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Diabetes Mellitus: Type 2 and Gestational01:22

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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The prognostic impact of insulin resistance surrogates in patients with acute myocardial infarction with and without

Dominika Rokicka1, Bartosz Hudzik2,3, Marta Wróbel4

  • 1Department of Internal Medicine, Diabetology and Cardiometabolic Disorders, Faculty of Medical Sciences Zabrze , Medical University of Silesia, Katowice, ul. M. Curie-Skłodowskiej 9, 41-800, Zabrze, Poland. dominika.rokicka@poczta.fm.

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Summary

The triglycerides and glucose index (TyG index) is an independent risk factor for in-hospital death after myocardial infarction (MI). However, TyG index, TyG-BMI, and METS-IR show limited predictive value for long-term major adverse cardiac and cerebrovascular events (MACCE).

Keywords:
In-hospital deathMACCEMETS-IRNSTEMISTEMITyG indexTyg-BMIType 2 diabetes mellitus

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Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Cardiovascular disease (CVD) is a leading cause of death, especially in type 2 diabetes mellitus (T2DM).
  • Insulin resistance and atherosclerosis progression are critical factors in CVD development.
  • Novel markers like the triglycerides and glucose index (TyG index), TyG-BMI, and METS-IR are being investigated for their prognostic value.

Purpose of the Study:

  • To assess the risk of in-hospital death and major adverse cardiac and cerebrovascular events (MACCE) up to 12 months post-myocardial infarction (MI).
  • To evaluate the prognostic significance of TyG index, TyG-BMI, and METS-IR in patients with and without T2DM.
  • To determine if these markers are independent risk factors for adverse outcomes after ST-segment elevation MI (STEMI) and non-STEMI (NSTEMI).

Main Methods:

  • Retrospective analysis of 1706 patients with STEMI and NSTEMI hospitalized between 2013 and 2021.
  • Analysis of the prognostic value of TyG index, TyG-BMI, and METS-IR for in-hospital death and MACCE (including death, MI, stroke, revascularization) within 12 months.
  • Comparison of outcomes and marker levels between patients with and without T2DM.

Main Results:

  • MACCE occurred more frequently in patients with T2DM (25.8%) compared to those without (14.4%).
  • TyG index, TyG-BMI, and METS-IR were significantly higher in patients with T2DM.
  • The TyG index demonstrated an area under the ROC curve (AUC-ROC) of 0.69 for predicting in-hospital death, while METS-IR had an AUC-ROC of 0.682.

Conclusions:

  • The TyG index is an independent risk factor for in-hospital death in patients with STEMI or NSTEMI.
  • TyG index, TyG-BMI, and METS-IR were not found to be independent risk factors for MACCE at 12-month follow-up.
  • These markers exhibit low predictive value for MACCE within 12 months post-MI.