• Title/Summary/Keyword: Complications of Diabetes Mellitus

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The Comparison of Clinical Outcomes of Off-pump versus On-pump Coronary Artery Bypass Grafting in Diabetes Patients (당뇨 환자에서 시행한 Off-pump CABG와 On-pump CABG의 비교 연구)

  • 송석원;임상현;홍순창;조수진;장병철;강면식;신혜란;유경종
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.553-558
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    • 2004
  • Avoiding cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CAB G) has been known to reduce early mortality and morbidity. Diabetes Mellitus is a significant risk factor for adverse early and late outcomes after CABG. We compared the clinical results of off-pump CABG versus on-pump CABG in diabetes patients. Material and Method: 682 patients (424 off-pump CABG and 258 on-pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Data were collected 242 patient who had diabetes. Among them, 154 patients underwent off-pump CABG and 90 patients underwent on-pump CABG. We analyzed the preoperative risk factors and postoperative results between 2 groups. Result: Two groups did not show statistical differences in age, sex, coronary and operative risk factors. Operative time was significantly shorter in off-pump CABG, however, number of grafts was fewer in off-pump CABG. Postoperative inotropic usage was lower in off-pump CABG. Postoperative CK-MB level was lower in off-pump CABG, and ICU stay and ventilation time was significantly shorter in off-pump CABG. However, there was no statistical difference between 2 groups in operative mortality, reoperation rate, perioperative myocardial infarction, wound infection, renal failure, neurological complications and hospital stay. Conclusion: Off-pump CABG group showed less myocardial damage and early recovery. We concluded that off-pump CABG is the more reasonable technique in diabetes patients although two techniques showed good results. The long-term follow up and prospective study may be warranted.

Effects of Treadmill Exercise on Memory and Hippocampal BDNF Expression in Streptozotocin-induced Diabetic Rats (트레드밀 운동이 당뇨흰쥐에서 기억력과 해마 BDNF 발현에 미치는 영향)

  • Lee, Hee-Hyuk;Yoon, Jin-Hwan;Kim, Seung-Hee
    • Journal of Life Science
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    • v.17 no.11
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    • pp.1464-1471
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    • 2007
  • Diabetes mellitus is a chronic metabolic disorder, leading to many complications including cognitive deficit. Regular exercise has often been recommended as a therapeutic maneuver to the diabetic patients for the prevention of secondary complications. In the present study, the effects of treadmill exercise on memory and brain-derived neurotrophic factor (BDNF) in the hippocampus of streptozotocin (STZ)-induced diabetic rats were investigated. Male SD rats, aged 6 weeks, were randomly assigned to the following three groups: control group(n=8), STZ-induced diabetic group(n=8), and STZ-induced diabetes and exercise group(n=8). Diabetes was induced by a single injection of STZ (50 mg/kg body weight). Treadmill running was conducted with duration and frequency of 30 minutes and 5 times per week, respectively, for 8 weeks. Memories were tested in the Morris water maze. Western blotting was performed to detect BDNF expression in the hippocampus. In this study, we found that compared to the control group, the STZ-induced diabetes group had a significantly impaired cognitive performance along with suppressed BDNF expression in the hippocampus and the exercise group had a higher cognitive function in diabetic rats. Therefore, the current findings of the study show that a treadmill running exercise can improve diabetes-induced impairment of cognitive function. And the improved cognitive function appears to be related to an alleviation in diabetes-induced BDNF expression in hippocampus.

