ABSTRACT
INTRODUCTION: Type-2 Diabetes is a heterogeneous group of disorders characterized by variable degrees of insulin resistance, impaired insulin secretion, and increased glucose production. Obese diabetic patients have 13.5% more chances of developing diabetic complications compared to non - obese diabetic patients. Vitamin D has found to be deficient in diabetic patient and it's role in insulin regulation. Obese females are more prone to develop diabetic complications and hypovitaminosis-D. MATERIALS AND METHOD: Total of 156 female diabetic patients aged 30 to 60 years who are a case of type-2 diabetes mellitus seen in Rajarajeswari Medical College and Hospital were clinically evaluated including anthropometric measurements are done, namely height, weight, waist-hip ratio, tested for vitamin-D levels and other necessary diabetes related investigations were carried out. RESULT: Among the studies 156 patients, Mean age of study group: 48.47±9.56 years. Mean duration of diabetes in the study population: ± SD: 5.10±4.36 years mean BMI was 24.97±4.16.Mean waist circumference: 98.93±12.18 cm, Mean Waist-Hip ratio: 0.98±0.08. Mean FBS: 202.73±81.73 mg/dl, Mean PPBS: 280.99±94.14 mg/dl, Mean HbA1C: 9.33±1.83 %. Almost all diabetic females (92.5%) have Vitamin-D deficiency. Mean Vitamin-D levels: 16.19±8.97 ng/ml. Duration of diabetes (P=0.082+, Fisher Exact test), Poor Glycemic control (P<0.001**, Chi-Square test) and increased BMI (P=0.011*, Fisher Exact test) had significant role in causing Vitamin-D deficiency. CONCLUSION: Almost all diabetic females were with Waist circumference > 80 cm and Waist-Hip ratio > 0.8. Most of the diabetic patients have poor control of diabetes. Vitamin-D deficiency is found in almost all diabetic female patients (92.5%) and the most probable cause is poor glycemic control and obesity according to this study.
Subject(s)
Diabetes Mellitus, Type 2 , Vitamin D Deficiency , Adult , Female , Humans , Middle Aged , Obesity , Vitamin D , VitaminsABSTRACT
INTRODUCTION: Diabetes mellitus is one of the most common diseases in the world and is acquiring epidemic proportions. Its prevalence is growing in both developed and developing countries. Indians are genetically more susceptible to diabetes compared to other races cardiovascular complications are known to be the main cause of morbidity and death in diabetic patients. There is an increased rate of ischemic heart disease and cardiomyopathy which may lead to heart failure (Diastolic heart failure). Left ventricular diastolic dysfunction represents an early stage of heart failure, without any clinical manifestations. In the view of these above facts the present study was done to assess the diastolic dysfunction in diabetic patients. METHODS: A cross-sectional hospital-based study was done which included 50 asymptomatic patients with type 2 diabetes mellitus without evidence of cardiovascular involvement and blood pressure less than 130/80 mmHg were studied. LVDD was evaluated by Doppler echocardiography, which included E/A ratio; left atrial size was assessed in relation with age/sex, duration of diabetes and HbAlc level. RESULTS: Results showed that diastolic dysfunction was present in 32 (64%) of the patients. Diastolic dysfunction was more common among female sex (68.18%) compared to male (60.17%). Diastolic dysfunction was significantly associated with uncontrolled diabetes as assessed by HbA1c levels. Diastolic dysfunction was more common in patients who were on treatment with both oral hypoglycemic agents and insulin. The prevalence of diastolic dysfunction increased with longer duration of diabetes. There was a linear progression of diastolic dysfunction with the increase age group. CONCLUSION: The findings in our study indicate that myocardial damage in patients with diabetes affects diastolic dysfunction before systolic function. E/A ratio and Left atrial size are significantly altered in diabetic patients with diastolic dysfunction. Diastolic dysfunction is significantly associated with duration of disease, glycemic levels and the type of treatments. Doppler Echocardiography is a simple non invasive valuable tool in diagnosing diastolic dysfunction. In diabetics before they develop cardiac symptoms it has to be done routinely on every diabetic patients to assess the cardiac function.
