Marina S. Kardara

Prevalence of Thyroid Dysfunction Among Greek Type 2 Diabetic Patients Attending an Outpatient Clinic

Background The aim of the present study was to determine the prevalence of thyroid dysfunction in patients with type 2 diabetes (T2D) attending an outpatient clinic. Methods We examined thyroid dysfunction in a total of 1,092 patients with T2D. Results Prevalence rate of thyroid dysfunction was 12.3%. In the group with thyroid dysfunction there was an excess of females in comparison with the group without thyroid dysfunction (P < 0.001). In addition, patients with thyroid dysfunction had higher values of body mass index (P = 0.03) and HDL-cholesterol levels (P = 0.01), and lower values of LDL-cholesterol levels (P = 0.001) in comparison with patients without thyroid dysfunction. Multivariate analysis demonstrated that presence of thyroid dysfunction was related with gender (OR: 0.220, 95% CI: 0.141 - 0.352) and LDL-cholesterol levels (OR: 0.990, 95% CI: 0.985 - 0.995). Conclusions The prevalence of thyroid dysfunction among Greek diabetic patients is 12.3%. Diabetic women were more frequently affected than men. Presence of thyroid dysfunction was associated with lower levels of LDL-cholesterol concentrations. Keywords Type 2 diabetes mellitus; Thyroid dysfunction; Hypothyroidism; Gender; LDL-cholesterol; Greece

Familial history of diabetes and clinical characteristics in Greek subjects with type 2 diabetes

BackgroundA lot of studies have showed an excess maternal transmission of type 2 diabetes (T2D). The aim, therefore, of the present study was to estimate the prevalence of familial history of T2D in Greek patients, and to evaluate its potential effect on the patients metabolic control and the presence of diabetic complications.MethodsA total of 1,473 T2D patients were recruited. Those with diabetic mothers, diabetic fathers, diabetic relatives other than parents and no known diabetic relatives, were considered separately.ResultsThe prevalence of diabetes in the mother, the father and relatives other than parents, was 27.7, 11.0 and 10.7%, respectively. Patients with paternal diabetes had a higher prevalence of hypertension (64.8 vs. 57.1%, P = 0.05) and lower LDL-cholesterol levels (115.12 ± 39.76 vs. 127.13 ± 46.53 mg/dl, P = 0.006) than patients with diabetes in the mother. Patients with familial diabetes were significantly younger (P < 0.001), with lower age at diabetes diagnosis (P < 0.001) than those without diabetic relatives. Patients with a diabetic parent had higher body mass index (BMI) (31.22 ± 5.87 vs. 30.67 ± 5.35 Kg/m2, P = 0.08), higher prevalence of dyslipidemia (49.8 vs. 44.6%, P = 0.06) and retinopathy (17.9 vs. 14.5%, P = 0.08) compared with patients with no diabetic relatives. No difference in the degree of metabolic control and the prevalence of chronic complications were observed.ConclusionThe present study showed an excess maternal transmission of T2D in a sample of Greek diabetic patients. However, no different influence was found between maternal and paternal diabetes on the clinical characteristics of diabetic patients except for LDL-cholesterol levels and presence of hypertension. The presence of a family history of diabetes resulted to an early onset of the disease to the offspring.

Pleiotropic Effects of Omega-3 Fatty Acids

Omega-3 fatty acids except for their effect on triglycerides levels have cardioprotective properties as well as antiarrhythmic properties.The pleiotropic effects of omega-3 fatty acids, also, include lowering of blood pressure and the favorable effect on endothelial function and high-density cholesterol levels. Furthermore, studies have showed their favorable action in subjects with dementia, Alzheimers disease and learning disorders. In this paper, a review of the recent patents on omega-3 fatty acids will be presented.

