Acute Kidney Injury In Diabetes Mellitus

Acute Kidney Injury in Diabetes Mellitus

Clinic of Nephrology and Rheumatology, University Hospital of Gttingen, Gttingen, Germany
Received 2016 May 26; Revised 2016 Sep 27; Accepted 2016 Oct 20.
Copyright 2016 D. Patschan and G. A. Mller.
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Diabetes mellitus (DM) significantly increases the overall morbidity and mortality, particularly by elevating the cardiovascular risk. The kidneys are severely affected as well, partly as a result of intrarenal athero- and arteriosclerosis but also due to noninflammatory glomerular damage (diabetic nephropathy). DM is the most frequent cause of end-stage renal disease in our society. Acute kidney injury (AKI) remains a clinical and prognostic problem of fundamental importance since incidences have been increased in recent years while mortality has not substantially been improved. As a matter of fact, not many studies particularly addressed the topic AKI in diabetes mellitus. Aim of this article is to summarize AKI epidemiology and outcomes in DM and current recommendations on blood glucose control in the intensive care unit with regard to the risk for acquiring AKI, and finally several aspects related to postischemic microvasculopathy in AKI of diabetic patients shall be discussed. We intend to deal with this relevant topic, last but not least with regard to increasing incidences and prevalences of both disorders, AKI and DM.
The incidence and prevalence of di Continue reading

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Dr. Aaron Vinik on Cycloset in Diabetes Treatment

In part 4 of this Exclusive Interview, Dr. Aaron Vinik talks with Diabetes in Control Publisher Steve Freed during the AACE 2017 convention in Austin, Texas about the untapped possibilities of Cycloset.
Aaron Vinik, MD, PhD, FCP, MACP is the Director of Research and Professor of Medicine, Pathology and Neurobiology at Eastern Virginia Medical School in Norfolk, Virginia. His research and recent discovery of a gene, INGAP, could prove to be a cure for diabetes.
Steve Freed: Three years ago, I asked you whats the most exciting things coming out of ADA and you said it was cycloset. I said cycloset? Its a postprandial drug, it reduces blood sugars insignificantly. Theres better drugs out there to reduce postprandial blood sugar. You said forget about postprandial blood sugars you reduce your risk for base by 55% percent. And now we know that SGLT2s it might be 35%, but nobody here is talking about cycloset and it showed to be much more effective. Now, is it because it was a smaller study? But even if it was why arent we seeing research or money being put into that to get the results out in a larger study because if its really 55% I mean it should be put in our drinking water.
Dr. Vinik: Now you put your finger on what the problem is. The problem is that was a safety study, it wasnt powered to do that and nor was it the primary endpoint. So you have the nay-sayers out there that say show us the money and what they mean by that is that the study is going to be conducted in such a way that this fulfills your primary endpoint. Thats one of the reasons why you cannot use the in Continue reading

Prevent Diabetes with these 5 Tips

Diabetes affects millions of people in the world. If not addressed properly through certain medical measures, it can lead to
Diabetes affects millions of people in the world. If not addressed properly through certain medical measures, it can lead to blindness, kidney failure, heart disease, and other severe health issues. Prior to getting diagnosed, theres prediabetes first. This means the blood sugar levels are high but not high enough to be determined as diabetes.
Unfortunately, 70 percent of people with prediabetes later develop type 2 diabetes. The good news is that the progression from prediabetes to diabetes can always be stopped through a series of lifestyle changes, such as proper nutrition and regular exercises.
Even though some factors arent changeable, such as your age, genes, or past lifestyles, there are still several things you can do to lower the risk of diabetes, which are as follows:
1. Reduce intake of refined carbs and sugar
Youre bound to develop diabetes fast if refined carbs and sugar are part of your daily diet. With the consumption of these, your body breaks them down into tiny sugar molecules, which are assimilated into the bloodstream. As the sugar increases, your pancreas is triggered to generate insulin, which is a hormone that aids in the removal of sugar from the bloodstream.
In the case of prediabetes, the bodys cells become defiant to insulins action, which is why sugar remains prolific in the blood. To make up for it, the pancreas creates more insulin, endeavoring to reduce blood sugar down to a normal level.
As time progresses, thi Continue reading

Working through: diabetes

Since 1996, the number of people living with diabetes in the UK has more than doubled; one person is diagnosed every two minutes. According to Diabetes UK’s latest estimates, almost 3.5 million adults have been diagnosed with the condition, while it remains undiagnosed in more than one million others.
About one person in ten has type 1, which is treated by daily insulin doses, taken either by injections or through an insulin pump. The rest have type 2, which can be managed with a healthy diet and increased physical activity, though in more serious cases medication or insulin (or both) may be required.
Type 1 often appears in childhood, while type 2 tends to develop after the age of 40, but in both cases there are exceptions: the UK’s prime minister, Theresa May, for example, was diagnosed with type 1 diabetes in her mid-50s, when she was home secretary.
With so many people affected and numbers rising all the time, you might expect it to be well understood by employers. According to people with the condition, however, this is far from being the case.
Christine Smythe, a health and safety manager, was diagnosed with type 2 insulin-dependent diabetes at just 24. She remembers the shock of receiving this “life-changing” diagnosis and having to tell her then manager, who said he hoped she would not use it as an excuse to skive off work. She has also encountered managers who are unaware that diabetes – a long-term condition that affects a person’s ability to do normal day-to-day activities – is generally classed as a disability under the Equality Act 2010. So worker Continue reading

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #82: Insulin Actions In Vivo: Glucose Metabolism Part 9 of 9

Home / Resources / Clinical Gems / International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #82: Insulin Actions In Vivo: Glucose Metabolism Part 9 of 9
International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #82: Insulin Actions In Vivo: Glucose Metabolism Part 9 of 9
At any point in time, the glycemic response to exogenous glucose is the balance between the rate at which glucose appears in the systemic circulation (from oral as well as endogenous sources) and the rate at which glucose is disposed of. Oral glucose appearance in the peripheral circulation depends on: (a) the rate at which the gastric contents are passed on to the small intestine; (b) the rate of intestinal glucose absorption; (c) the extent of gut glucose utilization; (d) the degree of hepatic glucose trapping; and (e) the dynamics of glucose transfer through gut, liver, and posthepatic circulation on to the right heart. The contribution of endogenous glucose to the glycemic response to feeding depends on the extent and rate of change of hepatic glucose production. Finally, glucose disposal depends on changes in the pattern of hormonal stimuli and substrate availability.
Being a summation phenomenon, the response to oral glucose explores the whole of glucose tolerance, not the individual contribution of the various components. The rate-limiting step in the transfer of ingested glucose from the stomach to the liver is the rate of gastric emptying. This depends on the volume, temperature, and osmolarity of the glucose solution in the case in which glucose alone is ingested. Glucose absorption Continue reading