Mitigating the Impact of Diabetes Mellitus: Highlighting Treatments and Trials for Customary Complications
DOI:
https://doi.org/10.47611/jsrhs.v14i1.8495Keywords:
diabetes, clinical trials, diabetic complications, diabetic treatment, hyperglycemia, type 1 diabetes, type 2 diabetes, diabetic neuropathy, diabetic retinopathyAbstract
The prevalence of Diabetes Mellitus (DM), more commonly referred to as diabetes, has surged exponentially over the last decades [1]. The rise of the disease further denotes the rise of its complications. The condition is associated with several complications ranging from various levels of severity, and understanding these complications is critical for diabetes management. In this research paper, I discuss the short- and long-term complications of diabetes, focusing particularly on Type 1 and Type 2 Diabetes. Each complication is introduced and thoroughly examined, with emphasis on the methods used for its detection and the functioning of various treatments. Given that many DM complications lack distinct treatments, I also specify relevant clinical trials for potential treatments, highlighting the trial’s statistics, results, and limitations, if any. I conclude by highlighting the personal experience of Mohammad Osama Minhas, a diabetic patient of 16 years, providing a valuable perspective to the daily challenges in managing the disease.
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References or Bibliography
Center for Disease Control and Prevention. (n.d.). Long-term trends in diabetes - centers for disease control and prevention. https://www.cdc.gov/diabetes/statistics/slides/long_term_trends.pdf
Egan, A. M., & Dinneen, S. F. (2019). What is diabetes? Medicine, 47(1), 1–4. https://doi.org/10.1016/j.mpmed.2018.10.002
Araetus C. On causes and symptoms of chronic diseases. Translated by Adam CF. London, (UK): London Sydenham Society; 1856. p. 138. https://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.01.0254%3Atext%3DSD
Ahmed A. M. (2002). History of diabetes mellitus. Saudi medical journal, 23(4), 373–378. https://www.researchgate.net/publication/291274449_history_of_diabetes_mellitus
Bluestone, J. A., Herold, K., & Eisenbarth, G. (2010). Genetics, pathogenesis and clinical interventions in type 1 diabetes. Nature, 464(7293), 1293-1300. https://doi.org/10.1038/nature08933
Harjutsalo, V., Sjöberg, L., & Tuomilehto, J. (2008). Time trends in the incidence of type 1 diabetes in Finnish children: A cohort study. The Lancet, 371(9626), 1777-1782. https://doi.org/10.1016/S0140-6736(08)60765-5
Gale, E. A. (2005). Type 1 diabetes in the young: The harvest of sorrow goes on. Diabetologia, 48(8), 1435–1438. https://doi.org/10.1007/s00125-005-1833-0
WebMD. (n.d.). Type 1 diabetes: Causes, symptoms, treatments, diagnosis, and prevention. WebMD. https://www.webmd.com/diabetes/type-1-diabetes
Centers for Disease Control and Prevention. (2023, April 18). Type 2 diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/type2.html
U.S. Department of Health and Human Services. (n.d.). Type 2 diabetes - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/type-2-diabetes#causes
U.S. Department of Health and Human Services. (n.d.-a). Insulin Resistance & Prediabetes - Niddk. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
World Health Organization. (n.d.). Diabetes. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/diabetes
Joslin, E. P. (1930). Arteriosclerosis in diabetes. Annals of Internal Medicine, 4(1), 54-66. https://dx.doi.org/10.7326/0003-4819-4-1-54
Emma Hook. (n.d.). Complications of diabetes. Diabetes UK. https://www.diabetes.org.uk/guide-to-diabetes/complications
Deshpande, A. D., Harris-Hayes, M., & Schootman, M. (2008). Epidemiology of diabetes and diabetes-related complications. Physical therapy, 88(11), 1254–1264. https://doi.org/10.2522/ptj.20080020
Orasanu, G., & Plutzky, J. (2009). The pathologic continuum of diabetic vascular disease. Journal of the American College of Cardiology, 53(5S), S35-S42. https://doi.org/10.1016/j.jacc.2008.09.055
