scholarly journals Assessment of Corneal Endothelial changes in type II Diabetes Mellitus by Non-Contact Specular Microscope

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
J E F Gendy ◽  
N M Elmowafy ◽  
M M Elfiky ◽  
Y M Shaaban

Abstract Introduction Numerous studies were dedicated to explaining the effect of type II diabetes on corneal endothelium. There seemed to be a conflict in the results of the studies, some highlighted that diabetes did not affect the corneal endothelium but rather the corneal thickness. While others disagreed stating that there was damage to the endothelium. The rest cited low endothelial cell density only in poor glycaemic control. This prospective analytical study will extensively investigate the effect of diabetes on the corneal endothelium using non-contact specular microscopy. Aim Prospective analysis of the effect of type II diabetes mellitus on the corneal endothelium performed by specular microscopic examination using KONAN Non-Contact Specular Microscope CC-5000 Cellchek; with regards to cell count, density, size, morphology and comparing them to normal subjects of the same age group. The aim of the study is to completely understand the changes that occur to the corneal endothelium in diabetic patients. Patients and Methods This is a cross-sectional study, in which 30 Diabetic eyes and 30 Control eyes were examined using non-contact specular microscope. Patients were recruited from the Specialized Eye Hospital Kobry El Kobba Military Medical Complex. Results The study included 17 males and 13 females in the non-diabetic control group while in the diabetic group it included 16 males and 14 females. By comparing the demographic data of the two study groups, no significant difference (p > 0.05) was found. The same results were obtained in data regarding the age. Comparing both groups regarding the cell count, density and average cell size showed a highly significant difference (p < 0.05). While comparing the coefficient of variation and the percentage of hexagonal cells in both groups showed a significant difference (p > 0.05). Conclusion Diabetes has been implicated in the morbidity of the corneal endothelium. Our study concluded that it appears that diabetes has a significant impact on the corneal endothelial anatomy, causing endothelial cell loss and a decrease in cell density producing compensatory polymegathism. Triggering a disturbance in the physiological functions of the endothelium when under stress e.g. trauma, surgery or intraocular inflammation. However, under normal physiological conditions we found out that there was no abnormality or impairment in the corneal endothelial functions; in keeping the corneal deturgesence (relatively dehydrated, 70% hydration). Therefore, we concluded from the results that special caution should be taken in diabetic patients to whom any stress is applied on the corneal endothelium so that they do not develop corneal decompensation leading to significant morbidity.

2017 ◽  
Vol 2 (2) ◽  
pp. 26-34
Author(s):  
Hridaya Parajuli ◽  
Jyotsna Shakya ◽  
Bashu Dev Pardhe ◽  
Puspa Raj Khanal ◽  
Narayan Prasad Parajuli ◽  
...  

Background: Hyperuricemia is associated with type 2 diabetes, which is a metabolic disorder of multiple etiologies resulting from defects in insulin action. The present study wascarried out to look for any association between uric acid and Type II Diabetes Mellitus and also status of triacylglycerol level among those patients.Methods: The blood samples were collected 100 diabetic and 100 non-diabetic individuals in the department of biochemistry and then analyzed for estimation of blood glucose, Uric Acid and Triacylglycerol level.Results: The average level of serum uric acid in diabetic patients was higher (5.706±1.617) in comparison to non diabetic subjects (4.322±0.784) with statistically significant difference (p≤0.05). For female the result indicate there was a positive correlation between (FBS and triglycerides) and (triglycerides and uric acids) which was statistically significant (r =-0.465, n = 41, p = 0.002) and(r =-0.370, n = 41, p = 0.017) respectively.Conclusions: This study documents that hyperuricemia is associated with type 2 diabetes mellitus. Furthermore, the serum triacylglycerol and serum uric acid is also found to be associated risk factors for diabetic complications. Hence, timely diagnosis and management of diabetes is vital to control the complications related to diabetes.Ann. Clin. Chem. Lab. Med. 2016:2(1); 26-34


