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Fundamento: las enfermedades cerebrovasculares constituyen una de las principales causas de mortalidad en el mundo. En las Américas constituyen la tercera causa de muerte y su incidencia se ve aumentada en los pacientes diabéticos tipo 2. Objetivo: caracterizar los pacientes diabéticos tipo 2 con enfermedad cerebrovascular isquémica aguda. Método: se realizó un estudio descriptivo en pacientes diabéticos que ingresaron en el Hospital Calixto García con diagnóstico de enfermedad cerebrovascular isquémica aguda en el período comprendido entre enero y diciembre 2022. El universo estuvo constituido por la totalidad de pacientes diabéticos tipo 2 que ingresaron en la Institución y la población por 148 pacientes. Las variables analizadas fueron: sexo, color de piel y edad; tensión arterial e índice de masa corporal; colesterol, triacilgliceridos y glicemia; tipo enfermedad cerebrovascular y su gravedad y comorbilidades. Se utilizaron métodos de la estadística descriptiva como frecuencia absoluta y porciento. Los resultados se presentaron en tablas creadas a los efectos. Resultados: predominó el sexo masculino, el color de piel blanca y el grupo etáreo entre los 60 y 69 años con un 58,1 43,9 y 40,5 % respectivamente. Predominaron los pacientes hipertensos y con sobrepeso relacionados con la mayor gravedad de la enfermedad cerebrovascular, los pacientes hiperglicémicos con valores de colesterol y triacilgliceridos altos, en ellos fue más grave el evento isquémico cerebral. La hipertensión arterial y la cardiopatía isquémica prevalecieron en la población estudiada con un 81,8 y 52,7 respectivamente. Conclusiones: la enfermedad cerebrovascular fue más frecuente en el sexo masculino, color de piel blanca y pacientes de edad avanzada. La hipertensión arterial, el sobrepeso, la hiperglucemia así como los valores altos de colesterol y triglicéridos predominaron en la muestra y se relacionaron con la mayor gravedad del evento cerebrovascular isquémico.
Foundation: cerebrovascular diseases are one of the main causes of mortality in the world. In the Americas they constitute the third cause of death and their incidence is increased in type 2 diabetic patients. Objective: to characterize type 2 diabetic patients with acute ischemic cerebrovascular disease. Method: a descriptive study was carried out in diabetic patients who were admitted to the Calixto García Hospital with a diagnosis of acute ischemic cerebrovascular disease in the period between January and December 2022. The universe consisted of all type 2 diabetic patients who were admitted to the Institution and the population of 148 patients. The variables analyzed were: sex, skin color and age; blood pressure and body mass index; cholesterol, triacylglycerides and glycemia; type of cerebrovascular disease and its severity and comorbidities. Descriptive statistical methods such as absolute frequency and percentage were used. The results were presented in tables created for the purpose. Results: the male sex, the white skin color and the age group between 60 and 69 years predominated with 58.1, 43.9 and 40.5 % respectively. Hypertensive and overweight patients related to the greater severity of cerebrovascular disease, hyperglycemic patients with high cholesterol and triacylglyceride values predominated, and in them the cerebral ischemic event was more severe. Arterial hypertension and ischemic heart disease prevailed in the studied population with 81.8 and 52.7 respectively. Conclusions: cerebrovascular disease was more frequent in males, white skin color and elderly patients. Arterial hypertension, overweight, hyperglycemia as well as high cholesterol and triglyceride values predominated in the sample and were related to the greater severity of the ischemic cerebrovascular event.
