RÉSUMÉ
Background: Glycaemic control in type 2 diabetes mellitus can be difficult to attain, even with a combination of multiple oral agents as well as Insulin. SGLT2 inhibitors are potential novel agents inhibits the sodium glucose co transporters operated in the kidney tubules independent of the action on insulin resistance or secretion. This study aimed to evaluate the effect on the mean reduction of HbA1c levels. Also, to evaluate the effect of gliflozins on the mean reduction of FBS and PPBS values at the end of 3rd and 6th months and to find out the ADR profile over 6 months. Methods: Prospective observational study conducted on the patients with type 2 diabetes mellitus with HbA1c >7% not controlled on metformin in the outpatient over a period of 15 months. An initial visit and thereafter follow up visits at 3rd and 6th month. HbA1c, FBS and PPBS was noted. ADR profile was also noted. Results: Significant mean reduction in the glycemic parameters among 90% study population with 0.5% reduction in mean HbA1c from the baseline. Also, the reduction in FBS and PPBS were statistically significant by 3rd month of the treatment. Incidence of genital itching was more compared with conventional drugs. Hypotension and polydipsia were rare. Conclusions: SGLT 2 inhibitors are found to be a promising new category of antidiabetic medications with better control of FBS, PPBS and HbA1c.
RÉSUMÉ
Background: Type 2 Diabetes mellitus remains a global health problem due to its poor clinical outcomes, high morbidity, and mortality caused by many complicated problems, one of which is the ineffective role of pharmacists in providing counselling to DM patients Methods: This pre and post cohort study analyzed the impact of pharmacist counselling on the blood glucose level and glycosylated hemoglobin (HbA1C) of T2DM outpatients (n=88) admitted to Asahan General Hospital period June to December 2022. Counselling provided comprised the importance of medication adherence and non-pharmacological approaches. Characteristics, BGLs and HbA1C of the patients were extracted from their medical records before and after counselling using a predetermined questionnaire. Characteristics of the patients were descriptively analyzed. Results: The significance of the counselling on these outcomes was analyzed by applying Wilcoxon test (p <0.05 was considered significant). The mean age of the patients was 57.89±9.75 (years). Most (57.95%) of them were female. Proportion of the patients with controlled BGLs (%): before counselling, 27.7; after counselling, 89.8. Proportion of the patients with controlled HbA1C (%): before counselling, 27.3; after counselling, 89.8. Pharmacist counselling significantly improved the clinical outcomes of T2DM patients, p=0.000. Conclusions: Pharmacist counselling plays an important role to improve BGLs and HbA1C in T2DM patients which can finally improve their quality of life
RÉSUMÉ
Background: Our study aims to compare HbA1c levels in hospitalized acute coronary syndrome and heart failure patients treated with atorvastatin versus rosuvastatin Methods: This is a retrospective, prospective observational study in which the study population includes ACS and HF Hospitalized patients, the study subjects are divided based on patients prescribed with Atorvastatin and Rosuvastatin based on the medication chart, and those patients' previous history of statin use is collected from history chart, patient case notes, doctors notes, laboratory data is collected and documented in data collection form, lab data includes HbA1c, finally compared Atorvastatin and Rosuvastatin using excel and JASP descriptive analysis. Results: Overall, we collected data for 132 cases, of which 55% are males and 45% females, 59.10% are above 61 years of age, 39.39% are diagnosed with ACS and 23.48% are diagnosed with HF, among 67 patients who are using Atorvastatin, there was a significant mean decrease in HbA1c% from 8.359% to 7.901%, and among 65 Rosuvastatin users there was an increase in mean HbA1c% from 8.386% to 8.389%. Additionally for non-diabetic individuals, there was an increase in Hba1c% from 6.339% to 6.387%. Conclusions: We concluded that Atorvastatin is a more effective statin than Rosuvastatin which will reduce the risk of new-onset Diabetes Mellitus in non- diabetic individuals and reduce the risk of increasing complications of diabetes mellitus in patients who are Diabetic.
