scholarly journals Hypoglycemia Is Independently Associated with Multidimensional Impairment in Elderly Diabetic Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
A. Pilotto ◽  
M. Noale ◽  
S. Maggi ◽  
F. Addante ◽  
A. Tiengo ◽  
...  

Aim. To identify the characteristics associated with multidimensional impairment, evaluated through the Multidimensional Prognostic Index (MPI), a validated predictive tool for mortality derived from a standardized Comprehensive Geriatric Assessment (CGA), in a cohort of elderly diabetic patients treated with oral hypoglycemic drugs.Methods and Results. The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers distributed throughout Italy, within the Metabolic Study. Inclusion criteria were diagnosis of type 2 diabetes mellitus (DM), 65 years old or over, and treatment with oral antidiabetic medications. Data concerning DM duration, medications for DM taken during the 3-month period before inclusion in the study, number of hypoglycemic events, and complications of DM were collected. Multidimensional impairment was assessed using the MPI evaluating functional, cognitive, and nutritional status; risk of pressure sores; comorbidity; number of drugs taken; and cohabitation status. The mean age of participants was 73.3 ± 5.5 years, and the mean MPI score was 0.22 ± 0.13. Multivariate analysis showed that advanced age, female gender, hypoglycemic events, and hospitalization for glycemic decompensation were independently associated with a worse MPI score.Conclusion. Stratification of elderly diabetic patients using the MPI might help to identify those patients at highest risk who need better-tailored treatment.

2016 ◽  
Vol 9 (5) ◽  
pp. 234
Author(s):  
Zahra Heidari ◽  
Zahra Sepehri ◽  
Aleme Doostdar

<p>In addition to known risk factors, the role of different micronutrients such as selenium in diabetes incidence has been proposed. Some previous studies have shown an association of selenium deficiency and type 2 diabetes mellitus, while other studies have not confirmed such a relationship. The aim of this study was to evaluate serum level of selenium in patients with Type 2 diabetes compared with the control group. This cross-sectional study was carried out on patients with type 2 diabetes in Zahedan, southeastern Iran. One hundred newly diagnosed type 2 diabetic patients were evaluated for serum selenium level. One hundred subjects from the general population who had normal fasting blood sugar levels were selected as the control group. The control group subjects were matched in pairs with each of patients on the basis of sex, age (± one year), and body mass index (±1). Serum level of selenium was determined by spectrometry method. Results were compared using t-test. The mean serum level of selenium in patients was 94.47±18.07 µg/L whereas in control group was 142.79±23.67 µg/L. The mean serum level of selenium was significantly different between the two groups (P&lt;0.001). Serum levels of selenium in diabetic patients with significant difference statistically were lower than the control group. In order to evaluate serum level of selenium in patients with diabetes, studies with larger sample size are required. Likewise, prospective studies along with selenium supplementation and investigating its effect on incidence of diabetes are accordingly needed.</p>


2021 ◽  
Vol 15 (3) ◽  
Author(s):  
Supriya Patil ◽  
Yamini Patil ◽  
Sanjay Kumar Patil

Diabetes is a chronic metabolic disorder that disturbs the quality of life (QOL) of patients. Therefore, evaluation of diabetes- related QOL could be a key outcome measure for its management. This study assessed the QOL in type 2 diabetes mellitus (T2DM) patients using the World Health Organization (WHO) quality of life (QOL)˗BREF questionnaire and disease-specific appraisal of diabetes scale (ADS). In this cross-sectional study, 520 T2DM patients were included. Patients’ demographic data, clinical information was collected through interviews, and the WHOQOL-BREF instrument and ADS were used for the QOL of patients. Statistical analysis was performed by using R software (Version 3.6.0). The mean ADS scores were lower in controlled diabetic subjects (18.50±3.08) and higher in uncontrolled diabetic subjects (19.29±2.73) (P<0.05). For WHOQOL-BREF, the mean scores for all the domains (overall general health, physical, psychological, social, and environmental) were significantly higher in controlled diabetic subjects (P<0.001). In addition, the age, duration of diabetes, associated comorbidities, treatment, and HbA1c level of patients showed a highly significant correlation with WHOQOL-BREF (P<0.001). Diabetic patients had poor-to-average QOL. Therefore, public health measures and education of diabetic patients are essential to create more awareness for improving the QOL of T2DM.


