Study of Possible Relation between Fasting Plasma Glucagon, Gestational Diabetes and Development of Type 2 DM.

BACKGROUND AND AIMS: Women who develop GDM (gestational diabetes mellitus) have a relative insulin secretion deficiency, the severity of which may be predictive for later development of diabetes. This study aimed to investigate the role of fasting plasma glucagon in the prediction of later development of diabetes in pregnant women with GDM. MATERIALS AND METHODS: The study was conducted on 150 pregnant women with GDM after giving informed oral and written consents and being approved by the research ethical committee according to the declaration of Helsinki. The study was conducted in two phases, first phase during pregnancy and the second one was 6 months post-partum, as we measured fasting plasma glucagon before and after delivery together with fasting and 2 hour post-prandial plasma sugar. RESULTS: Our findings suggested that glucagon levels significantly increased after delivery in the majority 14/25 (56%) of GDM women who developed type 2 DM within 6 months after delivery compared to 6/20 (30%) patients with impaired fasting plasma glucose (IFG) and only 22/105 (20%) non DM women, as the median glucagon levels were 80,76, 55, respectively. Also, there was a high statistical difference between fasting plasma glucagon post-delivery among diabetic and non-diabetic women (p ≤ 0.001). These results indicated the useful role of assessing fasting plasma glucagon before and after delivery in patients with GDM to predict the possibility of type 2 DM. CONCLUSION: There is a relatively high glucagon level in GDM patients, which is a significant pathogenic factor in the incidence of subsequent diabetes in women with a history of GDM. This could be important in the design of follow-up programs for women with previous GDM.

Study of relationship between total vitamin D level and NAFLD in a sample of Egyptian patients with and without T2DM.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is increasing recently due to increasing the prevalence of obesity. Insulin resistance (IR) is the mutual pathological cause for both T2DM and NAFLD. Vitamin D acts against IR by its anti-inflammatory and regulation of insulin secretion as pancreatic beta cells express vitamin D receptor (VDR). AIM: Assessment of relationship between Total vitamin D level and NAFLD a sample of Egyptian patients with and without T2DM. METHODS: The current study included 110 Egyptian subjects. They divided into 4 groups: Group 1: 30 diabetic patients with NAFLD Group 2: 30 diabetic patients without NAFLD Group 3: 30 NAFLD patients without diabetes Group 4: 20 healthy controls. Vitamin D level assessment, AST, ALT, GGT, total cholesterol, LDL, triglycerides, fasting and 2 h post prandial plasma glucose, glycosylated hemoglobin, albumin and creatinine calculation of FLI were assessed. RESULT: There was a statistical significant decrease in total vitamin D level in T2DM patients with NAFLD than either T2DM or NAFLD only patients.(15.5 ±â€¯7.46 vs 24.4 ±â€¯8.19 and 22.86 ±â€¯9.58 ng/ml respectively) also Total vitamin D level is negatively correlated with age, weight, BMI, WC, total cholesterol, LDL, TG, FPG, HbA1c and FLI. CONCLUSION: There is a decrease in total vitamin D in T2DM patients with NAFLD.

Relation between plasma Apelin level and peripheral neuropathy in Type 2 diabetic patients.

BACKGROUND: Peripheral neuropathy is one of the most common complications of both type 1 and type 2 diabetes, Long standing peripheral neuropathic pain associated with peripheral neuropathy occurs in one of six diabetic subjects, Apelin is a peptide secreted from adipocytes that seems to be beneficial in early detection of diabetic neuropathy, Itisnotedthatitincreasesindiabeticpatients and more in those with neuropathy. AIM: We aimed to study the relation between plasma apelin levels and peripheral neuropathy in a sample of type 2 egyptian diabetic patients METHODS: The current study included 60 subjects with type 2 diabetes divided into 30 with diabetic neuropathy (group I) and 30 without diabetic neuropathy (group II) and 20 healthy subjects as a control group (group III). Fasting plasma glucose, Fasting insulin, HOMA- IR, Hemoglobin A1c, Total cholesterol, Triglycerides, High density lipoproteins, Low density lipoprotiens and Apelin levels were assessed. Neurological evaluation in diabetic subjects wasdone by nerve conduction study and clinical examination by using microfilament and tunning fork. RESULTS: On comparing the three studied groups a statistical significant difference in plasma Apelin levels was found (p < 0.001) being highest in group I followed by group II then group III(957.433 ±â€¯221.031 pg/dl, 665.967 ±â€¯110.991 pg/dl and 502.950 ±â€¯201.008 pg/dl respectively). There was a statistical significant positive correlation between plasma Apelin and diabetes duration (r = 0.5), age (r = 0.4) and BMI (r = 0.2). CONCLUSIONS: Apelin levels in diabetic patients are higher in the presence of neuropathy, longer disease duration, advanced age and BMI. This draws attention to the possible association between the apelinergic system and diabetic peripheral neuropathy.