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Background Gestational Diabetes Mellitus [GDM] is de?ned as Carbohydrate intolerance with recognition or onset during pregnancy and resolves postpartum. Prevalence of GDM in India varies from 3.8 - 21% with different demography and diagnostic methods used. As early diagnosis and control of maternal hyperglycaemia plays a vital role in prevention of adverse outcomes, universal screening is almost mandatory due to high prevalence, we need a simple economical, feasible test with higher sensitivity to diagnose GDM. To compare diagnostic accuracy of two non- Aim fasting tests DIPSI & HBAIC and fasting WHO criteria for diagnosis of GDM. To compare DIPSI with WHO criteria as Objectives standard. To compare HBA1C with WHO criteria as standard This study was done on 100 ANC cases to compare Results: diagnostic accuracy of DIPSI & HBAIC with fasting World Health Organization Glucose Tolerance Test. Mean age of participants was 27.18±4.60 years. 39% patients were in age group of 21 to 25 years and 34% patients were in age group of 26 to 30 years. Majority (45%) of the patients were in gestational age of 26 to 30 weeks. In this study, gestational diabetes mellitus was diagnosed in 47 (47%) patients according to WHO GTT, in 48 (48%) patients according to DIPSI and in 34 (34%) patients according to Glycated Haemoglobin. Mean gestational age of patients during diagnosis of gestational diabetes mellitus was 29.21±2.84 weeks by DIPSI, 28.83±2.82 weeks by WHO GTT and 29.29±3.15 weeks by Glycated Haemoglobin. Mean blood sugar parameters of gestational diabetes mellitus women were 174.96±16.58 mg/dl by DIPSI, 173.21±17.58 mg/dl by WHO GTT and 9.41±1.91 gm% by Glycated Haemoglobin. The sensitivity of DIPSI with regard to WHO GTT was 89.36%, speci?city 88.68%, positive predictive value 87.50%, negative predictive value 90.38%, diagnostic accuracy 89.00% and chi square value of 60.78. These values convey that DIPSI is as good as gold standard WHO GTT criteria. The sensitivity of Glycated Haemoglobin with regard to WHO GTT was 51.06%, speci?city 81.13%, positive predictive value 70.59%, negative predictive value 65.15%, diagnostic accuracy 67.00% and chi square value of 11.51. These values convey that Glycated Haemoglobin is not as good as gold standard WHO GTT. Based on ?ndings from this study it can be concluded that DIPSI is Conclusions: equally as good as World Health Organization Glucose Tolerance Test criteria in diagnosing gestational diabetes mellitus in antenatal women of south India. Since DIPSI does not require fasting it is more feasible than World Health Organization criteria. Glycated haemoglobin estimation is another test to detect diabetes mellitus which does not require fasting however its results are not close to gold standard WHO criteria unlike DIPSI
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Glycated Haemoglobin (HbA1c) gives a measure of long term Glycemic control. However, how the values of HbA1c affects the outcome in various comorbidities and its effect on the short term and long term outcome of these comorbidities remains a matter of Grey Zone. Cardiovascular Diseases, Chronic Kidney Disease, Anemia, Chronic Liver Disease etc, can alter the interpretation of HbA1C level, where it may not reflect the appropriate Glycemic control. Hence this review is done to look for the evidence and appropriateness of HbA1c as Diagnostic and Prognostic marker for Glycemic control in various clinical scenario.
