obtained from participants. Results: Mean age of male and female participants were 58.00 ± 7.01 years and 55.48 ± 8.35 years respectively (p = 0.092). Eighty-two (75.9%) participants had metabolic syndrome. Median values of hs-CRP and total WBC were 0.89mg/L and 5.73 x10 3 /mm 3 respectively. On correlation, hs-CRP showed statistically significant association with waist circumference (r = 0.194; p = 0.044), fasting plasma glucose (r = 0.191; p = 0.048) and serum triglycerides (p = 0.226; r = 0.019). There was no statistically significant association between WBC and the metabolic components. Conclusion: Prevalence of metabolic syndrome is high, and C-reactive protein was associated with waist circumference, fasting plasma glucose and serum triglycerides.How to cite this paper: Soyoye, D.O.,

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The Pathophysiology of Cardiovascular Disease and Diabetes: Beyond Blood Pressure and Lipids

Cited by 241 publications

References 60 publications

Diabetic Foot Ulcer – Diagnosis and Management

Diabetic Foot Ulcer – Diagnosis and Management

Susceptibility of diabetics with superoxide dismutase gene 2 polymorphism to cardiovascular complications

Relationship between C-Reactive Protein, White Blood Cell Count and Metabolic Syndrome in Nigerians with Type 2 Diabetes Mellitus

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