ABSTRACT
Background: Prediabetes is the preceding stage of diabetes which puts an individual to induce complications same as that of diabetes; hence, it should be treated to prevent its progression to diabetes and other consequences. However, there is very less literature about impact of home-based physical therapy on glycemic control and quality of life in Indian prediabetic population. Aims and Objectives: The aims of this study were to evaluate whether the home-based physical therapy shows effect on glycemic control and individual’s quality of life after a 3-month intervention. Materials and Methods: The study was conducted on 55 individuals who were diagnosed with prediabetes (36 males and 19 females) on basis of HbA1c level ranging from 5.7% to 6.4%. A 12-week exercise protocol was made which includes warm up exercises, main exercise program (aerobic and strengthening training), and cool down exercises along with dietary changes. SF-36 and HbA1c level is taken at baseline and at the end of 12 weeks for quality of life and glycemic control measures in participants, respectively. Results: The difference in HbA1c levels before and after treatment was found to be statistically significant. The HbA1c levels after the 3-month intervention showed significant reduction (P < 0.008) along with significant difference in all domain of SF-36 except in domain 3 (role limitation due to emotional problem) and domain 6 (social functioning). Conclusion: The home-based physical therapy program is effective in glycemic control and quality of life in adults with prediabetes.
ABSTRACT
Background:Gestational diabetes mellitus (GDM) is a global health challenge and is known to affect pregnancy adversely. Glycosylated haemoglobin (HbA1c) level reflect long term glycaemiccontrol and is a more accurate measure than Fasting Plasma Glucose and post prandial plasma glucose level.Aims and Objectives:To determine the levels of HbA1c, perinatal outcomes and the relationship between maternal HbA1c level and perinatal outcomes in women with GDM at the University of Port Harcourt Teaching Hospital.Materials and Methods: This was a longitudinal study of 80 pregnant women from 36 weeks of gestation with GDM attending the antenatal clinic of the University of Port Harcourt Teaching Hospital (UPTH). Blood samples from all consenting pregnant women were collected and sent to the Chemical Pathology laboratory to determine the HbA1c level. The blood samples from the babies were also sent to determine the random plasma glucose (RPG) level. A structured proforma was used to obtain socio-demographic characteristics and other information. Data collected was analyzed with SPSS version 22.0.Results:The mean age of the women was 32.58 ± 4.95 years. A total of 57 (71.3%) women with GDM had elevated HbA1c levels (≥ 6.5%). Fetal macrosomia occurred in 17.5%, while 8.8% had birth asphyxia. The perinatal mortality ratio was 1.3%. There was a statistically significant relationship between HbA1c levels and neonatal hypoglycemia and perinatal mortality(p <0.05). Conclusion: Despite the higher proportions of adverse perinatal outcomes occurring among those with elevated HbA1c levels, onlyneonatal hypoglycemia and perinatal mortality were significantly associated with elevated HbA1c
ABSTRACT
Background: Diabetes is a metabolic disease which affects various organs of the body like heart, eye, kidney, skin and peripheral nerves. Diabetic cardiomyopathy is defined as the appearance of the symptoms of Congestive heart failure in diabetic patient in the absence of hypertension and any structural or congenital heart disease. The aim of the study is to find the relation between type 2 diabetes mellitus and cardiomyopathy, highlighting the variation in incidence according to age, sex and severity on basis of Doppler echocardiographic diagnosis. Methods: The prospective study was conducted for the duration of one year on 100 newly diagnosed Type 2 Diabetes patients aged between 30-60 years. Doppler echocardiography and HbA1c level of the patients was done. The study was conducted on the basis of grading of diastolic dysfunction on echocardiography. Quantitative data was analysed with the help of ‘t’ test and qualitative data with the Chi- Square and Fisher Exact Test. Statistical significance was taken as P < 0.05. Results: In this study, 39% of the newly diagnosed type 2 diabetes mellitus patients developed diabetic cardiomyopathy. In females, the disease was statistically absent in more patients (35) as compared to males (26) (<0.05). The commonest age group affected by grade 1 disease was 41-50 years. The incidence of grade 2 disease was more in age group 51-60 years. The grade 1 diabetic cardiomyopathy was statistically more common in males as compared to females (<0.05). The grade 2 diabetic cardiomyopathy was more common in females, but was statistically insignificant. Patients with HbA1c <8 have 16% chances to get LVDD with significant P value of 0.02. Patients with HbA1c between 8 to 10 have 30% chances to get LVDD with significant P value of 0.01. Conclusion: Diabetic cardiomyopathy is an important complication of type 2 diabetes mellitus patient. HbA1c level and Doppler echocardiography plays an important role in estimating the prevalence and severity of diabetic cardiomyopathy.
