The inflammatory and hemostatic cardiovascular risk markers during acute hyperglycemic crisis in type 1 and type 2 diabetes

Popović, Dragana; Lalić, Katarina; Jotić, Aleksandra; Miličić, Tanja; Bogdanović, Jelena; Dordevic, M.; Stanković, Sanja; Jeremić, Veljko; Lalić, Nebojša

doi:10.2478/jomb-2018-0024

Cited by 10 publications

(16 citation statements)

References 39 publications

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“…This suggests that low-dose insulin combined with electrolytes can improve the inflammatory response in children with DKA. In the study of Popovic et al (31), the levels of inflammatory factors CRP and IL-6 in DKA patients after intravenous insulin therapy were significantly decreased, which is similar to our study. This suggests that low-dose insulin combined with electrolyte therapy is related to the alleviation of inflammatory response.…”

Section: Discussionsupporting

confidence: 92%

Efficacy of low-dose insulin combined with electrolyte in the treatment of pediatric diabetic ketoacidosis and its effect on serum inflammatory factors

Wei

Feng²,

Zhao

2020

Cell Mol Biol (Noisy-le-grand)

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Diabetic ketoacidosis (DKA) is a very serious disease that can occur in both types of diabetes (type 1 and 2). It is caused by a combination of high blood sugar and low insulin levels, which can cause the body to produce too much ketone. Ketones are toxic to human organs. This research aimed to investigate the clinical efficacy of low-dose insulin combined with electrolyte in the treatment of pediatric DKA and its effect on serum inflammatory factors. For this purpose, a total of 122 children with DKA admitted to our hospital from April 2013 to May 2016 were selected as research objects. They were divided into group A with 60 cases and group B with 62 cases. Group B was treated with supplemental electrolytes, and group A was treated with low-dose insulin based on group B. The serum levels of TNF-α, IL-6, and IL-18 were measured by enzyme-linked immunosorbent assay (ELISA) before and after treatment, and the blood sugar, sodium, and potassium levels were measured by an automatic biochemical analyzer. The time when blood sugar reached the standard level when acidosis was corrected and hospitalization time was compared between the two groups. The total effective rate of group A was significantly higher than that of group B (p< 0.05). There was no significant difference in blood glucose, sodium, potassium, TNF-α, IL-6, and IL-18 levels between the two groups before treatment. (all p > 0.05). But the blood glucose, sodium and potassium levels in group A were significantly better than those in group B (all p< 0.001). The levels of serum TNF-α, IL-6, and IL-18 in group A were significantly lower than those in group B after treatment (all p< 0.001). After treatment, the time when blood sugar reached the standard level when acidosis was corrected and hospitalization time in group A were significantly shorter than those in group B (all p< 0.001). Low-dose insulin combined with electrolyte supplementation is effective in the treatment of DKA in children, which can effectively control blood sugar, sodium, potassium level, and inflammatory factor concentration.

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Section: Discussionsupporting

confidence: 92%

Efficacy of low-dose insulin combined with electrolyte in the treatment of pediatric diabetic ketoacidosis and its effect on serum inflammatory factors

Wei

Feng²,

Zhao

2020

Cell Mol Biol (Noisy-le-grand)

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“…In the current study, there was a significant decrease of CRP levels in patients with DKA without infection after improvement of the Acute illness in comparison to its levels at time of admission (P = 0.054) was still higher than the CRP levels determined in control subjects with mean ± SD (17.13 ± 24.66, 2.02 ± 1.25) respectively matching with a study done by Dragana et al 2019 [15].…”

