ABSTRACT
Introduction: Prevalence of diabetes is increasing worldwide. Good glycemic control is essential for prevention of complications of diabetes. Despite of availability of multiple medications, it is difficult to achieve good glycemic control. Insulin therapy is considered to be the best option available for attaining glycemic control. But, whether insulin therapy has achieved it is an important question to be addressed. Objective: To assess the glycemic control in subjects with diabetes on insulin therapy. Materials and Methods: A cross-sectional study was done at Karnataka Institute of Endocrinology and research, Bangalore, in 448 diabetic patients who were on insulin therapy as a part of their diabetic therapy. Data collected was analyzed using SPSS 22 version software. Results: Majority of the subjects were men (61.38%) and in the age group of > 60 years (44.9%). Many of the subjects on insulin therapy had duration of diabetes > 5 years, with 36.4% having duration of 10-20 years, while another 36% had duration of 5 -10 years. Premixed insulin (81.47%) was the most commonly used insulin regimen. 82.6% of the subjects were on conventional insulin and only 13.2% were on insulin analogues. Insulin syringe was the most commonly used delivery device, with 64.7% of subjects using it, while insulin pen was used by 33.5% subjects. Despite of insulin therapy, the glycemic control was poor and 81.4% had HbA1c >8%. Only 5.7% of the subjects had HbA1c <7%. 94.9% of the subjects reported that they were regular with their insulin therapy. Only 20.1% adjusted the insulin dose by self. Conclusions: The present study has found that despite being on insulin therapy, large percentage of subjects was unable to achieve good glycemic control.
ABSTRACT
Introduction: Subjects with diabetes have a higher prevalence of thyroid disorders compared to the general population. The reported prevalence of thyroid disorders is 10-24% in subjects with diabetes and 6 - 13% in subjects without diabetes. Auto immunity is held responsible for the increased prevalence of thyroid dysfunction in diabetes. Studies have proven the higher rates of autoimmune thyroid dysfunction in type 1 diabetes, but there is very little information regarding thyroid autoimmunity in type 2 diabetes. Objective: To estimate the prevalence of thyroid dysfunction and thyroid autoimmunity in women with type 2diabetes. Material and Methods: Samples for thyroid function test including free thyroxin (fT4), thyroid stimulating hormone (TSH) and thyroid peroxidase antibodies (anti -TPO) were obtained from 100 women with type 2 diabetes, attending the outpatient department of Karnataka Institute of Endocrinology and Research, Bangalore. Results: Thyroid dysfunction was found in 42% subjects, where 36% had subclinical hypothyroidism and 6% had overt hypothyroidism. Anti - TPO positivity was seen in 30% of the subjects. Anti-TPO positivity was found in 24.1% euthyroid subjects, 33.3% subclinical hypothyroid subjects and 66.7% overt hypothyroid subjects. Significant positive correlation was observed between anti-TPO and TSH (p value <0.001*). No statistically significant association was found between thyroid dysfunction and age, BMI, Hba1c, and diabetes duration. Conclusions: The prevalence of thyroid dysfunction is significantly high in women with type 2 diabetes. The most common abnormality is subclinical hypothyroidism and autoimmunity is the cause of thyroid dysfunction in large proportion of these subjects.