RÉSUMÉ
Background: The prevalence of type 2 DM is alarmingly rising on a global scale. Improved treatments for type 2 DM are still needed, in order to slow the disease抯 development. A role in the pathophysiology of type 2 DM has been suggested by the correlation between vitamin D insufficiency and several non-skeletal illnesses, including DM. The goal of the study was to determine if vitamin D supplementation may help type 2 DM patients whose glycemic status was uncontrolled even after using oral antidiabetics. Methods: 60 individuals with type 2 DM and vitamin D insufficiency participated in this 12-week open-label, before-and-after study. For 12 weeks, in addition to oral anti-diabetic medications, these patients also received 60,000 IU of vitamin D3 orally every week. HbA1c, FBS, and 25(OH)D levels parameters were included. Results: The majority of the patients were from 41-50 years of age group (48.3%) with a male predominance (60%). Most of them were having >1 year of type 2 DM duration (78.3%) with a high family history of type 2 DM (70%). After 12 weeks, there was a substantial (p<0.001*) drop in FBG levels and a significant (p<0.001*) decrease in HbA1c. 25(OH)D levels showed a high rise (p<0.001*). None of the patients had any side effects. Conclusions: Vitamin D treatment improves glycemic status, which slows the development of type 2 DM and its associated effects. As such, vitamin D supplementation is a safe and promising adjuvant treatment for individuals with type 2 diabetes who are low in vitamin D.
RÉSUMÉ
Objective To investigate the changes of blood lipid and glycosylated hemoglobin (HbA1c) levels in obese type 2 diabetes (T2DM) patients and their relationship with insulin resistance (Homa-IR). Methods A total of 120 cases of T2DM newly diagnosed in Motuo County, Tibet from February to October 2022 were selected as the observation group. According to BMI, the patients were divided into diabetes normal weight group (46 cases), overweight group (43 cases) and obesity group (31 cases); 145 healthy subjects were selected as the control group. The levels of HbA1c, fasting blood glucose (FPG), fasting insulin (FINS), serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C) were detected in the study subjects, and Homa-IR and Homa-β indices were calculated. The height, weight, and abdominal circumference were measured. The differences in the levels of the above indicators between the observation group patients and the control group, as well as among various subgroups within the observation group were compared. The influencing factors of Homa-IR in obese T2DM patients were analyzed. Results Compared with the control group, a significant increase in BMI, abdominal circumference, blood pressure, HbA1c, FBG, FINS, TC, TG, LDL-C, UA, visceral fat area, and the levels of Home-IR and Home-β was found in the observation group (all P<0.05). There were significant differences in BMI, abdominal circumference, and the levels of FINS, Homa IR, Homa-β, and HbA1c in diabetes patients with different BMI (all P<0.05). Correlation analysis showed that TG levels in obese T2DM patients in the observation group were significantly correlated with HbA1c (r=0.396, P=0.027), Homa-IR (r=0.405, P=0.024), and Home-β (r=-0.401, P=0.025); LDL-C was significantly correlated with Homa-IR (r=0.411, P=0.022) and Homa-β (r=-0.412, P=0.021); HbA1c was significantly positively correlated with BMI (r=0.371, P=0.040). Conclusion Insulin resistance is closely related to TG, LDL-C, and BMI in obese T2DM patients from the Motuo ethnic minority of Tibet, suggesting that these factors may play a role in the occurrence of T2DM.
