Correlation of Serum Adenosine Deaminase (ADA) with Glycated Heamoglobin (HbAcl) in Type 2 Diabetics Mellitus Patients: A Single Center Study in Bangladesh

Background: Worldwide, diabetes mellitus is a major health problem leading to remarkable mortality and morbidity day by day. Adenosine deaminase (ADA) catalyzes the irreversible deamination of adenosine to inosine is a polymorphic enzyme which is considered to be related to type 2 diabetes mellitus (T2DM). So, it may be useful in formulating proper guideline for evaluating the glycemic status in T2DM. The aim of the study was to assess the correlation of serum adenosine deaminase (ADA) with glycated heamoglobin (HbA1c) in type 2 diabetics mellitus patients.Material & Methods:It was a cross sectional study and conducted in the Department of Physiology, Dhaka Medical College, Dhaka, Bangladesh from July 2014 to June 2015. A total number of 150 participants of both sexes were included in this study as the study population. The samples were divided into major two groups. The control group (Group A) consisted of 50 age matched healthy subjects for comparison and the study group (Group B) consisted of 100 type 2 diabetic patients with the age ranging from 40-55 years. Again, depending on HbA1c level, the study group was divided into two subgroups. Group B1 consisted of 50 participants with HbA1c<6.5% and Group B2 consisted of 50 participants with HbA1c>6.5%. The study parameters were including serum ADA, FPG, HbA1c. For statistical analyses one-way ANOVA test, unpaired Student’s test and Pearson’s correlation coefficient (r) test were performed as applicable using SPSS version 20.0.Results:type-2 DM as compared to healthy controls. Again, serum ADA (P<0.001) levels were significantly higher in type2DM with HbA1c ?6.5% than that of type2 DM with HbA1c <6.5%. There is a positive correlation of serum ADA with FPG, HbA1c in type 2 diabetic patients.Conclusion:After analyzing the results of the study, it is concluded that estimation of serum ADA level might be used as a new marker for prediction of glycemic in type2 diabetes mellitus.

Triglyceride and glucose index as a predictive factor for diabetic retinopathy in Type 2 diabetic patients / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the validity of triglyceride glucose(TyG)index to identily diabetic retinopathy(DR)in type 2 diabetic patients. METHODS: A cross-sectional study. A total of 1061 type 2 diabetic patients in Shanghai who underwent health checkup in our hospital in 2021, all the subjects underwent questionnaire survey, physical examination, blood biochemical index detection and fundus examination. According to the fundus photos, they were divided into DR group(275 cases)and no DR group(786 cases). Risk factors for DR were evaluated by univariate and multivariate Logistic regression analyses, receiver operating characteristic(ROC)curve was used to analyse the predicted values of TyG with DR. RESULT: Elevated TyG index was an high risk factor for development of DR in type 2 diabetic patients. After adjusting for multiple confounding factors(gender, age, smoking history, the course of diabetes, glycosylated hemoglobin, systolic blood pressure, diastolic blood pressure, body mass index and serum uric), the OR value of the DR in the TyG index Q4 group relative to the Q1 group was 2.57(95%CI: 1.56-4.05), P<0.001. ROC curve analysis: the optimal cutoff value of TyG index was 6.1762, with a sensitivity of 66.92% and a specificity 63.27%, the AUC was 0.6952 and 95%CI was 0.6575-0.7329.TyG index had better predictive abilities than fasting blood glucose(AUC=0.6697), glycosylated hemoglobin(AUC=0.6864)and triglycerides(AUC=0.6521).CONCLUSION: The TyG index correlates well with the onset risk of DR and potentially is a useful predictive factors, especially in the early stages of DR in patients with type 2 diabetes.