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Background: Dyslipidemia is one of the common conditions associated with poor glycemic control in Type 2 diabetes mellitus (T2DM) patients. It is associated with an increased risk of cardiovascular disease which is the leading cause of death in these patients. Glycated Hemoglobin (HbA1c) is the gold standard test for monitoring glycemic control. Thus, the level of HbA1c could potentially be utilized as a possible biomarker for predicting the risk of dyslipidemia. However, there is a discrepancy in the data available till now regarding the relationship between HbA1c and the lipid profile. Hence, it requires further studies. Aim and Objectives: The present study was conducted to assess the role of glycemic control (as indicated by HbA1c level in blood) on lipid profile of patients with T2DM. Materials and Methods: This was an analytical cross-sectional study done over a period of 5 months. Total 165 participants were randomly selected from out patient department OPD of which 138 were diagnosed cases of T2DM and 27 were age and sex-matched non-diabetic healthy individuals. Patients of T2DM were sub grouped based on American Diabetic Association Criteria (2013) as having either controlled diabetes with HbA1c ?7% or uncontrolled diabetes with HbA1c >7%. Blood samples collected from all the participants were analyzed for HbA1c and lipid profile using standard methods. The collected data were analyzed with Statistical Package for the Social Sciences software using appropriate statistical method. Results: In the present study, we found a significant positive correlation between HbA1c and total cholesterol, Triglyceride, Low-density lipoproteins, and very low-density lipoproteins (P < 0.01) though high-density lipoprotein was not significantly correlated with HbA1c level. Conclusion: We concluded that apart from a reliable index of glycemic control, HbA1c can also be used as a predictor of dyslipidemia in T2DM patients, and thus regular monitoring of it can help us to reduce the mortality of these patients.
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Background: Diabetes mellitus is a chronic and progressive endocrine disorder that may result in macro and microvascular complications. Objective: This study assessed some biochemical analytes in Nigerians who were recently (≤ 6 months) diagnosed with Type 2 diabetes mellitus (T2DM). Methods: 160 T2DM and 90 non-diabetic control participated in this study. Blood samples were collected and analyzed for Heart-type fatty acid-binding protein (HFABP), high sensitivity C-reactive protein (hs-CRP), electrolytes, lipid and renal profile parameters, glycated haemoglobin (HBA1C) and fasting blood glucose (FBG), using standard guidelines. Result: The body mass index (BMI) of the T2DM volunteers was higher than control (P <0.001). The lipid profile, potassium, glucose, HBA1C, urea and creatinine values were elevated (P <0.001) while estimated glomerular filtration rate (eGFR) was lower (P<0.05) in diabetes. The median HFABP and hs-CRP were raised (P <0.05) in T2DM. Positive associations existed between FBG and urea (P <0.001), Creatinine and HBAIC (P <0.001). A logistic regression analysis, shows that an increased BMI, HBA1C, FBG, Cholesterol, urea and creatinine were associated with higher odds (p<0.001) of cardiovascular and renal complications. Conclusion: Elevated hs-CRP, glycated haemoglobin, urea and creatinine among T2DM increase the odds of cardiovascular and renal insults in this population
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Glycated Hemoglobin , Diabetes Mellitus, Type 2 , Renal Insufficiency, Chronic , C-Reactive Protein , NigeriaABSTRACT
Introduction: Diabetic foot ulcer is a major disablingcomplication of Diabetes Mellitus and often precedes lowerextremity amputation. This study aims to evaluate the level ofHbA1c and lipid profile in patients with diabetic foot ulcer asT2DM patients areprone to diabetic dyslipidemia,which puts them at risk ofdeveloping macrovascular and microvascular diseases.Material and methods: The study was accomplished at atertiary care hospital in Jammu & Kashmir. One hundred tensubjects with T2DM were enrolled for the present study, thisincluded 55 subjects with DFU and 55 subjects without DFU.The HbA1c and lipid profile of the subjects were measuredwith standard methods.Results: In our study HbA1c level was found higher indiabetic patients with diabetic foot ulcer when compared withpatients without. Also lipid profile was found deranged indiabetic foot ulcer patients in comparison to control group. Itwas found that approximately 78% DFU have HbA1c levels˃7%. Unlike the DFU-patients, 79% of patients without DFUhave HbA1c level controlled.Conclusion: As diabetic foot ulcer is a major disablingcomplication of Diabetes Mellitus and often precedes lowerextremity amputation, we conclude that HbA1c level shouldbe maintained in normal range and regulating it is imperativefor avoiding T2DM complications.