RÉSUMÉ
Introduction@#There has been an increasing awareness of the effects of combining bromocriptine-QR with other medications for diabetes mellitus type 2. This study aimed to assess the efficacy and safety of bromocriptine-QR as an adjunctive therapy for patients with uncontrolled type 2 diabetes mellitus.@*Methodology@#This systematic review is registered at the International Prospective Register of Systematic Reviews (CRD42022360326). Literature search was done via MEDLINE, NCBI, Google Scholar, Science Direct, Europe PMC and Cochrane Library databases. We included randomized controlled trials with participants 18 years old and above with uncontrolled type 2 diabetes mellitus. The primary outcome of interest is the efficacy and safety of bromocriptine-QR as an adjunctive therapy for glycemic control. Case reports, case series, reviews and animal studies were excluded. The risk of bias was reviewed using the Cochrane Risk of Bias tool. Meta-analysis was performed using Review Manager 5.4 and presented as a weighted mean difference and 95% confidence interval for changes from the baseline level.@*Results@#Nine studies were included in the systematic review with a total of 2709 participants. The baseline HbA1c in the bromocriptine-QR group was 7.42% and 7.51% in the control group. The bromocriptine-QR group was favoured, outperforming the control group in terms of reducing hemoglobin A1c(HbA1c), with a statistically significant difference (weighted mean difference -0.6%; 95% CI [-0.83,-0.36]; p<0.00001). The most common side effects were nausea (33.75% vs 6.92%), fatigue (13.11% vs 5.94%), and headache (11.17% vs 6.87%).@*Conclusion@#Administration of bromocriptine-QR at a dose range of 1.6 to 4.8 mg/day as an adjunctive therapy reduced HbA1c and FBG in patients with uncontrolled type 2 diabetes mellitus (T2DM). However, there were also statistically greater odds of the occurrence of adverse events such as nausea, vomiting, and headache compared to controls.
Sujet(s)
Diabète de type 2RÉSUMÉ
SUMMARY OBJECTIVE: Obesity is a chronic multisystem disease associated with increased morbidity and mortality. Obesity, which is a complex, multifactorial, and heterogeneous condition, is thought to result from the interaction of environmental, physiological, and genetic factors. In this study, the relationship between serum levels of hemoglobin A1c, mucin-1, and nuclear factor κB in obese and healthy cohorts was evaluated along with biochemical and gene expressions and with demographic and clinical covariates, and their effects on obesity were evaluated. METHODS: This case-control study included a total of 80 individuals, 40 healthy controls and 40 obesity patients, consisting of female and male aged between 18 and 63 years. Hemoglobin A1c, mucin-1, and nuclear factor κB levels were determined by ELISA in serum samples obtained from patients. In addition, aspartate aminotransferase, alanine transaminase, low density lipoprotein, and glucose values were measured. The gene expressions of the same markers were analyzed by quantitative real-time polymerase chain reaction, and their regulation status was defined. RESULTS: Serum levels of hemoglobin A1c, mucin-1, and nuclear factor κB were found to be high in obese individuals (p<0.05). The gene expression of these serum markers was found to be upregulated. Of the anthropometric measurements, waist circumference and body mass index were correlated with both serum markers and gene expressions (p<0.05). CONCLUSION: In addition to the known association of hemoglobin A1c and nuclear factor κB with obesity, serum levels of mucin-1 as well as upregulation of genes point to its modifier effect on obesity. These parameters can be the powerful markers in the diagnosis of obesity.
RÉSUMÉ
Abstract Objective: To discuss the correlation between serum progesterone, glycosylated Hemoglobin (HbA1c), and insulin levels in pregnant women with Gestational Diabetes Mellitus (GDM) and the risk of Premature Rupture of Membranes (PROM). Methods: A retrospective analysis was conducted on 52 patients diagnosed with GDM who also presented with PROM (Observation group) and compared with 89 patients diagnosed with GDM but not complicated with PROM (Control group). Progesterone, insulin, and HbA1c were detected. Risk factors for PROM in GDM patients were analyzed. Results: The observation group had higher HbA1c and fasting blood glucose levels. Poor blood glucose control and GWG are risk factors for PROM in GDM patients. PROM increases adverse pregnancy outcomes in GDM. HbA1c, insulin, and HOMA-IR can predict the risk of PROM in GDM. Conclusions: The effective prediction of preterm PROM can be achieved through the monitoring of serum HbA1c, insulin levels, and insulin resistance in patients with GDM.