Dietary Ascorbate Supplementation Reduces Oxidative Tissue Damage and Expression of iNOS in the Kidney of Streptozotocin Induced Diabetic Rats

  • Choi, Myung-Seoup;Jang, Yoon-Young;Lee, Woo-Seung;Song, Jin-Ho;Shin, Yong-Kyoo
    • The Korean Journal of Physiology and Pharmacology
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    • v.7 no.1
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    • pp.39-45
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    • 2003
  • Reactive oxygen species (ROS) have been suggested to be contributory factors in complications of diabetes mellitus. In the present study, we investigated the generation of superoxide, the lipid peroxide level measured as thiobarbituric acid reactive substances, the vasorelaxation of isolated thoracic aorta and the iNOS expression in kidney of streptozotocin induced diabetic rats. Sprague Dawley rats were divided into four groups: control, ascorbate (400 mg/kg rat weight daily in drinking water), diabetic (single dose of 50 mg of STZ/kg i.p.) and diabetic simultaneously fed with ascorbate for 12 wk. Rats in groups were studied at tri-weekly intervals (0 to 12 wk). Diabetic rats were evaluated periodically with changes of plasma glucose levels and body weight. The ascorbate supplimentation attenuated the development of hyperglycemia and weight loss induced by STZ injection in rats. In the present experimental condition, the ascorbate supplimentation had no significant effect on plasma glucose levels and changes in body weight of normal rate. The superoxide generation, formation of thiobarbituric acid reactive substance and iNOS expression in kidney were significantly increased in STZ-treated rats that were decreased by ascorbate supplimentation. The ascorbate supplimentation had no effect on vasorelaxation of isolated thoracic aorta. These results indicate that ascorbate supplimentation may exert an inhibitory effect on STZ-induced oxidative tissue damage through protection of pancreatic islet cells by scavanging reactive oxygen species. The ascorbate supplimentation may possibly attenuate the renal complication of diabetes mellitus.

Autumn olive (Elaeagnus umbellata Thunb.) berry reduces fasting and postprandial glucose levels in mice

  • Kim, Jung-In;Baek, Hee-Jin;Han, Do-Won;Yun, Jeong-A
    • Nutrition Research and Practice
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    • v.13 no.1
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    • pp.11-16
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    • 2019
  • BACKGROUND/OBJECTIVES: Fasting and postprandial hyperglycemia should be controlled to avoid complications of diabetes mellitus. This study investigated the effects of autumn olive (Elaeagnus umbellata Thunb.) berry (AOB) on fasting and postprandial hyperglycemia in mice. MATERIALS/METHODS: In vitro ${\alpha}$-glucosidase inhibitory effect of AOB was determined. Maltose solution (2 g/kg) with and without AOB extract at 500 mg/kg or acarbose at 50 mg/kg was orally administered to normal mice after overnight fasting and glucose levels were measured. To study the effects of chronic consumption of AOB, db/db mice received the basal diet or a diet containing AOB extract at 0.4% or 0.8%, or acarbose at 0.04% for 7 weeks. Blood glycated hemoglobin and serum glucose and insulin levels were measured. Expression of adiponectin protein in epididymal white adipose tissue was determined by Western blotting. RESULTS: In vitro inhibitory effect of AOB extract on ${\alpha}$-glucosidase was 92% as strong as that of acarbose. The AOB extract (500 mg/kg) or acarbose (50 mg/kg) significantly suppressed the postprandial rise of blood glucose after maltose challenge and the area under the glycemic response curve in normal mice. The AOB extract at 0.4% or 0.8% of diet or acarbose at 0.04% of diet significantly lowered levels of serum glucose and blood glycated hemoglobin and homeostasis model assessment for insulin resistance values in db/db mice. The expression of adiponectin protein in adipose tissue was significantly elevated by the consumption of AOB at 0.8% of diet. CONCLUSIONS: Autumn olive (E. umbellata Thunb.) berry may reduce postprandial hyperglycemia by inhibiting ${\alpha}$-glucosidase in normal mice. Chronic consumption of AOB may alleviate fasting hyperglycemia in db/db mice partly by inhibiting ${\alpha}$-glucosidase and upregulating adiponectin expression.

