The study of the effect of C-PAP therapy in type-II diabetic patients with obesity and obstructive sleep apnea

Type II diabetes mellitus (T2DM) is closely associated with Obstructive sleep apnea (OSA) and obesity. Type 2 diabetes and OSA may be pathophysiologically independent conditions although the joint association with obesity or visceral adiposity. There is a consistent relationship between obesity and OSA, which has been reported in 60-90% of OSA patients. The prevalence of obesity increases with a parallel increase in the prevalence of OSA. Continuous positive airway pressure (CPAP) therapy is an effective choice of treatment for OSA, an overnight test, or titration some patients may reduce apnea events by minimizes airway collapse by CPAP. Several studies showed that the effect of drug treatment with 3 months of C-PAP in patients with type 2 diabetes. In the present study, we include 300 patients in different groups, out of the 100 patients undergoing treatment of CPAP therapy minimum for three months. Blood sugar, HbA1c, and lipid profile were measured and an overnight sleep study was done. The obtained data shows the significant effect of therapy on physiological and biochemical parameters. AHI and BMI were highly significant in group II and Group III when compared to group I. FBS, HbA1C, and Lipid profile parameters also gave significance results (p-value <0.001) in group II and group III when compared with healthy subjects (group I).

Screening of Gestational Diabetes among Women Visiting Metabolic Clinic in the Department of Biochemistry of a Medical College in Eastern U.P

Background: Gestational diabetes mellitus (GDM) is a diabetic metabolic disorder that occurs in 4% of all pregnant women and 14% of ethnic groups with more prevalence of type II diabetes. It can be defined as increased or abnormal insulin resistance, decreased insulin sensitivity or glucose intolerance with first diagnosis during pregnancy. Aims/Objectives: 1. To find out prevalence of GDM. 2. To study associated risk factors. Methods: The study was conducted at the metabolic clinic; in the department of Biochemistry located at SIMS, Hapur. A semi-structured pretested questionnaire was used for data collection. Following the DIPSI guidelines, patients with plasma glucose values >140 mg/dl were labeled as GDM. Statistical methods used were OR (CI95%), percentage, Chi square. Results: ‘Out of 500, 6.72% had GDM. Among all GDM patients, 64.71% had age more than 30 years, 70.59% had BMI more than 25, 41.18% had gravida more than 3 and p- value was significant with regard to age and BMI. P value was found to be significant for risk factors namely positive family history of Diabetes Mellitus, history of big baby and presence of more than one risk factor. Conclusion: GDM is associated with high BMI, early pregnancy loss, family history of DM and previous history of big baby and there could be more than one risk factor. Thus universal screening followed by close monitoring of the pregnant women for early detection of GDM may help improving maternal and fetal outcomes.

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

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