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Background: Type 2 Diabetes mellitus affects the quality of life of individuals and their ability to function. It affects the physical, social and mental well-being of patients with immediate and delayed complications.This study determined the quality of life of type 2 diabetic patients attending a tertiary hospital in south-south Nigeria.Methods:This was a descriptive cross-sectional study conducted among type 2 diabetic patients attending the medical outpatient clinic of the University of Port Harcourt Teaching Hospital between September and November 2019. Purposive sampling technique was used to select a total of 347 participants for the study following ethical approval. WHOQOL-BREF questionnaire was used to measure the QoL of the participants. Data were analyzed using SPSS version 23.0. Descriptive data were presented in frequency distribution tables while summary statistics were done using mean and standard deviation for continuous variables and in proportions for categorical variables. Results:Results revealed that majority of the type 2 diabetic patients were females (53.3%) and between the ages of 51-60 years. 27.2% of them had poor overall QoL with the score of <45% while 65.7% had fair overall QoL with a score of 45-65 %. 7.1% had good overall QoL with a score of ≥65%. Conclusion:Majority of the type 2 diabetic patients had fair QoL while the least had good QoL. There is urgent need for increased health awareness and education of diabetic patients regarding diabetic care.
Subject(s)
Diabetes Mellitus, Type 2 , Tertiary Care Centers , Quality of Life , Diabetes Complications , Diet, DiabeticABSTRACT
Objective To examine the relationship between physical activity and glycemic control among type 2 diabetic patients with a good compliance level in China. Methods A total of 1 272 patients diagnosed with type 2 diabetes with a good compliance level were recruited from five community health centers in Nanjing Chemical Industry Administrative Zone from 2014 to 2016. Logistic regression models were used to examine the relationship between physical activity and glycemic control. Results In this cross-sectional study, 1 272 type 2 diabetic patients (596 men and 676 women) were recruited. The participants’ mean (standard deviation, SD) age was (64.63±9.04) years old. Male participants who achieved sufficient physical activity had the odds ratio (OR) of 2.11 (95%CI:1.17-3.18, P=0.013) for a tight glycemic control compared to their counterparts who had sufficient physical activity, after controling for the potential confounders, no significant association between physical activity and glycemic control status existed in women. Conclusions Physical activity is positively associated with glycemic control among male type 2 diabetic patients who had a good compliance level in Nanjing. Specific physical activity interventions should be implemented to type 2 diabetic patients
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Background: Cardiovascular disease (CVD) has emerged as the dominant chronic disease in many parts of the world. At the beginning of the twenty-first century, CVD accounts for nearly half of all deaths in the developed world and 25% in the developing world. Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Vascular diseases account for most morbidity and mortality in patients with DM. Aim and objectives: To study the clinical profile of type 2 diabetic patients presenting with Acute Coronary Syndrome (ACS) with reference to HbAlc level. Materials and methods: After selecting appropriate samples for the study based on the inclusion criteria, a detailed history was elicited and clinical examination was done as per the proforma. The necessary investigations were done as per the proforma. The clinical profile of these patients was then analyzed and correlated with reference to HbAlc level and statistical analysis performed using paired’ test. Results: The prevalence of microvascular diabetic complications was high with nephropathy amounting to 62% and retinopathy amounting to 58%. Neuropathy was not documented. About 32% of patients were free of microvascular complications. Other macrovascular diabetic complications were not documented. Among complications of ACS, 24% developed hypotension and no other complication was noted. Remaining 76% did not suffer any complications. No mortality was documented. Patients with systolic dysfunction constituted 82% and diastolic dysfunction 66%. The percentage of patients with HbA1c >7% constituted 62% which was very high and only 32% of patients had their HbA1c level in the control range. K. Babu Raj, G. Sivachandran. A study on clinical profile of acute coronary syndrome in type 2 diabetes mellitus patients with relevance to HbA1c. IAIM, 2018; 5(8): 1-8. Page 2 Conclusion: A majority of diabetic patients developing acute coronary syndrome have poor glycaemic control as reflected by their HbAlc levels. The coronary event is likely to occur sooner after the detection of diabetes if good glycaemic control is not achieved. Exercise, in the form of regular day to day activities, does not achieve satisfactory glycaemic control and cannot prevent the development of adverse complications of diabetes.
