Comparative Study Of Pulmonary Function Tests With Microvascular Complications, Retinopathy And Nephropathy In Type 2 Diabetes Mellitus And Correlation With Duration Of Diabetes

Background:Themajorintype2diabetesThough lung has been widely acknowledged to be a target organ in diabetes mellitus, its se-verity of involvement and correlation with other microvascular complications has not been studied. Aim:To study pulmonary function tests in type 2 diabetes mellitus and evaluate association of PFTs with microvascular complica-tions, retinopathy and nephropathy and further assess the relationship of retinopathy, nephropathy and lungs with duration of diabetes. Methods:A cross sectional study was carried out in 100 male type 2 diabetic patients attend-ing diabetic clinic in tertiary hospital. 100 non-diabetic subjects were selected as control from general population. PFTs tests were performed. Results were interpreted by one way ANOVA test. Association of PFT parameters FVC, FEV1, FEV1%in type 2 diabetic patients with nephropathy and retinopathy was analysed by Pearson’s correlation co-efficient. The patient population was subdivided according to the duration of diabetes into 2 groups; less than 10 years of illness and more than 10 years. Relationship of retinopathy, nephropathy and pulmonary function tests with duration of diabetes was assessed by one-way ANOVA test. Results:There was a significant decrease in PFT parame-ters as compared to non-diabetic controls. The PFTs in type 2 diabetic subjects with nephropathy showed decline in FVC, FEV1,FEV1%, however association of these parameters with Glomerular filtration rate (GFR) and microalbuminu-ria was not significant. Also, a similar decline of PFT parameters was observed with increasing grade of retinopathy, though not significant. There was a significant positive correlation of retinopathy with microalbuminuria and GFR (nephropathy) in type 2 diabetic subjects. Also, there was significant association of microalbuminuria, GFR and reti-nopathy with increase in duration of diabetes. On the contrary the decline in FVC, FEV1, FEV1%with duration of diabe-tes was not statistically significant. Conclusion:Type 2 diabetic patients with poor glycaemic control and longer du-ration of diabetes history had significant correlation with microvascular complications, nephropathy and retinopathy as compared to pulmonary complications (PFT parameters). It is highly suggestive that diabetic patients with reti-nopathy must be screened for nephropathy.

Normative reference database for bone mineral density in Indian men and women using digital X-ray radiogrammetry.

Osteoporosis is a major healthcare problem around the world and its importance lies in the fractures that result. A variety of devices are available in India and other Asian countries for bone mineral density (BMD) assessment, but their clinical utility is limited because of non-availability of local normative database. The purpose of this study was to establish the normative reference database for BMD in Indian women and men using digital x-ray radiogrammetry (DXR). Radiographs of the non-dominant hand were obtained on 262 women and 178 men between 20 and 79 years of age following strict inclusion and exclusion criteria. The radiographs were analysed by DXR using pronosco x-posure system V.2 to estimate the BMD (DXR-BMD). The peak value for DXR-BMD in women was 0.588 g/cm2 at age 35 years and 0.602 g/cm2 in men at age 42 years. There were statistically significant differences in BMD in women and men across all age ranges. An age dependent decline in BMD was seen in both women and men over the age of 50 years. The use of DXR should broaden the availability of fracture risk assessments in places where DXA is not available.

Poor knowledge about osteoporosis in learned Indian women.

OBJECTIVES: The present study was done to assess knowledge about osteoporosis in learned Indian women, identify their source of knowledge and to study the correlation of level of knowledge with other variables. METHODS: A total of 73 female staff members (average age 44.7 years) of a teaching institute completed the Osteoporosis Questionnaire (OPQ). The mean +/- SD of total score for the sample was 4.1 +/- 4.1 (range -8 to 15; maximum possible score 20). RESULTS: The correct definition of osteoporosis was given by 74%, but there was general lack of awareness in all the areas assessed. There was statistically significant difference in the total score depending on the faculty of education, with staff members from the science faculty having the maximum mean score (p < 0.05). We found no influence of age, menopausal status, previous history of fracture and family history of osteoporosis on the level of knowledge. Media (74%) was the commonest source of knowledge followed by friends (49%) and doctors (25%). CONCLUSIONS: This study highlights the general lack of knowledge about osteoporosis in learned Indian women and also the need for increased involvement of medical professionals in patient education.