Hepatic Subcapsular Steatosis as a Complication Associated with Intraperitoneal Insulin Treatment in Diabetic Peritoneal Dialysis Patients

2005 ◽  
Vol 25 (6) ◽  
pp. 596-600 ◽  
Author(s):  
Dilek Torun ◽  
Levent Oguzkurt ◽  
Siren Sezer ◽  
Aysegul Zumrutdal ◽  
Metin Singan ◽  
...  

Objectives The aim of this study was to evaluate hepatic subcapsular steatosis (HSS) and its association with clinical parameters in nondiabetic continuous ambulatory peritoneal dialysis (CAPD) patients and in diabetic CAPD patients receiving intraperitoneal (IP) or subcutaneous (SC) insulin. Design Cross-sectional study. Setting A tertiary-care university hospital. Patients 28 CAPD patients (17 males and 11 females; mean age 53.5 ± 14 years; mean CAPD duration 22.8 ± 9 months) were included in the study. 14 patients had type II diabetes mellitus and 14 were nondiabetics. In the diabetic group, 8 patients were receiving IP insulin and 6 were receiving SC insulin. Outcome Measures HSS was diagnosed on computed tomography without contrast administration. Other data collected were body mass index (BMI), weekly Kt/V, peritoneal equilibration test (PET) results, daily insulin dosage, duration of diabetes mellitus, duration of insulin treatment, dialysate glucose load, and serum findings for alanine aminotransferase, aspartate aminotransferase, albumin, and lipid profiles. Results HSS was detected in 5 of the 8 diabetics who were receiving IP insulin. None of the diabetics receiving SC insulin and none of the nondiabetic patients exhibited HSS. Daily insulin dosage [108 (95 – 108.5) vs 54 (36 – 72) U/day, p = 0.02], BMI [31 (30.5 – 36) vs 26.6 (26 – 30) kg/m2, p = 0.02], serum triglyceride level [194 (184 – 505) vs 69 (61 – 82) mg/dL, p = 0.04], and PET creatinine levels [D/P2 creat: 0.67 (0.54 – 0.74) vs 0.50 (0.50 – 0.56), p = 0.05; D/P4 creat: 0.75 (0.64 – 0.86) vs 0.60 (0.59 – 0.62), p = 0.02] were higher in diabetic patients receiving IP insulin who had HSS than in those who did not have HSS. PET glucose levels [D0/D2 glu: 0.40 (0.37 – 0.45) vs 0.50 (0.48 – 0.51), p = 0.03; D0/D4 glu: 0.36 (0.26 – 0.38) vs 0.44 (0.38 – 0.48), p = 0.04] were lower in diabetic patients receiving IP insulin who had HSS than in those who did not have HSS. Conclusions Our results suggest that IP insulin plays a more important role in the pathogenesis of HSS than glucose levels in diabetic CAPD patients. They also indicate that HSS is associated with higher daily insulin requirement, obesity, hypertriglyceridemia, and high peritoneal transport rate in diabetic CAPD patients receiving IP insulin.

2019 ◽  
Vol 5 (1) ◽  
pp. 31-36
Author(s):  
Jay Jha ◽  
Varun Malhotra ◽  
Om Jha ◽  
Shivani Gupta