ABSTRACT
Background: Diabetes is a global epidemic and India is regarded as the “diabetes capital of world”. Wound healing deficit are often seen in patients with diabetes mellitus. Aims & Objective: The present study was undertaken to correlate HbA1c level and plasma glucose level with wound complications in postoperative wounds in diabetic patients, to find out relationship of HbA1c and tuberculin test with wound complications, to correlate the role of HbA1c and tuberculin test in prediction of wound complications. Materials and Methods: The study is a prospective analysis of 100 patients from June 2006 to June 2008, in University Hospital in North India. All known diabetic and recently diagnosed diabetic patients with surgical illness were included in the study. All patients were investigated for HbA1c (by micromatTM Hemoglobin A1c test), Mantoux test (intradermally injecting 0.1 ml Tuberculin PPD with tuberculin syringe), blood sugar F/PP, serum albumin. Wound complications have been noted in postoperative period along with co-morbid condition of patients. Selected patients are divided in four group (i) clean wound; (ii) clean contaminated; (iii) contaminated and (iv) diabetic foot / dirty wound. Results: Out of 100 diabetic patients, male to female ratio was 3:2. Maximum number of patients are in age group of 51-60 years, 51 out of 100 patients were associated with comorbid condition. HbA1c level in diabetic patients were < 6 in 13%, 6-8 in 43%, 8-10 in 30% and >10 percent in 14% patients. Mantoux test was positive in 31 out of 92 patients. Wound complication was present in 54 patients, mostly in uncontrolled diabetes. Out of 99 patients, 41 have clean wound, 31 have clean contaminated, 6 contaminated and 21 patients having dirty / diabetic foot. Conclusion: Study show a fair correlation between HbA1c, Mantoux test and wound complication. There is decrease in cell mediated immunity leading to decrease in mantoux test positivity and increase in wound complication.
ABSTRACT
Background: Diabetes is global endemic with rapidly increasing prevalence in both developing and developed countries. There is a high risk of cardiovascular diseases in people with type 2 diabetes, while Abnormal lipid profiles and lipoprotein oxidation (especially LDL-C) are more common in diabetics and are aggravated with poor glycaemic control. The aim of the present study is to assess the glycaemic control status by HbA1c estimation and to compare the lipid profile in type 2 diabetes patients with good glycaemic control (HbA1c≤8) & those with poor glycaemic control (HbA1c>8). Materials and methods: The present study was conducted on 100 type-2 diabetic males aged 40-60 years. Among them 48 patients having HbA1c level ≤8% were categorized as having good glycaemic control (group-1)and 52 patients with HbA1c >8% were categorized as having poor glycaemic control(group-2). Result: A significant increase in S.cholesterol(254.46±45.54), s.LDL(162.57±39.79), S.VLDL(45.98±14.69) and S.triglycerides (225. ±76.61) in group-2 pateints (P≤0.05) were noticed as compare to group-1 patients. Our findings suggest positive association between dyslipidemia and glycemic control on the basis of screening with the HbA1c level. Raised triglyceride and LDL levels are established risk factors for coronary artery diseases. Conclusion: The optimal care of diabetic patients should also include periodic screening for lipid abnormalities and periodic measurement of HbA1C for glycaemic control.
ABSTRACT
Periodontal inflammation is a periodontal disorder of high prevalence in the population. Chronic periodontitis is associated with the accumulation of plaque and calculus as local factors, and systemic factors such an diabetes mellitus (DM) and HIV infection. Cytokine, especially IL-1β as inflammatory mediator for periodontal disease, may directly stimulated iNOS (inducible nitric oxide synthase) expression and NO (nitric oxide) production by β-cells, resulting in NO-mediated β-cell damage. The leucotoxin and proteases produced by periodontal pathogens will induce chemotactic and phagocytotic defect; therefore causing decreased PMN phagocytotic function. Hyperglicemia which occurs in diabetic patients increases calcium influx to the cell, resulting in the increased cytosol’s calcium ([Ca 2+]i) level and; therefore, resulting in dysfunction of PMN and impaired PMN phagocytotic function. Advanced glycosilation endproduct in NIDDM binds to monocytes resulting in the increase of pro-inflammatory cytokines (IL-1, TNFα) and produces activation of macrophages and osteoclasts. Hyperglicemia activates diacyl glycerol (DAG)-protein kinase C (PKC), thus increasing PGE2 and cytokine expression that induce inflammation and periodontal tissue destruction processes. Studies on the effect of scaling to remove calculus disposition on blood glucose control and cellular immune response in DM patient has never been carried out. The aim of the study was to analyze the effect of scaling as non-surgical periodontal therapy on immune response (IL-1β level and PMN phagocytotic function) and blood glucose level of type 2 diabetic patients. Subjects were diabetic patients, 60 controlled-DM (CDM) and 60 uncontrolled-DM (UCDM), in Metabolic-Endocrinology Clinic of Ciptomangunkusumo Hospital, aged 40-60 years. The subjects were divided into treatment (scaling) and control group, and cellular immune response and diabetic status, before and 6 weeks after treatment were evaluated. Statistical analysis (t test) were done using Stata 7.0 software, to compare the parameters before and after scaling in CDM and UCMD subjects. The results showed that scaling decreased IL-1β level and increased phagocytotic function significantly (P<0.05). Scaling decreased fasting and 2 hours post-prandial blood glucose levels and HbA1c level, but the decrease were not significant statistically (P>0.05), except for the decrease in HbA1c level in uncontrolled DM (P=0.00).
Subject(s)
Diabetes Mellitus, Type 2 , Blood GlucoseABSTRACT
Study on 98 type 2 diabete patients have been ill first time or being treat periodic. The result: HbA1C was significant higher than normal subjects at all test times. Means HbA1C values gradually decreased at test times of Co, C3, C6, C9, within at C3 and C6, this value is equivalent. This proved that controling plasma glucose of diabetes was improved better. However, this haven’t satisfied yet with treatment goal. The correlation between HbA1C and plasma glucose is closely direct proportion, between HbA1C and plasma insulin is moderately inverse proportion