Tight glycemic control and cardiovascular effects in type 2 diabetic patients

Moodahadu, Latha Subramanya; Dhall, Ruchi; Zargar, Abdul Hamid; Bangera, Sudhakar; Ramani, Lalitha; Katipally, Ramesh

doi:10.4103/1995-705x.151084

Cited by 17 publications

(18 citation statements)

References 62 publications

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“…Also, the classification of type II DM based on tongue thermogram using deep learning methods was not initiated till today. e poor glycaemic control in diabetic subjects leads to the cardiovascular problems; therefore tight glycaemic control (HbA 1c of <7%) recommended for the prevention of the onset of disease was discussed by Moodahadu et al [56]. of good glucose control, the endothelial cell levels were found to be higher in the diabetic subjects.…”

Section: Resultsmentioning

confidence: 99%

Human Tongue Thermography Could Be a Prognostic Tool for Prescreening the Type II Diabetes Mellitus

Thirunavukkarasu

Snekhalatha

Krishnan

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Diabetes mellitus is one of the life threatening diseases over the globe, and an early prediction of diabetes is of utmost importance in this current scenario. International Diabetes Federation (IDF) reported nearly half of the world’s population was undiagnosed and unaware of being developed into diabetes. In 2017, around 84 million individuals were living with diabetes, and it might increase to 156 million by the end of 2045 stated by IDF. Generally, the diagnosis of diabetes relies on the biochemical method that may cause uneasiness and probability of infections to the subjects. To overcome such difficulties, a noninvasive method is much needed around the globe for primary screening. A change in body temperature is an indication of various diseases. Infrared thermal imaging is relatively a novel technique for skin temperature measurement and turned out to be well known in the medical field due to being noninvasive, risk-free, and repeatable. According to traditional Chinese medicine, the human tongue is a sensitive mirror that reflects the body’s pathophysiological condition. So, we have (i) analysed and classified diabetes based on thermal variations at human tongue, (ii) segmented the hot spot regions from tongue thermogram by RGB (red, green, blue) based color histogram image segmentation method and extracted the features using gray level co-occurrence matrix algorithm, (iii) classified normal and diabetes using various machine learning algorithms, and (iv) developed computer aided diagnostic system to classify diabetes mellitus. The baseline measurements and tongue thermograms were obtained from 140 subjects. The measured tongue surface temperature of the diabetic group was found to be greater than normal. The statistical correlation between the HbA1c and the thermal distribution in the tongue region was found to be r2 = 0.5688. The Convolutional Neural Network has outperformed the other classifiers with 94.28% accuracy rate. Thus, tongue thermograms could be used as a preliminary screening approach for diabetes prognosis.

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Section: Resultsmentioning

confidence: 99%

Human Tongue Thermography Could Be a Prognostic Tool for Prescreening the Type II Diabetes Mellitus

Thirunavukkarasu

Snekhalatha

Krishnan

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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“…It has not yet been conclusively determined as to which target level of HbA1c, i.e., HbA1c <6.5% or HbA1c <7.0%, might be the more appropriate target level representing good glycemic control [25]. In the present study, when the patients were further subclassified according to the glycemic control status into an intensive glycemic control group (HbA1c <6.5%) and a non-intensive, but good glycemic control group (HbA1c 6.5–7.0%), no significant difference of the changes of the baPWV during the study period was observed between the two groups.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, when the patients were further subclassified according to the glycemic control status into an intensive glycemic control group (HbA1c <6.5%) and a non-intensive, but good glycemic control group (HbA1c 6.5–7.0%), no significant difference of the changes of the baPWV during the study period was observed between the two groups. While intensive glycemic control is thought to be beneficial against inflammation, oxidative stress, and/or accumulation of AGEs, transient hypoglycemia associated with intensive control might activate the sympathetic tone [5, 25]; thus, intensive glycemic control may have some counteractive effects on the arterial stiffness.…”

Section: Discussionmentioning

confidence: 99%

Impact of glycemic control with sitagliptin on the 2-year progression of arterial stiffness: a sub-analysis of the PROLOGUE study

