Diabetes associated complicated disorders and its treatment a review article
Abstract
Type 2 diabetes mellitus is increasingly prevalent in the worldwide and is associated with significant morbidity, mortality, and rising health care costs. Microvascular and, to a lesser extent, macrovascular complications are recognized to result from uncontrolled hyperglycemia. However, intensive therapy to achieve normal glucose levels is not without risk, as demonstrated by increased rates of hypoglycemia, weight gain, and all-cause mortality rates in the intensive treatment arm of the ACCORD trial. In addition, observational studies indicate that the presence of diabetes increases the risk of other comorbidities such as fracture and certain cancers, and treatment choice may affect risk. Thus, in an effort to maintain glucose control, the clinician encounters a complex interplay of primary disease management while simultaneously seeking to avoid complications associated with glucose lowering. The chronic nature of diabetes management, efficacy must be balanced against side effects to achieve a tolerable long-term regimen. The goal of this concept is to identify complications of non-insulin treatment of diabetes. The major classes of medication should be reviewed with special attention given to patient considerations, mechanism of action, effect on weight, and cardiovascular outcomes, and additional class-specific side effects including effects on bone. In addition, effects on β-cell function are rectified. It is possible to identify diabetes mellitus risk years or decades in advance on the basis of numerous personal, historic, and laboratory measures and user-friendly clinical decision-support tool to estimate absolute risk for individuals. The patient families, communities, and health organizations should encourage healthy eating and physical activity and should focus the most intensive diabetes mellitus prevention efforts on those at highest risk for progression to diabetes mellitus.
Keywords:
Type 2 diabetes mellitus, uncontrolled hyperglycemia, microvascular and macrovascular complications disease management, glucose controlDOI
https://doi.org/10.37022/wjcmpr.v5i4.274References
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3. Shuldiner A. R., Yang R., Gong D.-W. Resistin, obesity, and insulin resistance — the emerging role of the adipocyte as an endocrine organ. The New England Journal of Medicine. 2001;345(18):1345–1346.
4. Mazidi M., Toth P. P., Banach M. C-reactive protein is associated with prevalence of the metabolic syndrome, hypertension, and diabetes mellitus in US adults. Angiology. 2017;(article 331971772928).
5. Niyitegeka J.-M. V., Bastidas A. C., Newman R. H., Taylor S. S., Ongeri E. M. Isoform-specific interactions between meprin metalloproteases and the catalytic subunit of protein kinase A: significance in acute and chronic kidney injury. American Journal of Physiology Renal Physiology. 2015;308(1):F56–F68.
6. Brownrigg J. R. W., Schaper N. C., Hinchliffe R. J. Diagnosis and assessment of peripheral arterial disease in the diabetic foot. Diabetic Medicine. 2015;32(6):738–747.
7. Goto A., Arah O. A., Goto M., Terauchi Y., Noda M. Severe hypoglycaemia and cardiovascular disease: systematic review and meta-analysis with bias analysis. BMJ. 2013;347, article f4533.
8. Peppa M., Stavroulakis P., Raptis S. A. Advanced glycoxidation products and impaired diabetic wound healing. Wound Repair and Regeneration. 2009;17(4):461–472.
9. Li L., Wan X., Zhao G. Meta-analysis of the risk of cataract in type 2 diabetes. BMC Ophthalmology. 2014;14(1):p. 94.
10. Susmitha U, Kavitha R, Amareswarapu VS, Kiran Y, Mohammed G, Sriram N, Prasad PN. Effect of Pisonia Alba Root Extract On Cafeteria Diet-Induced Obesity In Rats. Journal of Pharmaceutical Negative Results. 2022 Dec. 1 [cited 2023 Feb. 15]; 3732-9. Schulz LO, Bennett PH, Ravussin E, et al. Effects of traditional and western environments on prevalence of type 2 diabetes in Pima Indians in Mexico and the U.S. Diabetes Care. 2006;29:1866–1871.
11. Kaye SA, Folsom AR, Sprafka JM, et al. Increased incidence of diabetes mellitus in relation to abdominal adiposity in older women. J Clin Epidemiol. 1991;44:329–334.
12. Jeon CY, Lokken RP, Hu FB, van Dam RM. Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Diabetes Care. 2007;30:744–752.
