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Resumo Objetivo Desenvolver e validar uma estratégia de intervenção breve baseada no conceito de implementation intention para promover adesão aos antidiabéticos orais em pessoas com diabetes mellitus tipo 2 em acompanhamento na atenção primária. Método Estudo metodológico realizado em uma unidade de saúde primária de Carmo do Cajuru, Minas Gerais, Brasil, no período de Mai/2022-Abri/2023. As etapas percorridas envolveram a construção da intervenção baseada no conceito de implementation intention, com a validação de seu conteúdo por sete especialistas e avaliação da sua compreensibilidade por 11 pessoas com diabetes mellitus tipo 2. O comitê de especialistas avaliou a relevância, compreensibilidade e abrangência da intervenção e o público-alvo avaliou exclusivamente sua compreensibilidade por meio de uma entrevista cognitiva. A concordância entre os especialistas foi avaliada pelo índice de validade de conteúdo (IVC) do item e total, sendo considerado satisfatório, IVC do item e total ≥ 0,85. Resultados A estratégia de intervenção foi denominada "Plano de enfrentamento de dificuldades para tomar os antidiabéticos orais" e sua versão final validada foi composta por um conjunto de instruções iniciais, um tópico sobre o comportamento pretendido, uma coluna com 13 possíveis dificuldades e uma coluna com 16 possíveis soluções para as dificuldades listadas. Foi obtido um IVC-total de 0,99; a estratégia de intervenção foi compreendida pelo público-alvo. Conclusão A estratégia de intervenção breve obteve evidência de validade de conteúdo. Esta tecnologia poderá fundamentar e motivar a prática de profissionais da saúde, principalmente do(a)s enfermeiro(a)s, para melhorar sua abordagem junto aos usuários com diabetes mellitus tipo 2 em relação à adesão aos antidiabéticos orais.
Resumen Objetivo Elaborar y validar una estrategia de intervención breve basada en el concepto de implementation intention para promover la adhesión a los antidiabéticos orales en personas con diabetes mellitus tipo 2 que realizan seguimiento en la atención primaria. Métodos Estudio metodológico realizado en una unidad de salud primaria de Carmo do Cajuru, Minas Gerais, Brasil, entre mayo de 2022 y abril de 2023. Las etapas llevadas a cabo fueron la elaboración de la intervención basada en el concepto de implementation intention, la validación del contenido por siete especialistas y la evaluación de la comprensibilidad por 11 personas con diabetes mellitus tipo 2. El comité de especialistas evaluó la relevancia, la comprensibilidad y el alcance de la intervención, y el público destinatario evaluó solo la comprensibilidad mediante una entrevista cognitiva. La concordancia entre los especialistas se evaluó mediante el índice de validez de contenido (IVC) de los ítems y total, donde se consideró satisfactorio IVC de los ítems y total ≥ 0,85. Resultados La estrategia de la intervención fue denominada "Plan para enfrentar las dificultades de tomar antidiabéticos orales" y su versión final validada estuvo compuesta por un conjunto de instrucciones iniciales, un tópico sobre el comportamiento esperado, una columna con 13 dificultades posibles y una columna con 16 soluciones posibles para las dificultades enumeradas. Se obtuvo un IVC total de 0,99, y la estrategia de intervención fue comprendida por el público destinatario. Conclusión La estrategia de intervención breve obtuvo evidencia de validez de contenido. Esta tecnología podrá justificar y motivar la práctica de profesionales de la salud, principalmente de enfermeros(as), para mejorar su forma de abordar a los pacientes con diabetes mellitus tipo 2 respecto a la adhesión a los antidiabéticos orales.
Abstract Objective To develop and validate a brief intervention strategy based on the concept of implementation intention to promote adherence to oral antidiabetics in people with type 2 diabetes mellitus being monitored in primary care. Method This is a methodological study carried out in a primary health unit in Carmo do Cajuru, Minas Gerais, Brazil, from May 2022 to April 2023. The stages taken involved intervention construction based on the concept of implementation intention, with validity of its content by seven experts and assessment of its comprehensibility by 11 people with type 2 diabetes mellitus. An expert committee assessed the intervention's relevance, comprehensibility and comprehensiveness, and the target audience exclusively assessed their comprehensibility through a cognitive interview. Agreement among experts was assessed by the item and total Content Validity Index (CVI), with item and total CVI being considered satisfactory ≥ 0.85. Results The intervention strategy was called "Plan for coping with difficulties in taking oral antidiabetics", and its final validated version was composed of a set of initial instructions, a topic on intended behavior, a column with 13 possible difficulties and a column with 16 possible solutions to the difficulties listed. A total CVI of 0.99 was obtained, and the intervention strategy was understood by the target audience. Conclusion The brief intervention strategy obtained evidence of content validity. This technology can support and motivate healthcare professionals' practice, especially nurses, to improve their approach to users with type 2 diabetes mellitus in relation to adherence to oral antidiabetic medications.