Complicaciones posoperatorias inmediatas en pacientes diabéticos tipo 2 operados de catarata por la técnica de facochop / Immediate postoperative complications in type 2 diabetic patients undergoing phaco chop cataract surgery

Objetivo: Describir la posible presencia de complicaciones posoperatorias en pacientes diabéticos tipo 2, operados de catarata por la técnica de facochop. Métodos: Se realizó un estudio observacional, descriptivo, y longitudinal prospectivo, con 128 pacientes diabéticos (168 ojos) operados de catarata en el Centro de Microcirugía Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer", entre septiembre del año 2017 y diciembre de 2018. Las variables clínicas y epidemiológicas objeto del estudio fueron la edad, el sexo, el color de la piel, la queratometría, la profundidad de la cámara, la longitud axial, la dureza del cristalino, la presión intraocular pre- y posoperatoria y las complicaciones posoperatorias en las primeras 72 horas. Resultados: En el estudio predominaron las mujeres (63,3 por ciento), de piel blanca (74,2 por ciento), quienes presentaron ojos biométricamente normales, con una diferencia estadísticamente significativa. La presión intraocular aumentó a las 24 horas de la cirugía. De los 128 pacientes diabéticos tipo 2 operados de catarata senil por la técnica de facochop, se pudo determinar que el promedio y la desviación estándar de la edad se ubicaron en los 69,49 ± 8,96 años, y osciló entre los 50 y 88 años. Conclusiones: Las complicaciones posoperatorias más frecuentes son el edema corneal y la uveítis. Es significativamente más probable encontrar la uveítis posquirúrgica en pacientes menores de 70 años, y el edema corneal en quienes sobrepasan esta edad(AU)

Objective: Describe the possible presence of postoperative complications in type 2 diabetic patients undergoing phaco chop cataract surgery. Methods: An observational prospective longitudinal descriptive study was conducted of 128 diabetic patients (168 eyes) undergoing cataract surgery at the Center for Ocular Microsurgery of Ramón Pando Ferrer Cuban Institute of Ophthalmology from September 2017 to December 2018. The clinical and epidemiological variables analyzed were age, sex, skin color, keratometry, chamber depth, axial length, crystalline hardness, pre- and postoperative intraocular pressure, and postoperative complications in the first 72 hours. Results: A predominance was found of women (63.3 percent) of white skin color (74.2 percent) and biometrically normal eyes, with a statistically significant difference. Intraocular pressure rose 24 hours after surgery. Mean age and standard deviation were 69.49 ± 8.96 years, range of 50-88 years, in the 128 type 2 diabetic patients undergoing senile cataract surgery by the phaco chop technique. Conclusions: The most common postoperative complications are corneal edema and uveitis. It is significantly more probable to find postsurgical uveitis in patients aged under 70 years and corneal edema in patients aged over 70 years(AU)

Effect of metabolic syndrome in the bone mineral density in elderly male type 2 diabetics / 实用医学杂志

Objective To explore the impact of metabolic syndrome (MS)in bone mineral density (BMD) in elderly male type 2 diabetics (T2DM). Methods One hundred and fourty cases were divided into MS group and non-MS(NMS)group according to with or without MS. Height,weight were measured, body mass index(BMI) were calculated and the total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c)were tested. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXA). The differences among these groups were compared and the risk factors for MS were analyzed. Results The MD, BMI, TC,TG in MS group was higher than that in NMS group (P < 0.05 vs. P < 0.01),and HDL-C was lower than NMS group (P < 0.05). Correlation analysis showed that BMD was negatively correlated with age , TG , HDL-C , and was positively correlated with BMI.The results of multiple stepwise regression analysis showed that age ,HDL-C,BMI were independent risk factors for BMD. Conclusion The BMD significantly increases in T2DM with MS.Obesity and low HDL-C have positive effects in bone mass.