RÉSUMÉ
Introducción: el Finnish Diabetes Risk Score (FINDRISC) mostró alta sensibilidad y especificidad para la detección de personas que evolucionarían a diabetes mellitus (DM) en las poblaciones estudiadas, por lo cual se decidió utilizarlo entre quienes concurrieron por diferentes motivos a realizarse análisis de laboratorio en centros de la Asociación de Laboratorios de Alta Complejidad (ALAC), con el objeto de identificar personas con diferentes niveles de riesgo de presentar alteraciones de la glucemia en ayunas (GA) y de la HbA1c. Objetivos: explorar la asociación entre la puntuación del FINDRISC con GA y HbA1c, estableciendo el punto de corte de mayor sensibilidad y especificidad para encontrar una GA ≥100 mg/dL y una HbA1c ≥5,7% (38,8 mmol/mol), en una población que concurrió a centros de la ALAC. Materiales y métodos: se incluyeron 1.175 individuos de 45 laboratorios de la ALAC, procesamiento local de glucemia y centralizado de HbA1c (high performance liquid chromatography, HPLC). Análisis estadístico: chi-cuadrado, Odds Ratio, ANOVA, test de Tukey, regresión logística binomial y curvas ROC. Resultados: los puntajes totales del FINDRISC se asociaron de manera positiva y estadísticamente significativa, tanto con los valores de GA como con los niveles de HbA1c. Entre sus variables, una edad mayor o igual a 45 años, un perímetro abdominal de alto riesgo, un índice de masa corporal mayor o igual a 25 Kg/m., la presencia de antecedentes familiares de DM (padres, hermanos o hijos) y la existencia de antecedentes de medicación antihipertensiva se asociaron de manera significativa con valores de GA iguales o superiores a 100 mg/dL y/o niveles de HbA1c iguales o mayores a 5,7% (38,8 mmol/mol). No se halló asociación significativa con la realización de actividad física (al menos 30 minutos diarios) ni con el registro de ingesta diario de frutas y verduras. Los valores medios de GA y HbA1c en individuos con puntajes totales del FINDRISC menores o iguales a 11 fueron de 89,9 mg/dL y 5,2% (33,0 mmol/mol), respectivamente, elevándose hasta valores medios de 116,1 mg/dL y 6,1% (43,0 mmol/mol) en los individuos con puntajes iguales o superiores a 21, siguiendo una asociación del tipo "dosis/respuesta". Por curvas ROC, un FINDRISC de 13 presenta una sensibilidad del 81,89%, especificidad del 67,60% y 70,55% de diagnósticos correctos de HbA1c ≥5,7% (38,8 mmol/mol), y una sensibilidad del 72,50%, especificidad del 70,62% y 71,20% de diagnósticos correctos para encontrar personas con una GA ≥100 mg/dL. Conclusiones: el puntaje del FINDRISC se relacionó con niveles crecientes de GA y HbA1c, resultando útil para encontrar personas con GA ≥100 mg/dL y HbA1c ≥5,7% (38,8 mmol/mol) en la población estudiada.
Introduction: the Finnish Diabetes Risk Score (FINDRISC) has high sensitivity and specificity for the identification of people at risk of diabetes mellitus (DM) in various populations. Therefore, we aimed to use this index to identify individuals at risk of having alterations in fasting glycemia (FG) and HbA1c among those who underwent laboratory analysis at ALAC, Argentina. Objectives: to explore the relationships of the FINDRISC score with the fasting blood glucose (FG) concentration and glycated hemoglobin (HbA1c) level, and to establish appropriate cut-off scores to predict FG ≥100 mg/dL and HbA1c ≥5.7% (38.8 mmol/mol) in this population. Materials and methods: we recruited 1,175 individuals from 45 ALAC laboratories for whom FG and HbA1c had been measured. We analyzed the data using the chi square test, odds ratios, ANOVA plus Tukey's post-hoc test, binomial logistic regression, and receiver operating characteristic (ROC) curves. Results: total FINDRISC score significantly positively correlated with both FG and HbA1c. Of the constituent variables, age ≥45 years, a large waist circumference, a body mass index ≥25 kg/m., a close family history of DM, and the use of antihypertensive medication were significantly associated with FG ≥100 mg/dL and/or HbA1c ≥5.7% (38.8 mmol/mol). However, no significant association was found with physical activity or the daily consumption of fruit and vegetables. The mean FG and HbA1c for individuals with total FINDRISC scores ≤11 were 89.9 mg/dL and 5.2% (33.0 mmol/mol), respectively, which increased to 116.1 mg/dL and 6.1% (43.0 mmol/mol) for individuals with scores ≥21, with a dose/response-type relationship. ROC analysis showed that a FINDRISC of 13 was associated with a sensitivity of 81.89%, a specificity of 67.60%, and a correct diagnosis rate of 70.55% for HbA1c ≥5.7% (38.8 mmol/mol); and a sensitivity of 72.50%, a specificity of 70.62%, and a correct diagnosis rate of 71.20% for FG ≥100 mg/dL. Conclusions: FINDRISC score increases with increasing FG and HbA1c, and is a useful means of identifying people with FG ≥100 mg/dL and HbA1c ≥5.7% (38.8 mmol/mol).