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Introducción: La diabetes mellitus tipo 2 (DM2) es un problema de salud pública creciente, frecuentemente asociada con sobrepeso y obesidad. El índice de masa corporal (IMC) y la hemoglobina glicosilada (HbA1c) son indicadores clave en el manejo de la DM2. Objetivo: Correlacionar el IMC y la HbA1c en pacientes con DM2 atendidos en el Hospital Distrital de Capiatá, Paraguay, en diciembre de 2022. Materiales y métodos: Estudio correlacional con datos secundarios de 38 pacientes DM2. Se recolectaron datos demográficos, clínicos, antropométricos y bioquímicos. Se utilizó la correlación de Pearson para determinar la correlación entre IMC y HbA1c, con un nivel de significancia de p<0,05. El protocolo de investigación fue aprobado por el Comité de Ética en Investigaciones de la FCQ-UNA (CEI913/2022). Resultados: El 65,8% fueron mujeres, con edad promedio de 55,8±5,2 años. El 86,8% presentó exceso de peso. La glucemia en ayunas promedio fue 245,0±57,0mg/dL y la HbA1c 8,8±3,4%. Se observó una tendencia al aumento de los niveles de HbA1c con el incremento del IMC. Los pacientes con peso normal presentaron una HbA1c promedio de 6,8±1,5% (buen control), mientras que aquellos con sobrepeso y obesidad mostraron valores de 8,6±2,7% (mal control) y 11,2±3,0% (control crítico), respectivamente. Estas diferencias resultaron estadísticamente significativas (p<0,01). Se observó una correlación fuerte y significativa entre IMC y HbA1c (r=0,681, p<0,01). Conclusión: Existe una correlación directamente proporcional entre el IMC y el control glucémico en pacientes con DM2. Estos hallazgos resaltan la importancia del control del peso en el manejo de la DM2.
Introduction: Type 2 diabetes mellitus (T2DM) is a growing public health problem, frequently associated with overweight and obesity. Body mass index (BMI) and glycated hemoglobin (HbA1c) are key indicators in the management of T2DM. Objective: To correlate BMI and HbA1c in patients with DM2 treated at the Capiatá District Hospital, Paraguay, in December 2022. Materials and methods: Correlational study with secondary data from 38 DM2 patients. Demographic, clinical, anthropometric and biochemical data were collected. Pearson's correlation was used to determine the correlation between BMI and HbA1c, with a significance level of p<0.05. The research protocol was approved by the Research Ethics Committee of the FCQ-UNA (CEI913/2022). Results: 65.8% were women, with an average age of 55.8±5.2 years. 86.8% were overweight. The average fasting blood glucose was 245.0±57.0mg/dL and the HbA1c was 8.8±3.4%. A tendency to increase HbA1c levels with increasing BMI was observed. Patients with normal weight had an average HbA1c of 6.8±1.5% (good control), while those with overweight and obesity showed values of 8.6±2.7% (poor control) and 11.2± 3.0% (critical control), respectively. These differences were statistically significant (p<0.01). A strong and significant correlation was observed between BMI and HbA1c (r=0.681, p<0.01). Conclusion: There is a directly proportional correlation between BMI and glycemic control in patients with DM2. These findings highlight the importance of weight control in the management of T2DM.
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Introduction: Diabetes is a chronic macro-vascular complication in the form of diabetic foot which can cause circulatory disorders as well as nerve damage (neuropathy). Nerve damage is quite dangerous for the feet, so it is important to do an assessment of foot abnormalities with the aim of supporting the prevention of foot problems. This study willObjective: identify risk categories for foot complications in diabetic patients. This was a descriptive study with a cross-Methods: sectional design on 90 patients diagnosed with type 2 diabetes mellitus. Recruitment of samples employs accidental sampling technique with the criteria no ulcers and willingness to become respondents. Data collection used an instrument in the form of an observation sheet containing demographic information and an assessment of the risk of complications of diabetic foot by IWGDF (International Working Group on Diabetic Foot) guidelines. Data analysis works with descriptive statistics. The majority of respondents diagnosed with diabetes were aged > 46 yearsResults: (elderly category) in 88.9%. The grouping of foot complications category showed that there were more diabetics in risk category 0, in 41.1% and followed by risk category 1, in 26.7%. The majority of the risk category forConclusion: diabetic foot complications was in the non-neuropathy category, followed by peripheral neuropathy, deformity and POAD. It is very important for diabetes sufferers to carry out early examination of the risk category for diabetic foot.