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Background: Diabetes mellitus is one of the major health problem and endemic with rapidly increasing prevalence in both developed and developing countries. It has strong association with dyslipidaemias in relation to glycaemic control and duration of the disease. Dyslipidaemias make diabetic patients more susceptible to coronary artery disease (CAD) which is the major cause of increased mortality and morbidity. Objectives were to estimate the blood glucose levels and lipid profiles among diabetics and to compare the lipid profiles among controlled and uncontrolled diabetic subjects.Methods: A cross sectional study was done including 100 diabetic subjects aged between 40 to 60 years of either sex. Patients were classified into 2 groups with 50 subjects in each group as per their glycemic index. Group 1 was controlled diabetic patients (HbA1c?7.5%) and Group 2 was uncontrolled diabetic patients (HbA1c>7.5%). Venous blood samples were collected from the subjects. The serum was used for analyzing FBS, PPBS, HbA1c and lipid profiles.Results: FBS, PPBS, HbA1c, total cholesterol, triglycerides and LDL were more in females than male patients but the mean values were not significant statistically except FBS and total cholesterol. All the lipid parameters were elevated among uncontrolled diabetic patients compared to controlled diabetic patients which was statistically significant.Conclusions: Present study concluded that the blood glucose levels and lipid parameters were elevated among uncontrolled diabetics compared to controlled diabetics strongly depicting the co-relation between the glycemic levels and lipid abnormalities. Patients should be educated to monitor regularly and control blood glucose and lipid levels.
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OBJECTIVE@#To explore the cytidine-phosphate-guanosine (CPG) sites associated with fas-ting plasma glucose (FPG) and glycated haemoglobin (HbA1c) in twins.@*METHODS@#In the study, 169 pairs of monozygotic twins were recruited in Qingdao, Zhejiang, Jiangsu, Sichuan and Heilongjiang in June to December of 2013 and June 2017 to October 2018. The methylation was detected by Illumina Infinium HumanMethylation450 BeadChip and Illumina Infinium MethylationEPIC BeadChip. According to the Linear Mixed Effect model (LME model), fasting plasma glucose and HbA1c were taken as the main effects, the methylation level (β value) was taken as the dependent variable, continuous variables, such as age, body mass index (BMI), blood pressure, components of blood cells, surrogate variables generated by SVA, and categorical variables, such as gender, smoking and drinking status, hypoglycemic drugs taking, were included in the fixed effect model as covariates, and the identity numbers (ID) of the twins was included in the random effect model. The intercept was set as a random. Regression analysis was carried out to find out the CpG sites related to fasting blood glucose or HbA1c, respectively.@*RESULTS@#In this study, 338 monozygotic twins (169 pairs) were included, with 412 459 CpG loci. Among them, 114 pairs were male, and 55 pairs were female, with an average age of (48.2±11.9) years. After adjustment of age, gender, BMI, blood pressure, smoking, drinking, blood cell composition, and other covariates, and multiple comparison test, 7 CpG sites (cg19693031, cg01538969, cg08501915, cg04816311, ch.8.1820050F, cg06721411, cg26608667) were found related to fasting blood glucose, 3 of which (cg08501915, ch.8.1820050f, cg26608667) were the newly found sites in this study; whereas 10 CpG sites (cg19693031, cg04816311, cg01538969, cg01339781, cg01676795, cg24667115, cg09029192, cg20697417, ch.4.1528651F, cg16097041) were found related to HbA1c, and 4 of which(cg01339781, cg24667115, cg20697417, and ch.4.1528651f) were new. We found that cg19693031 in TXNIP gene was the lowest P-value site in the association analysis between DNA methylation and fas-ting plasma glucose and HbA1c (PFPG=2.42×10-19, FDRFPG<0.001; PHbA1c=1.72×10-19, FDRHbA1c<0.001).@*CONCLUSION@#In this twin study, we found new CpG sites related to fasting blood glucose and HbA1c, and provided some clues that partly revealed the potential mechanism of blood glucose metabolism in terms of DNA methylation, but it needed further verification in external larger samples.