Tomiyama

Miwa

Kan

et al. 2016

Cardiovasc Diabetol

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BackgroundNo conclusive evidence has been obtained yet on the significance of the effects of dipeptidyl peptidase-4 (DPP-4 inhibitor) treatment on the arterial stiffness in clinical settings. In addition, the effects of good glycemic control on the arterial stiffness have also not been clarified yet. As a sub-analysis of the PROLOGUE study, we examined the effect of a DPP-4 inhibitor (sitagliptin) on the 2-year progression of the arterial stiffness and also to determine the effect of good glycemic control on the rate of progression of the arterial stiffness.MethodsIn the PROLOGUE study, the study participants were either allocated to add-on sitagliptin treatment or to continued treatment with conventional anti-diabetic agents. Among the 463 participants of the PROLOGUE study, we succeeded in measuring the brachial-ankle pulse wave velocity (baPWV) at least two times during the 2-year study period in 96 subjects.ResultsThe changes in the baPWV during the study period were similar between the both groups (i.e., with/without staglipitin), overall. On the other hand, when the study subjects were divided into two groups according to the glycemic control status during the study period {good glycemic control group (GC) = hemoglobin (Hb)A1c <7.0 at both 12 and 24 months after the treatment randomization; poor glycemic control group (PC) = HbA1c ≥7.0 at either 12 months, 24 months, or both}, the 2-year increase of the baPWV was marginally significantly larger in the PC group (144 ± 235 cm/s) as compared to that the GC group (−10 ± 282 cm/s) (p = 0.036).ConclusionWhile the present study could not confirm the beneficial effect of sitagliptin per se on the arterial stiffness, the results suggested that good glycemic control appears to be beneficial for delaying the annual progression of the arterial stiffness. Trial registration University Hospital Medical Information Network Clinical Trials Registry UMIN000004490

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“…Diabetes Mellitus (DM) with poor glycemic control is one of the leading causes for cardiovascular mortality in diabetic patients. [18] Metformin: It is a first-line therapy for patients with type 2 diabetes but contraindicated in individuals with severe heart failure (HF) classes III-IV [as per New York Heart Association, NYHA] due to lactic acidosis associated mortality rate of 50%. [3] Sulfonylureas (SU): Acute hypoglycaemia induced by sulfonylureas, may trigger ischemia and cardiovascular events.…”

Section: Cardiovascular Impact Of Oral Hypoglycemic Agentsmentioning

confidence: 99%

Post Prandial Hyperglycemia: A Real Threat for Patients with Type 2 Diabetes Mellitus

Faruqui¹

2017

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The aim of this article is to evaluate the impact of postprandial hyperglycemia in patients with type 2 diabetes mellitus (T2DM). Postprandial hyperglycemia is a major determinant in overall glycemic control. Diabetic mellitus is an endocrine disorder steadily increasing worldwide, particularly in the developing countries like India. Diabetic patients are at high risk of cardiovascular events and mealtime plasma glucose fluctuations are important cardiovascular risk factors in type 2 diabetic patients. Diabetes is also one of the most important risk factors for chronic kidney disease. For diabetic patients with chronic kidney disease (CKD), the risk of cardiovascular disease is even higher. CKD can impair the ability of the kidneys to metabolize drugs and as a consequence a dose adjustment or an extended dose interval is usually needed in CKD patients in order to keep an optimal safety/efficacy profile. Oral hypoglycemic agents like glinides and alpha glucosidase inhibitors do not require dose adjustments and hence can be used safely in patients with CKD. Oral treatment with Repaglinide has proven beneficial effect on cardiovascular risk factors. It is therefore very important to use pharmacological tools allowing keeping post-meal glucose oscillations within narrow range. Regimens that target both fasting and post meal glycemia are needed to achieve optimal glucose control to prevent microvascular and macrovascular complications.

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Tight glycemic control and cardiovascular effects in type 2 diabetic patients

Cited by 17 publications

References 62 publications

Human Tongue Thermography Could Be a Prognostic Tool for Prescreening the Type II Diabetes Mellitus

Human Tongue Thermography Could Be a Prognostic Tool for Prescreening the Type II Diabetes Mellitus

Impact of glycemic control with sitagliptin on the 2-year progression of arterial stiffness: a sub-analysis of the PROLOGUE study

Post Prandial Hyperglycemia: A Real Threat for Patients with Type 2 Diabetes Mellitus

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