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Complex elbow fracture dislocation involving fracture of Medial condyle of humerus and radial head of the ipsilateral side is a rare pattern of injury. Very few reports have shown such a pattern of injury. We present such a case of a 33 yr old lady with Complex elbow fracture dislocation with a Distal humerus- Milch fracture dislocation of medial condyle Type 2 or Kilfoyle Type 3 and Radial head-Masons Type 4 injury, treated with open reduction and internal fixation for the distal humerus ,radial head replacement as well as lateral collateral ligament reconstruction using suture anchors. Post operatively at 6 months patient has almost near normal range of movements with a good functional outcome score.
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Introduction: Type 2 diabetes mellitus is a global epidemic affecting 462 million people all over the world.Chronic microvascular complications of Type 2 Diabetes mellitus include diabetic retinopathy, nephropathy and neuropathy. The prevalence of Vitamin D deficiency is estimated to be 1 billion, i.e.nearly 15% of the world's population. Vitamin D has important actions on glucose metabolism. These include improved insulin exocytosis, direct stimulation of insulin receptor, improved uptake of glucose by peripheral tissues, improving insulin resistance. Objectives: 1. To measure levels of 25 hydroxy Vitamin D in patients with T2DM. 2. To assess the extent of microvascular complications in patients with T2DM and the Link Between Vitamin D Status and Microvascular Complications in Type 2 Diabetes. Methodology: A prospective study was conducted at JJM Medical college, Davangere and the study included 72 patients. Physical examination and investigations were done including: 1. Dilated fundus examination by ophthalmologist. 2. Presence or absence of neuropathy was confirmed by nerve conduction study 3. Urine was tested for protein creatinine ratio. 4. 25 Hydroxy Vitamin D levels were analysed by Electrochemiiluminecence method with machine COBAS 6000. Results: The average duration of diabetes in our subjects was 7.51�37 years and 28(38.9%) had diabetes for less than 5 years.The number of patients with Vitamin D deficiency tended to increase when the duration of diabetes was more than 5 years. Of the 39(54.16%) subjects with microvascular complications most 28(71%) had Vitamin D deficiency. Conclusion: Vitamin D deficiency is significantly associated with poor glycaemic control in Type 2 DM. Vitamin D deficiency is more common in patients with type 2 diabetes with microvascular complications than in those without.
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Background: Diabetes mellitus (DM) is a major public health problem globally and in India. Many studies in the past have documented inadequate glycemic control and complication rates among the Indian diabetic population due to inappropriate or inadequate pharmacological treatment. Studies assessing the prescription pattern are also very Scarce from the country. The present study has been conducted with the objective of assessing the profile of diabetic patients admitted to a tertiary care teaching hospital and the prescription pattern of anti-diabetic medication among them. Aims and Objectives: The study is aimed to analyze the current prescribing patterns for patients with both uncomplicated and complicated Type 2 DM in a tertiary care hospital and to identify the most commonly prescribed antidiabetic medications and their combinations in both uncomplicated and complicated cases. Materials and Methods: The present study was a retrospective case record review of 136 patients with Type 2 DM admitted in the ward of general medicine department of a Tertiary care teaching hospital. Results: The mean age was 54.39 ± 12.46 years and 61.03% of participants were males. Comorbidities such as systemic hypertension were present in 21.32% of participants and hyperlipidemia was present in 11.76% of participants. The proportion of subjects, who had complicated DM, was 52.21%. Among the study population, 77 (56.62%) had oral hypoglycemic agents (OHA) alone, 27 (19.85%) had insulin alone, and 32 (23.53%) had Insulin + OHA. Among the study population, 70 (51.47%) had single OHA, 32 (23.53%) had dual combination of OHA, and 7 (5.15%) had triple combination OHA. The majority (53.70%) people were taking metformin, 20 (14.71%) people were taking glimepiride, 16 (11.76%) people were taking glibenclamide, 13 (9.56%) people were taking gliptins. Among the study population, 34 (25%) people were taking actrapid, 32 (23.53%) people were taking mixtard, and 10 (7.35%) people were taking lup Insulin. Among the study population, 32 (23.53%) had anti-hypertensive drugs, 19 (13.97%) had statins, 14 (10.29%) had antiplatelet, 12 (8.82%) had antibiotics and 4 (8.94%) had diuretics. The mean fasting blood sugar at admission was 178.51 ± 69.56 g/dL and at the discharge was 123.23 ± 24.92 g/dL and the mean difference (55.29) between two groups was statistically significant (P < 0.001). The mean postprandial blood sugars at admission was 228.92 ± 67.03 g/dL and at the discharge was 166.66 ± 30.73 g/dL, and the mean difference (55.29) between two groups was statistically significant (P < 0.001). Conclusion: The treatment intake was inadequate and glycemic control was poor in majority of the diabetic population. There is high reliance on metformin and sulfonylureas and insulin is underutilized even in patients with poor glycemic control. There is strong need to optimize the therapy in diabetic patients.
