Perception of diabetic patients regarding basal bolus insulin injections and outcome of its use

Objective: To assess the perceptions regarding basal bolus insulin injections and the changes in blood glucose levels and glycosylated hemoglobin [HbA1c] before and after 3 months of such treatment in diabetic patients. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Endocrinology, Liaquat National Hospital, Karachi, from December 2014 to March 2015

Methodology: A total of 222 diabetic patients started on basal bolus insulin injection were enrolled and asked to answer 17 questions. Those with complications of diabetes were excluded. Fasting blood glucose [FBS], random blood glucose [RBS] and HbA1c levels were checked initially, and after 3 months of getting basal bolus insulin. Paired t-test and chi-square test were used for determining p-value with significance at p < 0.05

Results: Majority [n=217, 97.7%] of the patients were previously taking other insulins. Before starting this treatment, the mean FBS was 260.5 +/- 52.2 mg/dl, RBS was 385.5 +/- 47.61 mg/dl and HbA1c was 12.76 +/- 1.92%. After 3 months of treatment, FBS improved to 117.9 +/- 14.2 mg/dl, RBS was 156.7 +/- 17.09 mg/dl and HbA1c was 7.72 +/- 4.41% [p < 0.001]. Two hundred and sixteen [97.3%] patients believed that basal bolus insulin was started as their diabetes worsened; 157 [70.70%] thought that their blood glucose control would improve with the use of this form of insulin. One hundred and ninety four [87.4%] had fear of needle injections. Perceptions regarding hypoglycemia with this form of insulin were observed in 157 [70.7%]. One hundred and twenty seven [84.1%] of the females and 51 [71.8%] of the males thought that the basal bolus insulin regimen was too expensive [p=0.032]

Conclusion: There were many misconceptions in patients who were started on basal bolus insulin. Marked improvement in blood glucose levels and HbA1c were observed after the use of this regimen

Nephro-protective effect of vitamin C and Nigella sativa oil on gentamicin associated nephrotoxicity in rabbits

Oxidative stress causes the generation of reactive oxygen species [ROS] that lead to nephrotoxicity. An aminoglycoside, gentamicin, has pronounced nephrotoxic effect in humans and animals and this study was planned to observe the nephro-protective effect of antioxidants, vitamin C and Nigella sativa oil. Serum creatinine, blood urea nitrogen, and antioxidant activity were measured as indicators of nephrotoxicity for all the groups of rabbits. Results showed that vitamin C and Nigella sativa oil both had nephro-protective effect as they lowered the values of nephrotoxicity indicators [serum creatinine, blood urea nitrogen, and antioxidant activity] as compared to gentamicin control group values. When these two antioxidants were given as combination, they proved to have synergistic nephroprotective effect