Effects of Dual-phase Insulin Aspart with Different Dosing Regimens on the Related Indicators of Type 2 Dia-betic Patients with Poor Glycemic Control / 中国药房

OBJECTIVE:To explore the effects of dual-phase insulin aspart with different dosing regimens on the related indica-tors of type 2 diabetic (T2DM) patients with poor glycemic control. METHODS:70 T2DM patients with poor glycemic control were randomly divided into group A and group B. All patients were given metformin and stopped other antidiabetic drugs;based on it,group A was additionally given Dual-phase insulin aspart injection,0.5 U/(kg·d),in the morning and evening before a meal by subcutaneous injection;group B was given Dual-phase insulin aspart injection,0.5 U/(kg·d),once before lunch time for 6-10 U and other twice in the morning and evening before a meal by subcutaneous injection. Both groups were treated for 12 weeks. Glu-cose control rate,glucose control time,and glucose indicators,daily fluctuations of glucose before and after treatment and incidenc-es of hypoglycemia and adverse reactions in 2 groups were observed. RESULTS:Glucose control rate in group B was significantly higher than group A,glucose control time was significantly shorter than group A,incidence of hypoglycemia was significantly low-er than group A(P<0.05). After treatment,glucose indicators and daily fluctuations of glucose in 2 groups were significantly lower than before,and group B was lower than group A(P<0.05). There were no obvious adverse reactions during treatment. CONCLU-SIONS:Conpared with 2 times a day,Dual-phase insulin aspart with 3 times a day for administration can effectively improve the glucose control rate and glucose levels in the treatment of T2DM patients with poor glycemic control,with good safety.

A Cross-sectional Study of Adherence to Lifestyle Modifications among Ambulatory Type 2 Diabetic Nigerians in a Resource-poor Setting of a Primary Care Clinic in Eastern Nigeria.

Background: Despite the evidence that lifestyle modifications (LSMs) play important role in glycaemic control, adherence to healthy lifestyles has been variable in Nigeria and this has great impact on the success or failure of pharmacological care. Aim: The study was designed to determine adherence to LSMs among ambulatory type 2 diabetic Nigerians in a resource-poor setting of a primary care clinic in Eastern Nigeria. Study Design: This was a primary care clinic-based cross-sectional study done on consecutively sampled 120 adult type 2 diabetic patients who were on management for diabetes mellitus for at least 3 months at the primary care clinic of a tertiary hospital in Nigeria. Place and Duration of Study: The study was carried out at the primary care clinic of a tertiary hospital in South-Eastern Nigeria from April 2011 to December 2011. Methodology: Instrument of data collection was pretested, structured and intervieweradministered questionnaire. Each item of lifestyle was scored on a five points Likert scale ordinal responses of always, most times, sometimes, rarely and none. Adherence to lifestyle modifications was assessed in the previous 12 months for alcohol and tobacco use and 7 days for physical activity, dietary fruits, vegetables, fats and oil consumptions. Each of the domains of lifestyle was given a score of one point for healthy lifestyle and zero point for unhealthy lifestyle. Type 2 diabetic patients who scored 6 points in all the evaluated domains were adherent. Awareness of LSMs and Specific adherence to lifestyle factors were also determined. Results: The awareness and overall adherence rates to LSMs were 88.3% and 22.5% respectively Specifically, adherence was highest with the non-tobacco use (100.0%) followed by adequate dietary vegetables consumptions (96.7%) and non-use of alcohol (90.8%). Other adherence rates were consumptions of adequate dietary fruits (51.7%), dietary fat and oils (23.3%) and physical activity (22.5%). Adherence was significantly associated with young age <40 years (p=0.039). Conclusion: The awareness of LSMs was high but was not translated to comparative adherence. The adherence to non-tobacco use was rated highest and physical activity the lowest. Young age <40 years was significantly associated with adherence. Targeting the domains of inadequate adherence for improvement is a primary care imperative especially in resource-poor settings where there are limited options for healthy living

In vitro culture and characterization of alveolar bone osteoblasts isolated from type 2 diabetics