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Objective To evaluate the therapeutic effect of health education pathway on type 2 diabetic patients by using the Meta-analysis.Methods The domestic main databases were searched,the quality of included studies which screened by certain standards was evaluated.The Review Manager 5.0software was taken for analysis.Results Totally 12 studies were included,containing 2115 cases of type 2 diabetic patients.The Meta-analysis showed there were significant differences between the health education pathway group and the control group in hospitalization days and hospitalization expenses,rate of patients' satisfaction and rate of mastering knowledge of diabetes mellitus,fasting blood glucose and 2h postprandial blood glucose.Conclusions Health education pathway for type 2 diabetic patients can shorten hospitalization days,decrease hospitalization expenses,increase rate of patients' satisfaction and rate of mastering knowledge as well as lower fasting blood glucose and 2h postprandial blood glucose.
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Objective To make a status survey on type2 diabetic patients with metabolic Syndrome in middle-aged inhabitants.Methods 338 inpatients with type 2 DM including 179 male and 159 female,aged 46?5 years,with complete records in the computer database.Results The prevalent rates of the complications in group of 40～yrs type2 diabetic patients were 17.8% combined with coronary atherosclerotic heart disease,50.9% with hypertension,18.1% with left ventricular dilatation,53.6% with hypertriglyceridemia,46.2% with lower HDL,54.7% with obesity and 38.8% with metabolic Syndrome,respectively.These prevalent rates in the 40-year-old group were all lower than those in groups above 60 years,and the rates was higher in patients whose BMI was above 25(kg/m2).Conclusion There was high prevalence in type 2 diabetic patients with metabolic Syndrome,and was related with the age and obesity.Obesity was an independent risk factor for MS.
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Diabetic nephropathy has been known as one of the most serious long-term complications of diabetes mellitus (DM), which could lead to end-stage kidney failure. However, data showing the presence of diabetic nephropathy among ambulatory type 2 diabetic patients is currently not available. This cross-sectional study was conducted to find the prevalence of diabetic nephropathy among non-hospitalized type 2 diabetic patients, who came for the first time to the Metabolic and Endocrinology Clinic, Dr. Cipto Mangunkusumo Hospital, Jakarta. From December 2001 to June 2002, 100 new type 2 diabetic patients were included in the study. Forty-two of them were men and the mean age was 54 ± 9.6 years. Overt nephropathy (macroalbuminuria) was found in 11% of patients, while incipient nephropathy (microalbuminuria) was 26%, and the rest were normal (normoalbuminuria). Duration of illness of more than 5 years was significantly correlated with the degree of albuminuria. However, there is no significant correlation between the degree of albuminuria and other risk factors, i.e. patient’s age, dyslipidemia, hypertension, obesity, HbA1c level. All patients with overt nephropathy had creatinine clearance test below 75 ml/ min. (mean 45.3 mL/min), significantly lower than patients with micro- or normoalbuminuria (p=0.01). Retinopathy was found in 10 out of 11 (90%) patients with overt nephropathy. Multivariate analysis showed that the duration of illness and retinopathy was significantly correlated with the presence of diabetic nephropathy (p< 0.05). We concluded that the prevalence of diabetic nephropathy (i.e. overt nephropathy with retinopathy) among non-hospitalized type 2 diabetic patients was 10%. The duration of illness was an important risk factor for the development of this complication.
Subject(s)
Diabetic Nephropathies , Diabetes Mellitus, Type 2 , Diabetic Retinopathy , Renal Insufficiency, ChronicABSTRACT
BACKGROUND: Microalbuminuria is the main parameter used in diabetic patients for clinical evaluation of early diabetic nephropathy and other complications. The most common method for quantitative urinary protein relies on a 24-hour urine collection or overnight urine collection; however, this method is time consuming and sometimes obtains inaccurate results. This study is aimed to test whether the microalbumin to creatinine ratio (Uma/Ucr) in the first-morning urine samples correlates with the microalbumin content in the 24-hour urine collection. METHODS: 59 urine samples from 59 type 2 diabetic patients were analyzed for Uma/Ucr, and for 24-hour urine microalbumin that were successively collected. RESULTS: Daily microalbumin excretion varied from 2.4 to 168.7 mg/24 hr with a median value of 22.9 mg, and Uma/Ucr ranged from 3.4 to 200 g/mg with a median value of 29.0 g/mg. An excellent correlation was found between the microalbumin excretion measured from the 24-hour urine collections and the first-morning urine Uma/Ucr ratio (R=0.93, P<0.001). All patients that excreted more than 30 mg albumin in the 24-hour urine samples also had an Uma/Ucr of more than 30 g/mg. Patients who had less than 30 g/mg of Uma/Ucr were unlikely candidates for microalbuminuria. CONCLUSIONS: This study indicates that measurements of Uma/Ucr in first-morning urine samples are a simple and reliable alternative to measurements of the urinary albumin excretion rate in the 24-hour urine collections.