Laing, S. P., Swerdlow, A. J., Slater, S. D., Burden, A. C., Morris, A., Waugh, N. R., ... & Patterson, C. C. (2003). Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes. Diabetologia, 46, 760-765. https://doi.org/10.1007/s00125-003-1116-6
National Center for Chronic Disease Prevention and Health Promotion (U.S.), Division of Diabetes Translation. (2011). National Diabetes fact sheet, 2011. https://sunshinepando.com/wp-content/uploads/2015/01/national-diabetes-fact-sheet-2011-Sunshine-Prosthetics-and-Orthotics-Wayne-NJ.pdf
Centers for Disease Control and Prevention. (2022, June 20). Diabetes and your heart. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/diabetes-and-heart.html
Zabalgoitia, M., Ismaeil, M. F., Anderson, L., & Maklady, F. A. (2001). Prevalence of diastolic dysfunction in normotensive, asymptomatic patients with well-controlled type 2 diabetes mellitus. The American journal of cardiology, 87(3), 320-323. https://doi.org/10.1016/S0002-9149(00)01366-7
Ritchie, R. H., & Abel, E. D. (2020). Basic mechanisms of diabetic heart disease. Circulation Research, 126(11), 1501–1525. https://doi.org/10.1161/circresaha.120.315913
Liu, X., Yang, Z. G., Gao, Y., Xie, L. J., Jiang, L., Hu, B. Y., ... & Guo, Y. K. (2018). Left ventricular subclinical myocardial dysfunction in uncomplicated type 2 diabetes mellitus is associated with impaired myocardial perfusion: a contrast-enhanced cardiovascular magnetic resonance study. Cardiovascular diabetology, 17, 1-12. https://doi.org/10.1186/s12933-018-0782-0
Assunção, F. B., de Oliveira, D. C., Souza, V. F., & Nacif, M. S. (2016). Cardiac magnetic resonance imaging and computed tomography in ischemic cardiomyopathy: an update. Radiologia brasileira, 49(1), 26–34. https://doi.org/10.1590/0100-3984.2014.0055
Nagueh, S. F., Smiseth, O. A., Appleton, C. P., Byrd, B. F., Dokainish, H., Edvardsen, T., ... & Houston, Texas; Oslo, Norway; Phoenix, Arizona; Nashville, Tennessee; Hamilton, Ontario, Canada; Uppsala, Sweden; Ghent and Liège, Belgium; Cleveland, Ohio; Novara, Italy; Rochester, Minnesota; Bucharest, Romania; and St. Louis, Missouri. (2016). Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Journal of Echocardiography, 17(12), 1321-1360. https://dx.doi.org/10.1016/j.echo.2016.01.011
Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. (2005). Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. New England Journal of Medicine, 353(25), 2643-2653. https://dx.doi.org/10.1056/NEJMoa052187
Holman, R. R., Paul, S. K., Bethel, M. A., Matthews, D. R., & Neil, H. A. W. (2008). 10-year follow-up of intensive glucose control in type 2 diabetes. New England journal of medicine, 359(15), 1577-1589. https://dx.doi.org/10.1056/NEJMoa0806470
Duckworth, W., Abraira, C., Moritz, T., Reda, D., Emanuele, N., Reaven, P. D., ... & Huang, G. D. (2009). Glucose control and vascular complications in veterans with type 2 diabetes. New England journal of medicine, 360(2), 129-139. https://dx.doi.org/10.1056/NEJMoa0808431
Patel, A., MacMahon, S., & Chalmers, J. (2008). Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release and Controlled Evaluation (ADVANCE) Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med, 358(24), 2560-2572. https://dx.doi.org/10.1007/s00125-017-4539-1
Action to Control Cardiovascular Risk in Diabetes Study Group. (2008). Effects of intensive glucose lowering in type 2 diabetes. New England journal of medicine, 358(24), 2545-2559. https://dx.doi.org/10.1056/NEJMoa0802743
Matheus, A. S. D. M., Tannus, L. R. M., Cobas, R. A., Palma, C. C. S., Negrato, C. A., & Gomes, M. D. B. (2013). Impact of diabetes on cardiovascular disease: an update. International journal of hypertension, 2013. https://dx.doi.org/10.1155/2013/653789
Centers for Disease Control and Prevention. (2022b, December 30). Diabetes and chronic kidney disease. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/managing/diabetes-kidney-disease.html
U.S. Department of Health and Human Services. (n.d.-b). Kidney disease statistics for the United States - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease
Diabetic nephropathy (kidney disease). JHM. (2019, November 19). https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/diabetic-nephropathy-kidney-disease
Science Direct. (n.d.). Nephron. Nephron - an overview | ScienceDirect Topics. https://www.sciencedirect.com/topics/neuroscience/nephron
Groop, P. H., Thomas, M. C., Moran, J. L., Waden, J., Thorn, L. M., Mäkinen, V. P., ... & Forsblom, C. (2009). The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes. Diabetes, 58(7), 1651-1658. https://dx.doi.org/10.2337/db08-1543
Ormazabal, V., Nair, S., Elfeky, O., Aguayo, C., Salomon, C., & Zuñiga, F. A. (2018). Association between insulin resistance and the development of cardiovascular disease. Cardiovascular Diabetology, 17(1). https://doi.org/10.1186/s12933-018-0762-4
Mayo Foundation for Medical Education and Research. (2021, October 19). Diabetic nephropathy (kidney disease). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetic-nephropathy/symptoms-causes/syc-20354556
Whaley-Connell, A., Nistala, R., & Chaudhary, K. (2011). The importance of early identification of chronic kidney disease. Missouri medicine, 108(1), 25–28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188457/
McFarlane, P., Gilbert, R. E., MacCallum, L., & Senior, P. (2013). Chronic kidney disease in diabetes. Canadian Journal of Diabetes, 37. https://doi.org/10.1016/j.jcjd.2013.01.037
Babaei-Jadidi, R., Karachalias, N., Ahmed, N., Battah, S., & Thornalley, P. J. (2003). Prevention of incipient diabetic nephropathy by high-dose thiamine and benfotiamine. Diabetes, 52(8), 2110–2120. https://doi.org/10.2337/diabetes.52.8.2110
Angeline L. Wang, M.D. (2021, May 26). 4 conditions with signs and symptoms that arise in the eyes: Eyes and vision: UT southwestern medical center. Eyes and Vision | UT Southwestern Medical Center. https://utswmed.org/medblog/retina-vision-exams/
Crawford, T., Alfaro III, D., Kerrison, J., & Jablon, E. (2009). Diabetic retinopathy and angiogenesis. Current Diabetes Reviews, 5(1), 8–13. https://doi.org/10.2174/157339909787314149
Kollias, A. N., & Ulbig, M. W. (2010). Diabetic retinopathy: Early diagnosis and effective treatment. Deutsches Arzteblatt international, 107(5), 75–84. https://doi.org/10.3238/arztebl.2010.0075
U.S. Department of Health and Human Services. (n.d.). Get a dilated eye exam. National Eye Institute. https://www.nei.nih.gov/learn-about-eye-health/healthy-vision/get-dilated-eye-exam
NHS. (n.d.). Diabetic Retinopathy. NHS choices. https://www.nhs.uk/conditions/diabetic-retinopathy/treatment/
A randomized trial comparing intravitreal triamcinolone acetonide and focal/grid photocoagulation for diabetic macular edema. (2008). Ophthalmology, 115(9). https://doi.org/10.1016/j.ophtha.2008.06.015
Waisbourd, M., Goldstein, M., & Loewenstein, A. (2010). Treatment of diabetic retinopathy with anti‐VEGF drugs. Acta Ophthalmologica, 89(3), 203–207. https://doi.org/10.1111/j.1755-3768.2010.02010.x
Hicks, C. W., & Selvin, E. (2019). Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Current diabetes reports, 19(10), 86. https://doi.org/10.1007/s11892-019-1212-8
Mayo Foundation for Medical Education and Research. (n.d.). Diabetic neuropathy. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580
American Diabetes Association; Standards of Medical Care in Diabetes—2011. Diabetes Care 1 January 2011; 34 (Supplement_1): S11–S61. https://doi.org/10.2337/dc11-S011
Deli, G., Bosnyak, E., Pusch, G., Komoly, S., & Feher, G. (2013). Diabetic neuropathies: Diagnosis and management. Neuroendocrinology, 98(4), 267–280. https://doi.org/10.1159/000358728
Oyer, D. S., Saxon, D., & Shah, A. (2007). Quantitative assessment of diabetic peripheral neuropathy with use of the clanging tuning fork test. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 13(1), 5–10. https://doi.org/10.4158/EP.13.1.5
Apfel S. C. (2002). Nerve growth factor for the treatment of diabetic neuropathy: what went wrong, what went right, and what does the future hold?. International review of neurobiology, 50, 393–413. https://doi.org/10.1016/s0074-7742(02)50083-0
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