Glycemic Control and Its associated Determinants among Type II Diabetic Patients at Tertiary Care Hospital in North India

Introduction: Good glycemic control has been defined as achieving a target of fasting plasma glucose level of between 80 and 110 mg/dl, or glycosylated haemoglobin (HbA1C) of <7.0%. Poor glycemic control is highly correlated with chronic conditions related to the damaging effects of hyperglycaemia, resulting in serious complications. To restrict and delay the complications of diabetes mellitus, good glycemic control is essential. Objective: To identify the determinants associated with poor glycemic control among Type 2 diabetes mellitus patients. Method: A cross sectional study was conducted among 403 confirmed type 2 diabetic patients who attendedone of the tertiary care hospitals of North India over a period of six months (July- December 2021). The collected data was analysed using IBM SPSS version 28. Chi-square test was applied to compare various determinants of glycemic control. A p-value of <0.05 was considered to be statistically significant. Results: Out of 403 participants, 57.6% had poor glycemic control of diabetic condition. Higher age of participants, illiteracy, being overweight, having positive history of smoking and alcohol, longer duration of diabetes, participants taking both oral and insulin treatment for diabetes, taking medicine irregularly were the significant determinants of poor glycemic control. Conclusion: Higher percentage(57.6%) of poor glycemic control was observed in the study.To improve the glycemic control, efforts should be made towards improving modifiable factors like overweight, smoking, alcohol, regularity of medication etc. Good lifestyle interventions help in control of poor glycemic control.

Family-integrated diabetes education for individuals with diabetes in South-west Nigeria

Objectives: This study aimed to determine the effects of family-integrated diabetes education on diabetes knowthe ledge of patients and family members, as well as its impact on patients' glycosylated haemoglobin (A1C). Design: The design was a two-group Pretest Posttest quasi-experimental. Setting: The study took place at the diabetes clinics of two tertiary hospitals in southwestern Nigeria. Participants: People Living with Diabetes (PLWD) and family members aged 18 years and over and without cognitive impairment were placed, as clusters, into either a control group (CG) or an intervention group (IG) The CG comprised 88 patients and 88 family members while IG comprised 82 patients and 82 family members. Of these, 78 and 74 patients completed the study in CG and IG, respectively. Interventions: PLWD in IG along with their family members were given an educational intervention on diabetes management and collaborative support with an information booklet provided. This was followed by three (3) complimentary Short Messaging Service (SMS). Main outcome measures: A1C and diabetes knowledge. Results: Over half (52.4%) and about a fifth (18.2%) of family members and patients, respectively, had never had diabetes education. There was a statistically significant increase in the knowledge of patients and family members in IG. Unlike CG, the A1C of patients in IG improved significantly at three and six-month post-intervention, (p<0.01). Regression showed an independent effect of family members' knowledge on IG's A1C. Conclusions: Improved family members' diabetes knowledge positively impacted patients' glucose level. There is a need to integrate family members into diabetes care better

Family-integrated diabetes education for individuals with diabetes in South-west Niger

Objectives: This study aimed to determine the effects of family-integrated diabetes education on diabetes knowthe ledge of patients and family members, as well as its impact on patients' glycosylated haemoglobin (A1C). Design: The design was a two-group Pretest Posttest quasi-experimental. Setting: The study took place at the diabetes clinics of two tertiary hospitals in southwestern Nigeria. Participants: People Living with Diabetes (PLWD) and family members aged 18 years and over and without cognitive impairment were placed, as clusters, into either a control group (CG) or an intervention group (IG) The CG comprised 88 patients and 88 family members while IG comprised 82 patients and 82 family members. Of these, 78 and 74 patients completed the study in CG and IG, respectively. Interventions: PLWD in IG along with their family members were given an educational intervention on diabetes management and collaborative support with an information booklet provided. This was followed by three (3) complimentary Short Messaging Service (SMS).Main outcome measures: A1C and diabetes knowledge. Results: Over half (52.4%) and about a fifth (18.2%) of family members and patients, respectively, had never had diabetes education. There was a statistically significant increase in the knowledge of patients and family members in IG. Unlike CG, the A1C of patients in IG improved significantly at three and six-month post-intervention, (p<0.01). Regression showed an independent effect of family members' knowledge on IG's A1C. Conclusions: Improved family members' diabetes knowledge positively impacted patients' glucose level. There is a need to integrate family members into diabetes care better.