2020 ◽  
Vol 8 (E) ◽  
pp. 133-137
Author(s):  
Rusdiana Rusdiana ◽  
Maya Savira ◽  
Sry Suryani Widjaja ◽  
Dedi Ardinata

AIM: The aim of this study was to evaluate the effect of short-term education on glycemic control (glycated hemoglobin [HbA1c] and fasting blood sugar [FBS]) among type 2 diabetes mellitus patients attending to primary health care (PHC) in Medan Johor of North Sumatera, Indonesia. METHODS: The study was performed on type 2 diabetes mellitus patients in Johor PHC, Medan of North Sumatera, on 40 patients with type 2 diabetes mellitus. We took the samples of all the patients of type 2 diabetes mellitus who attend PHC in Medan Johor. The patients received for 3 months intervention by education. An educational course of diabetes together with exercise training and nutritional education was designed for the study population in order to increase the patients’ knowledge and attitude toward diabetes and to increase their participation in the self-monitoring of glycemic control. Samples of FBS and HbA1c were recorded for each patient at the time of the baseline survey, then health education was conducted to the diabetic patients of both sexes attending PHC. The patients received standard advice on diet management and variation about activity. We put HbA1c <6.5% as cut limit for the control of diabetes mellitus. RESULTS: All 40 type 2 diabetes patients completed the educational course. The mean of age of the samples is 62.53 years old, the mean of body mass index was 24.81 kg/m, and the mean of waist size was 92.15 cm. Before the education, the mean of FBS level was 238.83 mg/dl and the mean of Hba1c value is 8.90%. After education, the FBS was 216.88 mg/dl, the mean of HbA1c value was 8.74%. CONCLUSION: The effect of health education in Johor Public Health Care Medan city reduced glycemic control (FBS) in type 2 diabetes mellitus patients, North Sumatera, Indonesia.


2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Erhan Onalan ◽  
Nevzat Gozel ◽  
Emir Donder

Objective: To examine potential associations between neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, mean platelet volume (MPV), HbA1c and microvascular complications in diabetic patients from a cost-effectiveness perspective. Methods: One hundred patients with type 2 diabetes attending our outpatient unit between May 2018 and October 2018 were included, and 100 healthy individuals served as the control group. A retrospective file search was performed to collect information on hemoglobin, mean platelet volume (MPV), glycosylated haemoglobin (HbA1c), hematocrit (Hct), neutrophil and lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelets (Plt), platelet/lymphocyte ratio (PLR), and microvascular complications (neuropathy, retinopathy, nephropathy). Results: Demographic and laboratory data were retrospectively controlled between diabetes (n=100) and healthy control (n=100) groups. The mean age in diabetic patients and healthy controls was 56.34 and 36.68 years, respectively. The mean NLR in diabetics and healthy controls was 2.48 and 2.11, the difference in NLR being significant (p=0.002). MPV in diabetics and controls was 8.54 and 8.53, respectively, and the difference was not significant (p=0.93). PLR was also similar, i.e. 149.7 and 145.3 in diabetics and healthy controls (p=0.067). With respect to microvascular complications, retinopathy was found to be significantly associated with MPV and NLR (p=0.015, and p=0.051), and nephropathy showed a significant association with NLR (p=0.027) among diabetics. In contrast with the two other microvascular complications, no significant association between neuropathy and NLR could be detected, while PLR and neuropathy was significantly associated (p=0.003). Conclusion: Microvascular complications may be associated with certain hematologic parameters, as suggested by comparisons both between diabetics and healthy individuals and within the group of diabetic individuals. We believe that hematologic parameters such as hematocrit, MPV, NLR, and PLR, which can be obtained through a simple complete blood count, may be utilized as cost-effective predictors of diabetic microvascular complications. Further prospective studies with larger sample size are required to better delineate these associations. doi: https://doi.org/10.12669/pjms.35.6.1150 How to cite this:Onalan E, Gozel N, Donder E. Can hematological parameters in type 2 diabetes predict microvascular complication development? Pak J Med Sci. 2019;35(6):1511-1515. doi: https://doi.org/10.12669/pjms.35.6.1150 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.


