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Introduction: The numbers of people affected with lifestyle related diseases are increasing every day, diabetes being one of the major contributors to the increasing morbidity and mortality in the world. Diabetic retinopathy is one of the complications of diabetes which is thought to be associated with the duration of diabetes, we conducted this study to evaluate the same. Methodology:This study was conducted at Department of Ophthalmology. Total 100 cases were selected for the study and patient data was collected and analysed. Duration of diabetes and its association with diabetic retinopathy was studied. Results: There were 62 males (62%), most of the participants were more than 60 years of age (54%). Majority of the patients had diabetes for 5 to 10 years (44%) followed by 1 to 5 years (34%) and 0 – 1 year (22%). On FFAexamination, majority of the patients had no any diabetic retinopathy (52%) while rest 48 patients had retinopathy (48%). Significant association was seen between the duration of diabetes and presence of diabetic retinopathy. (p=0.002). Conclusion: We found a significant association between the duration of diabetes and diabetic retinopathy. It is important that in patients with diabetes who are not diagnosed as retinopathy by ophthalmoscopy, FFA should be done.
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Background: Thyroid diseases and diabetes mellitus, as comorbid condition these together throw a great burden to medicine and humanity. Considering the ever increasing population of diabetics in our country and the significant causal relationship established by current literature, this study was undertaken.Methods: A thorough clinical history regarding diabetes mellitus (onset, duration), any history of long-term illness, any previous thyroid dysfunction, previous history of any kind of drug therapy, whether the patient was on insulin or oral hypoglycaemic drugs was sought. All diabetic patients were evaluated for thyroid dysfunction by testing thyroid profile (T3, T4 and TSH).Results: In the present study, out of the 100 diabetic patients, 18 (18%) patients had thyroid dysfunction and 82 (82%) patients were found to be euthyroid. The prevalence of thyroid dysfunction more in females as compared to males (68.75% vs 31.25%) and highest in the age group of >60 years. The prevalence of thyroid dysfunction found to be more in patients with HbA1C >7 as compared to patients with HbA1C <7. Out of 18 diabetic patients who had thyroid dysfunction, 05 (27.78%) had duration of diabetes >1 - 5 years and 08 (44.44%) had duration of diabetes 6 - 10 years. The prevalence of thyroid dysfunction found to be more in patients who had BMI >30 and patients who were on both oral hypoglycaemic agents and insulin.Conclusions: There is a high prevalence of thyroid disorders in patients of type 2 diabetes mellitus which found to be more in Females, Elderly patients, Patients with uncontrolled diabetes and BMI > 30.
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Background: Diabetes mellitus is the most important risk factor associated with two to four fold increased incidence of coronary artery disease. The major risk factors for CAD are hypercholesterolemia, hypertension, diabetes mellitus, and cigarette smoking Objectives: To study the level of serum uric acid in type 2 diabetes mellitus and the correlation between elevated serum uric acid level and the component of metabolic syndrome like obesity, hypertension, dyslipidemia.Methods: The study was done as descriptive analytical study among the diabetic patients in a tertiary care setting during the period January 2018 to February 2019. The inclusion and exclusion criteria were clearly defined and the study participants were recruited for the study after getting the informed consent. The socio demographic profile, clinical and laboratory data were collected from the blood sample obtained from the patients with the standardized procedures. Data was entered in Microsoft excel spread sheet and analyzed statistically using SPSS statistical software. Student ‘t’ test and Chi-square test values were applied for significance.Results: Serum uric acid in the study population and control varied from 3.0 to 8.1 and 2.7 to 5.5 mg/dl respectively. The mean and standard deviation of uric acid among cases was 5.08±1.42 while in control it was 3.55±0.62 respectively. The serum uric acid level of diabetics was very much elevated compare with controls and it was highly significant. Significant correlation was noticed between serum uric acid and BMI as well as WHR. Elevated uric acid levels were significantly noticed among those with hypertension, dyslipidemia, coronary artery disease and chronicity of the diabetes.Conclusions: Uric acid was significantly elevated in diabetic population and the mean value of serum uric acid level was higher in longer duration of diabetes, hypertension, dyslipidemia, central obesity which are the components of metabolic syndrome.
