Is the ADA/EASD algorithm for the management of type 2 diabetes (January 2009) based on evidence or opinion? A critical analysis

2010

The ADA and the EASD recently published a consensus statement for the medical management of hyperglycaemia in patients with type 2 diabetes. The authors advocate initial treatment with metformin monotherapy and lifestyle modification, followed by addition of basal insulin or a sulfonylurea if glycaemic goals are not met (tier 1 recommendations). All other glucose-lowering therapies are relegated to a secondary (tier 2) status and only recommended for selected clinical settings. In our view, this algorithm does not offer physicians and patients the appropriate selection of options to individualise and optimise care with a view to sustained control of blood glucose and reduction both of diabe…

The Relationship between COVID-19 and Hypothalamic-Pituitary-Adrenal Axis: A Large Spectrum from Glucocorticoid Insufficiency to Excess-The CAPISCO I…

2022

Coronavirus disease 2019 (COVID-19) is a highly heterogeneous disease regarding severity, vulnerability to infection due to comorbidities, and treatment approaches. The hypothalamic–pituitary–adrenal (HPA) axis has been identified as one of the most critical endocrine targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that might significantly impact outcomes after infection. Herein we review the rationale for glucocorticoid use in the setting of COVID-19 and emphasize the need to have a low index of suspicion for glucocorticoid-induced adrenal insufficiency, adjusting for the glucocorticoid formulation used, dose, treatment duration, and underlying health problems. We a…

Erratum to: Is the ADA/EASD algorithm for the management of type 2 diabetes (January 2009) based on evidence or opinion? A critical analysis

2010

Glycemic Variability, Glycated Hemoglobin, and Cardiovascular Complications: Still a Dilemma in Clinical Practice

2021

COVID-19 and diabetes management: What should be considered?

2020

Promoting a Syndemic Approach for Cardiometabolic Disease Management During COVID-19: The CAPISCO International Expert Panel

2021

Efforts in the fight against COVID-19 are achieving success in many parts of the world, although progress remains slow in other regions. We believe that a syndemic approach needs to be adopted to address this pandemic given the strong apparent interplay between COVID-19, its related complications, and the socio-structural environment. We have assembled an international, multidisciplinary group of researchers and clinical practitioners to promote a novel syndemic approach to COVID-19: the CArdiometabolic Panel of International experts on Syndemic COvid-19 (CAPISCO). This geographically diverse group aims to facilitate collaborative-networking and scientific exchanges between researchers and …

Death by SARS-CoV 2: a Romanian COVID-19 multi-centre comorbidity study

2020

AbstractEvidence regarding the relation between SARS-CoV-2 mortality and the underlying medical condition is scarce. We conducted an observational, retrospective study based on Romanian official data about location, age, gender and comorbidities for COVID-19 fatalities. Our findings indicate that males, hypertension, diabetes, obesity and chronic kidney disease were most frequent in the COVID-19 fatalities, that the burden of disease was low, and that the prognosis for 1-year survival probability was high in the sample. Evidence shows that age-dependent pairs of comorbidities could be a negative prognosis factor for the severity of disease for the SARS-CoV 2 infection.

Post-COVID syndrome, inflammation, and diabetes

2022

The raging COVID-19 pandemic is in its third year of global impact. The SARS CoV 2 virus has a high rate of spread, protean manifestations, and a high morbidity and mortality in individuals with predisposing risk factors. The pathophysiologic mechanisms involve a heightened systemic inflammatory state, cardiometabolic derangements, and varying degrees of glucose intolerance. The latter can be evident as significant hyperglycemia leading to new -onset diabetes or worsening of preexisting disease. Unfortunately, the clinical course beyond the acute phase of the illness may persist in the form of a variety of symptoms that together form the so-called "Long COVID" or "Post-COVID Syndrome". It i…

40(th) EASD Annual Meeting of the European Association for the Study of Diabetes : Munich, Germany, 5-9 September 2004

2004

Diabetes and renin-angiotensin-aldosterone system: Implications for covid-19 patients with diabetes treatment management