2020 ◽  
Author(s):  
Fatemeh Haidari ◽  
Mehrnoosh Zakerkish ◽  
Fatemeh Borazjani ◽  
Kambiz Ahmadi Angali ◽  
Golnaz Amoochi

Abstract Background: The objective of this study was to investigate the effects of anethum graveolens (dill) powder supplementation on glycemic control, lipid profile, some antioxidants and inflammatory markers, and gastrointestinal symptoms in type 2 diabetic patients. Material and methods: In this study, 42 patients with type 2 diabetes were randomly allocated to intervention and control groups and received either 3g/day dill powder or placebo (3 capsules/day, 1 g each). Fasting blood sugar (FBS), insulin, homeostatic model assessment of insulin resistance (HOMA- IR), lipid profile, hs-C-reactive protein (hs-CRP), total antioxidant capacity (TAC), malondialdehyde (MDA), and gastrointestinal symptoms were measured in all of the subjects at baseline and post-intervention. Results: The dill powder supplementation significantly decreased the mean serum levels of insulin, HOMA-IR, LDL-C, TC, and MDA in the intervention group in comparison with the baseline measurements (p < 0.05). Also, the mean serum levels of HDL and TAC were significantly increased in the intervention group in comparison with the baseline measurement (p < 0.05). Colonic motility disorder was the only gastrointestinal symptom whose frequency was significantly reduced by supplementation (P = 0.01). The mean changes of insulin, LDL-C , TC, and MDA were significantly lower in the intervention group than in the control group (p < 0.05). In addition, the mean changes in HDL were significantly higher in the intervention group than in the control group (p < 0.05). Conclusion: Dill powder supplementation can be effective in controlling the glycemic, lipid, stress oxidative, and gastrointestinal symptoms in type 2 diabetic patients. Keywords: Type 2 diabetes; Dill powder; Glycemic control; Lipid profile; Stress oxidative status


2020 ◽  
Author(s):  
Joao Beato ◽  
Sonia Torres-Costa ◽  
Joao Esteves-Leandro ◽  
Manuel Falcão ◽  
Vitor Rosas ◽  
...  

Abstract BackgroundDiabetic retinopathy (DR) and cataract are major complications that lead to significant visual impairment of diabetic patients. This study aims to compare the changes in visual acuity, quality of life and satisfaction after phacoemulsification between type 2 diabetic and nondiabetic patients.MethodsFifty-seven diabetic patients (37 with no diabetic retinopathy [DR], 11 with mild/moderate nonproliferative DR and 9 with severe nonproliferative/proliferative DR) and 45 controls were submitted to first-eye cataract surgery by phacoemulsification alone or with co-adjuvant intravitreal injection of bevacizumab or triamcinolone. National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was recorded preoperatively and 6 months after surgery; and satisfaction evaluated at 1-month. ResultsCorrected distance visual acuity (CDVA) of the operated eye at 1 and 6-months (p<0.001) was significantly higher than preoperative value in the controls and all diabetic subgroups. The final CDVA in the severe nonproliferative/proliferative DR subgroup was significantly lower compared to the controls and the remaining diabetic subgroups (p<0.05). The mean NEI VFQ-25 composite score significantly improved in both control (15.413.2 points) and diabetic (15.413.0 points) groups, without differences among the diabetic subgroups (p>0.05). Overall patient satisfaction was 93% in both control and diabetic groups. ConclusionThis study provides vision-related patient-reported outcomes that support the benefit from phacoemulsification in all stages of DR, as long as there is adequate monitoring and treatment of retinopathy.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Francis Agyemang-Yeboah ◽  
Benjamin Ackon Jnr. Eghan ◽  
Max Efui Annani-Akollor ◽  
Eliezer Togbe ◽  
Sampson Donkor ◽  
...  