Section: Discussionsupporting

confidence: 88%

Inflammatory cytokine and plasma C-reactive protein response to ketoacidosis in adults with type 1 diabetes: Egyptian multicenter study

et al. 2020

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Background In adults with diabetic ketoacidosis (DKA), high plasma levels of C-reactive protein (CRP) and inflammatory cytokines such as interleukin-6 (IL-6) were reported to be sensitive markers of infection. However, elevation of both CRP and the pro-inflammatory cytokines which regulate CRP are probable without infection and may act as indicator of systemic inflammatory response (SIR). So, we wanted to determine if increased plasma CRP levels occur in young patients with severe DKA who do not have clinical evidence of infection and to relate observed changes in CRP level to the pro-inflammatory cytokine levels. Results Upon admission of 30 DKA patients with age ranging from 17 to 40 years, we found significant elevation of CRP (P = 0.001) and IL-6 (P = 0.001) in DKA patients than control group. After resolution of DKA, there was significant reduction in CRP and IL-6 compared to before DKA correction (P value = 0.054 and 0.001), respectively. There was a significant negative correlation between CRP after correction of DKA and RBCs (P = 0.042), and serum K (P = 0.021) and between CRP prior to DKA correction and PH (P = 0.025). Conclusions Patients with DKA without infection had increased levels of CRP and inflammatory cytokines. Intensive insulin therapy has a powerful anti-inflammatory effect that, at the time of DKA improvement, can normalize levels of CRP and inflammatory cytokines, and this beneficial effect is greater for IL-6 than CRP.

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“…Microalbuminuria was previously considered s a gold standard in early detection of DN despite being a non-specific marker, concomitantly present in other pathological conditions such as urinary tract infections, cardiovascular disease, in non-diabetic patients, etc. In addition, the body of evidence indicates a high percentage of patients with T2DM, who have renal involvement despite the absence of microalbuminuria (5,6). Studies have shown a progressive decline in the number of podocytes and disappearance of foot processes which occur in the early stages of DN due to apoptosis or shedding of podocytes.…”

Section: Introductionmentioning

confidence: 99%

Urinary nephrin is earlier, more sensitive and specific marker of diabetic nephropathy than microalbuminuria

Kostovska

Tosheska-Trajkovska

Topuzovska

et al. 2019

Journal of Medical Biochemistry

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Summary Background Diabetic nephropathy (DN) is a leading cause of end-stage renal disease. Progressive damage and decline in the number of podocytes often occur in the early stages of DN. Thus, nephrin as a podocyte-specific protein may be regarded as a potential biomarker of early detection of DN. The aim of this study is to determine whether urinary nephrin is an earlier marker in DN than microalbuminuria and to test the significance of urinary nephrin as a marker for early detection of DN. Methods Our cross-sectional study included 90 patients with type 2 diabetes mellitus (T2DM), 30 patients with diagnosed DN and 60 patients without diagnosed DN. As a control group, we used 30 healthy subjects. All patients with T2DM were classified into three subgroups according to urinary microalbumin/creatinine ratio (UMCR): normoalbuminuric, microalbuminuric and macroalbuminuric patients. Nephrin in urine was measured by immunoenzyme assay, microalbumin with turbidimetric and creatinine with the photometric method. In blood sera, we measured a few standard biochemical parameters. Results Nephrinuria was found to be present in 100% of patients with T2DM and macroalbuminuria, in 88% with microalbuminuria, as well as 82% of patients with T2DM and normoalbuminuria. A concentration of urinary nephrin was significantly increased in all groups of subjects with T2DM compared to the control group (p<0.05). Nephrinuria correlated statistically negative with eGFR (r=-0.54). ROC analysis showed that nephrin has a total predicted probability of 96% in patients with DN. Conclusions Urinary nephrin is earlier, more specific and sensitive marker than microalbumin in early detection of DN.

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The inflammatory and hemostatic cardiovascular risk markers during acute hyperglycemic crisis in type 1 and type 2 diabetes

Cited by 10 publications

References 39 publications

Efficacy of low-dose insulin combined with electrolyte in the treatment of pediatric diabetic ketoacidosis and its effect on serum inflammatory factors

Efficacy of low-dose insulin combined with electrolyte in the treatment of pediatric diabetic ketoacidosis and its effect on serum inflammatory factors

Inflammatory cytokine and plasma C-reactive protein response to ketoacidosis in adults with type 1 diabetes: Egyptian multicenter study

Urinary nephrin is earlier, more sensitive and specific marker of diabetic nephropathy than microalbuminuria

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