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Background: The objective was to measure the correlation between carotid intima medial thickness (CIMT) with duration of type 2 diabetes mellitus (DM) and its correlation with biochemical markers and body mass index (BMI). Methods: The study was conducted in a tertiary care hospital in Kolkata. Total 100 patients were selected randomly who met the inclusion criteria. Among total patients, 20 cases were newly detected type 2 DM patients and 80 were cases of established diabetes, with different duration of DM. CIMT was measured by carotid artery ultrasonography using an echo tomography system having midfrequency of 7.5MhZ and detection limit of 0.1mm. Duration of diabetes was measured as present age minus age of detection of DM. BMI was measured by the guideline of WHO. The parameters were estimated such as microalbuminuria by radioimmunoassay, fasting blood sugar (FBS) level and HbA1C by HPLC method, uric acid by uricase method. Data was collected using a predetermined proforma and statistical analyses were done. Results: Duration of DM was positively correlated with CIMT and association was statistically significant (P<0.02). There was increase in CCA-IMT and ICA-IMT across increasing level of FBS and HbA1c (P<0.01). Microalbuminuria is considered a novel atherosclerotic risk factor, was found significantly associated with mean CIMT (P<0.001). CIMT was also significantly associated with HbA1C (P<0.001). The significantly (P<0.01) increased level of uric acid indicated higher carotid plaque. Conclusion: CIMT is an objective measure of subclinical atherosclerosis, which is a non- invasive, less expensive, duration and reproducible way of demonstrating subclinical atherosclerosis. Thus, it can serve as a window for atherosclerosis status in other major arteries like coronary artery and cerebral arteries. The CIMT is closely associated with several markers viz. uric acid, blood sugar, HbA1c, albumin and BMI during the progression of type 2 DM.
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Objetivo: determinar con qué frecuencia se indica la insulina a personas con diabetes mellitus tipo 2 de la provincia Granma y los factores asociados a la indicación de este tratamiento.Métodos: estudio descriptivo transversal con 520 pacientes diabéticos tipo 2 ingresados en el Centro de Atención al Diabético de Bayamo, Granma, entre septiembre de 2011 y junio de 2013. Los pacientes se dividieron en 2 grupos: con tratamiento insulínico y sin él.Resultados: 308 pacientes (59,2 por ciento), llevaban tratamiento con insulina. De ellos, 156 (30 por ciento) la utilizaban de forma permanente y 152 (29,2 por ciento) de manera transitoria. El porcentaje de pacientes con tratamiento insulínico se incrementó significativamente a medida que aumentaba el tiempo de evolución de la diabetes (p= 0,0000). Los casos con tratamiento insulínico tenían un índice de masa corporal significativamente menor que aquellos que no la utilizaban (p= 0,0000). La presencia de complicaciones microvasculares de la diabetes se asoció notoriamente al uso de insulina (p= 0,0000).Conclusiones: la mayoría de los diabéticos tipo 2 en nuestro medio necesita insulina para su control y su uso está estrechamente relacionado con el tiempo de evolución de la diabetes, el índice de masa corporal, los niveles de glucemia y la presencia de complicaciones vasculares de esta enfermedad....
Objective: to determine how often insulin for people with type 2 diabetes mellitus is indicated in Granma province, and to determine the associated factors with the indication for this treatment. Methods: a cross-sectional descriptive study of 520 type 2 diabetic patients admitted to the Diabetic Care Center of Bayamo, Granma, from September 2011 to June 2013. Patients were divided into two groups: those with insulin therapy with and those with no insulin therapy. Results: 308 patients (59.2 percent) had insulin treatment. 156 (30 percent) out of them used it continuously and 152 (29.2 percent) had it briefly. The percentage of patients with insulin treatment significantly increased, increasing the duration of diabetes (p= 0.0000) as well. Cases with insulin treatment had a significantly lower body mass rate than those who did not use it (p= 0.0000). The presence of microvascular complications of diabetes is notoriously associated with the use of insulin (p= 0.0000). Conclusions: the majority of type 2 diabetics in our country need insulin to control it and its use is closely related to the duration of diabetes, body mass index, blood glucose levels, and the presence of vascular complications of this disease...
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Humans , /drug therapy , Insulin/therapeutic use , Body Mass Index , Cross-Sectional Studies , Epidemiology, DescriptiveABSTRACT
BACKGROUND: The present study was designed to develop criteria for screening patients with type 2 diabetes mellitus (T2DM) for asymptomatic coronary artery disease (CAD). METHODS: A total of 213 patients with T2DM without typical angina or chest pain were studied between 2002 and 2007. We also evaluated 53 patients with T2DM who had reported chest discomfort using an exercise treadmill test (ETT). RESULTS: Thirty-one of the 213 asymptomatic patients had positive ETT results. We performed coronary angiography on 23 of the 31 patients with a positive ETT and found that 11 of them had significant coronary stenosis. The main differences between the patients with significant stenosis and those with a negative ETT were age (63.1+/-9.4 vs. 53.7+/-10.1 years, P=0.008) and duration of diabetes (16.0+/-7.5 vs. 5.5+/-5.7 years, P or =60 years) with a long duration of diabetes (> or =10 years). The latter value is similar to that of patients with T2DM who presented with chest discomfort or exertional dyspnea. The PPV of the ETT in symptomatic patients was 76.9%. CONCLUSION: In the interest of cost-effectiveness, screening for asymptomatic CAD could be limited to elderly patients with a duration of diabetes > or =10 years.