13. Will JC, Galuska DA, Ford ES, et al. Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study. Int J Epidemiol. 2001;30:540–546.
14. Strodl E, Kenardy J. Psychosocial and non-psychosocial risk factors for the new diagnosis of diabetes in elderly women. Diabetes Res Clin Pract. 2006;74:57–65.
15. Eaton WW, Armenian H, Gallo J, et al. Depression and risk for onset of type II diabetes: a prospective population-based study. Diabetes Care. 1996;19:1097–1102.
16. Arroyo C, Hu FB, Ryan LM, et al. Depressive symptoms and risk of type 2 diabetes in women. Diabetes Care. 2004;27:129–133.
17. Grandinetti A, Kaholokula JK, Chang HK. Delineating the relationship between stress, depressive symptoms, and glucose intolerance. Diabetes Care. 2000;23:1443–1444.
18. Diez Roux AV, Jacobs DR, Kiefe CI. Neighborhood characteristics and components of the insulin resistance syndrome in young adults: the coronary artery risk development in young adults (CARDIA) study. Diabetes Care. 2002;25:1976–1982.
19. Schootman M, Andresen EM, Wolinsky FD, et al. The effect of adverse housing and neighborhood conditions on the development of diabetes mellitus among middle-aged African Americans. Am J Epidemiol. 2007;166:379–387.
20. Kirkness CS, Marcus RL, LaStayo PC, et al. Diabetes and associated risk factors in patients referred for physical therapy in a national primary care electronic medical record database. Phys Ther. 2008;88:1408–1416.
21. Andersen AR, Christiansen JS, Andersen JK, et al. Diabetic nephropathy in type 1 (insulin-dependent) diabetes: an epidemiological study. Diabetologia. 1983;25:496–501.
22. Kofoed-Enevoldsen A, Borch-Johnsen K, Kreiner S, et al. Declining incidence of persistent proteinuria in type I (insulin-dependent) diabetic patients in Denmark. Diabetes. 1987;36:205–209.
23. Bojestig M, Arnqvist HJ, Hermansson G, et al. Declining incidence of nephropathy in insulin-dependent diabetes mellitus. N Engl J Med. 1994;330:15–18.
24. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4–7 yr before clinical diagnosis. Diabetes Care. 1992;15:815–819.
25. Gall MA, Rossing P, Skøtt P, et al. Prevalence of micro- and macroalbuminuria, arterial hypertension, retinopathy and large vessel disease in European type 2 (non-insulin-dependent) diabetic patients. Diabetologia. 1991;34:655–661.
26. Feldt-Rasmussen B, Mathiesen ER, Deckert T. Effect of two years of strict metabolic control on progression of incipient nephropathy in insulin-dependent diabetes. Lancet. 1986;2:1300–1304.
27. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–986.
28. Wang PH, Lau J, Chalmers TC. Meta-analysis of effects of intensive blood-glucose control on late complications of type I diabetes. Lancet. 1993;341:1306–1309.
29. Mogensen CE. Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy. Br Med J (Clin Res Ed). 1982;285:685–688.
30. Tull ES, Roseman JM. Diabetes in African Americans. In: Harris MI, Cowie CC, Stern MP, et al, eds. Diabetes in America. 2nd ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995:613–630. NIH publication 95-1468.
31. Welborn T. Diabetes mortality. In: Ekoé JM, Zimmet P, Williams R, eds. The Epidemiology of Diabetes Mellitus: An International Perspective. Chichester, United Kingdom: John Wiley & Sons Ltd; 2001:369–382.
32. Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993;16:434–444.
33. Geiss LS, Herman WH, Smith PJ. Mortality in non-insulin-dependent diabetes. In: Harris MI, Cowie CC, Stern MP, et al, eds. Diabetes in America. 2nd ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995:233–257. NIH publication 95-1468.
34. Fox CS, Coady S, Sorlie PD, et al. Trends in cardiovascular complications of diabetes. JAMA. 2004;292:2495–2499.
35. Booth GL, Kapral MK, Fung K, Tu JV. Recent trends in cardiovascular complications among men and women with and without diabetes. Diabetes Care. 2006;29:32–37.