2007 ◽  
Vol 135 (3-4) ◽  
pp. 143-146 ◽  
Author(s):  
Nada Kostic ◽  
Zorica Caparevic ◽  
Sanja Ilic

Introduction. Lipid peroxidation and antioxidant systems are important factors affecting the metabolism of lipoproteins in diabetes mellitus. Objective. The aim of this study was to investigate the lipid and antioxidant parameters in type II diabetes mellitus patients, and also to determine the effect of diabetic complications on these parameters. Method. Lipid status, Oxidized LDL cholesterol, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and plasminogen activator inhibitor (PAI-1) levels in plasma of 50 type II diabetic patients were measured with commercially available kits. Results. The results showed only statistically significant higher levels of triglycerides (3.12?3.9 mmol/l) in diabetics compared with the controls. Ox-LDL cholesterol (84.7?16.9 mmol/l) and SOD activities (913.4?120.3 U/gHb) in type 2 diabetes mellitus were higher than those of the controls, but there was no statistical significance. On the other hand, in patients with diabetes mellitus and complications, LDL cholesterol, PAI-1, SOD and GSH-Px activities were higher but not significantly than those without complications. Triglycerides and Ox-LDL cholesterol were lower in the group of diabetic patients with complications in comparison to the group without complications. Conclusion. These results indicate that antioxidant status may be affected in type II diabetic patients and that the rise in some enzyme activities could be a compensatory mechanism to prevent tissue damage. Our results suggest that the rise in PAI-1 in type II diabetics with complications may be a good marker of vascular endothelial dysfunction.


2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Muhammad Khalid ◽  
Muhammad Kashif Hanif ◽  
Qamar Ul Islam ◽  
Muhammad Asim Mehboob

Objective: To compare the mean change in Corneal Endothelial cell Density (CED), from baseline (pre-operative value), two months after phacoemulsification cataract surgery between type II diabetic patients and non-diabetic patients. Methods: This prospective stratified controlled study was conducted at PNS Shifa Hospital, Karachi. 80 eyes of 72 type II diabetic patients and 80 eyes of 77 non diabetic controls, having Nuclear Opalescence (NO) grades 2 and 3 on slit lamp examination underwent phacoemulsification surgery. CED was measured in cells/mm2, of concerned eye of each subject preoperatively and 2 months post operatively using specular microscope. The difference in mean CED change between the two groups after surgery was analyzed. Results: Mean age of study population was 61.41± 6.76 years. Out of study population, 92 (57.5%) were males and 68 (42.5%) were females. There was a statistically significant difference between both groups in terms of mean post-operative CED, mean change in CED and mean frequency change in CED (p <0.05). There was no statistically significant difference between both groups in age, gender, laterality of eyes and mean pre-operative CED, (p >0.05). Difference of pre-operative CED from post-operative CED in each group was statistically significant. Conclusion: There is a significant difference between diabetic population and normal population in terms of corneal endothelial loss after uneventful phacoemulsification cataract surgery. doi: https://doi.org/10.12669/pjms.35.5.596 How to cite this:Khalid M, Hanif MK, Qamar ul Islam, Mehboob MA. Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.596 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 15 (7) ◽  
pp. 2317-2319
Author(s):  
Kashif Ali Samin ◽  
Khalil Ullah ◽  
Muhammad Ikram Shah ◽  
Abidamateen Ansari ◽  
Sadia Khalil ◽  
...  