Background. Metabolic syndrome (MS) is a collection of cardiovascular risk factors comprising insulin resistance, dyslipidemia, obesity, and hypertension, which may cause further complications in diabetes. Although metabolic syndrome (MS) is increasing in incidence in diabetics and leading to significant cardiovascular diseases and mortality, there is dearth of data in Ghana. This study investigated metabolic syndrome, its prevalence, and its associated risk factors in type 2 diabetes at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Methods. The study involved 405 diabetic patients attending the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH) Kumasi, in the Ashanti Region of Ghana. A well-structured questionnaire was used to obtain demographic background such as their age and gender. Anthropometric measurements were obtained using the Body Composition Monitor (Omron ® 500, Germany) which generated digital results on a screen and also by manual methods. Fasting venous blood was collected for the measurement of biochemical parameters comprising fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), high density lipoprotein cholesterol (HDL-c), and triglyceride (TG). Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Results. Out of the total of 405 participants, 81 were males and 324 were females, and the estimated mean age was 58.5 ± 9.9 years. The female patients exhibited higher mean waist circumference (WC) and mean hip circumference (HC) as well as an approximately higher body mass index than males (28.3 ± 5.1, 26.5 ± 4.2 for the female and male respectively). Overall, the prevalence of metabolic syndrome observed among the study population was 90.6%. Conclusions. The prevalence of metabolic syndrome observed among the study population was 90.6%, with a higher percentage in females than males. High triglyceride levels and high waist circumference were the main risk factors for MS in the diabetic population.


Author(s):  
Hanaa H. Ahmed ◽  
Wafaa Gh Shousha ◽  
Hatem A El Mezayen ◽  
Ibrahim A Emara ◽  
Marwa E Hassan

  Objective: This work was delineated to assess procalcitonin (PCT) and C-reactive protein (CRP) as prognostic markers for cardiovascular complication in type 2 diabetic patients.Methods: Forty diabetic patients without cardiovascular disease (CVD), 40 diabetic patients with CVD, and 20 healthy control counterparts were participated in this study. Serum PCT and CRP levels were assayed and correlated with metabolic parameters. Receiver operating characteristic (ROC) curve analysis was done for each biochemical marker.Results: The mean level of PCT was 707.17±99.19 ng/l in diabetic patients versus 881.30±123.56 ng/l for the cardio-diabetic patients (p<0.0001). The mean value of CRP was 34.43±17.27 mg/l in diabetic patients versus 50.32±20.19 mg/l for the cardio-diabetic patients (p=0.0003). PCT levels were significantly amplified in the cardio-diabetic patients with increasing CRP, triglycerides (TG), fasting blood glucose (FBG), and cholesterol (p=0.004, 0.0005, 0.002, and 0.01, respectively). CRP levels were significantly enhanced in the cardio-diabetic patients with increasing TG, FBG, cholesterol, and microalbumin (p=0.002, 0.047, 0.003, and 0.001 respectively). ROC curve analysis for PCT and CRP revealed that the area under curve (AUC) was 0.878 and 0.727, respectively. These findings indicate the good validity of the above biomarkers especially PCT as a prognostic marker for cardiovascular complication in type 2 diabetic patients.Conclusion: This study evidences the usefulness of measuring serum levels of PCT and CRP in diagnosis of cardiovascular complication in type 2 diabetic patients.