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Mucormycosis, a lethal fungal infection caused by Rhizopus oryzae, has gained significant attention due to its association with the COVID-19 pandemic. The causal relationship between COVID-19 and mucormycosis is not yet fully understood. This narrative review focuses on the pathophysiology of mucormycosis, particularly in the context of COVID-19. Mucormycosis primarily affects immunocompromised individuals and is commonly observed in diabetic patients with COVID-19 who receive high doses of corticosteroids. The most common presentation of mucormycosis in COVID-19 is rhino-orbital-cerebral mucormycosis. Early diagnosis and prompt initiation of treatment, including extensive surgical intervention and appropriate antifungal therapy, are crucial in preventing fatal complications. The global prevalence of mucormycosis varies widely, with a higher incidence in developing countries such as India. Diabetes mellitus remains the leading risk factor globally, while COVID-19 and corticosteroid therapy also predispose immunocompromised patients to mucormycosis. The impaired phagocytic activity in immunosuppressed individuals and the ability of Mucorales to acquire iron from the host play significant roles in the pathogenesis of mucormycosis. Endothelial damage and thrombosis, along with hyperglycemia, acidosis, and increased serum iron levels observed in COVID-19, contribute to the aggressive nature of mucormycosis in these patients. The review emphasizes the need for further research to establish a causal association between COVID-19, corticosteroid therapy, and mucormycosis, and highlights the importance of understanding the underlying mechanisms to improve the management and outcomes of patients with this devastating fungal infection.
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Background: The most common result of uncontrolled diabetes mellitus is diabetic foot ulcers (DFU), and extensive study has been done on the relationship between DFU and diabetes-related variables such as FBS, RBS, and glycosylated hemoglobin (HbA1c). Methods: During the study period, 150 individuals with a diagnosis of diabetic foot were enrolled in this cross-sectional study. The HbA1c values were determined by drawing blood samples. Wagner categorization grading was carried out following the diabetic foot ulcer examination. Age, gender, length of DM, and other foot ulcer risk variables were also reported as demographics. Results: The majority of the patients (46.7%) had very poor glycemic control (HbA1c level >10). The majority of the patients (43.5%) were 45-60 years old and predominantly male. The majority of the patients were overweight. Higher BMI was significantly associated with diabetic foot ulcers (p<0.05). Longer duration of DM, history of smoking and peripheral neuropathy were significantly associated with the DFU. Mostly, patients with grades 4 and 5 were found to have HbA1c >8%. However, patients with grades 1-3 had HbA1c<8%. The correlation of HbA1c with DFU showed a statistically significant linear relationship with p < 0.05. Conclusion: The longer duration of DM, increased HbA1c, and diabetic neuropathy are the common risk factors of diabetic foot. We have also established a positive association between uncontrolled diabetes and diabetic foot ulcers
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Pulmonary Tuberculosis (PTB) and Type 2 Diabetes Mellitus (T2DM) are two signicant public health issues, particularly in countries like India. This study evaluates the clinico-radiological prole of patients with PTB coexisting with T2DM in a tertiary care hospital in Chennai. A cross-sectional study of 212 patients was conducted to analyze clinical symptoms, radiological ndings, and their correlation with diabetic parameters such as fasting blood sugar (FBS), postprandial blood sugar (PPBS), and HbA1C levels. The study revealed a signicant correlation between uncontrolled diabetic parameters and the severity of tuberculosis. Cavitatory lesions were the most common radiological nding in PTB- T2DM patients. The ndings suggest that careful management of blood sugar levels in PTB patients can potentially improve clinical outcomes.