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Adult , Female , Humans , Male , Middle Aged , Blood Glucose , CpG Islands , DNA Methylation , Epigenesis, Genetic , Fasting , Glycated Hemoglobin , Twins, MonozygoticABSTRACT
Background: The study was conducted to evaluate the change in serum potassium level over follow up period in patients of diabetic nephropathy on spironolactone (25 mg) and ramipril (5 mg) and compare the results with diabetic nephropathy patients on Spironolactone (25 mg) alone.Methods: A comparative, prospective, non-randomized, non-blinded experimental study was conducted on 56 patients (30-70 yr.) of diagnosed type 2 diabetes mellitus showing proteinuria. Total duration of study was about one year from October 2017 to October 2018. Inclusion criteria followed in study were Age 30-70 years, diagnosed type 2 diabetes mellitus, serum potassium level <5 meq/l, estimated GFR >30 ml/min/1.73m2 and HbA1c <10%. Exclusion criteria were type 1 diabetes mellitus, impaired glucose tolerance secondary to endocrine disease, exocrine pancreatic disease, SBP >180 mmHg DBP >110 mmHg, UTI, hematuria, acute febrile illness, vigorous exercise, short-term pronounced hyperglycemia, obstructive uropathy, confirmed or suspected renal artery disease by USG doppler study, Serum potassium level >5.5 meq/l. Patients were divided in two groups, group A (n= 28, spironolactone 25 mg and ramipril 5 mg) and group B (n=27, spironolactone 25 mg). Subjects were followed over 12 weeks and baseline and 12-week serum potassium being compared. Other baseline base line laboratory investigation such as serum lipid profile, HbA1c, eGFR, fundus examination, ultrasonography (KUB), serum urea, serum creatinine, hemoglobin, were taken at the starting point.Results: Both the group after receiving respective drug were followed for 3-month duration and serum potassium level measured at end of 3 months. Mean values of baseline and follow up serum potassium for group A and group B were 4.24±0.59, 4.07±0.61 and 4.35±0.55, 4.16±0.61 respectively, p value found to be >0.05 at 95% CI.Conclusions: In the study it was concluded that p value found to be >0.05 at 95% C.I denoting that there is no significant difference between mean value of base line and follow up serum potassium value in both group. None of patients in either group had experienced hyperkalaemia over follow up period though serum potassium level were slightly higher in group A, but this difference was statistically not significant. Follow up period of study should be long enough to comment on safety profile of combining spironolactone and ACE inhibitors in diabetic nephropathy patients.
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Background & objectives: There has been an ongoing debate about the impact of Ramadan fasting (RF) on the health of these individuals who fast during Ramadan. The aim of this meta-analysis was to evaluate the relationship between RF and glycaemic parameters in type 2 diabetes mellitus (T2DM) patients. Methods: Search terms were decided and databases such as MEDLINE EBSCO, Google Scholar and EMBASE were searched for eligible studies. Standardized mean differences and 95 per cent confidence intervals (CIs) of post-prandial plasma glucose (PPG), fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) (%) and fructosamine levels were calculated for different treatment regimens. Results: Of the 40 studies, 19 were found eligible for inclusion in the meta-analysis. Based on pooled results, significant reductions in FPG were found in single oral antidiabetics (OAD) [standardized weighted mean difference (SMD)=0.47, 95% CI=(0.20-0.74)], multi-OAD [SMD=0.36, 95% CI=(0.11-0.61)] and multitreatment subgroups [SMD=0.65, 95% CI=(0.03-1.27)] and overall [SMD=0.48, 95% CI=(0.27-0.70)]. Furthermore, HbA1c(%) [SMD=0.26, 95% CI=(0.03-0.49)] and body mass index (BMI) [SMD=0.18, 95% CI=(0.04-0.31)] were significantly decreased in the multi-OAD group. Interpretation & conclusions: The meta-analysis showed that RF was not associated with any significant negative effects on PPG and fructosamine levels. However, BMI and FPG and HbA1c(%) were positively affected by RF.