2017 ◽  
Vol 8 (1) ◽  
pp. 47-51
Author(s):  
Md Towhidur Rahman ◽  
AS Mohiuddin ◽  
Md Mofazzal Sharif ◽  
Jafreen Sultana ◽  
Fahmida Yeshmine ◽  
...  

Background: Patients with diabetic peripheral neuropathy (DPN) have distal, symmetrical form of the disorder characterized by numbness, burning feet, pins-and-needles sensations and lightning pain. This study was designed to find out the difference between 2 Dimentional (D)-Brightness (B) mode high resolution ultrasonographically measured cross sectional areas of median nerve in type 2 diabetic patients with peripheral neuropathy and those of non-diabetic healthy adult subjects.Methods: This case-control study was done on 180 subjects aged 27-67 years in the department of Radiology and Imaging, BIRDEM from January 2012 to December 2013. Out of them 90 diabetic patients with peripheral neuropathy diagnosed electrophysiologically by nerve conduction study (NCS) were considered study group and age, sex and weight compatible 90 healthy subjects were considered as control group. Measurement of cross sectional areas of median nerve was performed first by the investigator himself purposefully, consecutively and subsequently confirmed by a radiologist in the department of Radiology and Imaging, BIRDEM, who did not know the subjects’ condition to eliminate bias. The major axis, minor axis and the cross sectional areas (CSA) of the median nerve were measured at the carpal tunnel.Results: In this study, the mean cross sectional areas (mm2) of median nerve healthy subjects was 7.78±1.00 mm2 and in diabetic patients with peripheral neuropathy was 13.67±2.97 mm2. The difference mean CSA of median nerve of diabetic subjects with peripheral neuropathy and control subjects were statistically significant (p<0.05) in unpaired ‘t’ test.Conclusion: This study showed that there is a significant difference between the cross sectional areas of median nerve in diabetic subjects with peripheral neuropathy and healthy adult subjects. The mean cross sectional areas of median nerve were increased in diabetic patients with peripheral neuropathy compared to control group.Birdem Med J 2018; 8(1): 47-51


2013 ◽  
Vol 10 (3) ◽  
pp. 44-47 ◽  
Author(s):  
Naval Kishor Yadav ◽  
C Thanpari ◽  
MK Shrewastwa ◽  
RK Mittal

Background Type-2 diabetes mellitus is an independent risk factor for coronary artery disease and risk of coronary disease is three to four fold increased in patients with diabetes compared with non-diabetic population and 60-80% 0f type-2 diabetics are obese. Methods This study was conducted in Nepalgunj Teaching Hospital, Kohalpur, Banke, Nepal, between 1st March, 2011 and 28th February, 2012. A total of 150 samples were taken to assess the lipid profile in type-2 diabetic patients associated with obesity and 25 obese controls for their lipid profile. Venous blood samples were taken from all the subjects in the morning after fasting overnight. Exclusion criteria included pregnancy, chronic infectious disease, heart failure; renal failure and drug allergy were confirmed from the subject’s personal physician report and a detailed history. The data was analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version. Results The mean ± SD age of diabetic patients with obesity was 53.76 ± 6.23 while the mean ± SD age of control was 49.61 ± 4.8. Out of 150 patients 105 (70%) were males and 45 (30%) were females. Among control subjects 16 (64%) were males and 9 (36%) were females. Obese type-2 diabetic patients when compared to obese control subjects showed statistically significant increase in the levels of serum total cholesterol (p ? 0.001), serum triglycerides (p ? 0.001), serum LDL-cholesterol (p ? 0.001) while serum HDL-cholesterol levels did not show statistically significant difference in the two group (p ? 0.05). Conclusion This study showed obese diabetic individuals have dyslipidemia and more prone to develop cardiovascular diseases. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 44-47 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8017


Sign in / Sign up

Export Citation Format

Share Document