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Background: Sedentary lifestyle is among the forerunner causes of major non-communicable diseases, including cardiovascular disease, Type 2 diabetes, and diverse types of cancer, contributing substantially to the global burden of disease. There is a massive increase in the prevalence of Type 2 diabetes mellitus (DM) worldwide. Cardiovascular diseases, especially atherosclerosis, contribute significantly to diabetes related deaths. Aims and Objectives: The present study was designed to compare the body mass index (BMI), nitric oxide (NO), and lipid profile in physically active and sedentary Type 2 DM patients. Materials and Methods: The study included a total of 70 patients of Type 2 DM. The inclusion criteria were HbA1c ?6.5%, age between 30 and 60 years, and a disease history of 5–10 years. The exclusion criteria were the presence of any other chronic/acute illness, patients having difficulty in walking, patients on any nitrate and nitrite drugs, patients on lipid-lowering drugs, history of alcohol, tobacco, or other substance abuse. Assessment of physical activity was done by International Physical Activity Questionnaire - long form. BMI, NO, and lipid profile were assessed for the two groups. Statistical analysis was carried out using GraphPad Prism 7.0. Groups of data were compared with an analysis of variance followed by the tukey test. A P < 0.05 was considered statistically significant. Results: In the physically active group, BMI (P = 0.0345), total cholesterol (P < 0.0001), low-density lipoprotein (P < 0.001), and triglycerides (P < 0.001) were significantly less; while their high-density lipoprotein (P < 0.0001) and NO (P < 0.0001) was significantly more as compared to the sedentary group. Conclusion: The conclusion of this study is that in patients of type 2 DM, a physically active lifestyle was associated with decreased cardiovascular risk.
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Background: Type 2 diabetes mellitus (T2DM) is a common and prevalent metabolic disorder linked to numerous health complications. Recent research has indicated a potential association between T2DM and cognitive impairment, although the underlying mechanisms remain unclear. Aims and Objectives: This cross-sectional study aimed to investigate neurocognitive functions and information processing ability in T2DM patients compared to healthy individuals. Materials and Methods: A total of 160 participants, including 80 T2DM patients under medication and 80 age- and sex-matched healthy controls, were enrolled. Cognitive assessments were conducted using Addenbrooke’s cognitive examination (ACE-III) and audiovisual reaction time tests. Statistical analyses were performed to assess differences and correlations between groups. Results: The study revealed that T2DM patients exhibited delayed neurocognitive functions, including prolonged auditory and visual reaction times, and lower ACE-III scores compared to healthy controls. Notably, a significant positive correlation between HbA1c levels and cognitive impairment was observed in the diabetic group. Conclusion: This study underscores the presence of cognitive deficits in T2DM patients and highlights the importance of routine cognitive assessment during clinical follow-up. The findings suggest that optimizing glycemic control may offer potential benefits in mitigating cognitive decline in individuals with T2DM. These insights contribute to our understanding of the interplay between T2DM and cognitive function, paving the way for improved patient care and interventions.
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Background: Type 2 diabetes mellitus (T2DM) poses a significant health-care challenge and is a primary contributor to both mortality and morbidity. Diabetic autonomic neuropathy (DAN) is a frequently occurring complication associated with diabetes mellitus. Autonomic nerve damage leading to cardiac autonomic dysfunction and peripheral sympathetic neuropathy can lead to changes in heart rate variability (HRV) and galvanic skin response (GSR), respectively. Aims and Objectives: The study was designed and done to evaluate the impact of T2DM on HRV and GSR for assessing DAN. Materials and Methods: A total of 100 individuals diagnosed with T2DM (cases) and 100 healthy individuals (controls) participated in this study. Physio Pac (PC-2004) was used to record the necessary data. Statistical analysis was performed using the non-parametric Mann– Whitney test to see the comparison of the cases and controls. In addition, to measure the statistical relationship between the duration of the disease and the HRV and GSR parameters, Spearman’s rank correlation coefficient was utilized. The study received approval from the Ethical and Research Committee at the Government Medical College, Patiala. Results: Significant statistical differences were observed between the cases and controls in all time domain measures, as well as GSR and the majority of frequency domain measures of HRV. The correlation analysis revealed a strong association between the duration of T2DM and a decrease in HRV as well as an increase in GSR. Conclusion: The findings from the present study provide evidence that T2DM has an impact on HRV, which suggests the presence of cardiac autonomic neuropathy among diabetic patients, leading to an increased risk of cardiovascular morbidity. In addition, the study indicates that reduced sudomotor function, as assessed by galvanic skin response (GSR), serves as a predictive measure for autonomic neuropathy. Therefore, these tests can serve as valuable tools in facilitating the assessment of DAN.
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Introduction: Type 2 diabetes mellitus (T2DM) is a chronic condition where obesity plays a key role. Metformin is commonly used to manage T2DM, with benefits in both glycemic control and weight management. This systematic review and meta-analysis update the evidence on metformin’s impact on weight loss and glycemic control in T2DM patients. Objective: To assess metformin’s efficacy in reducing body weight and improving glycemic control in T2DM patients by synthesizing recent studies. Methods: Following PRISMA guidelines, relevant studies were identified in PubMed, EMBASE, and clinicaltrials.gov. Fourteen randomized controlled trials and cohort studies, involving 11,686 T2DM patients, were analyzed using RevMan 5.4 software. Results: Metformin led to a modest but significant reduction in body weight (Mean difference = 0.16; 95% CI: 0.69 to 1.02, p<0.00001) and significantly lowered glycosylated hemoglobin (A1C) and fasting plasma glucose (FPG) levels. Despite some study heterogeneity, the risk of bias was minimal. Conclusions: Metformin is effective in modest weight reduction and significant glycemic control in T2DM patients, supporting its use as first-line therapy, especially for those who are overweight or obese.