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Humans , Creatinine , Diabetic Nephropathies , Urine Specimen CollectionABSTRACT
This study was performed to investigate the effect of a telephone-delivered intervention on glycemic control and body mass index in Korean type 2 diabetic patients. 38 patients were randomly selected, with 20 assigned to a telephone group and 18 to a control group. The goal of the intervention was to keep blood glucose concentrations close to the normal range. The intervention was applied to the telephone group for 12 weeks. It consisted of continuous education and reinforcement of diet, exercise and medication adjustment, as well as frequent self-monitoring of blood glucose levels. Telephone intervention was performed twice per week for the first month, and then weekly for the second and third months. Subjects were requested to write self-management logs, including blood glucose, diet and an exercise diary. The diet diaries were analyzed by a dietitian, and subjects instructed about the results by telephone counseling or mail. All medication adjustments were communicated to the subjects' diabetes specialist. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and 2-hour postprandial glucose were measured before, and after, the intervention. Patients in the telephone group had a mean decrease of 1.2%, with those in the control group having a mean increase of 0.6%, in HbA1c. There were no significant differences in the body mass index (BMI) between the two groups. These findings indicated that a telephone-delivered intervention would improve HbA1c, but would not affect BMI.
Subject(s)
Humans , Blood Glucose/metabolism , Body Mass Index , Diabetes Mellitus, Type 2/blood , Remote Consultation , TelephoneABSTRACT
This study was conducted to test the effect of a diabetic camp program on the fasting blood sugar in type 2 diabetic patients. The subjects of the study consisted of 33 diabetic patients who had participated with a diabetic camp program in the YangPung area from August 12 to August 15, 1998. Wilcoxon signed rank test was used for the significance of the differences between values before and after the diabetic camp program. The fasting blood glucose level, before of the closing day at the diabetic camp, was lower than that of the opening day. When comparing the blood glucose levels before meals, between the early and later part of the diabetic camp, fasting blood glucose levels before breakfast by the 4th day in the later part of the diabetic camp were lower than those of the 2nd day in the early part. Blood glucose level before lunch by the 4th day, in the later part of the diabetic camp, were lower than those of the 2nd day in the early part. Blood glucose levels before dinner by the 3rd day, in the later part of the diabetic camp, were lower than those of the 1st day in the early part. Blood glucose levels before sleep by the 3rd day, in the later part of the diabetic camp, were lower than those of the 1st day in the early part.
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Humans , Blood Glucose , Breakfast , Fasting , Lunch , MealsABSTRACT
Since the evidence for the hypercoagulable state in terms of prothrombin fragment 1+2 (F1+2) in Thai diabetic patients has never been reported, we studied plasma F1+2 levels in 68 type 2 diabetic patients and in 20 normal age-matched volunteers. Fibrinogen, D- dimer, glucose, HbA1C, cholesteroi, triglyceride, HDL-cholesterol and creatinine were also determined. It was found that the levels of F1+2 and fibrinogen in the diabetic patients were significantly higher than in the controls (p<0.001 and p<0.01 respectively), while D-dimer was detected positively in 17 out of 64 patients whereas none could be detected in the 20 healthy volunteers. A total of 23 out of 68 patients had higher levels of F1+2 than the normal range. When we compared the clinical characteristics, blood chemistry analysis and hypercoagulable markers of the diabetic patients between the groups of high F1+2 and normal F1+2, there were significantly higher numbers of positive D-dimer cases in the high F1+2 group compared with the normal F1+2 group (p=1.01). The correlation between F1+2 vs diabetic duration was 0.29 with p value less than 0.05. This study suggests that there are hypercogulable states in Thai diabetic patients.