Effects of Salicornia Herbacea L. Supplementation on Antioxidative Enzyme Activities in Streptozotocin-Induced Diabetic Rats (함초 첨가식이가 당뇨유발 흰쥐의 항산화효소 활성에 미치는 영향)

  • Kim, Myung-Wha
    • Journal of Nutrition and Health
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    • v.41 no.7
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    • pp.583-593
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    • 2008
  • This study was designed to examine the effects of Salicornia herbacea L. (glasswort: GW) on hepatic antioxidative enzyme activities in diabetic rats. Diabetes mellitus was induced in male Sprague-Dawley rats weighing 200-220g by an injection of streptozotocin (STZ) dissolved in a citrate buffer into the tail vein at a dose of 45 mg/kg of body weight. Sprague-Dawley rats were fed an AIN-93 recommended diet and the experimental groups were fed a modified diet containing 10% and 20% of glasswort powder for 4 weeks. The experimental groups were divided into 6 groups which consisted of normal (N)-control group, N-GW 10% and N-GW 20% treated groups, STZ-control, STZ-GW 10% and STZ-GW 20% treated groups. The activities of Xanthine oxidase (XOD), glutathione- S-transferase (GST), glutathione peroxidase (GPX), glutathione reductase (GR), superoxide dismutase (SOD) and CAT (CAT) were measured in the homogenates of liver. The activity of CAT was lower in the supplementary group with glasswort compare to the STZcontrol group but it was not significantly different. The activity of SOD was not significant in all of experimental groups. The activity of GR was significantly increased in the normal supplementary group with glasswort, and GPX activity was significantly increased in STZ-GW 10% group compare to the STZ-control group. The activity of XOD was significantly decreased in the all of supplementary groups with glasswort. The activity of GST was significantly increased in the N-GW 20% group and it was significantly decreased in the STZ-GW 20% group. These results show that the supplementation of glasswort may have favorable influence on antioxidative status in diabetic rats and it may be useful for the diabetic complications as functional food.

Percutaneous Acutrak Screw Fixation of Intra-articular Tongue Type Fracture of Calcaneus (설상형 관절내 종골 골절에 있어서 경피적 Acutrak 나사 고정을 이용한 수술적 치료)

  • Lee, Seong-Joo;Choi, Shin-Kwon;Yim, Moon-Sup;Hwang, Yoon-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.71-75
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    • 2006
  • Purpose: To evaluate the results of treatments by percutaneous Acutrak screw fixation for intra-articular tongue type fracture of calcaneus, especially in elderly patient or patients with underlying disease including diabetes mellitus. Materials and Methods: Seven cases with intra-articular tongue type fracture of calcaneus, from November 2003 to February 2005, were reviewed. There were 6 males and 1 female with 65 years old mean age (range: $61{\sim}71$ years old). The average follow-up period was 16 months (range: $10{\sim}25$ months). Two Steinmann pins were used for closed reduction. After closed reduction was done like Essex-Lopresti's method, two Acutrak screws were inserted. The third Acutrak screw was inserted at the sustentaculum tali away from sinus tarsi to fix the primary fracture line. The patients were evaluated with Salama scale, the extent of recovery of Bohler angle, state of subtalar joint. Results: Clinical results according Salama scale were excellent in 5 cases, and good in 2 cases. Average preoperative Bohler angle was $13^{\circ}$ (range: $12{\sim}15^{\circ}$). Average postoperative Bohler angle was 31o (range: $23^{\circ}-40^{\circ}$). There were no soft tissue complications. There were two mild subtalar arthritis. Conclusions: We think that percutaneous Acutrak screw fixation is a good option for tongue type fracture of calcaneus in elderly patient or patients with underlying disease including diabetes mellitus.