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Background: Saroglitazar is dual peroxisome proliferator-activated receptor (PPAR) ?/? agonist and approved for elevated triglyceride (TG) reduction in type 2 diabetes mellitus (T2DM) and Non-alcoholic fatty liver disease in India. This study was conducted to evaluate the effect of Saroglitazar in T2DM patients with moderate to severe hypertriglyceridemia to contribute to nationwide existing data of real time clinical practice. Methods: It is a retrospective, observational study conducted from April 2023-2024, among T2DM participants with either moderate hypertriglyceridemia (200-499 mg/dl) or severe hypertriglyceridemia (>500 mg/dl) who were prescribed Saroglitazar 4 mg once daily and followed up for 6 months with laboratory parameters (blood sugar and lipid profile). Results: A total of 53 patients’ data on demographic and clinical profile was collected and analysed. Saroglitazar, in addition with oral antidiabetic and lipid lowering medication showed statically significant improvement in total cholesterol, triglyceride and HbA1c at 6 months follow-up without any serious adverse events. Conclusion: In T2DM with moderate to severe hypertriglyceridemia, saroglitazar as an add on to statins is an effective and safe therapeutic option to reduce elevated TG and other lipid and glycemic parameters.
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Background: Type 2 diabetes mellitus (T2DM) has multiple pathogenesis. Hereditary propagation marks the genetic role as a very certain factor in the causation of T2DM. Reports have suggested that individuals with a family history (FH) of T2DM exhibit an altered chronotropic response even before the manifestations of the disease. Physical exercise is a proven way to extract any of the underlying cardiovascular abnormalities. These abnormalities may not be present during rest and identifying them can be useful as a good estimate of the individual’s cardiac functional sufficiency. After the stoppage of exercise, heart rate recovery (HRR) gives a thought toward the consideration of the coordinated equilibrium of the parasympathetic and sympathetic neural pathways. The withdrawal of the sympathetic influence and simultaneous parasympathetic reactivation make HRR as a measure of the underlying autonomic dysfunction. The early outcomes of cardiac effects in healthy children of T2DM parents were studied. Any evidence of changes observed will suggest that such individuals can avert and retard the genetically propagated diseases by following an appropriate healthy lifestyle. Aims and Objectives: (1) To assess subclinical cardiac autonomic dysfunction by way of an episode of acute aerobic exercise and study heart rate (HR), HRR, and blood pressure (BP) parameters in children of T2DM. (2). To compare above assessment parameters among the 2 groups - children of T2DM and children of non-diabetic parents. Materials and Methods: The present study is a cross-sectional observational study comprising 120 subjects in the age group of 18–40 years, 60 Cases – children of T2DM parents and 60 age-matched Controls – children of non-diabetic parents. HR and BP were measured at rest, during exercise, immediately after (Peak HR and BP), 10 min, 20 min, and 30 min after completion of exercise. An automated multipara monitor (RMS-Phoebus P513) was used to record these parameters. An informed written consent and ethics committee approval from the institution was taken. All data were summarized and statistically analyzed. Values for statistical analysis are expressed as Mean ± standard deviation (SD) and for statistical significance, P < 0.05 was considered. Results: Basic attributes, anthropometry of both cases and controls were comparable. Blood glucose parameters despite being in normal range, were higher in cases (P > 0.05). HR, BP parameters at rest, and their response (behavior) to exercise were similar in both groups. Cases had an increased HR and BP with an increase in exercise duration, at peak exercise and during the early phase of recovery but returned to baseline levels following a total recovery period (30 min). Conclusion: Young euglycemic, non-diabetic children of T2DM parents have an altered chronotropicresponse to exercise. There is an increased HR and BP response during peak exercise, beginning and early phase of the recovery period. Such a dysregulation is probably suggestive of higher cardiovascular risk. This emphasizes a healthy lifestyle and early detection.