36. Cade WT. Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Phys Ther. 2008;88:1322–1335.
37. Jermendy G, Ruggenenti P. Preventing microalbuminuria in patients with type 2 diabetes. Diabetes Metab Res Rev. 2007;23:100–110.
38. Chaturvedi N. The burden of diabetes and its complications: trends and implications for intervention. Diabetes Res Clin Pract. 2007;76(suppl 1):S3–S12.
39. Hovind P, Tarnow L, Rossing K, et al. Decreasing incidence of severe diabetic microangiopathy in type 1 diabetes. Diabetes Care. 2003;26:1258–1264.
40. Candrilli SD, Davis KL, Kan HJ, et al. Prevalence and the associated burden of illness of symptoms of diabetic peripheral neuropathy and diabetic retinopathy. J Diabetes Complications. 2007;21:306–314.
41. Gregg EW, Sorlie P, Paulose-Ram R, et al. Prevalence of lower-extremity disease in the US adult population ≥40 years of age with and without diabetes: 1999–2000 national health and nutrition examination survey. Diabetes Care. 2004;27:1591–1597.
42. Pirart J. Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973 [in French]. Diabetes Metab. 1977;3:97–107.
43. Adler AI, Boyko EJ, Ahroni JH, et al. Risk factors for diabetic peripheral sensory neuropathy: results of the Seattle Prospective Diabetic Foot Study. Diabetes Care. 1997;20:1162–1167.
44. Tesfaye S, Chaturvedi N, Eaton SE, et al; EURODIAB Prospective Complications Study Group. Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005;352:341–350.
45. Sinacore DR, Hastings MK, Bohnert KL, et al. Inflammatory osteolysis in diabetic neuropathic (Charcot) arthropathies of the foot. Phys Ther. 2008;88:1399–1407.
46. Hilton TN, Tuttle LJ, Bohnert KL, et al. Excessive adipose tissue infiltration in skeletal muscle in individuals with obesity, diabetes mellitus, and peripheral neuropathy: association with performance and function. Phys Ther. 2008;88:1336–1344.
47. Sugarman JR, Reiber GE, Baumgardner G, et al. Use of the therapeutic footwear benefit among diabetic Medicare beneficiaries in three states, 1995. Diabetes Care. 1998;21:777–781.
48. Reiber GE, Boyko EJ, Smith DG. Lower extremity foot ulcers and amputation in diabetes. In: Harris MI, Cowie CC, Stern MP, et al, eds. Diabetes in America. 2nd ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995:409–428. NIH publication 95-1468.
49. Larsson J, Agardh CD, Apelqvist J, Stenström A. Long-term prognosis after healed amputation in patients with diabetes. Clin Orthop Relat Res. 1998;350:149–158.
2. Scott A., Chambers D., Goyder E., O’Cathain A. Socioeconomic inequalities in mortality, morbidity and diabetes management for adults with type 1 diabetes: a systematic review. PLoS One. 2017;12(5, article e0177210)
3. Shuldiner A. R., Yang R., Gong D.-W. Resistin, obesity, and insulin resistance — the emerging role of the adipocyte as an endocrine organ. The New England Journal of Medicine. 2001;345(18):1345–1346.
4. Mazidi M., Toth P. P., Banach M. C-reactive protein is associated with prevalence of the metabolic syndrome, hypertension, and diabetes mellitus in US adults. Angiology. 2017;(article 331971772928).
5. Niyitegeka J.-M. V., Bastidas A. C., Newman R. H., Taylor S. S., Ongeri E. M. Isoform-specific interactions between meprin metalloproteases and the catalytic subunit of protein kinase A: significance in acute and chronic kidney injury. American Journal of Physiology Renal Physiology. 2015;308(1):F56–F68.
6. Brownrigg J. R. W., Schaper N. C., Hinchliffe R. J. Diagnosis and assessment of peripheral arterial disease in the diabetic foot. Diabetic Medicine. 2015;32(6):738–747.
7. Goto A., Arah O. A., Goto M., Terauchi Y., Noda M. Severe hypoglycaemia and cardiovascular disease: systematic review and meta-analysis with bias analysis. BMJ. 2013;347, article f4533.
8. Peppa M., Stavroulakis P., Raptis S. A. Advanced glycoxidation products and impaired diabetic wound healing. Wound Repair and Regeneration. 2009;17(4):461–472.
