Does insulin resistance correlate with routine blood examination? A review on erythrocytes of obese patients.

Aim: to identify whether hyperinsulinemia/insulin resistance affects the hematologic parameter of routine blood, especially the erythrocytes. Methods: cross sectional study was conducted on seventy one non-smoking obese patients who were not pregnant, not having lactating period, aged >22 years of age and visited the outpatient clinic of Endocrinology and outpatient clinic of Kidney and Hypertension division at the department of Internal Medicine Dr. Sardjito Hospital, Yogyakarta. Patients with cerebrovascular and blood disease; taking drugs affecting blood e.g.: cytostatics, and erythropoietin; and patients taking insulin, beta blocker, or steroids were excluded. Data on age, gender, body weight, and body height were recorded. Examinations on fasting blood glucose, fasting insulin, total cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), and routine blood were performed in the condition of ten hours of fasting. All laboratory examination was conducted at Prodia Laboratory, Yogyakarta. Results: of seventy one obese patients, 51.5% were male, and 9.1% were diagnosed with diabetes mellitus (DM) during the study and the mean age was 47.09+5.74 years, the mean body mass index was 28.07+4.07 kg/m2, the mean of hemoglobin level was 13.75+1.57 g%; the mean of leukocyte count was 7.86+1.19 103/mm3; erythrocytes count was 4.93+0.44 106/mm3; platelet count 300.28+80.57 103/mm3; and hematocrite count 41.23+4.28. There were very weak and statistically insignificant negative correlation between Log HOMA IR and erythrocytes (r= -0.048; p=0.693) Conclusion: this study demonstrates that insulin resistance has a very weak correlation with erythrocytes counts and it is statistically insignificant.

The difference between mean plasma levels of von Willebrand factor and platelet aggregation in type 2 diabetes mellitus with and without peripheral vascular disease at sardjito general hospital, yogyakarta.

Aim: to determine the differences in mean plasma values of von Willebrand factor and platelet aggregation in type 2 DM patient with or without peripheral arterial disease. Methods: this is a cross-sectional study, conducted from August to December 2006, in Dr. Sardjito General Hospital Yogyakarta, on type 2 DM patients, aged 50 years and above, and signed the informed consent. The exclusion criteria are cardiac failure, renal insufficiency (creatinine clearance <30 ml/minute), malignancy, acute disease, decrease hepatic function, having ulcer or DM gangrene, amputation, taking multivitamine and/or antiplatelet, and smoking. All samples that matched inclusion criteria were divided into 2 groups: with peripheral arterial disease and without peripheral arterial disease. The data of subjects are presented as mean and standard deviation and proportion. Variables with numeric data are analized with the student t-test for normal distribution and with Mann-Whitney U-test for abnormal distribution. Significancy limit was set at p value of <0,05. Statistical analysis was done by using SPSS 11.5 software. Results: there were 17 subjects having PVD. There were no significantly differences of mean vWF plasma levels (140.544 + 76,137% vs. 133.325 + 53,246%) and platelet aggregation (87.741 + 19.886% vs. 93.981 + 10.138%) between type 2 DM with and without PVD (p >0.05). Conclusion: there were no statistically difference in mean vWF plasma levels and platelet aggregation between type 2 diabetes mellitus with and without PVD.

Hypoadiponectinemia: a risk factor for metabolic syndrome.

Aim: to find out correlation between plasma adiponectin levels, insulin resistance and IDF criteria of Mets Patients. Methods: a case-control study was conducted on Native Javanese people from June 2006 to Januari 2007 in Outpatients Clinic of Dr Sardjito Hospital. The case group involved patients aged between 20 to 55 years old. The diagnosis of metabolic syndrome was confirmed according to IDF criteria. Patients without metabolic syndrome with matching age and sex,were taken as control group. Results: there were significant differences between case andh control group for BMI (body mass index) (30.2 +/- 4.1 vs 26.9 +/- 4.7 kg/m2), waist circumference (93.5 +/- 7.9 vs 84.4 +/- 11.5 cm), triglyceride (207.4 +/- 101.8 vs. 119.3 +/- 71.5 mg/dL) , HDL cholesterol (48.6 +/- 9.4 vs. 59.9 +/- 11.8m g/dL), systolic blood pressure (132.8 +/- 17.9mmHg vs 120.6 +/- 13.5 mmHg) and diastolic blood pressure (83.8 +/- 8.5 mmHg vs. 79.4 +/- 10.7), fasting blood glucose (128.3 +/- 40.8 mg/dL vs. 100.7 +/- 29.4 mg/dL), HOMA index (6.7 +/- 17.4 vs. 2.0 +/- 2.0) and adiponectin levels (3.8 +/- 1.4 vs. 5.9 +/- 2.5), respectively. For metabolic syndrome, hypoadiponectinemia showed the OR value of 6.0 (95% CI 2.13 to 16.98); insulin resistance showed the OR value of 5.7 (95% CI 1.3 to 25.02), after adjustment for waist circumference, TG, HLD, blood pressure, fasting blood glucose. Conclusion: hypoadiponectinemia and insulin resistance represent independent risk factors for metabolic syndrome development.

Effects of dietary pattern and education on glycemic control in patients with type 2 diabetes mellitus at Dr. Sardjito Central General Hospital, Yogyakarta.

AIM: to recognize the effect of education and diet on glycemic control in patients with type 2 diabetes mellitus at Dr. Sardjito Central General Hospital, Jogjakarta. METHODS: a cross-sectional study was conducted in 88 patients with type 2 DM who had routine visit to the outpatient clinic in Endocrinology Division of Dr. Sardjito Central General Hospital, Jogjakarta. As inclusion criteria, patients who had routine visit in 3 month continuously with fasting plasma glucose (GDN) < or = 126 mg/dl was participated as a well glycemic control group, and the one with GDN > 126 mg/dl as poor glycemic control group. Data were recorded which included age, sex, period of DM, daily diet pattern, and education received. RESULTS: we found that glycemic control was not affected by sex (p=0.52) and age (p=0.38), but it was affected by period of DM (p=0.02). Glycemic control in the present study was affected by dietary pattern (p=0.01), but not by education (p=1.00). CONCLUSION: the present study has found significant correlation between regulation of dietary pattern and glycemic control (p=0.01).