Sujet(s)
HémoglobinesRÉSUMÉ
Background: Diabetes mellitus and hearing loss are common public health problems. Sensorineural hearing loss in Type 2 diabetes mellitus patients is an underestimated complication. The aim was to study the correlation between level of HbA1c and degree of sensorineural hearing loss. Methods: It was a cross sectional study carried on 130 known cases of T2DM, aged 25-50 years. Various confounding factors such as coexisting hypertension, ear disease, ototoxic drug intake, any neuropathic disorder was excluded in advance. All patients underwent clinical ear examination and pure tone audiometry test. Their level of HbA1c was measured. This value of HbA1c was correlated with the hearing threshold. Results: Out of 130, 58 subjects had normal hearing while 72 had hearing impairment. Among subjects (72 out of 130) having hearing impairment, significant correlation (p-value 0.035 for right ear and 0.029 for left ear) between hearing threshold and HbA1c was found. Also, level of HbA1c significantly (p-value 0.049) correlated with degree of hearing loss. Conclusions: Hearing loss is an underestimated complication of T2DM. This needs to be addressed with periodic hearing assessment of diabetes patients.
RÉSUMÉ
Background: Metformin monotherapy is the primary therapeutic approach in most cases of newly diagnosed type 2 diabetes mellitus (T2DM) as it is safe, efficient, and is known to lower risks like vascular complications in patients. Previous studies have shown that glycemic control provided by metformin monotherapy is not consistent and needs to be monitored in association with other factors. Due to the complex nature of the disease and other factors like genetic predisposition, ethnicity, and geographic distribution, it is crucial to investigate its effect on the Saudi population. This study aimed to evaluate the glycemic response of metformin monotherapy in individuals with newly diagnosed T2DM who had not previously taken any other medications. Methods: A retrospective study model was followed to determine metformin monotherapy in newly diagnosed type 2 diabetes patients. The efficacy of the metformin monotherapy was evaluated in the patients who were drug naive and had undergone treatment for six months. Results: HbA1c levels for our study population (n=136) before and after metformin monotherapy for a period of six months was collected from patient records. The study cohort included both male (n=71) and female (n=67) patients. There was a significant difference in the HbA1c levels of all diabetes patients before (Mean=9.1, SD=2.84) and after (Mean=7.13, SD=1.51) medication; 2-tailed significance p<0.001. Conclusions: Metformin monotherapy was effective in reducing the HbA1c levels across both genders and all age groups in the present study. These results suggest that metformin monotherapy could be the first line of therapy for newly diagnosed T2DM individuals.