Association between T2DM and the lowering of testosterone levels among Kashmiri males

ABSTRACT Objective: The objective of this study is to study association between testosterone and diabetes in Kashmiri males. Subjects and methods: A total of 300 males with Type 2 diabetes visited an outpatient and inpatient clinic at Shri Maharaja Hari Singh (SMHS) hospital, Srinagar, J&K India. The blood sugar and HbA1c, which are the markers of diabetes, and sérum testosterone levels were measured. The blood samples from both the cases and controls were collected. Results: Out of 300 subjects, 42% had a testosterone deficiency. A relationship between type 2 diabetic males and healthy males was observed, and testosterone levels were determined to be significantly lower among diabetic males (p < 0.001) when compared to healthy males. Then, we compared diabetic markers among testosterone deficient and normal testosterone level groups; the mean fasting plasma glucose (p = 0.0019) and glycated haemoglobin (HbA1c; p = 0.0449) levels were significantly higher in the testosterone deficient group than in the control group. To elucidate the relationship between the serum total testosterone level and fasting plasma glucose and HbA1c values, Pearson's correlation test was performed. Fasting plasma glucose levels (r = −0.252, p = 0.001) and HbA1c values (r = −0.697, p = 0.001) showed a significant negative correlation with serum testosterone levels among diabetic males. Conclusions: This study shows that diabetes causes low testosterone levels among males, and lower testosterone levels can act as a marker for diabetes. Thus, with timely intervention, mortality and co-morbidity associated with diabetes can be prevented.

A Study on the Effect of Iron Deficiency Anaemia on Haemoglobin A1c Levels in Non-Diabetic Adults.

Iron deficiency anaemia is a common entity in India. Diabetic parameters may fluctuate with respect to the haemoglobin variants and nutritional anaemia. However, the exact association between them has not been fully elucidated. We aimed to estimate and compare the diabetic parameters and the levels of glycosylated haemoglobin (HbA1c) among anaemics and non-anaemics in non- diabetic patients.METHODSA comparative study was done in the Department of General Medicine, over a period of one-and-a-half years where 50 non-diabetic IDA patients as cases and 50 non- diabetic non-anaemic patients as controls were enrolled in the study. Iron profile and HbA1c levels were measured and compared at baseline. IDA patients were treated with iron supplements and the effects on the HbA1c levels after 3 months of treatment of iron deficiency were noted and analyzed. The data was entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. A P value of <0.05 was considered to be statistically significant.RESULTSWe found that anaemic patients had significantly higher fasting and random blood sugar levels with more patients in the pre-diabetic range as per HbA1c levels. The glycosylated Hb levels were significantly higher in Group A patients. (p<0.05). After initiating IDA treatment, there was a significant improvement in all the haematological parameters at 3 months follow up. There was a significant decrease in the HbA1c levels after three months of anaemia treatment. (p<0.0001).CONCLUSIONSIron deficiency anaemia has an inverse correlation with HbA1c levels. After correction of iron deficiency in the anaemic subjects, in most of the cases, the HbA1c levels declined to near normal values.