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Background: Vitamin D (VD) plays a crucial role in regulating calcium and phosphorus metabolism and bone growth and has emerging roles beyond the skeleton. Deficiency is linked to various health issues, especially in postmenopausal women. The burden of T2DM in India, particularly among women, emphasizes the need for exploring the VD-diabetes connection. Aim and Objective: To investigate VD levels in postmenopausal women with T2DM compared to premenopausal women, assessing the association between VD deficiency and glycemic control. Materials and Methods: A case–control study was conducted in Chennai, India, involving pre-menopausal and post-menopausal women with T2DM. Ethical clearance was obtained, and participants were recruited with informed consent. Fifty pre-menopausal and post-menopausal women, each with T2DM, were included. Exclusions involved individuals taking calcium and vitamin D supplements, anticonvulsants, and those afflicted with osteoporosis, renal disease, asthma, and hypertension. Blood samples were collected for glucose and VD level assessments, employing standard methodologies. Results: Pre-menopausal women exhibited significantly higher VD levels compared to their post-menopausal counterparts. Blood sugar levels did not significantly differ based on menopausal status. Conclusion: This study contributes valuable insights into the complex interplay between VD, menopausal status, and glycemic control in women with T2DM. The high prevalence of VD deficiency and its association with suboptimal glycemic control emphasize the need for further research. Understanding these relationships is crucial for developing targeted interventions for postmenopausal women with diabetes.
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Background: Adults having type 2 diabetes mellitus satisfying inclusion and exclusion criteria will be included. Consent of those who fit into inclusion criteria taken. 100 patients were analysed on the basis of history, clinical presentations, investigations. Patients presenting with signs and symptoms of neuropathy were accessed by nerve conduction studies (NCV), autonomic testing, heart rate variation with deep breathing, blood pressure response to standing. Arterial blood gas analysis, and CT /MRI also done. Methods: 100 patients of type 2 diabetes were taken and study of autonomic dysfunction was done for 3 months across tertiary health care centre. Results: Out of 100 diabetic patients under study 54 patients (54%) had diabetic neuropathy. Out of these 54, distal sensory motor neuropathy- most common (77%), sensory neuropathy- 24%. Axonal neuropathy was more prevalent than demyelinating neuropathy. Out of 100, 51 (51%) patients have autonomic neuropathy. Peripheral neuropathy was most common complication in which distal sensory motor polyneuropathy were common. Most common symptom of autonomic neuropathy was postural dizziness followed by erectile dysfunction. Conclusions: Most common complication of type 2 DM is neuropathy. Most common neuropathy was distal sensory motor polyneuropathy whereas most common symptom of diabetic neuropathy was postural dizziness. Other autonomic dysfunction was change in blood pressure and heart after standing.
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Background: Type 2 diabetes mellitus (T2DM) has a heavy disease burden and is one of the leading causes of death worldwide. Oxidative stress leads to the generation of inflammatory mediators and reactive oxygen species, which results in an inflammatory state, which plays a key role in the pathogenesis of diabetes and its complications. We aimed to correlate the levels of Glycated Haemoglobin with Oxidative Stress. Methods: This study included 200 subjects, 100 were type 2 diabetics and 100 healthy non-diabetic individuals. All the individuals were subjected to analysis of Fasting Plasma Glucose, Glycosylated Haemoglobin, Malondialdehyde, Superoxide Dismutase, Glutathione, Catalase, Uric Acid and Ascorbic Acid. The data thus generated was analyzed Statistically using the student 憈� test. ANOVA for comparison of mean in more than two groups. Pearson抯 coefficient of correlation was used to calculate the correlation between different parameters. p <0.05 was considered statistically significant. Results: The results showed that as the Glycated Hb increased, the levels of FBS, MDA, Uric acid increased and Serum SOD, Glutathione, Catalase, and Ascorbic acid levels decreased this change was statistically significant (p<0.05). A positive significant correlation between HbA1c, and fasting blood Glucose, MDA, Uric Acid. SOD, Catalase, Ascorbic Acid and Glutathione showed a negative correlation with glycosylated Haemoglobin. Conclusions: It is hereby concluded that when glycated Hb increases the natural antioxidants that are SOD, catalase, and glutathione decrease to combat the increased formation of ROS. Serum MDA, increased with increased glycated Hb and shows a positive correlation, indicating increasing lipid peroxidation.
