Essential parameters and risk factors of the patients for diabetes care and treatment.

AIM: The aim was to explore the association between Type 2 Diabetes Mellitus [T2DM] treatment satisfactions of patients regarding their socio-economic, life-style, history medication and clinical outcome in a Turkish population SUBJECT AND METHODS: A cross-sectional study conducted from February 2016 to September 2016. Of the total 1500 diabetic patients approached, 1094 (72.9%) gave their consent. Data analysis included, sociodemographic, serum lipid profiles (LDL, HDL), calcium, uric acid, blood pressure and glycated hemoglobin (HbA1c) at baseline and after six months. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) tools were used to measure the patient satisfaction. RESULTS: The mean and standard deviation of age among gender, there were significant differences between males (51.81±14.40) and females (49.76±13.99) (p=0.024). There were statistically significant differences between males and females regarding place of living (city 76% vs town 26%) p<0.001) and consanguinity (p=0.040). Almost of the patients with diabetes were overweight (males 44.5% vs females 41.8%) while more than a quarter (31.2%) males were obese. Among patients with diabetes, significantly larger proportion were treated for DM with insulin (females 28.8% vs males 22.5%) and 'insulin & oral anti diabetic drugs' (females 21.6% vs males 18.4%%; p<0.001) in comparison. Reported average sleeping haours was significantly more among males (6.5±1.1 vs. 6.1±1.2; p<0.001) than females. Males and females reported significantly greater improvements in mean values of blood glucose (-2.07 p<0.001; vs. -2.36; p=0.007), HbA1c (-1.72 p<0.001; vs. -1.47 p=0.038), potassium (+0.98 p<0.001; vs. +0.93 p<0.005); albumin (-3.38 p<0.001; vs. -3.60; p<0.001); billirubin (-0.69 p=0.049; vs. -0.98; p<0.001); uric acid (+11.9 p=0.017; vs. +14.3; p<0.001); systolic blood pressure (-3.86 p<0.001; vs. -3.2 p<0.001) and diastolic blood pressure (-3.17 p<0.001; vs. -3.2 p<0.001) in comparison to 6 months before. Multivariate stepwise regression analysis showed that the satisfaction DTSQ scores for HbA1c (p<0.001), h of sleep (p<0.001), neuropathy (p=0.007), diabetic education (p=0.014), SBP (mmHg) (p=0.021) DBP (mmHg) (p=0.028) were identified as significantly associated with higher treatment satisfaction. CONCLUSION: The study confirms a positive correlation between diabetes patient's satisfaction with care and treatment. Females DM patients compared to males had a better satisfaction score with current treatment, unacceptably low blood glucose level, flexibility in treatment and understanding of DM.

Can the T-peak to T-end interval be a predictor of mortality in patients with ST-elevation myocardial infarction?

BACKGROUND: The interval between the peak and the end of the T wave (Tp-e interval) on 12-lead ECG is a measure of transmural dispersion of repolarization and may be related to malignant ventricular arrhythmias. The objective of this study was to investigate whether the Tp-e interval predicts in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction (STEMI) undergoing a primary percutaneous coronary intervention (pPCI). METHODS: This study included 488 consecutive patients with STEMI treated with pPCI. Electrocardiograms were obtained after pPCI and the Tp-e interval was measured in leads without ST-segment elevation. RESULTS: There were 46 (9.4%) deaths in the population, with a mean follow-up time of 21.1±10.2 months. The Tp-e interval was associated with not only in-hospital ventricular tachycardia/fibrillation, target vessel revascularization, and death but also long-term target vessel revascularization and death. Furthermore, the Tp-e interval measured using the tail method was found to be a significant predictor of long-term mortality in multivariable Cox analyses [odds ratio 1.018, 95% confidence interval (1.004-1.033)]. Findings were similar in the Tp-e interval and the heart rate-corrected Tp-e interval (cTp-e). CONCLUSION: Tp-e and cTp-e measured using the tail method were found to be predictors of both in-hospital and long-term mortality.

The independent association of plateletcrit with long-term outcomes in patients undergoing primary percutaneous coronary intervention.

PURPOSE: Platelets play a key role in the genesis of thrombosis. Plateletcrit (PCT) provides complete information on total platelet mass. The relationship between PCT values and long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary angioplasty is not known. We sought to determine the effect of PCT values on the outcomes of primary angioplasty for STEMI. METHODS: Overall, 2572 consecutive STEMI patients (mean age, 56.6±11.8 years) undergoing primary percutaneous coronary intervention were enrolled retrospectively into the present study. Plateletcrit at admission was measured as part of the automated complete blood count. Patients were classified into 2 groups: high PCT (>0.237, n=852) and nonhigh PCT (<0.237, n=1720). Clinical characteristics and in-hospital and long-term (median, 21 months) outcomes of primary angioplasty were analyzed. RESULTS: A higher in-hospital shock rate was observed among patients with high PCT values compared with those with nonhigh PCT values (6.5 vs 3.8%, respectively; P=.003). The long-term cardiovascular prognosis was worse for patients with high PCT values (Kaplan-Meier, log-rank test; P=.007). We used Cox proportional hazard models to examine the association between PCT and adverse clinical outcomes. High PCT values were also an independent predictor of cardiovascular mortality (hazard ratio, 1.85; 95% confidence interval, 1.061-3.22; P=.03). CONCLUSION: High PCT values on admission are independently associated with long-term adverse outcomes in patients with STEMI who undergo primary angioplasty.