Thursday, 28 November 2013

Diabetes – Diseases associated with diabetes

Diabetes is defined as a condition caused by insufficient insulin entering the bloodstream to regulate the glucose. It is either caused by cells in pancreas dying off or receptor sites clogged up by fat and cholesterol. In some cases, diabetes is also caused by allergic reactions of cells in the immune system.
1. Acute myocardial infarction
Diabetes is considered as a risk factor for acute myocardial infarction (AMI). The relative risk (RR) in diabetic men was 2.9; 95% confidence interval (CI) 2.6-3.4, and in diabetic women, RR 5.0; CI 3.9-6.3. The risk for re-infarction was about twice as large in patients with diabetes as in patients without diabetes. In both sexes the overall 28 day case fatality (CF) was significantly higher in diabetic compared to non-diabetic subjects, according to the study by Department of Medicine, Kalix Hospital(36).
2. Risk of esophagus cancer
A study of 549 patients with esophageal cancer newly diagnosed in 2000-2009 and randomly selected 2196 controls without any cancer, frequency matched by sex, age and diagnosis year of cases. found that patients with DM are not at higher risk for esophagus cancer. However, esophageal disorders and anti-diabetic drugs are associated with the risk of the disease, according to the Taiwan’s insurance data(37).
3. Cardiovascular disease
Type 2 diabetes is associated with a increased risk of cardiovascular disease. In the study of 2838 patients aged 40-75 years in 132 centres in the UK and Ireland were randomised to placebo (n=1410) or atorvastatin 10 mg daily (n=1428), showed that Atorvastatin 10 mg daily is safe and efficacious in reducing the risk of first cardiovascular disease events, including stroke, in patients with type 2 diabetes without high LDL-cholesterol(38).
4. Mortility
In the study to examine mortality in ICU patients with type 2 diabetes with and without pre-existing heart and kidney diseases compared with nondiabetic patients, reseachers at the Department of Anesthesiology and Intensive Care, Aarhus University Hospital, showed that among 45 018 ICU patients, 7219 (16·0%) had type 2 diabetes. Overall, 1-year mortality was 36·0% in ICU patients with type 2 diabetes, rising to 54·6% in patients with pre-existing heart and kidney diseases, compared with 29·1% in nondiabetic patients. Comparing diabetic with nondiabetic patients, the adjusted 0- to 30-day HR was 1·20 (95% confidence interval (CI): 1·13-1·26) and 1·19 (95% CI: 1·10-1·28) during the 31- to 365-day follow-up period(39).
5. Cognitive decline in elder patient
According to the study by Centre Mémoire de Ressources et de Recherche, Neurology Unit, University Hospital of Saint-Etienne, in a sample of elderly non-demented community dwellers, diabetes mellitus (but not IFG) is associated with a higher decline in selective attention and executive functioning. These results emphasize the importance of detecting and man- aging diabetes and impaired fasting glucose, in order to prevent cognitive impairment and dementia(40).
6. Dementia
Dementia is the loss of mental ability that is severe enough to interfere with people’s every life and Alzheimer’s disease is the most common type of dementia in aging people. In the study to determine the risk of developing dementia in subjects with type 2 diabetes mellitus of a  749 participants (13.8%) with diabetes mellitus in the Mexican elder population, showed that diabetes mellitus have an increased risk of developing dementia. Sociodemographic factors and other co-morbidities highly prevalent in the Mexican population contribute to the diabetes-dementia association(41).
7. Etc.
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