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Aged , Humans , Chest Pain , Constriction, Pathologic , Coronary Angiography , Coronary Artery Disease , Coronary Stenosis , Coronary Vessels , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Dyspnea , Exercise Test , Mass Screening , ThoraxABSTRACT
The importance of dietary intake in the treatment of type 2 diabetes was emphasized. This study was performed to investigate the dietary intakes of Korean type 2 diabetes patients according to the treatment and duration of diabetes and to examine the relationships between their diet and serum lipid profiles. The subjects were 111 type 2 diabetic patients who were treated by medical nutrition therapy only, oral hypoglycemic agents (OHA), or insulin with medical nutrition therapy. Dietary intake was assessed by a registered dietitian using semi-quantitative food frequency questionnaires. Comparisons according to treatment type were made using covariance analyses. General linear models identified the independent effects of the different treatments after covarying for age, duration of diabetes, and 2-way interactions. There were no significant differences in age and BMI but was in duration of diabetes according to treatment type in these subjects. Carbohydrate to energy ratio was higher in the OHA group (P < 0.05), whereas the fat to energy ratio was higher in the insulin group for males (P < 0.05). Carbohydrate (R2 = 0.24, P = 0.005) and fat (R2 = 0.26, P = 0.02) to energy ratios were independently associated with the duration of diabetes after covarying for age, sex, treatment, and 2-way interactions. The levels of triglyceride (TG; R2 = 0.32, P = 0.02) and total cholesterol (TC) were associated independently with energy intake and the carbohydrate (R2 = 0.15, P = 0.02) and fat (R2 = 0.15, P = 0.01) to energy ratios, respectively. The concern that the independent association of dietary intake with either duration of diabetes or dietary factors affects blood lipid levels could suggest that specific dietary recommendations may work better for identifiable groups of diabetes patients.
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Humans , Male , Cholesterol , Diet , Energy Intake , Hypoglycemic Agents , Insulin , Linear Models , Nutrition Therapy , Surveys and QuestionnairesABSTRACT
PURPOSE: This study evaluated the differences of intraocular pressure (IOP), corneal thickness, and corneal endothelial morphology compared with age-matched, healthy control subjects, as well as the correlation according to the duration of diabetes. METHODS: Goldmann applanation tonometry, ultrasound pachymetry, and non-contact specular microscopy were performed in 200 patients with diabetes and 100 control subjects. RESULTS: The diabetic subjects had higher IOP, thicker cornea and less cell density, less hexagonality, and more irregular cell size of corneal endothelium than the controls (P<0.05). Central corneal thickness and coefficient of variation in cell size were higher in diabetes of over 10 years duration than in diabetes of under 10 years duration (P<0.05), while endothelial cell density and percentage of hexagonal cells were lower in the diabetes of over 10 years group (P<0.05). Central corneal thickness was correlated with duration of diabetes but IOP and corneal endothelial morphologic characteristics were not. CONCLUSIONS: Especially, those with a diabetes duration of over 10 years have more corneal morphological abnormalities and a higher IOP than normal subjects. Therefore, any surgical procedures should be performed carefully in the diabetic cornea that is easily damaged by, for example, phacoemulsification.
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Humans , Cell Count , Cell Size , Cornea , Endothelial Cells , Endothelium, Corneal , Intraocular Pressure , Manometry , Microscopy , Phacoemulsification , UltrasonographyABSTRACT
We performed a epidemiologic study to find a prevalence and risk factors of diabetic retinopathy. We reviewed 130 diabetic patients who had been performed the fundus examination for the first time for retinopathy at the ophthalmic department of Chung Ang university hospital from March 1993 to December 1993. We studied epidemiologic work-up sheet and performed ophthalmic and laboratory examination. The patients' ages ranged from 25 to 81 years, with an average age of 58.9 years. The age, sex, intraocular pressure, fasting blood sugar, post cibos 2 hours (Pc2hrs), age of onset, residence, smoking, alcohol drinking, diet pattern, blood type, treatment method and menstruation status were not significantly correlated with prevalence of diabetic retinopathy statistically(p>0.05). But the duration of diabetes(p<0.01), glycosylated hemoglobin(HbA1C) and cataract operation(p<0.05) were significantly correlated with diabetic retinopathy statisically. The prevalence of diabetic retinopathy was 28.5%(background changes in 21.5%, preproliferative changes in 4.6% and proliferative change in 2.4%). The mean interval between diagnosis of diabetes and the first examination of retinopathy was 6.62 years.