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Background: Type II Diabetes mellitus has emerged as aglobal public health problem with more effect on developingworld. India is considered to become epicentre of DM in nearfuture. Serum uric acid is a by-product of purine metabolism.Most of the studies provide a positive relationship betweenhyperglycemia & hyperuricemia.Objectives: To co-relate the level of serum uric acid ineuglycemic persons having family history of DM and in personshaving no family history of DM and to assess the level ofHbA1c among these two groups.Materials and Methods: Present study was undertaken atMGM Medical College, Jamshedpur and Sadar Hospital,Jamshedpur with a sample size of 60 (30 in each group).Results: The present study didn’t find any significantdifference in serum uric acid between two groups although asignificant difference was observed in HbA1c in both groups.
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Background: Obesity has major adverse effects on health. Obesity is associated with an increase in mortality, with a 50-100% increased risk of death from all causes compared to normal-weight individuals, mostly due to cardiovascular causes. The aim of this study was to correlate Body Mass Index (BMI) and glycaemic control (HbA1c) in type 2 Diabetic patients.Methods: In this study 100 patients of type 2 diabetic were subjected to detailed history, clinical examination, BMI, HbA1c and routine biochemical investigations.Results: Out of 100 diabetic patients included in this study 62 of them were male and 38 were female. Among 100 patients. Majority of patients were overweight (BMI 25-29.9) which is account to about 58 of total cases, 30 patients were normal BMI and 12 patients were obese. Statistical analysis a positive correlation found between BMI and poor glycaemic control (HbA1c), which is significant.Conclusions: From this study it was concluded that obesity (BMI) is associated with poor glycaemic control.
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Background: The aim of this study was to determine as well as to compare the salivary glucose levels in the diabetic and non-diabetic population and correlate the values with their fasting blood glucose and HbA1c (glycated Haemoglobin) levels. Many researchers have proposed the possibility of using salivary glucose estimation for screening and monitoring of effect in general population and in resource poor settings. But studies on this subject in Indian population are limited.Methods: The current study was an analytical cross sectional study of a group of 100 diabetic patients and 100 healthy controls, conducted in the Department of General Medicine, SRM medical college hospital. The mean difference in the salivary glucose between diabetic and non-diabetic population was compared using unpaired t-test.Results: There was a strong positive association between FBS (fasting blood sugar) and salivary glucose in the overall population. There was a strong positive correlation between FBS and Salivary glucose in FBS <200. There was a moderate positive association between FBS and salivary glucose in people with FBS value between 200 to 300 mg/dl. There was a weak positive association between FBS and salivary glucose in people with FBS value >300 mg/dl, which was statistically not significant. There was a strong positive correlation between HbA1c and salivary glucose in the overall population.Conclusions: There appears to be a strong positive association between fasting blood sugar and salivary glucose value in both study groups. But the correlation seems to be relatively weak in fasting blood sugar range above 300 mg/dl. Considering this positive association, further studies are needed to explore the possibility of utilizing salivary glucose for monitoring glycemic control.