Role of ambulatory glucose profile in identifying and managing a patient with disparity between FPG, PPG and HbAlc levels: a case report

This case report describes the management of a patient with mismatch/disparity between his Fasting Plasma Glucose (FPG)/ Postprandial Glucose (PPG) levels with that of Glycosylated Haemoglobin (HbA1c) levels. This 43-year-old male patient with Type 2 Diabetes Mellitus (T2DM) was presented with increased urination and tiredness, especially in the evening hours, along with a tingling sensation in bilateral feet on and off, with leg pain since past 4 months. The patient was obese with a family history of cardiovascular disease. In this patient, SGLT2 inhibitors were found to be effective in addressing glycaemic variability without triggering hypoglycaemic risk. Continuous glucose monitoring system aided in understanding the blood glucose fluctuations caused by the diet. This case study indicated that careful evaluation and appropriate management using Ambulatory Glucose profile would aid in preventing complications in such patients and improve the overall clinical outcomes.

Correlation of Risk Factors with Severity of Diabetic Retinopathy - A Retrospective Study.

Diabetic retinopathy (DR) is a major microvascular complication of diabetes. It is the most common cause of blindness in the working-age population in developed countries. We wanted to analyse the correlation between risk factors of blindness like duration of diabetes, dyslipidaemia, hypertension, HbA1c with severity of diabetic retinopathy in order to design appropriate strategies for prevention and treatment of diabetic retinopathy.METHODSThis was a retrospective study of all diabetic patients with diabetic retinopathy who presented to the eye OPD at KS Hegde Medical Academy from April 1st 2018 to March 31st 2019 that fulfilled the inclusion criteria. A dilated fundus examination was done to note the grade of diabetic retinopathy. The demographic data along with the duration of diabetes, HbA1c values, Cholesterol levels and Blood pressure were documented and correlated with the severity of diabetic retinopathy.RESULTSThe study included 92 patients, of which 63 were males and 29 were females with a mean age of 54.5±2.8 years. We found that there was statistically significant association between the duration of diabetes and HbA1c levels with severity of diabetic retinopathy (p= 0.022 and 0.034 association), whereas there was no statistically significant correlation between blood pressure and cholesterol levels with severity of diabetic retinopathy (p= 0.52 and 0.456 respectively)CONCLUSIONSDiabetic retinopathy showed a male preponderance, with risk factors like duration of diabetes and HbA1c levels having a significant association with the severity of diabetic retinopathy. Therefore, it is essential to have a good systemic control of diabetes with diet and suitable medications. Diabetic retinopathy is a preventable cause of blindness when diagnosed early and screening of diabetic retinopathy must be done in all diabetics to prevent the progression of the disease.

Infections in type 2 diabetic patients and its correlations with glycosylated haemoglobin in a tertiary care teaching hospital

Background: Diabetes mellitus increases the risk of infections and results in adverse outcomes, but the effect of better glycaemic control has not been thoroughly investigated. Therefore, it was intended to study the various types of infections in Type 2 diabetic patients and its correlation with HbA1c.Methods: It was a prospective observational study for one year, conducted on Type 2 diabetic patients hospitalized for various causes. Patients with HIV infection or immunocompromised state were excluded. Routine investigations, radiological and culture studies were conducted as required to identify the various infections present. The prevalence of infections was then corelated with blood glucose and HbA1c levels.Results: Total 105 hospitalized diabetic cases were studied, out of which infections were detected in 72 (68.6%) patients, which was found to be statistically significant. The most common infection detected was UTI (45.8%). Among the UTI patients, E. coli was the most common organism isolated (52.3%) followed by Enterococcus (19%), Pseudomonas (19%) and Citrobacter (9.5%). Infections occurred in 61 (82.4%) patients with HbA1C >6.5% and in 11 (35.5%) patients with HbA1C <6.5%, which was found to be statistically significant.Conclusions: Diabetes increases the risk of infections. Urinary tract infection is the most common infection, affecting the females predominantly. An association between current hyperglycaemia, glycosylated haemoglobin  and infection risk in type 2 diabetes patients was found.

