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Background: The association of high serum homocysteine concentration and C- reactive protein as a risk factor for the acute coronary syndrome. The aim of study was to evaluate serum homocysteine and hs-CRP level in newly diagnosed ACS patients together with comparison of homocysteine and hs-CRP level in ACS patients with & without type 2 diabetes and also to find out the correlation between serum homocysteine and hs- CRP level among the ACS patient with and without type 2 DM.Material & Methods:This was a cross sectional study and total of 260 patients with new onset of ACS admitted in the CCU, Department of Cardiology, DMCH were included in the study during Jan, 2011 to Feb, 2012. Among them 72 ACS patients with type 2 diabetes was considered as group I and 188 ACS patients without diabetes was considered as group II. Serum total homocysteine level, hs-CRP level and traditional risk factors for ACS were documented from all the study population.Results:Most of the patients were found in 4th decade in both groups. Acute STEMI was more common clinical feature in both groups. The mean serum homocysteine level in all groups of ACS patients were significantly higher in patients without DM in comparison to type 2 DM. Similarly, the mean hs-CRP level in all groups of ACS patients were significantly higher in patients without type 2 DM. The mean serum homocysteine and hs-CRP level were significantly higher in nondiabetic ACS patients. However, dyslipidaemia was significantly higher in patients with type 2 DM. Hypertension, obesity and family history of ACS were not significant between two groups. There was no correlation found between serum homocysteine with serum hs-CRP in ACS patients with type 2 DM and ACS patients without DM respectively.Conclusion: So, both serum homocysteine and hs-CRP level in ACS patients were significantly higher in patients without DM. In ACS, C-reactive protein elevation was a better marker of extension of myocardial damage than homocyesteine. No correlation was found between serum homocysteine with hs-CRP level in ACS patients with and without type 2 DM respectively.
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Introduction: India has the second-largest population of diabetes globally. The long-term complications due to poor glycemic control are concerning. Diabetes Self-Management Education (DSME) is a fundamental component in managing diabetes better. Objectives: This study was conducted to compare the effectiveness of group-based DSME in achieving glycemic control and improving self-care practices among people with type-2 diabetes as against the usual care. Methods: A nonblinded parallel-arm RCT among adults (? 30 years) diagnosed with Type-2 DM. Written informed consent was taken from each patient before enrollment. The sample size is estimated to be 85 in each arm according to the formula for equivalence design for an RCT. Randomization was done using a computer-generated random number table. The control arm received usual care, while the intervention group received group-based DSME in addition to usual care. At the end of 6 months, the change in glycemic control and self-care activity scores were compared between the two arms. Results: A total of 139 individuals (intervention =69; control =70) were analyzed. The proportion of females (62.1%) was higher than males (37.9%). There was no statistically significant difference at baseline. At end line, HbA1c showed a reduction from 9.3% to 6.9% in the intervention arm (P<0.001), which was greater than that in the control arm (p=0.017). All the self-care components showed a statistically significant improvement, except the medication score. Conclusions: Group-based DSME effectively increases self-care practices among people with diabetes, resulting in better glycemic control.
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Background: Type-2 Diabetes mellitus (T2DM) is a metabolic disease characterized by hyperglycemia and may causes long term organs dysfunctions like retinopathy, nephropathy, neuropathy, cardiovascular and autonomic dysfunction. Musculoskeletal and nervous system can also be affected by T2DM resulting pain, dysfunctions and disabilities. Objectives: This study is to find the prevalence of different pain conditions in patients with T2DM.Material & Methods:The study was conducted in public and private hospitals of four cities (Brahmanbaria, Dhaka, Gazipur and Faridpur) of Bangladesh from 1st April to 31st September, 2021. The patients of type II diabetes mellitus with both gender and age above 40 were included, and patients with other active systemic disease of bones and soft tissues were excluded. A self-structured questionnaire was developed. The questionnaire was distributed among 500 patients, out of whom 450 patients responded. The non-probability convenient sampling technique was used for data collection. The data was analyzed by SPSS and percentages were calculated to estimate the musculoskeletal complications in patients with T2DM.Results:The result showed high prevalence of pain conditions in T2DM patients. Older age groups of 61-65 (24%) years suffering from T2DM for more than 3 years having higher bloodsugar level 17-19 mmol/L with positive family history of DM were affected mostly. The prevalence of musculoskeletal pain condition in T2DM was 71.11%, while the low back pain was (42.88%), frozen shoulder was 31.33%, diabetic neuropathy was (26.89%) were the most common musculoskeletal problems, followed by knee pain (17.33%). Conclusions:It is concluded that the prevalence of different pain conditions are high among patients of T2DM and low back pain, shoulder pain, peripheral neuropathy and knee pain are common. These are mostly manageable conservatively.