9. Li L., Wan X., Zhao G. Meta-analysis of the risk of cataract in type 2 diabetes. BMC Ophthalmology. 2014;14(1):p. 94.
10. Susmitha U, Kavitha R, Amareswarapu VS, Kiran Y, Mohammed G, Sriram N, Prasad PN. Effect of Pisonia Alba Root Extract On Cafeteria Diet-Induced Obesity In Rats. Journal of Pharmaceutical Negative Results. 2022 Dec. 1 [cited 2023 Feb. 15]; 3732-9. Schulz LO, Bennett PH, Ravussin E, et al. Effects of traditional and western environments on prevalence of type 2 diabetes in Pima Indians in Mexico and the U.S. Diabetes Care. 2006;29:1866–1871.
11. Kaye SA, Folsom AR, Sprafka JM, et al. Increased incidence of diabetes mellitus in relation to abdominal adiposity in older women. J Clin Epidemiol. 1991;44:329–334.
12. Jeon CY, Lokken RP, Hu FB, van Dam RM. Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Diabetes Care. 2007;30:744–752.
13. Will JC, Galuska DA, Ford ES, et al. Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study. Int J Epidemiol. 2001;30:540–546.
14. Strodl E, Kenardy J. Psychosocial and non-psychosocial risk factors for the new diagnosis of diabetes in elderly women. Diabetes Res Clin Pract. 2006;74:57–65.
15. Eaton WW, Armenian H, Gallo J, et al. Depression and risk for onset of type II diabetes: a prospective population-based study. Diabetes Care. 1996;19:1097–1102.
16. Arroyo C, Hu FB, Ryan LM, et al. Depressive symptoms and risk of type 2 diabetes in women. Diabetes Care. 2004;27:129–133.
17. Grandinetti A, Kaholokula JK, Chang HK. Delineating the relationship between stress, depressive symptoms, and glucose intolerance. Diabetes Care. 2000;23:1443–1444.
18. Diez Roux AV, Jacobs DR, Kiefe CI. Neighborhood characteristics and components of the insulin resistance syndrome in young adults: the coronary artery risk development in young adults (CARDIA) study. Diabetes Care. 2002;25:1976–1982.
19. Schootman M, Andresen EM, Wolinsky FD, et al. The effect of adverse housing and neighborhood conditions on the development of diabetes mellitus among middle-aged African Americans. Am J Epidemiol. 2007;166:379–387.
20. Kirkness CS, Marcus RL, LaStayo PC, et al. Diabetes and associated risk factors in patients referred for physical therapy in a national primary care electronic medical record database. Phys Ther. 2008;88:1408–1416.
21. Andersen AR, Christiansen JS, Andersen JK, et al. Diabetic nephropathy in type 1 (insulin-dependent) diabetes: an epidemiological study. Diabetologia. 1983;25:496–501.
22. Kofoed-Enevoldsen A, Borch-Johnsen K, Kreiner S, et al. Declining incidence of persistent proteinuria in type I (insulin-dependent) diabetic patients in Denmark. Diabetes. 1987;36:205–209.
23. Bojestig M, Arnqvist HJ, Hermansson G, et al. Declining incidence of nephropathy in insulin-dependent diabetes mellitus. N Engl J Med. 1994;330:15–18.
24. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4–7 yr before clinical diagnosis. Diabetes Care. 1992;15:815–819.
25. Gall MA, Rossing P, Skøtt P, et al. Prevalence of micro- and macroalbuminuria, arterial hypertension, retinopathy and large vessel disease in European type 2 (non-insulin-dependent) diabetic patients. Diabetologia. 1991;34:655–661.
26. Feldt-Rasmussen B, Mathiesen ER, Deckert T. Effect of two years of strict metabolic control on progression of incipient nephropathy in insulin-dependent diabetes. Lancet. 1986;2:1300–1304.
27. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–986.
28. Wang PH, Lau J, Chalmers TC. Meta-analysis of effects of intensive blood-glucose control on late complications of type I diabetes. Lancet. 1993;341:1306–1309.
29. Mogensen CE. Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy. Br Med J (Clin Res Ed). 1982;285:685–688.
30. Tull ES, Roseman JM. Diabetes in African Americans. In: Harris MI, Cowie CC, Stern MP, et al, eds. Diabetes in America. 2nd ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995:613–630. NIH publication 95-1468.
