Active clinical trials for "Diabetes Mellitus, Type 2"

Glucagon like peptides receptors expression in the stomach of diabetes type 2 Glucagon like peptides (GLP-1, GLP-2), are hormones secreted by L cells located along the gastrointestinal tract. These hormones are secreted after meals and have some roles in regulating the digestion process, absorption, and sending signals to the brain that regulate food consumption. GLP peptides affect peripheral targets and have an important homeostatic role. GLP-1 decreases the circulatory glucose level and GLP-2 has trophic effects which enable adequate intestine growth. We aimed in our study to investigate the GLP-1 and GLP-2 receptor expression in different zones of the stomach in diabetes type 2 patients. If there are differences, it might explain the pathological gastric emptying in these patients. Understanding the function of these peptides may lead to new therapeutic options for diabetic patients with delayed gastric emptying. Methods: 20 diabetes type 2 patients with symptoms that need upper endoscopy will be included in the study and 20 controls aged 18-70 years. Patients with neurological disease will be excluded. During esophagogastroduodenoscopy 3 biopsies will be taken from the antrum, corpus and cardia. The biopsies will be stored in -70. After RNA extraction the GLP receptors expression will established by real time PCR method. Patients with different expression compared to control will undergo isotopic scan for gastric emptying.

Rationale: The global prevalence of diabetes, along with its devastating effects on life expectancy and quality of life, continues to increase. Worldwide, the total number of people with diabetes is projected to rise from about 171 million in 2000 to 336 million in the year 2030. Type 2 diabetes accounts for about 85 percent to 95 percent of all diagnosed cases of diabetes and is associated with a number of serious long-term complications, which are a major cause of morbidity, hospitalization and mortality in diabetic patients. More evidence is becoming available that both lifestyle and clinical intervention in the pre-diabetic condition are effective in slowing down progression of pre-diabetes to overt diabetes. Over many centuries, several forms of traditional medicine have developed which are often based on fundamental principles that differ from those of "Western" medicine. One of the most prominent characteristics of Traditional Chinese Medicine (TCM), is a more holistic approach to the functioning and disfunctioning of living organisms. Every healthy organism is in a Yin Yang balance and is considered to be a complex interplay between body and mind. Western medicine relies on detailed classification of diseases, empirical investigations and treatments targeting those disorders. However, "Western medicine" is showing an increased interest in traditional forms of medicine. Objectives: The primary objective of the present study is to determine consistency in classification of DM type 2 in three categories as defined by Traditional Chinese Medicine (TCM) in pre-diabetic subjects. Secondary objectives are to find relationships between diagnosis according to TCM and risk profile according to Western approach (fasting glucose and HbA1c in plasma, age, BMI, waist circumference). Another objective is to find relationships between classification of risk for DM type 2 according to TCM and objective parameters.

Diabetes is a common chronic condition associated with the risk of heart disease, and eye and kidney damage. Many people are diagnosed with diabetes when they develop symptoms or complications, suggesting that the true onset of disease occurs years earlier. Early detection of diabetes may result in health benefits, but this is not proven. People of South Asian origin are at more risk of having diabetes and of getting the heart disease complications associated with it. The study aims to test whether screening for diabetes is feasible in a South Asian population and to measure the benefits of early detection and intensive treatment. Hypothesis: A program of screening and an intensive multi-factorial intervention for type 2 diabetes is both feasible and cost effective within primary care.

The study tests whether implementing professional evidence-based guidelines and best practices for diabetes care -through participation of multidisciplinary teams in a Breakthrough collaborative- results in an improvement of diabetes care, its health outcomes and economic costs. Determinants of success are studied. Data on diabetes will also be used to better understand Breakthrough as an implementation or improvement method.

To evaluate additional cardiovascular risk factors using data from the VA HDL Intervention Trial (VA-HIT).

To determine the effect of the method of hyperglycemic management on pro- thrombotic potential in diabetic subjects.

This is a questionnaire based study (no study drug is involved) that asks if more patients with uncontrolled type 2 diabetes on diabetes pills will choose insulin as the next treatment choice if inhaled insulin were available in addition to all currently available treatments, compared with if inhaled insulin was not available as part of currently available treatments. This study will also ask if patients with uncontrolled type 2 diabetes currently managed on diabetes pills + once daily insulin will choose as the next treatment choice to take insulin multiple times a day if inhaled insulin were available in addition to all currently available treatments, compared with if inhaled insulin was not available as part of currently available treatments.

To evaluate very low density lipoprotein (VLDL) and low density lipoprotein (LDL) particle types as predictors of initial coronary events.

To evaluate the relationship of baseline toenail chromium concentrations to weight loss, as well as the interaction between heavy metals and the beneficial effects of weight loss.

To test whether novel cardiovascular risk factors are related to the presence and development of atherosclerosis and macrovascular events in Type 2 diabetes mellitus and to determine whether intensive glucose lowering therapy will reduce the levels of these cardiovascular risk factors.