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Background:Peripheral arterial disease (PAD) is one of the major macrovascular complications of diabetes mellitus (DM) which is largely neglected by clinicians. DM-associated atherosclerosis can lead to complications in all major of vascular beds, including the coronary arteries, carotid vessels, and lower extremity arteries. Aims and objective were tostudy the prevalence of PAD in patients with type 2 DMand to study the correlation with carotid artery intima-media thicknessMethods:Hospital based cross-sectional study was conducted among the 124 patients admitted with type 2 diabetes (age >25 year) from Dec 2019 to Oct 2021 in the various units of department of medicineor surgery, KPS institute, GSVM medical college Kanpur. Color doppler of limbs and carotid artery was done in study population.Results:In our study based on doppler ultrasound, the prevalence of PAD was found in 31 patients (25%) out of 124 with men having a higher prevalence (24 out of 74; 77.4%), as compared to women (7 out of 50; 22.6%) (p=0.020). The mean Carotid IMT (mm) (Average) was 0.82±0.16 in all diabetics. Patients with PAD have more increase in CIMT (0.95±0.12) as compare to non-PAD (0.77±0.15) p<0.001.Conclusions:By using doppler, we found evidence of PAD in 25% of type 2 diabetics (M>>F). Patients with PAD have more increase in CIMT as compare to non-PAD.
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During the last few years India has maximum increase of Type 2 diabetes mellitus. Type 2 diabetes is characterized by high blood sugar, insulin resistance, and relative lack of insulin. There are approximate 72.96 million cases of diabetes mellitus in adult population of India. In modern era single anti-diabetic drug is not sufficient for glucose control. These days multidrug therapy is building its popularity for maintaining glycaemic levels. A 59-year-old female presented with known case of Type 2 diabetes with evidence of polyuria, itching over extremities, and fatigue was poorly controlled despite a drug regimen consisting of oral metformin and glimepiride. Her Blood Sugar level was constantly around 200 mg/dl in spite of having modern medicine with adjusted doses. She has administered Nisha-Amalaki Churna with warm water early in the morning along with standard conventional treatment for 8 weeks. The effect of therapy was evaluated at the interval of 4 weeks for 8 weeks which is done on the basis of objective parameters. Objective parameters were fasting and post prandial Blood Sugar Level. Nisha-Amalaki churna has reduced Blood Sugar Level to normal. It also reduced the dose of conventional drug which may cause side effects with long term use. There is a need for combined multidisciplinary treatment to maintain suggested glycaemic control. Thus, the present case study is to understand the significant effect of Nisha-Amalaki as an adjuvant to standard conventional treatment in chronic uncontrolled type 2 Diabetes Mellitus.
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@#Introduction. Vitamin B12 deficiency is more common among metformin-treated subjects although the prevalence is variable. Many factors have been associated with this. The aim of this study is to determine the prevalence of vitamin B12 deficiency and its associated factors among patients with type 2 diabetes mellitus (DM) who are on metformin. Methodology. A total of 205 patients who fit eligibility criteria were included in the study. A questionnaire was completed, and blood was drawn to study vitamin B12 levels. Vitamin B12 deficiency was defined as serum B12 level of ≤300 pg/ mL (221 pmol/L). Results. The prevalence of vitamin B12 deficiency among metformin-treated patients with type 2 DM patients was 28.3% (n=58). The median vitamin B12 level was 419 (±257) pg/mL. The non-Malay population was at a higher risk for metformin-associated vitamin B12 deficiency [adjusted odds ratio (OR) 3.86, 95% CI: 1.836 to 8.104, p<0.001]. Duration of metformin use of more than five years showed increased risk for metformin-associated vitamin B12 deficiency (adjusted OR 2.06, 95% CI: 1.003 to 4.227, p=0.049). Conclusion. Our study suggests that the prevalence of vitamin B12 deficiency among patients with type 2 diabetes mellitus on metformin in our population is substantial. This is more frequent among the non-Malay population and those who have been on metformin for more than five years.