RÉSUMÉ
Background: Recent studies have indicated that patients, both with and without diabetes with an increased HbA1c, have a higher rate of adverse outcomes following cardiac surgeries. Our study is focused on to evaluate the prognostic impact of admission value of HbA1c in non?diabetic patients for postoperative renal failure and infections. Materials and Methods: Plasma HbA1c levels were collected from 200 consecutive nondiabetic patients who got admitted for elective off pump coronary artery bypass graft (CABG) procedure over a 2?year period under two groups, Group A whose HbA1c was < 6% at admission and Group B whose HbA1c was ?6% and ?6.4% at admission. After surgery, patients were followed up to see if they have got infection or renal failure as postoperative complication. Student抯 unpaired t test was used to test the significance of difference between the quantitative variables, Yate抯 and Fisher抯 chi square tests were used for qualitative variables. Results: We found early postoperative renal failure in 14 (3/96 in Group A and 11/104 in Group B) out of 200 patients (7%) and infection in 21 (8/96 in Group A and 13/104 in Group B) out of 200 patients (10.5%). After data analysis, it was noted that there is a positive correlation between HbA1c and postoperative renal failure (P = 0.0213) whereas no association was found between HbA1c and postoperative infections (P = 0.175) in patients undergoing off?pump CABG surgery. Conclusion: In patients without diabetes, a plasma HbA1c ?6% was a significant independent predictor for early postoperative renal failure.
RÉSUMÉ
Background: The prevalence of hyperglycemia first detected during pregnancy is showing an escalating increase in recent years contributed by the increasing obesity prevalence, advanced maternal age at delivery, and the universal screening protocol during the first antenatal visit. There exists a very little data on the role of HbA1c in pregnancy and the results remain inconsistent. There is a need to define diagnostic criteria to predict the adverse perinatal outcomes in gestational diabetes mellitus (GDM). Aims and Objectives: This study was aimed to assess the role of HbA1c as a prognostic indicator of third trimester mean blood glucose in GDM pregnancies and in predicting the birth of large for gestational age (LGA) babies. Materials and Methods: 200 pregnant women with GDM and 200 pregnant women without GDM and their neonates participated in this analytical cross-sectional study. Maternal age, height, weight, BMI, and neonatal birth weight were recorded. Third trimester maternal HbA1c level was analyzed by high-performance liquid chromatography. The association between HbA1c and LGA births was analyzed. Results: The mean HbA1c levels and percentage of LGA births were high in GDM group. Multiple logistic regression analysis showed association between high HbA1c values and LGA births in GDM. A Receiver operating characteristic curve was drawn to derive the optimal cut-off value, sensitivity, and specificity of HbA1c in predicting birth of LGA neonates in GDM. Conclusion: This study shows that high third trimester HbA1c levels in GDM increase the risk of LGA births. Further studies are needed to define standard cut-off values of glycated Hb in each trimester of pregnancy.
RÉSUMÉ
Objective: Diabetes is the most common endocrine disorder and is the leading cause of death worldwide. Thyroid dysfunction is another common endocrine disorder frequently encountered in clinical practice worldwide, second only to diabetes. The present study was undertaken with the following aims and objectives: To know the prevalence of thyroid dysfunction in type 2 diabetes mellitus and the spectrum of thyroid dysfunction in type 2 diabetes mellitus.Methods: Type 2 diabetes mellitus patients, as per World Health Organisation criteria, without pre-existing thyroid disease attending the Medicine Outpatient Department or admitted to the Department of Medicine from June 2019 to May 2020 were taken as cases. Patients with type 2 DM aged>15 y were included in our study. Patients below 15 y of age, pregnant or lactating women, patients suffering from malignancy and tuberculosis, hepatic dysfunction, renal dysfunction, and those on drugs known to affect thyroid function (steroid, oral contraceptive pills, beta-blockers, and amiodarone), and patients who had proven pre-existing thyroid dysfunction were excluded from the study.Results: In our study, thyroid dysfunction was present in 14.69% of patients among 320 patients with diabetes. Thyroid dysfunction was present in 7.73% of males and 23.74% of females with diabetes. Out of 47 diabetic patients who had thyroid dysfunction, 76.60% had glycosylated haemoglobin (HbA1C)>7.Conclusion: There was a higher prevalence of thyroid disorders in patients with type 2 diabetes. This finding was more common in female diabetics. Subclinical hypothyroidism was the most frequent thyroid disorder found among diabetics.