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Resumen La presión arterial media es un indicador indirecto del grado de perfusión orgánica, la cual podría variar en pacientes con y sin diabetes mellitus-2. El objetivo fue determinar las diferencias y riesgo de alteraciones en la presión arterial media de adultos con y sin diabetes mellitus-2 de la población peruana según datos de la encuesta demográfica de salud familiar. Se realizó un estudio observacional, analítico, retrospectivo y transversal;. Los datos provinieron de la encuesta demográfica y de salud familiar-2022 (ENDES-2022), se incluyó adultos diabéticos y no diabéticos. Las variables fueron: presión arterial media, diabetes mellitus-2, sexo y se incluyeron las variables: edad, consumo de alcohol, nivel educativo e índice de masa corporal para el análisis multivariado. Se realizó la prueba de Chi-cuadrado de Pearson, la prueba T student para muestras independientes, Odds Ratio crudo y ajustado mediante regresión logística binaria. El promedio de presión arterial media en diabéticos fue de 94,81 y 93,52 mmHg en la primera y segunda medición y en no diabéticos de 89,18 y 88,02 mmHg. La presión arterial media alta fue más frecuente en diabéticos que en no diabéticos; En el modelo logístico, incluyendo las variables sexo y edad, los diabéticos tuvieron un riesgo 2 veces mayor que los no diabéticos de alteraciones en la presión arterial media tanto en la primera como en la segunda medición. En conclusión, la diabetes mellitus-2 incrementa la presión arterial media y representa un factor de riesgo para la elevación de la presión arterial media en la población peruana.
Abstract Mean arterial pressure is an indirect indicator of the degree of organ perfusion, which could vary in diabetics and non-diabetics. The objective of this research was to determine the differences and risk of alterations in the mean arterial pressure of adults with and without diabetes mellitus-2 of the Peruvian population according to data from the family health demographic survey. An observational, analytical, retrospective and cross-sectional study was carried out. The data came from the demographic and family health survey-2022 (ENDES-2022). Diabetic and non-diabetic adults were included. The variables were mean arterial pressure, diabetes mellitus-2, sex, and the variables age, alcohol consumption, educational level, and body mass index were included for multivariate analysis. Pearson's Chi-square test, student's T test for independent samples, crude Odds Ratio and adjusted by binary logistic regression were performed. The mean arterial pressure in diabetics was 94.81 and 93.52 mmHg in the first and second measurements, and in non-diabetics it was 89.18 and 88.02 mmHg. High mean arterial pressure was more frequent in diabetics than in non-diabetics. In the logistic model, including the variables sex and age, diabetics had a risk twice as high as non-diabetics for alterations in mean arterial pressure in both the first and second measurements. In conclusion, diabetes mellitus-2 increases mean arterial pressure and represents a risk factor for elevated mean arterial pressure in the Peruvian population.
ABSTRACT
Introducción: La Enfermedad Renal Crónica ha cobrado interés debido a su alta tasa de morbimortalidad. Además de las causas vasculares y de la diabetes mellitus, se ha identificado una causa de Origen Desconocido en jóvenes agricultores. Objetivo: El objetivo del estudio es determinar la prevalencia de la población en hemodiálisis, sospechosa de la Nefritis Intersticial Crónica en Comunidades Agrícolas, para categorizar la verdadera etiología de su patología renal. Metodología: Se aplicó un diseño observacional descriptivo durante los meses de diciembre de 2022, enero y febrero de 2023; y se encuestó a 684 pacientes de ambos sexos en 8 centros de hemodiálisis de la Capital y el Departamento Central del Paraguay. Resultados: La prevalencia de casos sospechosos por la exposición a factores de riesgo resultó ser del 18.1%. Esta cifra podría ser mayor, ya que 22.6% de los pacientes con diabetes mellitus tipo 2, no presentó retinopatía clínica ni otros signos clínicos de la enfermedad al momento del diagnóstico de la falla renal. Este panorama nos advierte de un probable diagnóstico desacertado en una cantidad considerable de pacientes. Conclusión: La importancia de esta investigación se sustenta en generar acciones preventivas en la población agrícola y concientizar a la sociedad médica de la relevancia diagnóstica de esta patología para mejorar la calidad y pronóstico de vida en la población paraguaya.
Introduction: Chronic Kidney Disease has gained interest due to its high morbidity and mortality rate. In addition to vascular causes and diabetes mellitus, an unknown cause has been identified in young farmers. Objective: This study aims to determine the prevalence of the population on hemodialysis, suspected of Chronic Interstitial Nephritis in agricultural communities, to categorize the true etiology of their renal pathology. Methodology: A descriptive observational design was applied during December 2022, January, and February 2023; and 684 patients of both sexes were surveyed in 8 hemodialysis centers in the Capital and the Central Department of Paraguay. Results: The prevalence of suspected cases due to the exposure to risk factors was 18.1%. This figure could be higher since 22.6% of patients with type 2 diabetes mellitus did not present clinical retinopathy or other clinical signs of the disease at the time of the diagnosis of kidney failure. This scenario warns us of a probable misdiagnosis in a considerable number of patients. Conclusion: The importance of this research lies in generating preventive actions in the agricultural population and raising awareness in the medical community about the diagnostic relevance of this pathology to improve the quality and prognosis of life in the Paraguayan population.