In order to understand the mechanisms of poor osseointegration following dental implants in type 2 diabetics, it is important to study the biological properties of alveolar bone osteoblasts isolated from these patients. We collected alveolar bone chips under aseptic conditions and cultured them in vitro using the tissue explants adherent method. The biological properties of these cells were characterized using the following methods: alkaline phosphatase (ALP) chemical staining for cell viability, Alizarin red staining for osteogenic characteristics, MTT test for cell proliferation, enzyme dynamics for ALP contents, radio-immunoassay for bone gla protein (BGP) concentration, and ELISA for the concentration of type I collagen (COL-I) in the supernatant. Furthermore, we detected the adhesion ability of two types of cells from titanium slices using non-specific immunofluorescence staining and cell count. The two cell forms showed no significant difference in morphology under the same culture conditions. However, the alveolar bone osteoblasts received from type 2 diabetic patients had slower growth, lower cell activity and calcium nodule formation than the normal ones. The concentration of ALP, BGP and COL-I was lower in the supernatant of alveolar bone osteoblasts received from type 2 diabetic patients than in that received from normal subjects (P < 0.05). The alveolar bone osteoblasts obtained from type 2 diabetic patients can be successfully cultured in vitro with the same morphology and biological characteristics as those from normal patients, but with slower growth and lower concentration of specific secretion and lower combining ability with titanium than normal ones.

A correlation between dyslipidaemia and glycaemic control in type 2 diabetic patients.

Background: Diabetes is global endemic with rapidly increasing prevalence in both developing and developed countries. There is a high risk of cardiovascular diseases in people with type 2 diabetes, while Abnormal lipid profiles and lipoprotein oxidation (especially LDL-C) are more common in diabetics and are aggravated with poor glycaemic control. The aim of the present study is to assess the glycaemic control status by HbA1c estimation and to compare the lipid profile in type 2 diabetes patients with good glycaemic control (HbA1c≤8) & those with poor glycaemic control (HbA1c>8). Materials and methods: The present study was conducted on 100 type-2 diabetic males aged 40-60 years. Among them 48 patients having HbA1c level ≤8% were categorized as having good glycaemic control (group-1)and 52 patients with HbA1c >8% were categorized as having poor glycaemic control(group-2). Result: A significant increase in S.cholesterol(254.46±45.54), s.LDL(162.57±39.79), S.VLDL(45.98±14.69) and S.triglycerides (225. ±76.61) in group-2 pateints (P≤0.05) were noticed as compare to group-1 patients. Our findings suggest positive association between dyslipidemia and glycemic control on the basis of screening with the HbA1c level. Raised triglyceride and LDL levels are established risk factors for coronary artery diseases. Conclusion: The optimal care of diabetic patients should also include periodic screening for lipid abnormalities and periodic measurement of HbA1C for glycaemic control.

Body Weight Satisfaction: Association with Weight Control Practices among Type 2 Diabetic Patients

Introduction: The recommendation to lose weight has been the guiding principle in the treatment of type 2 diabetic patients. However, to facilitate this process, it is vital to understand factors associated with personal feelings about body weight and related behaviour. Methods: The objectives of this cross-sectional study were (1) to determine mean BMI and weight of satisfaction and (2) to measure the association between body weight satisfaction vs. sex, BMI, glycaemic control (as measured by Fasting Blood Glucose (FBG), and attempts to lose weight among type 2 diabetic patients. Descriptive statistics and non-parametric tests were employed (SPSS 16). A total of 67 subjects were recruited from Klinik Kesihatan Bandar Kuantan (age = 54.1 ± 8.1 years; female = 62.7%; Malay = 73.1%; overweight/obese = 62.7%) who completed a set of self-administered questionnaires. Results: The mean BMI and weight of satisfaction were 27.9 ± 5.3 kg/m2 and 62.7 ± 10.9kg respectively. A greater proportion of women (65.0%) reported dissatisfaction with their body weight. Patients with higher BMI generally reported greater dissatisfaction with body weight compared to those with lesser BMI (p = 0.090). There was no significant difference in the glycaemic control of patients who were satisfied or dissatisfied with their weight (p = 0.839). There was also no significant association between body weight satisfaction and diet (p = 0.957), physical activity (p = 0.517) or both (p = 0.734). Conclusion: This study implies that body weight satisfaction alone is not a strong factor that may drive type 2 diabetic patients to control their body weight.