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Vitamin B 12 , Metformin , Diabetes Mellitus, Type 2ABSTRACT
@#The critical micro-vascular complications of diabetes ultimately result in renal dysfunction known as diabetic nephropathy (DN). Measurement of glomerular filtration rate (GFR) is considered to be an important parameter in renal function assessment, evaluating GFR by Creatinine level. Recently, Cystatin C is used as a substitute indicator in several studies to assess diabetic nephropathy. This work was conceived to determine whether serum cystatinC would replace serum creatinine (Scr) in patients with type2 diabetes for early evaluation of nephropathy. A Case-Control Study was enrolled on 30 Patients with diabetic and 30 apparently healthy as control, aged between 25 - 83 years. Levels of serum cystatine C and serum Creatinine were calculated for both groups. Serum Creatinine, as well as serum cystatin C levels, was significant relationship with diabetic pt. in compared to non-diabetic individuals. ROC analysis noted the cystatinC was more predict indicator in diagnosed Diabetic Nephropathy (DNP) from Serum Creatinine level. In Type 2 diabetics, CystatinC is a good marker for uncontrolled diabetic nephropathy relative to serum creatinine.
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Prevention is always better than cure especially in diseases such as Type 2 DM which is fast gaining the status of a potential epidemic in India with more than 62 million diabetic individuals currently diagnosed with the disease. The disease Madhumeha can be correlated with Type 2 DM. The disease is characterized by metabolic abnormalities and long term complications involving the eyes, kidneys, nerves and blood vessels. Madhumeha being an Anushangi vyadhi will make the person suffer for life time. Complications are further more difficult to treat. Hence it is always recommended in Ayurvedic classics to prevent the manifestation of diseases as much as possible and also to prevent the Upadravas if Madhumeha is already manifested. A good and proper diet in disease is worth a hundred medicines and no amount of medication can do well to a patient who does not follow a strict regimen of diet. Pathya ahara is the first and foremost step while considering the prevention of Madhumeha. Another factor which has important role in the disease manifestation is improper Vihara which can be considered for increased urbanisation, high prevalence of obesity, sedentary lifestyles and stress. Healthy life style has a key role in preventing Madhumeha and also to ease the life with Madhumeha by delaying the complications. Hence the present study is aimed at collecting and compiling various preventive measures which are explained by our Ayurvedic Acharyas to prevent Madhumeha and its complications.