Prevalence of Diabetic Retinopathy and Associated Factors in Type 2 Diabetes in a Tertiary Care Centre in Kannur District of Kerala

The purpose of this study is to determine the prevalence in diabetic retinopathy in type 2 diabetic (DM) patients and to establish associated factors. Methods: Hospital based descriptive study was conducted from April 2017 to March 2018 in the Department Of Ophthalmology, Govt Medical College Kannur, Pariyaram Known diabetics were evaluated for the prevalence of diabetic retinopathy (DR) and to establish relation with age, sex, duration of diabetes, type of medications, hypertension, end organ disease, HbA1c, body mass index. Results: Out of 293 patients with type 2 DM, 182 (62.1%) were males and 111(37.9%) female. Mean patient age was 56.7 ± 11.2 years, with duration of diabetic less than 10yrs 185(63.1%) and for more than or equal to 10 yrs. 108(36.9%). Majority of the patients 228 (77.8%) were on oral hypoglycemic agents, 26 (8.9%) on insulin and 39 (13.3%) on both. Conclusion: Prevalence of DR is high in our study132(45.1%) and DR is significantly associated with male gender, older age, longer duration of diabetic state, poorly controlled blood sugars (HbA1c levels) and in patients with hypertension.

Is Serum Uric Acid an Added Risk Factor for Micro-Vascular Complications of Diabetes Mellitus? – A Prospective Study

Introduction: Diabetes is the leading cause of adult blindnessdue to retinopathy, end stage renal disease due to nephropathyand foot ulcers and lower limb amputation due to neuropathy.Serum uric acid levels independently predict the developmentof micro vascular complications. In this study, we analysethe association of serum uric acid with the micro vascularcomplications of diabetes.Material and methods: In this hospital based observationalstudy, hundred diabetic patients were included; of which fiftyhad micro vascular complications, the remaining fifty had nocomplications. Blood investigations including fasting(FBS)and post prandial blood sugars(PPBS), glycosylatedhaemoglobin (HbA1C), and serum creatinine and serumuric acid were done in all patients. All the parameters werecompared between the two groups.Results: Females presented with significantly highercomplications as compared to males. The mean age of thepatients presented with and without complications was 56.4± 9.3 and 59.9 ± 10.3 respectively. HbA1C had a positivecorrelation with the serum uric acid (SUA) (r=0.327, P =0.001). Mean uric acid levels were higher among patientswith complications (5.96 ± 2.16) compared to patients withoutcomplications (4.95 ± 2.04) which was statistically significant(P value =0.021). Patients with nephropathy and neuropathyhad significant elevation in serum uric acid levels than thosewithout; however this significance was not noted in those withretinopathy.Conclusion: Patients with micro vascular complications hadhigher levels of serum uric acid compared to those withoutcomplications. Also there was positive correlation betweenHbA1C and serum uric acid levels

Correlation between Fasting Blood Sugar Level, HbA1C Level and Serum Lipid Levels in Type 2 Diabetes Mellitus Patients

Introduction: Diabetes Mellitus is one of the most commonendocrinal diseases in the world. Incidences of this disease areincreasing worldwide and this disease is called disease of thismillennium. This study was undertaken to correlate fastingblood sugar level, Glycosylated haemoglobin (HbA1C) leveland serum lipid levels in patients with diabetes mellitus.Material and Methods: This study was a cross sectionalstudy conducted on 100 patients of diabetes mellitus came toM.B Govt. Hospital, Udaipur. The fasting blood sugar (FBS)levels, HbA1C levels and serum lipid levels were performedand then correlated fasting blood sugar level with HbA1Clevels and FBS and HbA1C with serum lipid levels. There wasa significant positive correlation between FBS and HbA1C,and FBS and HbA1C with serum cholesterol and serumtriglycerides level and negative correlation with serum HDLcholesterol levels.Results: This study demonstrated that HbA1C level wasincreased in diabetics and it showed correlation with the statusof control of diabetes.Conclusion: Diabetics have got increased level of serumcholesterol, triglycerides and decreased levels of serumHDL-cholesterol. HbA1C showed stronger correlation withserum cholesterol and triglycerides as compared to FBS.HDL-cholesterol showed stronger correlation with FBS thanHbA1C.