RÉSUMÉ
Background:There is a synergistic effect between diabetes mellitus and pulmonary tuberculos is. India has the highest number of tuberculosis patients and India has also the second- highest number of patients with diabetes mellitus in the world. The dual curse of these two diseases may have an impact on both sides as an outcome of treatment and poor glycaemic control. There were many studies have been done about the relation ship between diabetes and tuberculosis but still there is a large gap about its synergistic effect. Methods: In this study, we include 164 patients with pulmonary tuberculosis aged more than 18 years 72 out of 164 patients are diabetic and 92 patients are nondiabetic. Demographic details, physical and clinical examination, Blood sugar fasting and postprandial, Hba1c, x-rays chest, sputum for AFB and CBNAA T test have been done on all patients then ATT was given to patients and appropriate antidiabetic treatment given to diabetic patients. follow up done on all patients on the 2nd month and 6th months. Results:In this study, the commonest age group for tuberculosis infection is 45-54 but in diabetic patients common age group for tuberculosis infection is 55-64. Patients of diabetes and tuberculosis commonly have elevated Hba1c and relatively poor treatment outcome reflected by a sputum conversion rate of 77.7%, 16.7%has failed treatment and also diabetic patients has 3+ sputum positivity. Conclusions: In patients with tuberculosis screening of diabetes may improve treatment outcomes and prevent complications b y appropriate management of diabetes and tuberculosis.
RÉSUMÉ
Background: Diabetic ketoacidosis (DKA) is the most serious metabolic disturbance of type 1 diabetes mellitus (T1DM) and about 25 to 40% of the newly diagnosed T1DM children present with DKA. This research was conducted to study the clinical profile and identify the precipitating factors at time of presentation of DKA and to correlate the type onset of disease with the severity of DKA and the treatment outcome.Methods: Ambispective record based study of children admitted in in the paediatric ward of a tertiary care hospital with DKA between 01 July 2019 and 31 January 2022.Results: A total of 19 patients were enrolled and the mean age of presentation was 10.79±4.17 years with a female predominance. The family history of type 2 DM was noted in 73.7% and osmotic symptoms in 68.4% of the patients. 52.6% of the patients presented in severe DKA. Mean HbA1C noted was 15.14±2.74%. Acute Kidney Injury was present in 10.5% of the patients. Pneumonia was the major precipitating factor. The average length of hospital stay was 7.42±3.27 days. There was no significant correlation with the type of onset of T1DM and the treatment outcome. There was a significant reduction in HbA1c (p<0.05) on follow-up.Conclusions: This study highlights the need for creating awareness, early referral and timely management of T1DM presenting not only in DKA but also during the ambulatory management.
RÉSUMÉ
Background: Prediabetes is the preceding stage of diabetes which puts an individual to induce complications same as that of diabetes; hence, it should be treated to prevent its progression to diabetes and other consequences. However, there is very less literature about impact of home-based physical therapy on glycemic control and quality of life in Indian prediabetic population. Aims and Objectives: The aims of this study were to evaluate whether the home-based physical therapy shows effect on glycemic control and individual’s quality of life after a 3-month intervention. Materials and Methods: The study was conducted on 55 individuals who were diagnosed with prediabetes (36 males and 19 females) on basis of HbA1c level ranging from 5.7% to 6.4%. A 12-week exercise protocol was made which includes warm up exercises, main exercise program (aerobic and strengthening training), and cool down exercises along with dietary changes. SF-36 and HbA1c level is taken at baseline and at the end of 12 weeks for quality of life and glycemic control measures in participants, respectively. Results: The difference in HbA1c levels before and after treatment was found to be statistically significant. The HbA1c levels after the 3-month intervention showed significant reduction (P < 0.008) along with significant difference in all domain of SF-36 except in domain 3 (role limitation due to emotional problem) and domain 6 (social functioning). Conclusion: The home-based physical therapy program is effective in glycemic control and quality of life in adults with prediabetes.