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Introduction: Diabetic kidney disease (DKD) representsone of the most frequent microvascular complications ofdiabetes with an overall prevalence of approximately 40% intype 2 diabetes population. Microalbuminuria is one of themost serious problems in type 2 DM. Vildagliptin, DPP-4inhibitors, is a novel oral anti-diabetic drug for the treatmentof type 2 diabetes mellitus (T2DM). The objective of the studywas to evaluate the therapeautic efficacy of vildagliptin onmicroalbuminuria in type 2 diabetes mellitus.Material and methods: We included in our study 103 T2DMpatients with microalbuminuria. Exclusion criteria: NSAIDsinduced nephropathy, Lupus nephropathy, Polycystic KidneyDisease, Medullary Sponge Kidney, All causes of nephriticand nephrotic syndrome, ESRD due to diabetes mellitus andmoderate to severe hepatic failure. We measured UrinaryACR value of parameters at 0,3.6,9,12 months respectively.Vildagliptin was given to those patient and was observed thatafter giving vildagliptin was there any change in albumin tocreatinine i.e microalbuminuria.Result: The mean of ACR baseline (mean±s.d.) of patientswas 125.1436 ± 58.810 with range 50.7000 - 298.0000 and themedian was 100.0000. The mean of ACR of 3, 6, 9, 12months(mean±s.d.) of patients were 110.3184 ± 57.5647, 106.7340 ±48.8492, 103.7252 ± 45.6745, 95.4466 ± 62.342 respectively.Association of ACR in five groups was not statisticallysignificant (p=0.6118).Conclusion: We found that after 12 months of therapy withvildagliptin, a DPP-4 inhibitor, there was some reduction ofACR and it is approximately 30%
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Inflammation plays a vital role in accentuating the formation of atherosclerotic plaque in diabetes mellitus. So, the measurements of inflammatory markers provide a method of assessing cardiovascular risk. Among the inflammatory markers, highly sensitive C-reactive protein (hs-CRP) is used to detect the low-level inflammation when it is within the normal range. Also, hs-CRP measurement may be useful for assessment of the risk of complication in diabetes patients. So, the present study is conducted to measure plasma hs-CRP level in T2DM and to determine adequate glycaemic control reduces hs-CRP level. The objectives of this study were to correlate HbA1c and hs-CRP in T2DM and predict cardiovascular risk with glycaemic status.Methods: Authors took 50 diabetic patients. The investigation includes FBS, PPBS, hs-CRP and HbA1c. hs-CRP is measured by immunoturbidimetry method. The reports were collected and compared with normal reference range.Results: The correlation between hs-CRP levels and HbA1c level after six months show a significant relationship where mean HbA1c values on day 1 and after 6 months were 8.088±1.219 and 7.518±0.693 respectively. The hs-CRP values were 2.508±1.050 on day 1 and 2.15±0.927 after 6 months proving that better glycaemic controls decrease hs-CRP thereby decreasing cardiovascular risk.Conclusions: hs-CRP values are directly related to HbA1c and better glycaemic control reduces risk of CVD.
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Background: To evaluate the comparison of clinical outcomes of sitagliptin +metformin and glimepiride in uncomplicated Type-2 diabetics.Methods: This one year (July 2016 to August 2017) prospective, open label, observational clinical cohort study was carried out on type-2 diabetics. In this study 299 Type-2 diabetics patients were enrolled and were randomly allocated to two groups viz Group A and Group B. Group A received sitaglitin+metformin (50+500) mg/day and Group B received glimepiride 1mg/day respectively. The follow up started after 10 days of stabilization of the patient and data recorded on 10th day was considered Zero month data and follow up continued up to Six month in each group. Comparison of FPG, PPG and HbA1c was evaluated between zero and six months within group and at six month between groups. Adverse events were recorded and summarized by treatment group.Results: At the end of six months follow up the patients of Group A who received sitaglitin+metformin (50+500) mg/day had greater reduction in FPG, PPG and HbA1c (all P<0.001) was recorded when compared between zero and six month within group. A significant reduction in FPG, PPG and HbA1c (all P<0.01) also recorded in Group B who received glimepiride 1mg/day when compared between zero and six months within group. A statically significant difference (all P<0.05) was recorded at six months between group. The adverse events like hypoglycemic episodes, gastrointestinal adverse events etc were greater in Group B than Group A. Changes in weight also noted in both Groups. Weight loss in Group A and weight gain in Group B was recorded.Conclusions: The present study suggests that a significant difference may be existing in the clinical outcome interm of glycemia control and adverse events between sitagliptin+metformin combination and glimepiride in type-2 diabetic patients.
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Background: Metformin is considered as the first-line antidiabetic agent in the treatment of type 2 diabetes mellitus (T2DM) due to its effect on glucose and lipid metabolism. The mechanism of action of Metformin in improving hyperglycemia involves in improving the signaling of insulin together with suppressing hepatic gluconeogenesis. Methods: 45 patients with type-2 diabetic patients on metformin therapy with an age ranged from 30 to 65 years along with 45 healthy controls were recruited from the General Medicine Department of HMCH, Rourkela according to inclusion and exclusion criteria. RESULTS: The mean age and BMI of both the cases and controls were 48.62 ± 7.94 and 43.52 ± 5.24; 28.04 ± 4.34 and 26.54 ± 3.32 respectively. Mean serum vitamin B12 levels in the case group was 217.45±86.32 and in control was 370.08±91.6and the difference was statistically significant. Conclusion: Metformin which is first line oral hypoglycemic agent as recommended by ADA is significantly associated with decrease in vitamin B12. There is moderate correlation between the markers of B12 status and levels of fasting blood sugar as well as HbA1C. There is a significant correlation between insulin and C-peptide with the markers of vitamin B12 status.