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Background: Haemoglobin A1c (HbA1c) is a glycated form of haemoglobin reflects average plasma glucose over the previous 8 to 12 weeks. HbA1c can be affected by multiple non-glycaemic parameters. Iron deficiency anaemia (IDA) is one among them which is the most common type of anaemia in India. However, reports on the effects of iron deficiency anaemia on HbA1c levels are inconsistent. Hence we conducted a study to find out the influence of iron deficiency anaemia over HbA1c levels. Methods: 120 patients confirmed to have iron deficiency anaemia were enrolled in this study. HbA1c levels were measured at baseline and 3 months after treatment, and these values were compared with those in the control population.Results: The mean baseline HbA1c level in anaemic patients (4.62%) was significantly lower than that in the control group (5.45%, P<0.001). A significant increase was observed in the patients HbA1c levels at 3 months after treatment (5.82%, P<0.001). There was a significant correlation observed between haemoglobin and HbA1c level (Coefficient of correlation=0.26, P<0.01) in the study group before correction.Conclusions: In contrast to the observations of previous studies, ours showed that HbA1c levels increased with treatment of iron deficiency anaemia. This could be attributable to nutritional deficiency, racial-ethnic variations and/or certain unknown variables. Further studies are warranted.
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Background: Poor glycemic control has been reported to be associated with increased vascular complications in diabetes mellitus (DM) patients. High fibrinogen level has been described as an independent risk factor for cardiovascular diseases. High fibrinogen has been suggested to be involved in the excess rate of cardiovascular diseases in patients with type 2 DM. The present study was undertaken to find correlation between glycemic control and plasma fibrinogen level in patients with type 2 DM.Methods: Three hundred ten patients aged ≥30 years of either sex were included in this cross sectional study. Estimation of glycated haemoglobin (HbA1c), serum fibrinogen, serum total cholesterol (TC), serum triglycerides (TG), serum high density lipoprotein (HDL) cholesterol, and serum low density lipoprotein (LDL) cholesterol was done. Categorical and continuous variables were tested using Chi-Square test/Fisher’s exact test and unpaired ‘t’ test respectively. Pearson’s correlation was used to study correlation between serum fibrinogen levels and HbA1c, Body mass index (BMI), TC, LDL cholesterol, HDL cholesterol, and TG.Results: Mean serum fibrinogen levels were significantly higher in DM patients whose HbA1c, LDL cholesterol and TG levels were higher. Correlation between serum fibrinogen was 0.59, and 0.45 with HbA1c, and BMI respectively. Multivariate step-wise regression analysis showed higher HbA1c and higher BMI were the independent and significant predictors of higher serum fibrinogen levels. HbA1c was the stronger predictor of serum fibrinogen than BMI.Conclusions: Fibrinogen levels were independently associated with HbA1c value in patients with type 2 DM.
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INTRODUCTION@#Type 2 diabetes mellitus (T2DM), the tenth leading cause of death in Hong Kong, has a prevalence of approximately 10%. Sodium-glucose co-transporter-2 (SGLT2) inhibitors lower glycated haemoglobin (HbA1c) levels in T2DM patients via a non-insulin-dependent mechanism of action, but real-world data is limited, particularly for Chinese patients.@*METHODS@#A retrospective single-centre study was performed among Chinese patients with T2DM who were prescribed SGLT2 inhibitor therapy in Hong Kong. Changes in HbA1c levels, body weight, systolic and diastolic blood pressure, estimated glomerular filtration rate (eGFR), lipid profiles and adverse events were observed for patients who completed at least one follow-up visit during the study period.@*RESULTS@#Overall, 100 patients were included, and 53 patients attended an additional final visit. By the final visit, SGLT2 inhibitor therapy had significantly decreased HbA1c levels (change [Δ] 0.31%, 95% confidence interval [CI] -0.11% to -0.51%, p < 0.001), body weight (Δ -4.59 kg, 95% CI -3.75 to -5.54 kg, p < 0.001) and systolic blood pressure (Δ -5.72 mmHg, 95% CI -1.72 to -9.72 mmHg, p < 0.001) from baseline. No significant change in eGFR or lipid profiles was observed, except for a significant reduction in high-density lipoprotein cholesterol (Δ -0.09 mmol/L, 95% CI -0.16 to -0.02 mmol/L, p < 0.05). Adverse events were consistent with previous reports for SGLT2 inhibitors, apart from appetite loss associated with canagliflozin.@*CONCLUSION@#The real-world efficacy and safety profile of SGLT2 inhibitors in Chinese patients was comparable to that reported in Phase III clinical trials, with the exception of appetite loss among patients who received canagliflozin.