2020

In the context of the COVID-19 continuous spreading, this paper focuses on the increased risk of diabetic patients regarding the metabolic control and the uncertainties related to SARS-CoV-2 infection. Chronic hyperglycaemia negatively affects the immune system, which triggers an increase of morbidity and mortality for viral infections. A key aspect of COVID-19 resides in the involvement of renin-angiotensin-aldosterone (RAAS) system that causes a cascade of reactions mediated by vasoactive peptides with implications in vasoconstriction, vascular permeability, oxidative stress remodelling and tissue injuries. Activation of RAAS at pulmonary level, is responsible for the local damage. Many q…

Liraglutide improves metabolic parameters and carotid intima-media thickness in diabetic patients with the metabolic syndrome: an 18-month prospectiv…

2016

Abstract Background Liraglutide, a GLP-1 analogue, exerts several beneficial non-glycemic effects in patients with type-2 diabetes (T2DM), such as those on body weight, blood pressure, plasma lipids and inflammation markers. However, the effects of liraglutide on cardiovascular (CV) risk markers in subjects with the metabolic syndrome (MetS) are still largely unknown. We herein explored its effects on various cardio-metabolic risk markers of the MetS in subjects with T2DM. Methods We performed an 18-month prospective, real-world study. All subjects had T2DM and the MetS based on the AHA/NHLBI criteria. Subjects with a history of a major CV event were excluded. One hundred-twenty-one subject…

Molecular and pro-inflammatory aspects of COVID-19: The impact on cardiometabolic health

2022

Obesity, type 2 diabetes (T2DM), hypertension (HTN), and Cardiovascular Disease (CVD) often cluster together as "Cardiometabolic Disease" (CMD). Just under 50% of patients with CMD increased the risk of morbidity and mortality right from the beginning of the COVID-19 pandemic as it has been reported in most countries affected by the SARS-CoV2 virus. One of the pathophysiological hallmarks of COVID-19 is the overactivation of the immune system with a prominent IL-6 response, resulting in severe and systemic damage involving also cytokines such as IL2, IL4, IL8, IL10, and interferon-gamma were considered strong predictors of COVID-19 severity. Thus, in this mini-review, we try to describe the…

Additional file 1: of Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

2018

Table S1. Clinical characteristics of patients at baseline and at 4-year grouped by of basal GFR. (DOCX 20 kb)

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

2018

Background Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohort of patients affected by T1DM. Methods A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici D…

Additional file 2: of Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

2018

Table S2. Baseline clinical characteristics of patients grouped by eGFR and albuminuria. (DOCX 19 kb)

The Dual Pandemics of COVID-19 and Obesity: Bidirectional Impact

2022

: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the COVID-19 pandemic, has been shown to disrupt many organ systems in the human body. Though several medical disorders have been affected by this infection, a few illnesses in addition may also play a role in determining the outcome of COVID-19. Obesity is one such disease which is not only affected by the occurrence of COVID-19 but can also result in a worse clinical outcome of COVID-19 infection. This manuscript summarizes the most recent evidence supporting the bidirectional impact of COVID-19 and obesity. It highlights how the presence of obesity can be detrimental to the outcome of COVID-19 in a given …

Data on the age, sex, comorbidities, and location of the COVID-19 fatalities in Romania

2021

This dataset consists of 2 .xlsx spreadsheet and 1 .Rmd R markdown file. These data underlie the related manuscript: "Death by SARS-CoV 2 - a Romanian COVID-19 multi-centre comorbidity study".The related study investigated the relationship between SARS-CoV-2 mortality and underlying medical conditions via an observational, retrospective study based on Romanian official data about location, age, sex and comorbidities for COVID-19 fatalities.The data files are as follows:- Pantea Stoian et al Death by SARS-CoV 2 -PneumoniaCOVID19_data.xlsx: This spreadsheet contains all the data on COVID-19 comorbidities gathered in the related study. The data are de-identified to protect patient privacy.- De…