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Background: Non-alcoholic steatohepatitis (NASH) is commonly associated with type 2 diabetes mellitus (DM). Prevalence of NASH in type 2 DM has not been well studied and there is an epidemic rise in type 2 DM in Asian and Western populations. Its association with chronic liver disease in the form of NASH makes it an important health problem. Hence, we have studied its prevalence and correlation of biochemical parameters with histological grades of non-alcoholic fatty liver disease (NAFLD) in otherwise asymptomatic type 2 DM patients. Materials & Methods: One hundred and twenty-five individuals were screened. N=30 individuals were excluded due to history of alcohol intake or liver disease as a result of other causes. N=95 non-alcoholic individuals with type 2 DM underwent abdominal ultrasonography (US abdomen). N=28 patients had evidence of fatty liver on US abdomen, and 16 of these 28 patients underwent liver biopsy. Results: Out of 125 patients enrolled with the suspicion of Nonalcoholic Fatty Liver Disease (NAFLD) and Non-alcoholic steatohepatitis in patients of Type 2 Diabetes Mellitus, female patients were 70 (56%) and male patients 55 (44%). The prevalence of NAFLD was found to be more in females n=40 than males n=30. N=16 patients were undergone liver biopsy for the suspicion NASH. Out of 22 patients suspected, only 9 patients were found to be having NASH. Conclusion: We conclude that the prevalence of NASH is high in type 2 DM patients and liver biopsy is the only investigation to differentiate between non-alcoholic fatty liver and steatohepatitis.
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Background & Objective: Type 2 Diabetes mellitus(DM) is a chronic disease. It isone of the important causes of increasing morbidity and mortality in India, which is now known as ‘Capital of Diabetes’. It affects all the major systems in the body bringing down the quality of life of the patient. Objective is to assess the Three - minute walk distance in patients and to compare it with the age and gender matched healthy controls. Methodology: A cross- sectional tertiary care Government hospital based study was conducted in forty diagnosed patients of type 2 DM taking oral hypoglycemics, aged between 40-60 years. All the patients were thoroughly interviewed by a well structured questionnaire, which included personal details as well as the history of complications. 3- Minute walk test was conducted, as per the standardized technique in diabetic patients as well as age and gender matched healthy controls. The distance was compared by applying unpaired t test. Results: The mean 3-minute walk distance in patients of type 2 DM was 139.55±54.90 meters as compared to controls which was 200.01± 45.40 meters. The decrease in distance was statistically highly significant (p<0.001). Conclusion: Type 2 Diabetes mellitus affects walking distance of the patient bringing down the quality of life. These findings are useful for targeting the importance of treatment of diabetes, which needs to be addressed with priority to improve the quality of life.
