ABSTRACT
Objective: Glycemic variability [GV] is a new term with the episodes of hyper and hypoglycemia in diabetic patients. Both prolonged QT interval and QTd are potential risk factors for malignant ventricular arrhythmias affecting the mortality of different groups of patients including diabetes mellitus. In this study, we aimed to evaluate if the glucose variability increasing the QTc interval and QTc dispersion in type 2 diabetes mellitus
Methods: We included 275 consecutive patients with type 2 diabetes. We quantified the GV with standard deviation [SD] and coefficient of variation [CV] from 7 point glucose measures. We investigated the relationship of GV parameters with QT parameters
Results: The prevalence of prolonged QTc duration was 21%, no patients have prolonged QTc dispersion [> 80 ms]. SD of the patients with prolonged QTc duration was significantly higher than the others [45.14 +/- 24.45 vs. 37.78 +/- 9.03 p<0.05]. There was also a significant relationship between SD and QTc dispersion [r: 0.164; p: 0.007]. There were no relationship between the QT parameters and microvascular diabetic complications. SD and HbA1c levels were significantly higher on the patients having peripheral neuropathy [p<0.005]
Conclusion: The result of this study demonstratess that increased glycemic variability is associated with prolonged QTc duration and QTc dispersion. It is important to focus on targeting optimal glycemic control with GV as an additional goal point along with the traditional following parameters such as fasting-postprandial blood glucose and HbA1c
ABSTRACT
No prospective studies have evaluated the effects of correction of iron deficiency anemia on insulin resistance in non-diabetic premenopausal women. We investigated this relationship in 54 non-diabetic premenopausal women with iron deficiency anemia. All patients were treated with oral iron preparations. Insulin resistance was calculated with the Homeostasis Model Assessment formula. All patients were dichotomized by the median for age and BMI to assess how the relationship between iron deficiency anemia and insulin resistance was affected by age and BMI. Although the fasting glucose levels did not change meaningfully, statistically significant decreases were found in fasting insulin levels following anemia treatment both in the younger age [<40 years] [P=0.040] women and in the low BMI [<27 kg/m[2]] [P=0.022] subgroups but not in the older age [>/=40 years] and the high BMI [>/=27 kg/m2] subgroups. Post-treatment fasting insulin levels were positively correlated both with BMI [r=0.386, P=0.004] and post-treatment hemoglobin levels [r=0.285, P=0.036]. Regression analysis revealed that the factors affecting post-treatment insulin levels were BMI [p=0.001] and post-treatment hemoglobin levels [P=0.030]. Our results show that following the correction of iron deficiency anemia, insulin levels and HOMA scores decrease in younger and lean non-diabetic premenopausal women
ABSTRACT
PURPOSE: To investigate the contribution of HCV infection to insulin resistance in chronic haemodialysis patients. MATERIALS AND METHODS: The study was performed with 55 patients who were on regular haemodialysis therapy three times per week. Of the 55 patients, 34 (20 females and 14 males with an average age of 40.9 years) were anti-HCV (+) and were defined as the HCV (+) group. The remaining 21 patients (8 females and 11 males with an average age of 50 years) were negative for HCV and other viral markers and were defined as the HCV (-) group. BMI of all patients were below 27. Insulin resistance (IR) was calculated according to the HOMA formula and patients were called HOMA-IR (+) if their HOMA scores were higher than 2.5. All of the HOMA-IR (+) patients in both groups were called the HOMA-IR (+) subgroup. None of the patients had a history of drug use or any diseases that were related to insulin resistance except uremia. In both groups and the healthy control group, insulin and glucose levels were studied at three different venous serum samples taken at 5- minute intervals after 12 hours of fasting. Other individual variables were studied at venous serum samples taken after 12 hours of fasting. RESULTS: HOMA scores were (3)2.5 in 22 of 34 HCV (+) patients (64.7%) and 7 of 21HCV (-) patients (33.33%) (p=0.024). Insulin levels of HCV (+) group (13.32 +/- 9.44mIU/mL) were significantly higher than HCV (-) (9.07 +/- 7.39mIU/mL) and the control groups (6.40 +/- 4.94mIU/ mL) (p=0.039 and p=0.021 respectively). HCV (+) patients were younger (40.94 +/- 17.06 and 52.62 +/- 20.64 years, respectively) and had longer dialysis duration (7.18 +/- 3.61 and 2.91 +/- 2.69 years, respectively). Significant positive correlations of HOMA score with insulin (r=0.934, p=0.000) and fasting glucose levels (r=0.379, p=0.043) were found in the HOMA- IR (+) subgroup. Also, a significant positive correlation was found between ALT and insulin levels in the HOMA IR (+) subgroup. C-peptide levels of both HCV (+) and (-) groups were significantly higher than the control group (p < 0.001). There were not any significant correlations between HOMA score and some of the other individual variables including levels of triglyceride, ferritin, ALT, iPTH and Mg in any of the groups. CONCLUSION: In chronic haemodialysis patients; HCV infection is related to a high prevalence of insulin resistance, higher insulin and glucose levels.