Comparison of metabolic effects of glimepride and sitagliptin with metformin in patients suffering from type 2 diabetes mellitus in a tertiary care hospital

Background: Diabetes mellitus (DM) is one of the major causes of mortality & morbidity, and patient’s with better control of glycaemic parameters have lesser chronic complications associated with it. Though monotherapy with metformin is first choice for T2DM but is effective in less than 50% of patient and they should be managed with two drug therapy. Both Glimepiride and Sitagliptin are effective with metformin but there has been no study done in this region hence, we planned to study comparison of effects of glimepiride and sitagliptin with metformin in patient of T2DM.Methods: This prospective, open-label, randomized study was done in all patient diagnosed with T2DM, not adequately managed by metformin alone. The patient was divided into two group G (Glimepiride with Metformin) and Group S (Sitagliptin with Metformin) and had a follow up at 3 and 6 months. The biochemical parameters were assessed at 12 weeks and 24 weeks.Results: The result of this study show that both glimepiride and sitagliptin with metformin significantly (p<0.05) lowered both the fasting blood sugar as well as postprandial blood glucose at 3 and 6 months. Glimepiride was more effective in lowering (p<0.05) the plasma glucose at 3 months but both the drugs had comparable result at 6 months. This study also showed that glycosylated haemoglobin was lowered in both groups at three and six months as compared to Day 0 (p<0.05), with glimepiride having better control of glycosylated haemoglobin at 3 months with both groups having comparable result at 6 months.Conclusions: To conclude, this study compared effects of sitagliptin and glimepiride on glycaemic parameters in patients of T2DM and found that both drugs had comparable results.

Evaluative Research on Pharmacist-managed Diabetes Care: Focus on Self-Monitoring of Blood Glucose / Investigación Evaluativa sobre Atención a la Diabetes Gestionada por los Farmacéuticos: Enfoque del Automonitoreo de la Glucosa en Sangre

ABSTRACT Objective: Pharmacists have not demonstrated the ability to manage chronic diseases such as Type 2 Diabetes Mellitus, which is an ongoing problem in Trinidad and Tobago. The primary objective was to demonstrate that pharmacists can assist patients to achieve at least a 1% decrease in glycosylated haemoglobin (HbA1c). Methods: A randomized, controlled Pharmacist Evaluative Research Study compared the efficacy of pharmacist-managed care (the intervention), and routine standard management (control) of poorly controlled (abnormal HbA1c, blood pressure, blood glucose and lipid panel) adult diabetic patients. Participants in the intervention group met with the pharmacist at their respective primary care sites on a regular basis for an assessment of adherence to medications, barriers to adherence and education. Control group participants consisted of patients receiving routine care by their primary physician but with no direct intervention by the pharmacist except for the filling of prescriptions. Results: Seventy-five patients were initially recruited. Of these, 48 (20 intervention and 28 control) met the inclusion criteria. It was only possible to analyse the result from 20 patients: 14 (70%) intervention and 6 (21.4%) control because of incomplete collected data. A minimum decrease of at least 1% HbA1c was obtained by 8 (57%) intervention participants compared to 2 (33%) in the control group; while HbA1c remained unchanged for two participants, each in the intervention and control groups (14% and 33%, respectively). Conclusion: We could not conclude any statistical or clinical significance in the paper as the data could only be analysed using descriptive methods. Building a culture of research among pharmacists may promote the use of pharmacists as adjunctive healthcare practitioners to achieve better patient outcomes.