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Introduction: Type 2 diabetes is an increasingly common metabolic disorder characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetes mellitus is frequently associated with dyslipidemia and an increased percentage of glycated hemoglobin. Patients with type 2 diabetes mellitus are at increased risk for cardiovascular complications. Objective: To assess the relationship between glycemic control (as reflected by glycated hemoglobin; HbA1c) and serum lipid profile in type 2 diabetic patients. Materials and Methods: A total of 60 patients were selected from those attending Diabetes Mellitus Clinic, Seventeenth of February Teaching Hospital, Al- Baida as outpatients. The subjects were divided into 3 groups such as group I as the control group, group II as the diabetic group with all related complications excluded and group III as those with type 2 DM with atleast cardiovascular event in the last two years considered as cardiovascular complication of DM. Blood samples were collected from all the subjects and tested for glucose level, glycated hemoglobin, total cholesterol, triglycerides and HDL cholesterol using authenticated reagents kits on an auto analyzer. LDL cholesterol was calculated using Friedwald’s formula. Results: The levels of glycated hemoglobin (p<0.0001), fasting glucose level (p<0.0001) and triglycerides (p<0.0001), were significantly raised and HDL cholesterol (p<0.0001) is found to have significantly decreased in diabetic patients with or without cardiovascular complications. In those patients with diabetic complications, total cholesterol and low density lipoprotein cholesterol were significantly raised and high density lipoprotein cholesterol significantly decreased when compared to control subjects. Conclusion: The findings of the study showed significant positive correlation between glycated hemoglobin with the levels of total cholesterol, triacylglycerol, and low density lipoprotein cholesterol in both control and diabetic groups with or without complications. Glycated hemoglobin level was significant and positively correlated with total cholesterol and triglycerides in type 2 DM.
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The prevalence of Type 2 diabetes mellitus (T2DM) is increasing worldwide and many of these affected individuals remain unidentified. Undiagnosed T2DM may impose substantial public health implications because these individuals remain untreated and at risk for complications. The objective of this study was to determine the national prevalence of undiagnosed T2DM and to identify the associated risk factors. A nationwide cross-sectional study was conducted involving 17,783 respondents. Two-stage stratified sampling design was used to select a representative sample of the Malaysian adult population. Structured validated questionnaires with face to face interviews were used to obtain data. Respondents, who claimed that they were not having diabetes, were then asked to perform a fasting blood glucose finger-prick test by Accutrend GC machine. The prevalence of undiagnosed T2DM was 8.9% (n=1587). The highest percentage of undiagnosed T2DM was found among males (10.2%), 55-59 years old (13.4%), highest education attainers of primary school (11.1%), Indians (10.3%), married (10.3%), working (8.9%) and living in the urban areas (9.2%). Multivariate analyses showed that factors associated with undiagnosed T2DM were gender, age group, ethnicity, marital status, obesity and hypertension. This study found an increasing trend of undiagnosed T2DM in Malaysia compared to 2006. This finding is alarming as risk factors associated with undiagnosed diabetes were related to most of the socio-demographic factors studied. Therefore, early diabetic screening is crucial especially among adults aged 30 and above to prevent more serious complications of this disease.
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Human serum paraoxonase is physically associated with HDL and has been implicated in the detoxification of organophosphates and possibly in the prevention of LDL lipid peroxidation and therefore retards atherosclerosis. HDL levels are inversely related to the risk of developing atherosclerosis. We investigated the serum activity and concentration of paraoxonase and HDL levels in 104 subjects (42 diabetic patients without complications, 42 controls, 20 diabetic patients with complications.). Paraoxonase activity was found to be lower in diabetic patients than in controls. Similarly there was reduction in HDL levels in cases suggesting a positive correlation between HDL and paraoxonase levels.
