ABSTRACT
Background:Type 2 diabetes mellitus (T2DM) is a multifactorial, complex disease associated with chronic hyperglycemia, resulting from the interplay of genetic, environmental, and epigenetic factors. T2DM can causes various disabling complications. Diabetic autonomicneuropathy (DAN) is one of the common complications in diabetes. The taste threshold affected by various factors such as age, ethnic backgrounds, drugs, local and systemic diseases, consumption of alcohol, smoking, and tobacco chewing.Method: The presentstudy is undertaken with the objectives to compare the taste dysfunction of four primary sensations in Type 2 DM with autonomic neuropathy and its relation with glycemic control. The 60 patients of T2DM with autonomic neuropathy and 60 healthy controls were taken for the study. Autonomic neuropathy was assessed clinically. Chemical taste test using four solutions of basic tastes (sweet, sour, salty, bitter) were done.Results: Taste dysfunction for sweet was significant in T2DM with uncontrolled hyperglycemia. The taste dysfunction in T2DM patients was not related to gender, disease duration, and type of treatment taken. The study found a significant correlation between taste dysfunction, HbA1C level and blood sugar fasting level in T2DM patients. Conclusions: The taste dysfunction was mainly for sweet. Sour and bitter did not show any difference in case groups compared to controls
ABSTRACT
Background: The study was conducted to evaluate and compare the protective effects of spironolactone (alone) and its effects along with ACE inhibitor (ramipril) on diabetics (30-70year) in relation to proteinuria and state of diabetic nephropathy.Methods: A comparative, prospective, non-randomized, non-blinded experimental study was conducted on 56 patients (30-70year) of diagnosed type 2 diabetes mellitus showing proteinuria. Total duration of study was about one year from October 2017 to October 2018. Patients were divided in two groups, group A (n=28, spironolactone 25mg and ramipril 5mg) and group B (n=27, spironolactone 25mg). Subjects were followed over 12weeks and baseline and 12-week urine ACR being compared.Results: Both the group after receiving respective drug were followed for 3month duration and response were assessed by measuring urine ACR value at end of 3months. Mean values of baseline and follow up urine ACR for group A and group B were 471.5±465.62, 244.66±237.54 and 474.88±438.94, 268.42±268.16 respectively, P value found to be >0.05 at 95%C.I. It was observed that percentage reduction of urine ACR were 48% and 43.47% in group A and group B respectively.Conclusions: In the study, it was concluded that spironolactone had significant effect over proteinuria reduction over follow up period in patient with diabetic nephropathy though there was no additional statistically significant advantage of addition of spironolactone and ACE inhibitor over proteinuria reduction. Significant reduction of proteinuria occurred in both group A and group B over 12weeks follow up period, 48 % reduction in group A and 43.47% in group B. This difference proved statistically not significant after applying independent t-test.