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Effects of the Diabetic Condition on Grafted Fat Survival: An Experimental Study Using Streptozotocin-Induced Diabetic Rats

  • Jung, Jae A.;Kim, Yang Woo;Cheon, Young Woo;Kang, So Ra
    • Archives of Plastic Surgery
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    • v.41 no.3
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    • pp.241-247
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    • 2014
  • Background Autologous fat grafts have been widely used for cosmetic purposes and for soft tissue contour reconstruction. Because diabetes mellitus is one of the major chronic diseases in nearly every country, the requirement for fat grafts in diabetes patients is expected to increase continuously. However, the circulation complications of diabetes are serious and have been shown to involve microvascular problems, impairing ischemia-driven neovascularization in particular. After injection, revascularization is vital to the survival of the grafted fat. In this study, the authors attempted to determine whether the diabetic condition inhibits the survival of injected fat due to impaired neovascularization. Methods The rat scalp was used for testing fat graft survival. Forty-four seven-week-old male Sprague-Dawley rats were allocated to a diabetic group or a control group. 1.0 mL of processed fat was injected subcutaneously into the scalp of each rat. The effect of diabetes was evaluated by calculating the volume and the weight of the grafted fat and by histologically analyzing the fat sections. Results The surviving fat graft volume and weight were considerably smaller in the diabetic group than in the control group (P<0.05), and histological evaluations showed less vascularity, and more cysts, vacuoles, and fibrosis in the diabetic group (P<0.05). Cellular integrity and inflammation were not considerably different in the two groups. Conclusions As the final outcome, we found that the presence of diabetes might impair the survival and the quality of fat grafts, as evidenced by lower fat graft weights and volumes and poor histologic graft quality.

Liver Dysfunction and Oxidative Stress in Streptozotocin-Induced Diabetic Rats: Protective Role of Artemisia Turanica

  • Yazdi, Hassan Bgheri;Hojati, Vida;Shiravi, Abdolhossein;Hosseinian, Sara;Vaezi, Gholamhassan;Hadjzadeh, Mousa-Al-Reza
    • Journal of Pharmacopuncture
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    • v.22 no.2
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    • pp.109-114
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    • 2019
  • Objectives: Oxidative stress plays a central role in diabetes-induced complications. In the present study, the protevtive effect of Artemisia turanica (A. turanica) was evaluated against diabetes-induced liver oxidative stress and dysfunction. Methods: Fifty male Wistar rats were randomly divided into five groups: control, diabetic, diabetic + metformin, diabetic + A. turanica extract, and diabetic + A. turanica extract + metformin. Experimental diabetes was induced by a single-dose (55 mg/kg, intraperitoneally (ip)) injection of streptozotocin (STZ). Metformin (300 mg/kg) and A. turanica extract (70 mg/kg) were orally administrated three days after STZ injection for four weeks. The levels of malondialdehyde (MDA), total thiol content and superoxide dismutase (SOD) and catalase activities were measured in the liver tissue. Serum glucose concentration, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities were also determined. Results: In the diabetic group, serum glucose concentration, serum AST and ALT activities and liver MDA level were significantly higher while tissue total thiol content as well as catalase and SOD activities were lower, compared to the control group. Serum glucose in diabetic rats treated with metformin + A. turanica extract showed a significant decrease compared with the diabetic group. In all the A. turanica extract and metformin treated groups, serum ALT, tissue MDA level, total thiol content and SOD activity significantly improved compared with the diabetic rats. However, treatment of the diabetic rats only with metformin could not significantly change the activities of catalase and AST compared with the diabetic group. Conclusion: These findings suggested that A. turanica extract had a therapeutic effect on liver dysfuncyion and oxidative stress induced by diabetes, that may be probably due to its antioxidant and antiinflammatory effects.

The Difference of Efficacy for Oral Hypoglysemic Pharmacotherapy Based on Sasang Constitutional Medicine Among Type II Diabetes Mellitus Patients in Korea (제 2형 당뇨병 환자에서 사상체질에 따른 경구 혈당강하요법의 치료 반응성 및 사용 패턴 평가)