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Background: Diabetic retinopathy is a vascular disorder affecting the microvasculature of retina. It is caused by changes in the blood vessels of retina. If untreated, it may lead to blindness which is usually preventable if retinopathy is diagnosed early and treated promptly. In ophthalmology, color Doppler imaging is a new method that enables us to assess the orbital vasculature. It allows for simultaneous two dimensional anatomical and Doppler evaluations of hemodynamic characteristics of retinal artery. Objective: To observe the difference between Doppler flow velocity indices (peak systolic velocity, end diastolic velocity and resistive index) of retinal artery in type 2 diabetic subjects without retinopathy and those of normal controls. Materials and Methods: This case-control study was carried out in the department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) in collaboration with Ophthalmology Outpatient Department, BIRDEM, Dhaka from July 2011 to June 2013. Eighty diabetic patients without retinopathy aged 27–68 years were enrolled as cases and age and sex matched 80 healthy subjects were selected as controls. Type 1 diabetic patients, type 2 diabetics with retinopathy, hypertensive and dyslipidemic subjects were excluded from the study. All the selected subjects underwent duplex Doppler ultrasonography of both eyes using 5 to 7.5 MHZ linear phase transducer. Duplex color Doppler findings including spectral analysis (PSV, EDV and RI) were recorded. Unpaired t test was done to compare blood flow velocity indices of retinal artery in type 2 diabetic patients without retinopathy and that of healthy control subjects. p value <0.05 was considered as significant. Results: Majority (42.5% and 47.5%) of subjects were in 4th decade of life in both groups with predominance of males. The mean duration of diabetes was 4.56 ± 2.1 years. Mean peak systolic velocity (PSV) in 80 diabetic patients without retinopathy was 10.70 ± 1.50 cm/sec ranging 5.30–16.10 cm/sec and that of 80 healthy subjects was 11.27 ± 0.98 cm/sec ranging 9.0–13.10 cm/sec. Mean end diastolic velocity (EDV) in 80 diabetic patients without retinopathy was 2.58 ± 0.67 cm/sec ranging 1.00 –5.10 cm/sec and that of 80 healthy subjects was 4.11 ± 2.7 cm/sec ranging 3.00–4.60 cm/sec. Mean resistive index (RI) in 80 diabetic patients without retinopathy was 0.75 ± 0.04 ranging 0.66–0.81 and that of 80 healthy subjects was 0.64 ± 0.02 ranging 0.60–0.70. Mean difference of retinal arterial RI of diabetic subjects without retinopathy and healthy control eyes was statistically significant (p<0.001). Conclusion: From the present study it can be concluded that, there is statistically significant difference between retinal arterial RI of type 2 diabetic patients without retinopathy and that of healthy control adult subjects.
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Increase in diabetes mellitus (DM) is a major health concern. Offspring’s of subjects with diabetes are known to express various trait characteristics. In the present study, anthropometric and metabolic parameters among healthy offspring’s with (cases, n=50) and without (control, n=50) family history of type 2 DM is compared. Anthropometric measurements, fasting blood sugar and lipid profile were estimated. Cases showed significant increase in their anthropometric measurements than controls and they also demonstrated significant increase in total cholesterol, LDL and decreased HDL and HDL/LDL ratio. Cases were further categorized into two subgroups based on BMI (group 1, BMI=21.55±1.7 kg/m2, group 2, BMI=29.03±4.3 kg/m2). Groups 2, inspite of showing significant increase in their anthropometric measurements than group1 the lipid profiles were comparable. Thus, demonstrating a temporal dissociation between anthropometric and lipid changes, former preceding the later. Therefore, in younger age group, anthropometric measures could be used for risk stratification and as a metric to evaluate the efficacy of preventive intervention.
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PURPOSE: Monocyte chemoattractant protein-1 (MCP-1) is a chemokine that can increase adhesion molecule expression on monocytes and produce superoxide anions. Hyperglycemia induces MCP-1 production in vascular endothelial cells and retinal pigmented epithelial cells, and has been implicated as a causal factor in the facilitation of vascular complications in diabetes. In the present study, we evaluated the association of a single nucleotide polymorphism (SNP) in the MCP-1 gene with proliferative diabetic retinopathy (PDR) in a Korean population with type 2 diabetes. MATERIALS AND METHODS: We conducted a case-control study, which enrolled 590 subjects with type 2 diabetes, and SNP genotyping of c.2518A/G in the MCP-1 gene was performed using polymerase chain reaction followed by digestion with PvuII restriction enzyme. RESULTS: The prevalence of c.2518A/G polymorphism in diabetic patients was 13.2% (A/A), 47.1% (A/G) and 39.7% (G/G). In patients with diabetic retinopathy, the prevalence of PDR was significantly higher (p=0.009) in diabetic subjects with the c.2518A/A genotype (35.9%; n=78) compared to those with either the A/G or G/G genotype (22.3%, n=512). The prevalence of any other micro and macro-complications, including nephropathy and cerebrovascular events, were not different according to the c.2518A/G genotype. CONCLUSION: Our new genetic findings suggest that the c.2518A/A genotype in MCP-1 could be used as a susceptibility gene to predispose Koreans exhibiting type 2 diabetes for the development of PDR.