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  • 1
    In: Diabetes, American Diabetes Association, Vol. 69, No. Supplement_1 ( 2020-06-01)
    Abstract: Aim: The aim of the study was to assess vitamin D status in patients with type 2 diabetes (T2D) and diabetic foot ulcers (DFU). Material and Methods: A total of 224 patients with T2D, mean age 59.2±10.1 years, BMI 31.5±6.3 kg/m2 and eGFR ≥ 45 ml/min/1.73m2, not on vitamin D supplementation, were enrolled in a cross-sectional study. Subjects were divided in two groups - with DFU (n=61) and non-DFU (n=163). The non-DFU group was subdivided into groups with peripheral neuropathy (n=106) and without any complications (n=57). Neuropathy was assessed by standard clinical tests (10g monofilament and 128 Hz tuning fork). Serum 25(OH)D was assessed by ELISA method. Results: 25(OH)D level was 12.7 ng/ml (IQR 9.35-18.1 ng/ml) in the studied cohort, which is below the sufficient range (sufficient & gt; 30 ng/ml; insufficiency - 20-30 ng/ml; deficiency 10-20 ng/ml, severe deficiency & lt; 10 ng/ml). The DFU group presented with significantly lower 25(OH)D level as compared to non-DFU group, 12.08 ng/ml (IQR 8.5-15.5 ng/ml) vs. 13.50 ng/ml (IQR 9.6-18.6 ng/ml), p=0.006; 86% of DFU patients being with vitamin D deficiency and severe deficiency. There was no difference in diabetes duration (p=0.096), whereas there was a significant difference in eGFR in DFU group as compared to non-DFU group (81±20 ml/min/1.73m² vs. 89±19 ml/min/1.73m², p=0.008). No relationship was established between 25(OH)D levels and BMI in both groups. The subanalysis of non-DFU group demonstrated significantly lower 25(OH)D level in patients with peripheral neuropathy as compared to patients without any complications - 12.5 ng/ml (IQR 9-17 ng/ml) vs. 16.2 ng/ml (IQR 10-21 ng/ml), p=0.027. There was no difference in serum calcium levels between the different groups. Conclusion: Patients with DFU and diabetic neuropathy are at higher risk of low 25(OH)D levels probably because of poor self-care and less sunlight exposure. Therefore, this population should be screened for vitamin D deficiency as it may lead to poor wound healing. Disclosure A.S. Todorova: None. R. Dimova: Consultant; Self; Amgen, Boehringer Ingelheim International GmbH. Speaker’s Bureau; Self; Sanofi, Wörwag Pharma. N. Chakarova: None. M. Serdarova: None. G. Grozeva-Damyanova: None. P. Tsarkova: None. T. Tankova: Board Member; Self; Amgen, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mundipharma International, Novo Nordisk A/S, Sanofi. Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Sanofi, Servier. E.B. Jude: Speaker’s Bureau; Self; AstraZeneca, Novo Nordisk Inc., Sanofi. Other Relationship; Self; Lilly Diabetes, Menarini Group.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2020
    detail.hit.zdb_id: 1501252-9
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  • 2
    In: Diabetes, American Diabetes Association, Vol. 69, No. Supplement_1 ( 2020-06-01)
    Abstract: Aim: The present study assesses the relation between uric acid and cardiovascular autonomic function (CAF), blood pressure (BR) and visceral obesity at early stages of glucose intolerance. Material and Methods: A total of 100 subjects - 50 males, mean age 47.4±14.2years, mean BMI 32.2±7.5kg/m2, divided into 3 groups according to glucose tolerance: 30 subjects with normal glucose tolerance (NGT), 37 with prediabetes and 33 with type 2 diabetes (T2D) with duration ≤5 years were included. Glucose tolerance was assessed by OGTT according to WHO 2006 criteria. Anthropometric indices, BP, HbA1c and plasma glucose were measured. Body fat distribution was estimated by a bioimpedance method (InBody 720, BioSpace). CAF was assessed by ANX-3.0 using frequency-domain analysis during standard clinical tests. Results: Uric acid levels were higher in prediabetes and T2D (p & lt;0.0001 and p=0.004, respectively) as compared to NGT. There was a decreased parasympathetic tone at rest (p=0.026 and p=0.001, respectively), deep breathing (p=0.025 and p=0.003, respectively), Valsalva maneuver (p=0.023 and p=0.003, respectively) and standing (p=0.012 and p=0.002, respectively) test in T2D in comparison to prediabetes and NGT. Sympathetic tone was diminished at rest (p=0.004), deep breathing (p=0.040) and standing (p=0.016) test in T2D as compared to NGT. Uric acid positively correlated with waist circumference (r=44, p & lt;0.0001), visceral fat area (r=24, p=0.022), diastolic BP (r=0.023) and HbA1c (r=22, p=0.030); and negatively with sympathetic activity at rest (r=-23, p=0.024), deep breathing (r=-26, p=0.010) and standing (r=-21, 0=0.039) test and with parasympathetic activity during deep breathing test (r=-21, p=0.033). Conclusions: It seems to be an increase in uric acid levels and a decline in CAF in prediabetes and T2D with short duration. Uric acid is probably associated with CAF, visceral obesity and BP at early stages of dysglycaemia. Disclosure R. Dimova: Consultant; Self; Amgen, Boehringer Ingelheim International GmbH. Speaker’s Bureau; Self; Sanofi, Wörwag Pharma. N. Chakarova: None. G. Grozeva-Damyanova: None. T. Tankova: Board Member; Self; Amgen, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mundipharma International, Novo Nordisk A/S, Sanofi. Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Sanofi, Servier.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2020
    detail.hit.zdb_id: 1501252-9
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
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