Discrepancies between Glycated Hemoglobin and Fasting Plasma Glucose in New-onset Diabetes Mellitus.

Background Fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) are commonly used for diagnosing diabetes mellitus in Nepal. Though HbA1c criteria are convenient for diagnosis there is a discrepancy between the fasting plasma glucose and HbA1c for diagnosis. Objective To assess the comparability between fasting plasma glucose and glycated hemoglobin levels in the new-onset diabetes mellitus. Method This is a hospital-based descriptive cross-sectional study including 128 newly diagnosed diabetes mellitus conducted at Dhulikhel Hospital, Kathmandu University Hospital. New onset diabetes patients above 18 years of age who met inclusion criteria were included. The clinical characteristics and biochemical parameters were analyzed. Statistical analysis was done using student's t-test and correlation coefficient. Result There were 128 newly diagnosed diabetes mellitus patients included in the study among which 57.0% were males with a mean age of 49.48±11.40 years. The mean fasting plasma glucose, postprandial sugar (PPBS), and glycated hemoglobin were 205.54±88.93 mg/dL, 331.08±146.61 mg/dL, and 9.59±2.70% respectively. Diabetes was diagnosed using fasting plasma glucose, and glycated hemoglobin criteria in 84.4% and 90.6% of patients. In new-onset diabetic patients, 76.56% of patients had both elevated levels of fasting plasma glucose and glycated hemoglobin. Of the diabetic patients who had fasting plasma glucose ≥126 mg/dL, 90.7% of patients had HbA1c ≥ 6.5% whereas 1.6% of new-onset diabetes had < 126 mg/dL and glycated hemoglobin < 6.5%. There was a strong correlation between fasting plasma glucose and glycated hemoglobin (r=0.723; p<0.01). Conclusion Both fasting plasma glucose and glycated hemoglobin tests have to be used together for diagnosing diabetes mellitus.

Prevalence and Risk Factors of Diabetic Peripheral Neuropathy in T2DM Patient Presenting to Community Hospital in Nepal.

Background Diabetic peripheral neuropathy (DPN) is a well-known microvascular complication of type 2 diabetes mellitus (T2DM) attributed to chronic hyperglycemia, and is defined as the presence of peripheral nerve dysfunction in patients with diabetes after exclusion of other causes. Objective To determine the prevalence and risk factors of Diabetic Peripheral Neuropathy among type 2 diabetes mellitus patients. Method A cross sectional study was carried out in a University Teaching Hospital. Type 2 diabetes mellitus patients with diabetes duration of more than 6 months were recruited. Michigan Neuropathy Screening Instrument Scoring was used to diagnose Diabetic Peripheral Neuropathy. Result Among a total of 160 patients who were enrolled, 61 (38.1%) had diabetic peripheral neuropathy and 26 (16%) had diabetic peripheral neuropathy within 1 year of being diagnosed with diabetes. Mean Diabetes duration was 5.56 years and mean age was 57.32 years, with 90 (56%) of the participants being female. The mean HbA1c was 8.33%. Among them 25% of the participants were alcoholics and 30% were smoker. No statistically significant risk factors are evident on multivariate analysis. Conclusion Diabetic peripheral neuropathy was found to be highly prevalent in patients with type 2 diabetes including the patients with relatively shorter diabetes duration. This finding warrants the need of improving the preventive measures and quality of care related to foot complication among patients with type 2 diabetes.

Dysmenorrhea and Stress among the Nepalese Medical Students.

Background Dysmenorrhea is the most common gynecological disorder in women of reproductive age with implications as reduced quality of life and school absenteeism. Mental stress is possibly the most important known predisposing factor for primary dysmenorrhea. Objective This study aims to assess the relationship between stress and dysmenorrhea amongst the Nepalese medical students. Method This is cross-sectional descriptive study, conducted from 1st Dec. 2012 to 31st Jan. 2013. The study was conducted in Kathmandu University School of Medical Sciences. A total of 184 participants consented for this study and each one was given a questionnaire to complete. This study included only unmarried nulliparous, healthy (all through first to final years) female medical students, in age group of 16 to 24 years. Result The mean age of the participants was 19.43(±3.9) years. Among them, 67% of the participants experienced dysmenorrhea. Of them, 85% experienced increase in frequency and severity of dysmenorrhea after joining medical college. Similarly, 65% of participants considered medical education to be stressful. Of participants experiencing dysmenorrhea, 29.45% missed classes and 17.39% participants had positive family history of dysmenorrhea in first and second degree relatives. Conclusion The present study indicated a positive relationship between psychological stress and dysmenorrhea. Dysmenorrhea is the leading cause of recurrent short-term school absence in young ladies; this issue certainly needs to be addressed.