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Background: Diabetes mellitus is one of the most common endocrine disorders affecting about 6% of the world’s population. Diabetes mellitus is the leading cause of end stage renal disease (ESRD), a major cause of non-traumatic amputations, responsible for preventable blindness and a leading cause of cardiovascular mortality. Objective: The objective of the study was to assess the glycemic control by estimation of glycated hemoglobin (HbA1c), and lipid profile in patients of Diabetes mellitus without complications and in Diabetes mellitus with complications like neuropathy, retinopathy and nephropathy and compare with controls. Material and methods: The present study comprised of 100 clinically diagnosed and confirmed cases of type 2 Diabetes mellitus attending and admitted in RNT Medical College and Hospital, Udaipur, Rajasthan, India. Glycosylated hemoglobin (HbA1c), Total Cholesterol, Triglycerides, HDL-Cholesterol, LDLCholesterol and VLDL-Cholesterol were calculated in all groups using Friedewald’s formula. Result: Our study showed that HbA1c levels were significantly higher (p<0.01) in all groups of patients as compared to controls. The increase in Serum Cholesterol, Triglyceride, LDL-Cholesterol, VLDL-Cholesterol and decrease in HDL-Cholesterol levels were statistically significant (p<0.01) in Diabetic retinopathy and Diabetic nephropathy group as compared to controls, whereas in Diabetic neuropathy group and in Diabetes mellitus without complication, the increase in Serum Cholesterol, Triglyceride, LDL-Cholesterol, VLDL-Cholesterol and decrease in HDL-Cholesterol levels was not statistically significant as compared to controls. Conclusion: Our study revealed that poor glycemic control and dyslipidemia are associated with Diabetic complications like neuropathy, retinopathy and nephropathy. Estimation of glycosylated hemoglobin and lipid profile helps in predicting the development of microvascular complications.
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The risk of coronary heart disease (CHD) is dramatically increased in diabetic patients due to their atherogenic lipid profile. The severity of CHD in diabetic patients has been found to be directly associated with glycated haemoglobin (HbA1c). According to the Malaysian Clinical Practice Guidelines on diabetes mellitus (DM), HbA1c level less than 6.5% reduces the risk of microvascular and macrovascular complications. Hence, this study aimed to determine the relationship between dyslipidaemia and glycaemic status in patients with type 2 DM (T2DM) patients in Hospital Putrajaya, a tertiary endocrine centre in Malaysia. This was a cross sectional, retrospective study of 214 T2DM patients with dyslipidaemia who had visited the endocrine clinic between January 2009 and December 2012. Significant correlations were found between fasting blood glucose (FBG) and HbA1c with total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL), non-high density lipoprotein cholesterol (non-HDL), LDL/HDL ratio and TC/HDL ratio; greater correlation being with HbA1c than FBG. In patients with HbA1c ≥ 6.5%, TC, TG, non-HDL and TC/HDL ratio were significantly higher than in patients with HbA1c < 6.5%. Non-HDL, LDL/HDL ratio, TC/HDL ratio and HbA1c were significantly lower in patients on statin treatment than nontreated patients (p<0.05). This significant association between glycaemic status and dyslipidaemia emphasises the additional possible use of HbA1c as a biomarker for dyslipidaemia as well as a potential indirect predictor of cardiovascular disease (CVD) risk in T2DM patients.