RESUMEN Objetivo: Los farmacéuticos no han demostrado ser capaces de manejar el tratamiento de enfermedades crónicas como el tipo 2 Diabetes mellitus, que es un problema actual en Trinidad y Tobago. El objetivo principal fue demostrar que los farmacéuticos pueden ayudar a los pacientes a lograr al menos una disminución del 1% en hemoglobina (Hba1C). Métodos: Un Estudio de Investigación Evaluativa Farmacéutico controlado aleatorio, comparó la eficacia de la atención gestionada por los farmacéuticos (intervención) y el manejo estándar de rutina (control) de pacientes diabéticos adultos con pobre control (niveles anormales de hemoglobina glicosilada, presión arterial, glucosa en sangre, y perfil lipídico). Los participantes en el grupo de intervención se reunieron de manera regular con el farmacéutico en sus respectivos centros de atención primaria para evaluar el cumplimiento con los medicamentos, así como los obstáculos a la observancia y la educación. Los participantes del grupo de control eran pacientes que recibían atención de rutina de parte de su médico primario, pero sin intervención directa del farmacéutico, excepto para el llenado de prescripciones. Resultados: Setenta-cinco pacientes fueron reclutados inicialmente. De estos, 48 (20 de intervención y 28 de control) cumplían los criterios de inclusión. Debido a que los datos recopilados estaban incompletos, sólo fue posible analizar el resultado de 20 pacientes: 14 (70%) de intervención y 6 (21.4%) de control. Una disminución mínima de al menos 1% de HbA1C fue obtenida por 8 (57%) participantes de intervención en comparación con 2 (33%) en el grupo de control, mientras que el HbA1C permaneció inalterado para 2 participantes, cada uno en los grupos de intervención y control (14% y 33%, respectivamente). Conclusión: Los datos apoyan la hipótesis de que la gestión de los farmacéuticos como profesionales complementarios de la salud, posibilita lograr mejores resultados en los pacientes, a diferencia de lo que ocurre en ausencia de tal gestión.

Thyroid hormones, blood glucose and glycosylated hemoglobin in healthy Sudanese subjects

Background: Diabetes mellitus and thyroid diseases are the most prevalent metabolic disorders in Sudan. The value of HbA1C reflects the glycemic status over the last 2-3 months. So, in this study, an insight for thyroid hormone regulation of glucose metabolism is investigated. Is to study the association between thyroid hormones levels, fasting blood sugar (FBS) and HbA1c in healthy adults.Methods: A cross sectional study was performed in a healthy Sudanese cohort in the period between September 2017 to November 2018, involving 610 healthy adult Sudanese aged 20 to 60 years. HbA1c, fasting blood sugar (FBS), T3, T4 and TSH were measured.Results: The study results demonstrated a significant association between the median concentration of T3 and T4 with plasma level of HbA1c. A significant linear correlation between serum concentration of T3 and fasting blood sugar (FBS) was observed. Inverse correlation was detected between serum TSH and HbA1c, FBS in study population.Conclusions: The present study concluded that FBS and HbA1c levels were increased with increasing of both T3 and T4. Based on this study all the thyroid patients’ especially hyperthyroid patients should have regular checkup of their glucose levels.

Screening of Subclinical Hypothyroidism and Glycosylated Hemoglobin Levels in Healthy Subjects Attending Rural Tertiary Care Centre in Western U.P. (Hapur)

Background: Subclinical hypothyroidism is defined as an elevated serum TSH level and normal concentrations of free T3 (FT3), free T4 (FT4), T3 and T4. A positive association between thyroid and diabetes mellitus is well recognized but to study the effect of thyroid disorders on glucose metabolism in non-diabetic patients is an area for extensive research. Present study was planned to assess correlation between subclinical hypothyroidism and glycosylated hemoglobin levels in non-diabetic patients. Methods: A case-control study was conducted on total 209 subjects. 109 patients were allotted in case group and 100 in control group. Controls were relatives and friends of patients who were matched for age and sex. Comparison between the case and the control groups were made using Student’s t-test (unpaired) and Box and Whisker Plot and regression graph were presented for correlation between serum TSH and HbA1c. Results: It was found that there was a positive correlation between the levels of serum TSH (µU/L) and HbA1c (%) in all the participants of the study by Pearson’s correlation coefficient (r=0.35, p < 0.0001). Conclusion: HbA1c levels are increased in subclinical hypothyroid patients. The effects of the elevated levels of Serum TSH on the HbA1c must be considered when interpreting the HbA1c for the diagnosis of diabetes or prediabetes in the subclinical hypothyroid patients.