Environmental Pollution and Diabetes Mellitus

Long-term exposure to environmental pollution has been associated with an increased incidence of diabetes. In addition, environmental pollution has been associated with higher relative risk of mortality among people with diabetes compared to the general population. An association between exposure to air pollution and markers of cardiovascular risk has been shown including decreased heart rate variability, and increased levels of thrombotic and inflammatory factors. Since there is a growing body of evidence regarding the role of environmental pollution and smoking to the pathogenesis of diabetes mellitus, we tried to review the literature and patents to provide current literature data on the relationship between environmental pollution and diabetes mellitus.

Challenges for the Treatment of Diabetes Mellitus

The present review summarizes the existing literature data regarding the development of newer categories of antidiabetic agents, their mechanism of action and their clinical importance. In this paper, a review of the recent patents for the treatment of diabetes will be presented. In recent years significant achievements have been done, including the development of SGLT2 inhibitors, glucokinase activators as well as the role of free fatty acids and bile acid metabolism in the treatment of diabetes are reviewed.

Predictors of In-Hospital Mortality after Acute Ischemic Stroke in Subjects with and without Diabetes Mellitus

Background: Diabetes mellitus is a well-established risk factor for ischemic stroke and is associated with in- creased in-hospital mortality. The aim of the present study was to determine the potential predictors of in-hospital mortal- ity after an ischemic stroke in diabetic and nondiabetic subjects. Methods: 159 diabetic subjects (66 males / 93 females, mean age ± SD: 77.4 ± 6.4 years) and 159 non diabetic subjects (66 males / 93 females, mean age ± SD: 77.3 ± 5.2 years) hospitalized for ischemic stroke were studied. Demographic characteristics and laboratory tests on admission as well as outcome were recorded. Brain computed tomography scan was performed in all study subjects. Results: In-hospital death rates did not differ between the diabetic and the nondiabetic patients (36 (22.6%) vs. 27 (17.0%), respectively, P = 0.20). In the diabetic study group multivariate analysis, after controlling for CRP, total choles- terol, LDL-C, urea and creatinine levels, demonstrated that death was related with WBC count (OR: 1.002, 95% CI: 1.001-1.004, P = 0.005), glucose levels (OR: 1.007, 95% CI: 1.002-1.012, P = 0.008), and UA levels (OR: 1.51, 95% CI: 1.003-2.260, P = 0.05). In the nondiabetic study group, after controlling for WBC count, CRP, total cholesterol and LDL- C levels, death was related only with glucose levels (OR: 1.016, 95% CI: 1.001-1.031, P = 0.03). Conclusions: WBC count and UA levels on hospital admission are independent predictors for in-hospital mortality in dia- betic subjects with ischemic stroke. Plasma glucose levels are predictor for in-hospital mortality in both diabetic and nondiabetic subjects.

Frontiers in Clinical Drug Research – Diabetes and Obesity

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Role of Incretin, Incretin Analogues and Dipeptidyl Peptidase 4 Inhibitors in the Pathogenesis and Treatment of Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) is increasing in prevalence worldwide, and is expected to affect 440 million people by 2030 (IDF, 2009). Despite the development and use of several medications to control patients’ blood glucose levels, the effective management of T2DM continues to be a challenge to physicians. In order to achieve HbA1c targets (<7.0%), patients must reach desirable fasting (90 mg/dL 130 mg/dL) and postprandial glucose levels (<180 mg/dL) (American Diabetes Association, 2006). However, two thirds of patients with T2DM remain unable to reach the HbA1c targets (Koro, 1988; Fan, 2006). Blood glucose levels are dependent on the dynamic processes of hepatic production of glucose and skeletal muscle use of glucose. Treatment strategies designed to improve these processes have as a result the improvement in patient’s glycemic status. Different agents are currently available, providing physicians with several options for the management of T2DM. These clinical therapies include insulin and oral drugs that are classified as insulin sensitizers (e.g., biguanides and thiazolidinediones), insulin secretagogues (e.g., sulfonylureas and meglitinides), and alpha-glucosidase inhibitors. Newer treatment agents, incretin mimetics and dipeptidyl peptidase 4 (DPP-4) inhibitors, have been recently added to clinicians’ therapeutic choices (Drucker, 2003; Drucker, 2006a).