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Abstract: Background& Objectives: Diabetic neuropathy is the most common and troublesome complication of diabetes mellitus, leading to great morbidity and resulting in burden for diabetes care. The progression of neuropathy can be reduced by early detection and intervention. Nerve conduction studies are the most sensitive indices of the severity of neuropathy. These tests can be used to localize lesions and describe the type and severity of the pathophysiologic process, including alterations that are not recognized clinically. This study was undertaken to compare nerve conduction study results in diabetes mellitus patients with good glycemic control and poor glycemic control and to compare it with non-diabetic subjects. This study aims to signify the role of nerve conduction study in diabetes mellitus. This can help in identifying the asymptomatic stage of diabetic neuropathy so that suitable preventive measures can be taken. Methodology: Total 90 subjects were included in the study group. 30 were non diabetic subjects and 60 were known cases of Type II diabetes mellitus patients attending diabetic OPD at GMCH, Aurangabad of age 30-50 years with duration of 5-10 years. Glycated haemoglobin levels were estimated and on this basis the cases were divided into two groups; diabetic patients with good glycemic control and diabetic patients with poor glycemic control. Nerve Conduction parameters were measured by computerized micromed RMSEMG system. Results: There was an increase in mean latency and decrease in amplitude and velocity values in both the diabetic groups. Intergroup comparison showed that, the increase in latency and decrease in amplitude and velocity was more in diabetics with poor glycemic control as compared to other study groups and this difference was statistically highly significant. Conclusion: The study concluded that there is statistically significant changes in nerve conduction parameters in Type II diabetes.
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Background: Diabetes mellitus is one of the most important risk factors of coronary artery disease. Admission hyperglycemia adversely influences the outcome of acute coronary syndrome patients. The study was conducted to compare the various diagnostic methods for the detection of undiagnosed diabetes mellitus in acute coronary syndrome patients with admission hyperglycaemia in Bangladeshi population. Methods: It was a cross sectional comparative study involving 157 patients with admission blood glucose level e”7.8 mmol/l. Fasting plasma glucose, Glycated haemoglobin, pre-discharge oral glucose tolerance test was measured in all subjects and comparison of performance of different methods was done. Results: Oral glucose tolerance test revealed that in spite of admission hyperglycaemia, 57 (36.3%) patients were diabetic and 52 (33.12%) patients had impaired glucose homeostasis and 48 (30.57%) patients had normal glucose metabolism. Undiagnosed diabetes could not be adequately predicted with admission plasma glucose, fasting plasma glucose or HbA1c alone (area under the ROC curve 0.589, 0.825 and 0.852 respectively). Conclusion: Admission hyperglycaemia does not diagnose diabetes reliably in a stressful condition like acute coronary syndrome. Although neither admission plasma glucose, fasting plasma glucose, nor HbA1c level were as good as oral glucose tolerance test in detecting true diabetes, but combined fasting plasma glucose & HbA1c were found to be more sensitive & specific screening tool for detecting unknown diabetes in acute coronary syndrome patients with admission hyperglycaemia.
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The relationship between glycated haemoglobin, fasting plasma glucose, packed cell volume and albumin creatinine ratio in diabetic patients in south-south Nigeria was investigated in 118 diabetic patients (80 females and 38 males) and 36 apparently healthy controls (20 females and 16 males). The glycated haemoglobin (HbA1c), fasting blood glucose (FBG) and albumin creatinine ratio (ACR) of (6.5±0.65%, 113±7.9mgldL and 48.4±6.3 respectively) were significantly higher in the diabetic patients than in control subjects (3.7±0.13%, 86±2.6mgldL and 21.0±5.1 respectively), while the packed cell volume (PCV) was higher in the control subjects than in diabetic patients (46.3±1.13% vs 40.6±0.92%). There was a significant positive correlation between the HbA1c, and FBG in both the diabetic patients and control subjects (r=0.418 and 0.782 respectively, P<0.001) and there was also a significant positive correlation between the HbA1c and ACR in both the diabetic patients and control subjects (r= 0.244 and 0.618 respectively, P< 0.001). In conclusion, there is a strong relationship between HbA1c, FBG and ACR in diabetic patients and control subjects.