ABSTRACT
Background: In addition to its effect on the bones, vitamin D has a myriad of extra skeletal roles. It has been implicated both in the development of type 1 and type 2 diabetes mellitus as well as glycemic control. There is widespread vitamin D deficiency in Pakistan. Incidence of diabetes mellitus is also increasing exponentially. There is a need to define the relationship between 25 hydroxy vitamin D and type 2 diabetes
Objective: The purpose of this study was to determine the prevalence of hypovitaminosis D in type 2 diabetes and its association with the level of control of diabetes mellitus
Materials and methods: This descriptive cross sectional study was conducted at the Department of Internal Medicine, Sir Syed College of Medical Sciences and Hospital Karachi from January to June 2015. Total 168 adult cases of Male and Females patients having type 2 Diabetes Mellitus were included. After taking the informed consent; demographic details, duration of diabetes, and modes of treatment for diabetes were recorded. The glycemic profile and levels of vitamin D were assessed. Glycemic control was categorized as satisfactory and unsatisfactory glycemic control while vitamin D levels were categorized as sufficient, insufficient and deficient. The data was analyzed on SPSS version 20.0. Mean +/-SD was computed for quantitative variables. Frequency and percentages was computed for categorical variables. Relationship of the glycemic control with vitamin D was computed through Chi-square test. P-value of <0.05 was considered significant
Results: Among 168 cases [45.2% males and 54.8% females], mean age was 46.7+/-12 years and mean duration of diabetes 7+/-4.4 years. Mean HbA1c was 8.3 +/-2.28 with 62% patients having unsatisfactory glycemic control. A large proportion of the patients had vitamin D deficiency [80.8%]. Deficiency of vitamin D was significantly associated with both fasting and random blood glucose levels as well as HbA1c
Conclusion: A large majority of patients with type 2 diabetes mellitus have vitamin D deficiency and the poorly controlled diabetes mellitus is significantly associated with vitamin D deficiency
ABSTRACT
To assess the clinical efficacy of Metformin in the prevention of fetal macrosomia and neonatal morbidity in gestational diabetes pregnancies compared with insulin treatment. In this interventional study, randomized clinical trial a total of 150 patients with gestational diabetes between 20-35 weeks of gestation were selected for pharmacological treatment using metformin or insulin during the study period form 20-Dec-2008 till 20-Dec-2010 from Antenatal OPD after screaning with 75 grams OGTT. The primary outcomes were fetal macrosomia and neonatal morbidity. Patients on metformin and insulin were matched in age, parity, BMI and gestational age at study entry. Mean birth weight did not differ in both groups but fetal macrosomia was less in metformin group than in insulin group 18.67% V/S 10.65% P < 0.05. Neonatal morbidity and NICU admissions were less in metformin group. Metformin is a safe and effective alternative to insulin in gestational diabetes. Metformin treatment resulted in less fetal macrosomia and fewer NICU admissions and neonatal morbidity with advantages of cheap oral therapy in our resource poor setting