The clinical and ultrasound features of Klebsiella pneumoniae liver abscess in diabetes mellitus patients with different levels of HbA1c / 重庆医学

Objective To compare the clinical and ultrasound features of Klebsiella pneumoniae liver abscess(KPLA) in dia‐betes mellitus(DM ) patients with different levels of HbA1c .Methods Totally 146 patients with diabetes mellitus of Klebsiella pneumoniae liver abscesses(KPLA‐DM )were divided into three groups on the basis of their levels of HbA1c:complete glycemic controlled (HbA1c≤7% );good glycemic controlled (7% 9% ) .The patients′characteristics ,clinical features ,ultrasound features and complications among the three groups were compared .Results Compared with patients in complete glycemic controlled group and good glycemic controlled group ,patients in bad glycemic controlled group had lower onset age and longer length of hospital stay(P<0 .05) ,are more susceptible to underlying diseases such as hyperlipoi‐demia and chronic renal failure(P<0 .05) ,had more life‐threatening clinical crisis ,and had higher infection rate(P<0 .05) .KPLA‐DM could be characterized by patchy ,mass like enhancement echoultrasound image .Patients in bad glycemic controlled group al‐so had higher risk of biliary pneumatosis ,hepatic venous thrombosis and gas‐forming pyogenic liver abscess than other two groups (P<0 .05) .Conclusion The ultrasound image of KPLA has characteristics .The occurrence of hepatic venous thrombosis and gas‐forming observed by ultrasound is associated with bad glucose control in KPLA‐DM patients ,which suggests that there may be oth‐er complications such as metastatic infection .

Comparative clinical evaluation of glycosylated haemoglobin level in healthy and chronic periodontitis patients: A chairside diagnostic method.

Objective and Background: Glycosylated haemoglobin (HbA1c) level can consequently be interpreted as an average of the blood glucose present over the past 3–4 months. Periodontitis is associated with glycemic control in patients with diabetes. The purpose of this study was to determine the level of HbA1c in healthy and periodontitis patients who were previously not diagnosed with diabetes mellitus. Materials and Methods: A total of 40 patients were selected for study and divided into two groups. Group 1 included patients with a healthy periodontium, and Group 2 included patients suffering from chronic periodontitis. Finger stick blood was collected by special collection unit (A1CNOW+® Bayer Health Care, Tarrytown New York, USA), for estimating level of HbA1c. Result: Both groups showed similar HbA1c levels clinically with slight increase in levels in the test group, but was statistically significant (test ‑ 5.66 ± 0.35%, control ‑ 5.17 ± 0.3% P = 0.003). Conclusion: Indians are at a high‑risk of developing periodontitis and diabetes. These data suggest a possible link between periodontitis and glycemic control in nondiabetic individuals, periodontal disease may be a potential contributor to the development of type 2 diabetes.

