AACE2021-A-1037: Poor Glycemic Control and Associated Factors Among Patients with Type 2 Diabetes Mellitus in Peshawar

2021 ◽  
Vol 27 (12) ◽  
pp. S15-S16
Author(s):  
Arshad Hussain ◽  
Iftikhar Ali ◽  
Arshad Hussain ◽  
Waqar Ahamad Kaleem
Author(s):  
Eleonora Palella ◽  
Rossella Cimino ◽  
Salvatore A. Pullano ◽  
Antonino S. Fiorillo ◽  
Elio Gulletta ◽  
...  

Background: Type 2 diabetes mellitus (T2DM) is characterized by a prothrombotic state, predisposing to vascular complications. Some related markers, linking thrombophilia to hemostasis and inflammation, however, have been poorly explored in relation to patients’ glycemia. We therefore investigated the association of laboratory hemostatic parameters, circulating adhesion molecules (ADMs), white blood cell (WBC) count, and neutrophil/lymphocyte ratio (NLR) with T2DM and glycemic control. Research design: In this study, 82 subjects, grouped into T2DM patients (n = 41) and healthy individuals (n = 41) were enrolled. To evaluate glycemic control, the T2DM cohort was expanded to 133 patients and sub-classified according to glycated hemoglobin (HbA1c) <7% and ≥ 7% (n = 58 and n = 75, respectively). We assessed glycemia, HbA1c, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), platelet and leukocyte parameters, vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and selectins (E-, P-, L-). Results: PT % activity, PAI-1, VCAM-1, WBC, and neutrophil counts were significantly higher in T2DM patients than in healthy subjects. Poor glycemic control (HbA1c ≥ 7%) was correlated with increased PT activity (p = 0.015), and higher levels of E-selectin (p = 0.009), P-selectin (p = 0.012), and NLR (p = 0.019). Conclusions: Both T2DM and poor glycemic control affect some parameters of hemostasis, inflammation, and adhesion molecules. Further studies are needed to establish their clinical utility as adjuvant markers for cardio-vascular risk in T2DM patients.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251506
Author(s):  
Shambel Nigussie ◽  
Nigussie Birhan ◽  
Firehiwot Amare ◽  
Getnet Mengistu ◽  
Fuad Adem ◽  
...  

Objective To assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia. Methods A cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control. Result A total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10–4.29). The odds of poor glycemic control in patients who did not understand the pharmacist’s instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10–3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13–2.55). Conclusion The overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist’s advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.


2021 ◽  
Vol 6 (2) ◽  
pp. 1444-1448
Author(s):  
Santosh Timalsina ◽  
Shishir Mahato ◽  
Sandesh Nepal

Introduction: Insulin resistance (IR) and glycemic control are two very important aspects to be considered during management of patients with Type 2 Diabetes Mellitus (T2DM). The triglyceride-glucose (TyG) index has been proposed as a simple and inexpensive parameter that correlates well with IR and glycemic control. Objectives: To explore the association of TyG index (and other TyG derived indices) with glycated hemoglobin (HbA1c) and evaluate their predictive ability for glycemic control in patients with T2DM. Methodology: This cross-sectional study comprised of 160 adult patients diagnosed with T2DM visiting the medical outpatient department of Chitwan Medical College, Bharatpur, Chitwan between July–December 2019. Socio-demographic data and anthropometric measurements were collected. Glycemic control was assessed by HbA1c. TyG index was calculated by the formula: ln [fasting TG (mg/dl) x fasting glucose (mg/dl)/2]. Receiver operating characteristic (ROC) curve analysis was performed to analyze the predictive ability of TyG-index for poor glycemic control. Results: One hundred and sixty patients (mean age: 53.6 ± 10.7 years, 55.0% males) were included in the study. Eighty (50.0%) had good glycemic control (HbA1c <7.0%). TyG index, along with TyG-BMI and TyG-WC (other TyG derived indices) were significantly increased in the poor glycemic control group. TyG index had a good predictive ability for poor glycemic control (AUC: 0.803, 95% CI: 0.731 – 0.874). A TyG cutoff ≥ 9.12 was optimal for predicting poor glycemic control, with 86.1% sensitivity and 61.5% specificity. Conclusion: TyG index could be a simple and cost-effective screening tool for assessment of glycemic control in patients with T2DM.


2021 ◽  
Vol 18 (7) ◽  
pp. 1539-1546
Author(s):  
Sultan A.M. Saghir ◽  
Abdullah E.A. Alhariri ◽  
Sameer A. Alkubat ◽  
Amer A. Almiamn ◽  
Saleem H. Aladaileh ◽  
...  

Purpose: To determine the status of glycemic control and its associated factors among adult patients with type 2 diabetes mellitus (T2DM) in Hodeidah City, Yemen. Methods: This cross-sectional study involved T2DM patients attending an outpatient clinic at the Military Hospital in Hodeidah, from January to March 2017. Relevant socio-demographic characteristics, clinical factors and self-management behaviours were recorded in face-to-face interviews. Blood pressure, body weight, and height measurements were also obtained. Glycosylated hemoglobin (HbA1c) and lipid profile were evaluated. Urine samples were also obtained and analysed by albuminuria assay. Results: Of 246 participants, 73.2 % showed poor glycemic control (HbA1c ≥ 7 %). Female patients, those aged ≥ 40 years, the illiterate, and Khat chewers were more likely to have poor glycemic control. Moreover, longer disease duration, insulin administration and albuminuria were significantly associated with poor glycemic control. In contrast, a healthy diet, physical exercise, proper self-monitoring of blood glucose levels and taking medicines as prescribed significantly increased the likelihood of good glycemic control. Conclusion: A majority of the Yemeni diabetic patients have poor glycemic control. To achieve better awareness, diabetes educational programs that highlight the benefits of self-management are recommended.


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