Background and Aim: Morbidity and mortality from non-communicable diseases, particularly diabetes are increasing rapidly in Pakistan, the prevalence has reached 17.1%. A strong association has been witnessed between type II diabetes mellitus with atherosclerosis and serum uric acid level. The current study aim was to assess the levels of serum uric acid in type II diabetes mellitus. Materials and Methods: This cross-sectional study was carried out on 85 diagnosed patients of type II diabetes mellitus in Diabetes hospital, Peshawar and the Department of General Medicine, Shaikh Zayed Medical Complex, Lahore during the period from March 2020 to August 2020.Type II diabetes mellitus (DM) diagnosed patients 85 and healthy control 30 were evaluated in this study. The level of hyperuricemia was defined for women > 6 mg/dl and men >7 mg/dl in men. Results: In this study, a total of 85 diabetic diagnosed patients and 30 healthy controls were enrolled. No significant differences were there in the baseline characteristics like anthropometric and socio-demographic parameters. The mean age for diagnosed and control cases was 58.6±8.7 and 56.5±7.6 years with an age range of 40 and 80 years. Hyperuricemia proportion among diabetic patients was 12.13% while none of the control cases had hyperuricemia. The uric acid means level increased from 4.29±0.81 mg/dl with a diabetic duration between 3 and 4 years to 4.59±0.99 mg/dl with a diabetic duration of 5 to 7 years. Furthermore, mean serum uric acid level reached 6.50±1.08 in cases with diabetic duration 8 to 12 years. Statistically, a significant association was found between diabetic duration and serum uric acid. Also, a positive correlation was found in hyperlipidemia, serum uric acid levels, and hypertension. Conclusion: In diabetic patients serum uric acid levels were found to be significantly higher. Diabetic patients had hypertension, elevated serum uric acid levels, and high triglycerides with dyslipidemia. The rise in serum uric acid levels is proportional to the duration of diabetes. Keywords: Serum uric acid, Type 2 diabetes mellitus, Hypertension


2018 ◽  
Vol 08 (01) ◽  
pp. 11-14
Author(s):  
Aditya Mungamuri ◽  
Sunil Kumar Y. ◽  
Suchetha Kumari N. ◽  
Ullal Harshini Devi

Abstract Background: Diabetes Mellitus (DM) has become an epidemic in the 21st century where India leads the world with largest number of patients. There is increasing evidence that inflammation is closely involved in the pathogenesis of type 2 diabetes and associated complications such as dyslipidaemia and atherosclerosis. Many previous studies indicate inflammatory markers like CRP, IL-6, IL-8, TNF-alpha, fibrinogen, total sialic acid, ceruloplasmin and total leucocyte count (TLC) are raised in Type II Diabetes Mellitus. However, not many studies have done association of ESR and TLC in DM. Aims: In the present study inflammatory markers like CRP, total leukocyte count and ESR were compared in diabetic and non-diabetic patients. Materials and Methods: 5mL of venous blood was taken from the study subjects.CRP, TLC and ESR was estimated. Results: There was a significant rise in the CRP, TLC and ESR values seen in patients diagnosed with type II diabetes mellitus when compared to normal individuals. All three parameters (CRP, TLC, and ESR) were raised in a total of 7 cases (14%). 14 cases (28%) showed elevated levels of both CRP and ESR. A significant 8 cases (16%) showed elevation of CRP alone. There was a rise of ESR alone in 5 cases (10%). Conclusion: CRP, TLC and ESR are elevated in diabetic patients in comparison to normal individuals. These increase the risk of diabetic related complications like atherosclerosis and dyslipaedemia. Hence, anti-inflammatory drugs in combination with antidiabetic treatment can delay these complications.


Author(s):  
Sameer Aggarwal ◽  
Vikas Kakkar ◽  
Chandni Sharma ◽  
Surender Bishnoi ◽  
Ankit Gulati ◽  
...  

