Atherosclerotic Cardiovascular Disease in Diabetes Patients.

BACKGROUND: Diabetes mellitus (DM) is a metabolic disorder characterized by abnormally elevated levels of blood glucose. The hyperglycemic condition is caused by abnormalities in either insulin secretion, insulin action, or both. Two-thirds of diabetes-related deaths are caused by atherosclerotic cardiovascular disease (ASCVD). OBJECTIVE: The purpose of this study was to determine the risk of ASCVD and related factors in type 2 DM patients in Medan, North Sumatra. METHODS: We conducted a cross-sectional observational study. A total of 252 DM patients visiting primary health centers in Medan were recruited after fulfilling the inclusion and exclusion criteria. The level of risk of atherosclerotic cardiovascular disease (ASCVD) was determined by using ASCVD Risk Calculator. Data required to use this calculator are age, sex, race, total cholesterol, HDL-C, systolic blood pressure, diastolic blood pressure, history of diabetes, history of hypertension treatment, smoking history, and use of statins for anti-hyperlipidemia. The data were then analyzed with Chi-square Test (p < 0.0%) and processed with SPSS. RESULTS: There were 59 (23.41%), 140 (55.56%), and 53 (21.03%) participants who had high, moderate, and low risks of ASCVD, respectively. Bivariate analysis showed significant association between risk of ASCVD with age, SBP, total cholesterol level, HDL-C levels, and duration of diabetes (p < 0.05). Meanwhile, gender and familial history not related to ASCVD risks among DM patients (p > 0.05). CONCLUSION: The risks for atherosclerotic complications of cardiovascular disease in type 2 DM patients in Medan were predominantly high. The variables related to ASCVD risks included age, gender, HbA1C, systolic blood pressure (SBP), total cholesterol levels, HDL-C, and LDL-C levels.

Early detection of macrovascular complications in type 2 diabetes mellitus in Medan, North Sumatera, Indonesia: A cross-sectional study.

Background: Macrovascular complications occur very frequently in patients with type 2 diabetes mellitus (T2DM) with a high mortality rate, due to the development of cardiovascular disease (CVD), such as stroke, atherosclerosis acceleration, and atrial fibrillation. T2DM is a significant risk factor for CVD and has become the leading cause of death. The purpose of this study was to detect the early risk of macrovascular complications by using the ankle brachial index (ABI) as a marker. Methods: This study was an analytic study with a cross-sectional approach. The study population was patients with T2DM from several primary health care centers in Medan. In total, 89 subjects who met the inclusion and exclusion criteria were recruited with consecutive sampling. ABI was determined as the ratio of systolic blood pressure in the brachial artery to the posterior tibial artery after the subjects had been relaxed and felt comfortable in a supine position. Examination of vitamin D and lipid profile was derived from examination of venous blood.  Data were processed using SPSS and analyzed with one-way ANOVA. Results: The study found that there was a relationship between LDL-C, triglyceride, and vitamin D (25OH-D) based on the ABI (p > 0.05). Conclusions: ABI can be used for an early detection of macrovascular complications. Apart from being easy to perform, ABI was non-invasive. Some other risk factors that can also be used to assess complications and have relationships with ABI were LDL-C, triglyceride, and vitamin D (25OH-D). Complications in T2DM patients can be prevented with reasonable blood sugar control and lifestyle changes. Education and motivation need to be given to patients so that they become more independent in controlling their disease and improving their quality of life.

Natural product of gambier (Uncaria gambier Roxb) extracts to counter against hepatotoxicity effects due to monosodium glutamate induction in male mice.

Monosodium glutamate (MSG) is often added in foods to enhance the flavor. It has adverse effect to body organs. Natural remedies, such as: gambier have been known for generations used to improve health. Substances contained in gambier, i.e.: catechins are believed to reduce the occurrence of hepatotoxicity. The study aims to analyze the effects of gambier in reducing the hepatotoxicity of MSG. This study with a posttest only control group design. Mice amount 25 (5 groups, n = 5/group). All interventions are given orally for 4 weeks. At the end of the study, it carried out euthanasia taken the liver of mice to made histopathology preparations then examine by light microscope, ×400, ×5 view field. Liver damage was found in each group with various levels of histological appearance:(I) 2 normal, 2 minimal, 1 moderate and none severe; (II) none normal, 1 minimal, 3 moderate and 1 severe; (III) 1 normal, 4 minimal, none moderate and severe;, (IV) 2 normal, 3 minimal, none moderate and severe; and (V) 4 normal, 1 minimal, none moderate, and severe. The data were analyzed using Kruskal-Wallis test. The level of liver damage among all groups was significantly different (p = 0.017). The same on the Dunn test also showed the level of liver damage in Group-II to compare with other groups (p < 0.05). The present study proves that Gambier (Uncaria gambier Roxb) can reduce occurrence of hepatotoxicity caused by MSG.

Diabetic Neuropathy among Type 2 Diabetes Mellitus Patients at Amplas Primary Health Care in Medan City.

BACKGROUND: Diabetic neuropathy is one of the most complicated complications of diabetes patients with Type 2 diabetes. AIM: The purpose of this study was to determine the diagnosis of diabetic neuropathy based on Clinical Neurological Examination (CNE) and the factors that influence the occurrence of diabetic neuropathy in Type 2 DM patients at Amplas Primary Health Care (PHC) in Medan City. METHODS: The research design was descriptive-analytic with the cross-sectional approach. The study population was all Type 2 DM patients who came to Amplas PHC with a total sample of 53 people using the consecutive sampling. The research data source is primary data, namely the assessment of diabetic neuropathy using the Clinical Neurological Examination (CNE) criteria. Data were processed using SPSS and analysis using the chi-square test. RESULTS: The results showed the majority of Type 2 DM patients had mild neuropathy as many as 24 people (45.3%). The Chi-square test results showed there was a relationship between age and duration of diabetes with the incidence of diabetic neuropathy in Type 2 DM patients at Amplas Primary Health Care. CONCLUSION: Education and early detection with proper management can prevent more severe complications so that the quality of life of patients can be maintained better.