Identificação do limiar anaeróbio em indivíduos com diabetes tipo-2 sedentários e fisicamente ativos / Identification of the anaerobic threshold in sedentary and physically active individuals with type 2 diabetes

OBJETIVO: Comparar intensidades de limiar anaeróbio (LA) obtidas a partir do lactato, ventilação e glicemia em diabéticos tipo-2 ativos (DA) e sedentários (DS) e não-diabéticos ativos (NDA), e correlacionar variáveis metabólicas, hemodinâmicas e de composição corporal com o LA. METODOLOGIA: Grupos de DS (n= 09, 56,7 ± 11,9 anos), DA (n= 09, 50,6 ± 12,7 anos) e NDA (n= 10, 48,1 ± 10,8 anos) foram submetidos a um teste em cicloergômetro com incrementos de 15W até a exaustão. Freqüência cardíaca, pressão arterial (PA), percepção de esforço, lactato, glicemia e variáveis ventilatórias foram mensuradas nos 20seg finais de cada estágio de 3min para determinação dos limiares de lactato, ventilatório e glicêmico. RESULTADOS: As intensidades associadas ao LA identificado pelos diferentes métodos não diferiram entre si (p> 0,05). As intensidades absolutas foram menores para o grupo DS em relação aos grupos ativos (p< 0,05), não sendo observadas diferenças entre os grupos para as intensidades relativas ao consumo máximo de oxigênio ( por centoVO2 pico) e potência máxima ( por centoPpico) de ocorrência do LA. Observou-se correlação significativa entre LA e o percentual de gordura (r= -0,52), com tendência à correlação entre o LA e a glicemia ambulatorial (r= -0,33). Variáveis hemodinâmicas e LA não demonstraram correlações. CONCLUSÃO: O LA foi identificado a partir das técnicas estudadas em diabéticos tipo-2 e não-diabéticos. Apesar das diferenças entre grupos para as intensidades absolutas (Watts), a patologia pareceu não influenciar as intensidades relativas em que o LA foi observado. O LA apresentou correlação com a composição corporal e tendência a se correlacionar com a glicemia ambulatorial, sugerindo-se, com isso, o LA como um parâmetro importante na avaliação clínica destes pacientes.

OBJECTIVE: To compare anaerobic threshold (AT) intensities determined from blood lactate, blood glucose and ventilatory responses among sedentary (SD) and physically active (AD) type-2 diabetics and active non-diabetics (AND), and to correlate metabolic, hemodynamic and body composition variables with the AT. METHOD: The SD (n= 9, 56.7 ± 11.9 years), AD (n= 9, 50.6 ± 12.7 years) and AND (n= 10, 48.1 ± 10.8 years) groups performed a cycle ergometer test with increases of 15 watts every three minutes until exhaustion. Heart rate, arterial pressure, perceived exertion, blood lactate, blood glucose and ventilatory variables were measured during the last 20 seconds of each incremental stage, to determine the lactate, ventilatory and glucose thresholds. RESULTS: The AT intensities identified by the different methods did not differ from each other (p> 0.05). However, the absolute intensities were lower for SD than for the active groups (p< 0.05). No differences in intensity were found between the groups in relation to maximum oxygen consumption ( percentVO2 peak) and maximum power ( percentPpeak) at which the AT was observed. There was a significant correlation between AT and percentage fat (r= -0.52), and there was a trend towards correlation between AT and ambulatory blood glucose (r= -0.33). The hemodynamic variables did not show any correlations with AT. CONCLUSION: The AT was identified by means of the techniques studied, among type 2 diabetics and non-diabetics. Despite the differences between the groups with regard to absolute intensities (watts), diabetes did not appear to influence the relative intensities at which the AT was observed. The AT presented a correlation with body composition and a trend towards correlation with ambulatory blood glucose, thus suggesting that the AT is an important parameter in clinical assessments for such patients.