ABSTRACT Objective This study has been undertaken to study the effect of type II diabetes mellitus (T2DM) and its duration on hearing. Materials and methods The present study was conducted on 100 persons of age group 20 to 45 years. All subjects included in the study were divided into two groups. Group I: 50 patients suffering from T2DM (fasting blood sugar ≥ 126 mg/dL and postprandial ≥ 200 mg/dL) of either sex, in the age group of 20 to 45 years. Group II: 50 healthy volunteers in the age group of 20 to 45 years, of either sex were included in control group. Hearing assessment was done by using pure tone audiometry (PTA). Results In diabetic patients, the mean threshold in the PTA was higher at all frequencies as compared with healthy controls, and there was a positive correlation between the duration of diabetes and hearing loss. Conclusion Various audiological investigations have revealed that there is a strong association of diabetes with sensorineural part. The prevalence of sensorineural hearing loss (SNHL) in type II diabetics observed was 64%. In the majority of the patients, the hearing loss was bilateral, affecting mid and higher frequencies from 2 to 8 kHz. Hence, to conclude, we can say that the high prevalence of hearing loss in T2DM supports the importance of audiometric evaluation in such patients. How to cite this article Gulati A, Kakkar V, Aggarwal S, Sharma C, Panchal V, Pareek M, Bishnoi S. To Study the Effect of Type II Diabetes Mellitus and Its Duration on Hearing. Int J Adv Integ Med Sci 2017;2(3):140-143.


2017 ◽  
Vol 3 (2) ◽  
pp. 55-58 ◽  
Author(s):  
NH Rekha ◽  
MS Bharath ◽  
SP Channakeshava

ABSTRACT Introduction Diabetes mellitus is a common metabolic disorder. Prevalence of diabetes is increasing globally and it is one of the major health problems of the 21st century. The disturbance in serum magnesium (SMg) has been reported among patients with type II diabetes mellitus. Hypomagnesemia has negative impact on glucose homeostasis and insulin sensitivity in patients with type II diabetes mellitus. Aim This study was undertaken to know the prevalence of hypomagnesemia in patients with type II diabetes mellitus and its relation with glycated hemoglobin (HbA1c). The study was conducted on 200 patients with type II diabetes and 100 healthy controls at RajaRajeswari Medical College & Hospital, Bengaluru. Results Out of 200 diabetic patients, 115 (57%) had hypomagnesemia. We observed mean SMg (1.7 mg) significantly low in diabetic patients compared with controls (2.1 mg). We also found HbA1c was high (9%) in hypomagnesemia patients. We found that diabetic hypomagnesemic patients had high mean fasting blood glucose (242.6 mg%) and postprandial blood sugar (313 mg%) than controls. How to cite this article Rekha NH, Bharath MS, Channakeshava SP. Study of Prevalence of Hypomagnesemia in Patients with Type II Diabetes Mellitus. J Med Sci 2017;3(2):55-58.


2021 ◽  
Vol 15 (5) ◽  
pp. 1718-1720
Author(s):  
Kashif Ali Samin ◽  
Sara Malik ◽  
Sidra Sadiq ◽  
Talha Rasheeq ◽  
Nisar Khan Sajid ◽  
...  

Background: Urinary tract infections (UTIs) are very communal, and patients with diabetics develop UTIs more frequently. Acute kidney injury (AKI) can be a complication of UTI. This study is designed to determine whether Urinary tract infections because of extended-spectrum beta-lactamase (ESBL) could be a risk factor of acute kidney injury in individuals with type-II diabetes mellitus. Methods: This case study was conducted in the Outpatient department of Diabetes Hospital Peshawar and Nishter Hospital Multan for duration of six months from August 2020 to January 2021. People of type II diabetes were assessed with culture confirmed UTI. The cases of UTI patients complicated with AKI were included in the study group, and people without AKI were taken as a control group. ESBLs positivity from isolated organisms have been assessed as risk factors for AKI. A total of 140 subjects were selected with equal distribution in two groups. The group A has UTI complicated with AKI and group B included has patients without AKI but with UTI. Results: UTI was diagnosed in 140 cases among type-II diabetic patients with 2:4 male to female ratio. The duration and mean age of diabetes mellitus were 8.60±5.35and55.80±14.10 years, correspondingly. The strongest common etiological factor was Escherichia coli (60.7%), trailed by Klebsiella pneumoniae (11.4%). In ESBL positive organism; E. coli was present in 81.4% and K. pneumoniae in 10% of individuals. Of the 140 UTI cases, AKI was observed in 70 (50%); out of which 48 (62.5%) were ESBL-positive microorganisms and 22 (22/70, 31.43%) for non-ESBL microorganisms. Conclusions: Nearly50% of the patients with type-II diabetes mellitus and UTI had ESBL-positive microorganisms as etiological mediators in this analysis. Owing to the presence of ESBL-positive microorganisms, UTI was the main cause of AKI and is a strong risk factor. Keywords: ESBL, Acute kidney injury, UTI, type 2 diabetes, risk factor.