SERUM FERRITIN AND HbA1c LEVELS IN TYPE 2 DIABETES MELLITUS

Introduction: Complications due to diabetes are a major cause of disability, reduced quality of life and death. Recent studies have emphasized the role of serum ferritin in insulin resistance and the incidence of diabetes mellitus. However, the role of ferritin as a marker of iron overload in pancreatic damage and peripheral insulin resistance or its role as an inflammatory marker is not clear. The aim of this study is to establish a correlation between serum ferritin, FBS and HbA1c in type 2 diabetes mellitus and to evaluate the role of serum ferritin on the glycemic status in type 2 diabetes mellitus. Methods: This was a cross- sectional study of 100 cases, visiting medical outpatient department of a tertiary care teaching hospital. Diabetic patients were compared with age and sex matched normal healthy controls. Effect of serum ferritin on glycemic status, gender and age was noted. Results: Statistically significant increase of FPG, HbA1C and serum ferritin levels were observed in type 2 diabetes mellitus group than controls in both females and males while there was no statistically significant difference of hemoglobin between diabetic group and controls in females and males. There was a high (r= 0.62, r= 0.66) positive correlation between SF and HbA1c of females and males respectively in diabetic group P-value=< 0.01. Conclusion: Higher positive correlation of serum ferritin with HbA1c shows that hyperglycemia affects ferritin levels possibly due to inflammation or oxidative stress or a combination of the two.

STUDY OF HbA1c AS A BIOMARKER IN DYSLIPIDEMIA AND ATHEROGENICITY IN TYPE 2 DIABETES MELLITUS

HbA1c is being used to assess the glycemic control for many years. This study was done to evaluate the importance of HbA1c in predicting dyslipidemia and atherogenecity in type 2 Diabetes. Methods: 200 type 2 diabetic patients were taken as subjects. Fasting and post meal blood sugar, Glycated haemoglobin(HbA1c), lipid profile, lipid ratios and atherogenic index of plasma(AIP) was analysed in these patients. The patients were divided into 2 groups depending on their HbA1c; Good Glycemic Control was defined as having HbA1c ≤ 7.0% and Poor Glycemic Control as HbA1c >7.0%. Results& Discussion: We found a significant increase in the levels of blood glucose, total serum cholesterol (TC), triglyceride, LDL cholesterol(LDL-C) and VLDL cholesterol(VLDL-C),TC/HDL-C,LDL-C/HDL-C, atherogenic index of plasma (AIP) and a significant decrease in the levels of HDL cholesterol (HDL-C) in patients with HbA1c>7% as compared to patients with HbA1c ≤ 7%. HbA1c had a direct and significant correlation with TC, TG, VLDL-C, LDL-C, TC /HDL-C, LDL-C/HDL-C, and an inverse correlation with HDL-C. AIP correlates with cardiovascular risk very well, and the association between HbA1c with various lipid parameters and atherogenic ratios suggests the importance of glycemic control in order to control dyslipidemia and future risk of cardiovascular disease in type 2 diabetics.

To study the effect of glycemic control and duration of disease on pulmonary function tests and diffusion capacity in type 2 diabetes mellitus.

Background: Type 2 diabetes mellitus is known to cause serious progressive macro and micro vascular complications leading to end organ damage like retinopathy, nephropathy and neuropathy. Pulmonary complications due to collagen and elastin changes as well as microangiopathy has also been demonstrated in type 2 diabetes mellitus but prevalence in most of population is unknown and its possible correlation with duration of disease and degree of glycemic control is not studied more in our population. Aims and objectives: To compare Pulmonary Function Tests (PFT) in type 2 diabetes mellitus with control group and to evaluate possible correlation of PFT with status of sugar control and duration of disease. Methods: Consecutively consenting 120 subjects who satisfied the inclusion criteria were recruited over one year duration. These 120 subjects are categorised into two i.e. healthy volunteers recruited as controls (n=60) and type 2 diabetic patients (n=60). Results: Both group compared and studied with each other. Diabetic patients showed a significant reduction in Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC) and pulmonary diffusion capacity for carbon monoxide (DLCO) relative to their matched controls and these values were further reduced in diabetic patients with uncontrolled glycemic status. Conclusion: Our study concluded that lung functions in type2 diabetes mellitus are impaired with restrictive pattern of respiratory abnormality. Duration of diabetes did not influence on pulmonary function and diffusion capacity.