31. Welborn T. Diabetes mortality. In: Ekoé JM, Zimmet P, Williams R, eds. The Epidemiology of Diabetes Mellitus: An International Perspective. Chichester, United Kingdom: John Wiley & Sons Ltd; 2001:369–382.
32. Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993;16:434–444.
33. Geiss LS, Herman WH, Smith PJ. Mortality in non-insulin-dependent diabetes. In: Harris MI, Cowie CC, Stern MP, et al, eds. Diabetes in America. 2nd ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995:233–257. NIH publication 95-1468.
34. Fox CS, Coady S, Sorlie PD, et al. Trends in cardiovascular complications of diabetes. JAMA. 2004;292:2495–2499.
35. Booth GL, Kapral MK, Fung K, Tu JV. Recent trends in cardiovascular complications among men and women with and without diabetes. Diabetes Care. 2006;29:32–37.
36. Cade WT. Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Phys Ther. 2008;88:1322–1335.
37. Jermendy G, Ruggenenti P. Preventing microalbuminuria in patients with type 2 diabetes. Diabetes Metab Res Rev. 2007;23:100–110.
38. Chaturvedi N. The burden of diabetes and its complications: trends and implications for intervention. Diabetes Res Clin Pract. 2007;76(suppl 1):S3–S12.
39. Hovind P, Tarnow L, Rossing K, et al. Decreasing incidence of severe diabetic microangiopathy in type 1 diabetes. Diabetes Care. 2003;26:1258–1264.
40. Candrilli SD, Davis KL, Kan HJ, et al. Prevalence and the associated burden of illness of symptoms of diabetic peripheral neuropathy and diabetic retinopathy. J Diabetes Complications. 2007;21:306–314.
41. Gregg EW, Sorlie P, Paulose-Ram R, et al. Prevalence of lower-extremity disease in the US adult population ≥40 years of age with and without diabetes: 1999–2000 national health and nutrition examination survey. Diabetes Care. 2004;27:1591–1597.
42. Pirart J. Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973 [in French]. Diabetes Metab. 1977;3:97–107.
43. Adler AI, Boyko EJ, Ahroni JH, et al. Risk factors for diabetic peripheral sensory neuropathy: results of the Seattle Prospective Diabetic Foot Study. Diabetes Care. 1997;20:1162–1167.
44. Tesfaye S, Chaturvedi N, Eaton SE, et al; EURODIAB Prospective Complications Study Group. Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005;352:341–350.
45. Sinacore DR, Hastings MK, Bohnert KL, et al. Inflammatory osteolysis in diabetic neuropathic (Charcot) arthropathies of the foot. Phys Ther. 2008;88:1399–1407.
46. Hilton TN, Tuttle LJ, Bohnert KL, et al. Excessive adipose tissue infiltration in skeletal muscle in individuals with obesity, diabetes mellitus, and peripheral neuropathy: association with performance and function. Phys Ther. 2008;88:1336–1344.
47. Sugarman JR, Reiber GE, Baumgardner G, et al. Use of the therapeutic footwear benefit among diabetic Medicare beneficiaries in three states, 1995. Diabetes Care. 1998;21:777–781.
48. Reiber GE, Boyko EJ, Smith DG. Lower extremity foot ulcers and amputation in diabetes. In: Harris MI, Cowie CC, Stern MP, et al, eds. Diabetes in America. 2nd ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995:409–428. NIH publication 95-1468.
49. Larsson J, Agardh CD, Apelqvist J, Stenström A. Long-term prognosis after healed amputation in patients with diabetes. Clin Orthop Relat Res. 1998;350:149–158.
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2023-07-22
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Diabetes associated complicated disorders and its treatment a review article. World Journal of Current Med and Pharm Research [Internet]. 2023 Jul. 22 [cited 2026 Jan. 27];5(4):99-106. Available from: https://www.wjcmpr.org/index.php/journal/article/view/274
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How to Cite
1.
Diabetes associated complicated disorders and its treatment a review article. World Journal of Current Med and Pharm Research [Internet]. 2023 Jul. 22 [cited 2026 Jan. 27];5(4):99-106. Available from: https://www.wjcmpr.org/index.php/journal/article/view/274