2019 ◽  
Vol 26 (12) ◽  
pp. 2040-2043
Author(s):  
Munir Ahmed ◽  
Abdul Hayee ◽  
Shahla Afsheen Memon ◽  
Ismail Salim Memon ◽  
Abdul Qayoom Memon

Objectives: To determine the frequency of diastolic dysfunction in patients presenting with type II Diabetes Mellitus. Study Design: Cross sectional study. Setting: Sheikh Zayed Hospital, Rahim Yar Khan. Period: From 01-01-2017 to 30-06-2017. Material & Methods: In this study the cases were selected via non probability consecutive sampling of both male and female gender with age more than 40 years having type II DM of at least more than 2 years were included. The cases suffering from type I DM, gestational DM and those with HTN, end stage kidney and liver failure were excluded. Trans thoracic echocardiography was done to label diastolic dysfunction and was labelled as yes when the E/A ratio was <0.8. The data was analysed using chi square test and p value less than 0.05 was taken as significant. Results: In this study, 100 cases of type II DM were included with mean age of 51.31±7.89 years at presentation. There were 61% males and 39% females. Diastolic dysfunction was observed in 53% of the cases. There was no significant difference in terms of gender where it affected 56.41% of females with p= 0.92. Diastolic dysfunction was more in cases that had duration of DM more than 3 years affecting 48 (70.58%) cases with p= 0.001 and it was also significantly high in cases that had BMI more than 30 where it was seen in 40 (70.17%) of cases with p= 0.001. Conclusion: Diastolic dysfunction seen in half of the cases suffering from type II DM and it is significantly high in cases that had duration of DM more than 3 years and BMI more than 30.


Author(s):  
Z. Naveen Kumar ◽  
B.N.S. Gowri Kumari

Background: The objective is to evaluate the sweet taste sensitivity among type-II diabetes mellitus patients. Methods:  This is a cross sectional study consisted of 227 subjects (127 type-II Diabetic patients & 100 non diabetic individuals) of both the genders and age matched. Sweet taste sensitivity tests were done using different concentrations of glucose solution and compared among the diabetic patients with FBS more than 180mg/dl and diabetic patients with FBS less than 180mg/dl and also compared among the diabetic patients and non diabetic individuals.  The final concentration at which patient was able to perceive the taste was recorded. statistical analysis was done using Student’s unpaired T test. P­values of < 0.05 were considered to be statistically significant. Results: The mean of sweet taste sensitivity among diabetic patients with FBS >180 mg/dl was 6245 mg/l and the mean of sweet taste sensitivity in the diabetic patients with FBS <180 mg/dl was 2249mg/l with P<0.001 which is significant. The mean of sweet taste sensitivity among diabetic patients with FBS >180 mg/dl was 6245mg/l and the mean of sweet taste sensitivity in the non diabetic individuals was 1979mg/l with P<0.01 which is significant. the mean of sweet taste sensitivity among diabetic patients with FBS <180 mg/dl was 2249 mg/l and the mean of sweet taste sensitivity in the non diabetic individuals was 1979mg/l  with P>0.05 which is not significant. Conclusion: In our study it was concluded that type-II Diabetes Mellitus patients have lesser sensitivity for the sweet taste. Loss of sensitivity leads to the increase in sugar consumption being the risk factor for worsening the disease.


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