  • Kim, Ji Yeon;Lee, Myung Koo;Kim, Jung Tae;Lim, Sung Cil
    • YAKHAK HOEJI
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    • v.58 no.1
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    • pp.71-79
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    • 2014
  • Although Korean patients with type 2 diabetes mellitus (T2DM) are generally treated by western medicine, many of them strongly believe in the traditional oriental Sasang constitutional classification and depend on it for food, health supplements, and oriental medicines decision making. Sasang constitutional classification is a part of traditional Korean medicine that divides people into four constitutional types (Tae-Yang: TY, Tae-Eum: TE, So-Yang: SY, and So-Eum: SE), which differ in inherited characteristics such as appearance, personality traits, susceptibility to diseases, and drug responses. It is recommended for T2DM patients to control their blood glucose very well from early stages with drugs and diet. However, many T2DM patients respond differently to their drugs, even though they receive the same medicine. Therefore, the present study investigated whether Sasang constitutional type can explain the therapeutic differences between oral hypoglycemic agents (OHAs) therapy (mono, dual and triple drug therapy). Patients of 618 with T2DM diagnosis and Sasang constitutional type known who received both western and oriental medicine treatment in a hospital between April 2006 and April 2013 retrospectively studied. HbA1c (%) and blood glucose (mg/dl) levels before OHAs therapy and 3 month after were collected for metformin (MET) or sulfonylurea (SU) monotherapy, MET+SU dual therapy, MET+except SU (where was either alpha-glucosidase inhibitor, dipeptidyl peptidase-4 inhibitor, meglitinide or thiazolidinedione) dual therapy, and triple therapy, according to Sasang constitutional type. For statistical analysis, ANOVA was used and paired t-test by SPSS 19.0 where P values less than 0.05 were considered statistically significant. Pattern was similar levels of HbA1c and blood glucose and which was decreased in order of mono, MET+SU dual, MET+except SU dual and triple therapy. In all patients comparison, for the So-yang (SY) constitutional type, either monotherapy was less effective; for Te-eum (TE) type, MET+SU dual therapy was less effective while MET+except SU dual therapy was more effective and the triple therapy was less effective; and for So-eum (SE) type, the triple therapy was more effective. For the management of TE type it is recommended to use drugs except SU when dual therapy is needed, restrict triple therapy and consider dual and insulin therapy; for SY type it is recommended to follow current guidelines; and for SE type it is advisable to skip dual therapy and start the triple therapy early. Finally, the therapeutic response to OHAs is different among Korean T2DM patients with different Sasang constitutional types. Taken together, the choice of effective OHAs therapy for each type is necessary in order to minimize the poor control of blood glucose level, the risk of complications, and the costs from a failure of therapy.

Effect of Health status and Health Behavior on the Diabetes Mellitus Prevalence (성인의 건강상태, 건강행위가 당뇨병 유병률에 미치는 영향)

  • Hong, Ji-Yeon;Park, Jin-Ah
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.198-209
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    • 2014
  • Diabetes Mellitus (DM) is well known for increasing morbidity and mortality, especially related to their complications. The purpose of this study was to investigate the factors affecting the prevalence rate of DM and provide a fundamental material to develop an intervention strategy to reduce the prevalence rate of DM. The study subjects were adults aged over 19 on the basis of the primitive data of "The Fifth Korean National Health and Nutrition Examination Survey, 2012". Therefore, the data of 5995 participants were analyzed. For data process, the complex sample analysis module of SPSS 18.0 program was employed to add weighting before analysis. According to the analysis, the prevalence rate of DM of the study subjects was 10.5%. Regarding the odds ratio of DM prevalence, the subjects who graduated from middle school had the odds ratio 2.51 times higher than those who graduated from college and more; those in subjective bad health condition 4.77 times higher than those in subjective good health condition; those in obesity 1.44 times higher; those with high blood pressure 2.57 times higher; those with hyperlipidemia 2.63 times higher; those who fail to control their weight 1.31 times higher; those going on a diet 2.75 times higher. This study revealed that a level of education, perceived health status, obesity, high blood pressure, hyperlipidemia, weight control, and dietary therapy were the predictable variables of the prevalence rate of DM, and thereby suggested the nursing direction and research direction to reduce the prevalence rate of DM.