QT dispersion in type 2 diabetic patients

Diabetes mellitus is one of the most common causes of patient contact with a physician, and is a major cause of premature disability and mortality. Several studies have described a poor survival prognosis in type 2 diabetic patients compared with non-diabetic populations. It has been postulated that QT prolongation and QT dispersion [QTd]. predispose to cardiac arrhythmias and sudden death. The aim of our study was to detect the relationship between [QT corrected] QTc and QTd with type 2 diabetes mellitus. This study included eighty subjects divided into two groups; Group I: included sixty patients with type 2 diabetes and group II: included twenty healthy controls. All subjects were subjected to the following: Careful history taking and clinical examination, assessment of BMI, assessment of cardiovascular autonomic function tests and laboratory investigations including fasting and postprandial blood glucose levels, blood urea and serum creatinine levels, lipid profile, serum electrolytes [Na, K and Ca levels] and electrocardiography [ECG] for measurement of QT interval and calculation of QTc and QTd. The results of our study revealed that QTc and QTd was significantly increased in diabetic patients compared to non-diabetic controls. QTd was significantly related to QTc. QTc and QTd have no relation to the patient's gender. QTc was significantly related to BMI, type of therapy, fasting blood glucose and triglycerides. QTd was significantly related to the patients age, fasting and posiprandial blood glucose levels, triglycerides, HDL-c, type of therapy, presence of cardiac autonomic neuropathy and smoking. QT dispersion should now, be used as a screening test, and those with high QTd should undergo extensive cardiac examinations to identify reversible contributors to future cardiac death, with particular emphasis on examination designed to detect underlying cardiac ischemia. Recommendations: We recommend extending this study to be done on a wider scale and a big number of diabetic patients with different diabetic complications in order to study the correlation of QTc and QTd with diabetic complications

Assessment of thyroid function in patients with. Dysmetabolic syndrome [DS]

The DS is a highly prevalent clinical entity and primarily a lifestyle disease with significant morbidity and premature mortality. We hypothesized that thyroid dysfunction may be relevant to the DS. We studied thyroid function [total T3, total T4, TSH, basal and after 20 and 60 minutes of IV injection of 200 micro g TRH] in thirty five type 2 diabetic patients with DS, in addition to ten age and sex -, matched controls. Fasting serum insulin, S cortisol, S uric acid, and lipogram were also performed for all participants after complete clinical history taking and examination. Body mass index [BMI], Waist [W], hip [H], W/H ratio together with blood pressure measurements were significantly higher in patients than in controls [P<0.001 each]. Furthermore, S cortisol, S insulin and S uric acid were significantly higher in patients than in controls [P< 0.001 each]. In addition total cholesterol [TC], triglyceride [TG], and LDL were significantly raised in patients than in controls while HDL was significantly reduced in patients than in controls [P<0.001 each]. Basal T3, T4, and TSH were not different in patients and controls. However, following TRH injection particularly after 60 minutes, patients were classified into three groups; Group I which had normal thyroid function in 25 patients [71.4%], Group II which had sub-clinical primary hypothyroidism in 4 patients [11.4%], and Group III which had secondary hypothyroidism in 6 patients [17.2%]. All patients with group II and 5 out of 6 patients with group III were females. Moreover, TSH response to TRH injection after 60 minutes was correlated significantly positively with S cortisol [r=.477, P<0.01], S insulin [r=.743, P<0.01,], S uric acid [r=.335, P<0.05], TC [r=.317, P<0.05] and LDL [r=0326, P<0.05,] and correlated significantly negatively with HDL [r= -.341, P<0.05]. The clustering of metabolic abnormalities in DS suggested underlying hormonal disturbances not only in insulin but also in thyroid dysfiunction in the form of sub-clinical hypothyroidism and suspected disturbed hypothalamo - pituitary - adrenal axis. However such conclusions should be re- evaluated on a large number of patients aiming to elucidate a possible dysfunction of hypothalamo -pituitary-thyroid axis in DS

Glycemic control and cardiopulmonary dysfunction in asymptomatic patients with insulin dependent diabetes mellitus

The study was undertaken to evaluate the cardiopulmonary functions in asymptomatic patients insulin dependent diabetes Mellitus [IDDM] and also to investigate the relationship of cardiopulmonary dysfunction to chronic glycemic control and the duration of diabetes. Thirty-three diabetic patients with mean age 26 +/- 7 years, with no history or physical findings of ardiovascular or respiratory disease, were compared with fifteen healthy non diabetic control subjects. According to the level of glycosylated hemoglobin [HBA1c], patients were classified into hyperglycemic [group A n=17] with elevated HbA1c levels and normoglycemic [group B n=16] who had near normal HbA1c levels. Pulmonary function via spirometry and Doppler echocardiogram were performed in all patients and control subjects. The results revealed significant reduction in forced vital capacity [FVC] in patients versus control and in hyperglycemic than normoglycemic patients [58.9 +/- 8.6% vs 67.0 +/- 2.8% respectively'; forced expiratory volume in the first second [FEV1] was also significantly diminished in patients versus control and in hyperglycemic than normoglycemic patients [60.9 +/- 11.0% vs 72.1 +/- 2.9% respectively. Ejection fraction [EF] was significantly diminished in patients versus control and in hyperglycemic patients versus normoglycemics [64.3 +/- 2.4% vs 65.9 +/- 3.0%, respectively. Also fractional shortening [FS] was significantly diminished in hyperglycemic than normoglycemic patients [32.9 +/- 6.1% vs 33.4 +/- 5.6% respectively]

effect of ginseng on glucose, free fatty acids and cholesterol serum levels in diabetic patients

Twenty insulin dependent and twenty non insulin dependent diabetic patients and fifteen controls were studied. Ginseng extract was administered in a dose of 85 mg. t.d.s. for forty five days. A significant decrease was observed in the serum levels of glucose, cholesterol and free fatty acids in groups of patients. It is suggested that ginseng extract contains antilipolytic and insulin like substances