Anthropometric criteria of type-2 diabetics attending national institute of diabetes and endocrinology [NIDE]

Egyptian people have a body shape and cardiovascular risk profiles different from that of other ethnic populations. This study aimed at assessment of anthropometric indices of type-2 diabetics attending National Institute of Diabetes and Endocrinology [NIDE] and to examine the association of these anthropometric indices with hypertension, dyslipidemia, and uncontrolled DM among type-2 diabetics. Besides, to determine which indices can best predict these individual risk factors among these patients. A total of 500 type-2 diabetic patients [79.2% females and 20.8% males], of which 79.6% were obese and 20.4% non obese were enrolled in this work. Their mean age was 51.2 +/- 6.36 year and their mean duration of DM was 11.5 +/- 6.26 year. The anthropometric indices [BMI, WC, WHR and WHTR] of our type-2 diabetics were measured. The history taking, a thorough physical examination and blood sampling for fasting plasma glucose, lipid profile, glycated hemoglobin and creatinine were done for every patient. The prevalence of obesity, central obesity, hypertension, dyslipidemia and uncontrolled DM among our patients were of 79.6%, 89.6, 49.9%, 93.0% and 87.0%, respectively. Most of anthropometric indices [all except WHR] were associated with blood pressure [systolic and diastolic] but all of them were associated with some types of blood lipids. Binary logistic regression revealed that WC was the only anthropometric predictor of hypertension and dyslipidemia among our type-2 diabetics. Both obesity and central obesity are very common among our type-2 diabetics particularly in females. Although most of anthropometric indices are associated with high blood pressure and blood lipids levels, waist circumference is the only anthropometric predictor of hypertension and dyslipidemia among our type-2 diabetics

Profile of the thyroid function and ultrasound among patients with type-2 diabetes mellitus

Both diabetes mellitus and thyroid disorders are common in the general population. A lot of studies in different countries have tried to estimate the prevalence of thyroid disorders among type-2 diabetics. The aim of our work was to evaluate thyroid function, autoimmunity and morphology among patients with type-2 diabetes attending medical clinics at National Institute of Diabetes and Endocrinology [NIDE]. The study subjects included 250 type-2 diabetics and 50 healthy non-diabetic persons of matched age and gender who were recruited from medical clinics of [NIDE]. Routine and related specialized investigation [HbA1c, lipids profile, thyroid function tests and anti-thyroid autoantibodies] and thyroid ultrasound were done for all study subjects. Both thyroid dysfunction [13.1%] and abnormal thyroid ultrasound findings [47.6%] were significantly higher among diabetic patients than control subjects with higher frequency among females than males. The ratio of frequency of thyroid dysfunction in females to males was [14.7%: 7.5%], while the abnormal thyroid ultrasound findings female to male ratio was [51.5%: 34.5%]. Thyroid autoimmunity was comparable among both type-2 diabetics and control subjects. Hypothyroidism [subclinical 6.3% and overt 3.4%] was the most common thyroid dysfunction and nodular [multinodular and solitary] disorders were the most frequent abnormal thyroid morphology among diabetic subjects. While female sex, fasting plasma glucose, LDL, freeT4 and free T3 were associated with TSH [as a marker of thyroid dysfunction], linear regression revealed that the fasting plasma glucose, free T4 and free T3 were the independent risk factors for thyroid dysfunction. High prevalence of both thyroid dysfunction and abnormal thyroid morphology were determined among type-2 diabetics. These conditions not only occurred more frequently among female than male diabetics but also were associated with comparable lipid profile to non-diabetics. The frequency of thyroid autoimmunity was high among type-2 diabetics with thyroid dysfunction denoting the important role of autoimmunity in development of thyroid dysfunction among type-2 DM. Hypothyroidism [subclinical and overt] was the most common type of thyroid dysfunction while nodular [multinodular and solitary] disorders were the most abnormal thyroid morphology reported among these patients. The fasting plasma glucose, free T4, free T3 and anti-TPO antibodies were predictors for thyroid dysfunction while patient's age was the only predictor of abnormal thyroid morphology

Echocardiographic evaluation of diastolic dysfunction in normotensive patients with type-2 diabetes mellitus

Diastolic dysfunction in diabetic patients is believed to represent an earlier stage in the natural history of diabetic cardiomyopathy. Previously published reports on the prevalence of LV diastolic dysfunction in diabetics are conflicting, mainly because of the confounding effect of systemic hypertension and coronary artery disease [CAD] and neglecting to account for pseudonormal patterns of ventricular filling. This study was conducted to estimate the prevalence of diastolic functions in patients with type-2 diabetes without co-existing hypertension or known CAD and to assess the risk factors for the development of diastolic dysfunction in such patients. A total of 100 normotensive patients with type-2 diabetes without any history of cardiac illnesses and 50 age and sex matched healthy controls, were enrolled in this work. All patients and controls underwent conventional Doppler echocardiography, color M-mode echocardiography and tissue Doppler imaging [TDI]. In the diabetic group, 76% had diastolic dysfunction. Impaired relaxation and pseudonormal filling pattern were observed in 30% and 46% of our diabetics respectively. On the other hand, impaired relaxation and pseudonormal filling pattern were observed in 8% and 2% of the controls. The diabetics with diastolic dysfunction were older and had more central obesity than those with normal diastolic function. Both age and waist circumference were associated with the presence of diastolic dysfunction but age was the only independent risk factor for such condition. The prevalence of diastolic dysfunction is very high in normotensive type-2 diabetics, who are free of clinically detectable heart disease. Patient's age appears to be an independent risk factors for such condition in such patients