RÉSUMÉ
Background: Type-2 diabetes mellitus is related to decreased lung function. Prolonged inadequate control of glucose levels may alter regulation of inflammatory pathways that are implicated in pulmonary function complications. Aim and Objectives: The objjectives of the study were to assess the relationship of pulmonary function test (PFT) with factors influencing glycemic status in type 2 diabetes mellitus. Materials and Methods: A total of 110 diabetic cases with uncontrolled blood sugar levels and similar number age- and gender-matched control subjects above 30 years of age were recruited. Sociodemographic details were collected and participants underwent laboratory ad radiological investigations. PFTs including Forced vital capacity (FVC), peak expiratory flow rate (PEFR), forced expired volume in 1 s (FEV1), forced expiratory flow (FEF 25–75%), and FEV1/FVC ratio were assessed. Results: The comparison of PFTs with levels of HbA1c (<7 and >7) showed that the levels of FVC, PEFR, FEV1, and FEF 25–75% were higher in diabetics with HbA1c <7 and FEV1/FVC ratio was high in diabetic cases with HbA1c >7. The mean difference of PFT with HbA1c and body mass index (BMI) was statistically not significant in diabetics (P > 0.05). The person’s correlation analysis showed a negative correlation between FVC, FEV1 with HbA1c, and BMI in diabetics. Conclusion: Uncontrolled glycemic status and increased BMI were associated with functional impairment of lungs. Organized glycemic control and duly checking the PFTs may reduce the risk of onset of respiratory complications and lung function.
RÉSUMÉ
Diabetes has become worldwide pandemic. Among the diabetic population 90-95% patients have type 2 diabetes mellitus (T2DM). The development of T2DM can be slowed down by modification in lifestyle through physical activities such as brisk walking, physical body movement and adopting proper balanced diet. Various physical exercises such as aerobic exercises, resistance exercises, high intensity interval training performed regularly can help with management of blood glucose level, lipid profile, blood pressure, quality of life and cardiovascular complications. Geriatric patients with type 2 diabetes are either extremely frail, wheelchair bound, or bed bound and do not have sufficient physical work capacity to exercise aerobically and with high resistance. Static stretching of the skeletal muscles accrues the benefits of exercise without its accompanying physical stress as in case of aerobic exercise and resisted exercises. Several studies have shown that stretching helps in lowering the blood glucose level in patients with T2DM immediately after the intervention. Till date there are no definitive guidelines are present for stretching exercises as treatment protocol for reduction of blood glucose level and HbA1c level in patients with T2DM. In order to establish a definitive stretching protocol in patients with T2DM and for individual based exercise to be decided further research needs to be conducted.
RÉSUMÉ
Background: A variety of musculoskeletal conditions have been associated with diabetes mellitus which involves multiple joints affecting activities of daily living. It warrants screening of such symptoms in patients with diabetes mellitus in routine health checkup and to address such complaints. Using a simple questionnaire such as Nordic questionnaire which can aid in studying presence or absence of musculoskeletal symptoms in diabetic patients and to know the frequently involved joint. Methods: Cross sectional data of 156 adults with type 2 diabetes mellitus attending tertiary hospital were examined. The patient’s demographic details were collected. Musculoskeletal pain was assessed using Nordic questionnaire. Multiple logistic regressions were used to examine risk associated with musculoskeletal pain. Results: The study showed that prevalence of musculoskeletal pain was 64.1%. The participants mean age was 50.57 years. The study group contained 48.7 % females and 51.3% males. The mean BMI was 27.56kg/m2 with mean HBA1c of 9.29%. 26% of the study population had significant discomfort in last 7 days which was interfering with their work. Majority of them (73%) had suffered shoulder pain. Presence Of musculoskeletal symptoms showed association with HbA1c, BMI, and waist circumference. There was no association between joint pains with respect to years of job Conclusions: Musculoskeletal symptoms are frequent in diabetic patients. Addressing such complaints is important to screen pathology related to joint and surrounding soft tissue on routine check-up, thus preventing future complication which may result in disability by using simple Nordic questionnaire.