Introduction Alterations in the lipid metabolism have been reported in the subject of diabetes mellitus. They may be influenced by the presence of hypertension. Aims The present study was undertaken to estimate the serum lipids profiles of diabetics with and without hypertension. Study design The study design is experimental with comparative study method, Methodology The sample size taken is 80 which is divided into four groups as A group of 20 healthy individuals of age 20-70 years, other B group of 20 diabetic patients without Hypertension, other C group of 20 hypertensive patients without diabetes and the rest 20 diabetic patients along with hypertension of age 20-70 years of D group. They were matched with respect to various lipid parameters such as total cholesterol, Triglycerides, lipoprotein ratio etc. with control group A. Place and duration of study: the study took place at Santosh group of institutions between August 2013 to August 2016. Result The serum cholesterol levels were significantly higher in hypertensives without diabetics and in diabetics with hypertension as compared to normal controls. No significant difference in the serum triglyceride level was observed among various groups in this study. The ?: ? lipoprotein ratio was found to be affected in all the groups as compared to controls with maximum ratio in diabetics without hypertension and in hypertension without diabetes. Patients who were suffering from diabetes and hypertension were at a maximum risk of developing atherosclerosisand its complications such as coronary artery disease. Diabetics with hypertension had significant higher levels of cholesterol as compared to that of without hypertension. The diabetics with hypertension had lipid abnormalities because of diabetic element in them rather than the hypertension. All the groups studied except the controls were found to be increasingly susceptible to the risk of atherosclerosis and its complications. This risk was found to be maximum in diabetics with hypertension rather than diabetics or hypertensive’s alone. Conclusion The need for right balanced diet, regular exercise and a stress free life is essential for prevention and management of diabetes and hypertension. 


1970 ◽  
Vol 36 (2) ◽  
pp. 64-67 ◽  
Author(s):  
AKM Salek ◽  
MAA Mamun ◽  
MA Haque ◽  
M Mannan ◽  
E Ali ◽  
...  

Background: Musculoskeletal disorders are very common among the diabetic patients and frozen shoulder is one of the disabling conditions. The present study was conducted to compare the serum triglyceride level among the patients of type 2 diabetic presented with and without frozen shoulder.Methodology: This case control study was conducted from January 2008 to December 2009, in the department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka with an aim to compare the serum triglyceride level among diabetic patients presented with, and without frozen shoulder. Thirty types 2 diabetic patients with frozen shoulder were selected as cases and similar number well matched type 2 diabetic patients without frozen shoulder were selected as control.Results: We prospectively studied 30 diabetes mellitus (type 2) patients with the diagnosis of frozen shoulder. The blood sugar both fasting and 2 hours after breakfast, HbA1c and serum triglyceride levels were measured in all patients and compared with those in 30 diabetic patients without frozen shoulder. The blood sugar, fasting and 2 hours after breakfast, HbA1C and serum triglyceride levels were significantly elevated in the frozen-shoulder group (fasting blood sugar p = 0.012; blood sugar 2 hours after breakfast p<0.01; HbA1C p<0.05; and triglyceride p < 0.001).Conclusion: Diabetic type 2 patients presented with frozen shoulder had higher serum triglyceride level compare to the diabetic type 2 patients without frozen shoulder. DOI: 10.3329/bmrcb.v36i2.6990Bangladesh Med Res Counc Bull 2010; 36: 64-67


2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Abdul Aziz ◽  
Syed Ahsan Ali

Background and Objectives: The prevalence of diabetes mellitus worldwide was 171 million one and half decade ago, while the prediction is 366 million patients by 2030 and more than 640 million people by 2040. HbA1c value represents average blood glucose over the past 2-3 months and accounts for both pre-prandial and post-prandial blood glucose levels. A link between HbA1c and diabetic complications has been confirmed. In general, patients with controlled diabetes mellitus should have at least biannual testing, while patients with uncontrolled diabetes mellitus or unmet glycemic targets should be tested every three months. The objective was to see compliance of checking HbA1c in tertiary care hospital of a developing world. Methods: This was a retrospective observational study done from 1st February 2019 to 31st March 2019 in the Department of Medicine and Surgery, The Aga Khan University Hospital, Karachi. All patients of age 18 years and above, admitted with a diagnosis of diabetes mellitus (DM) from 1st February 2019 to 31st March 2019 were included. If HbA1c was less than 7% the patients were labelled as having controlled DM, otherwise, uncontrolled DM. If HbA1c of patients with controlled DM was not checked in last six months and if HbA1c of patients with uncontrolled DM was not checked in last three months then it was labelled as non-compliance of checking HbA1c. Results: Out of 1732 diabetic patients only 94 patients fulfilled inclusion criteria. Out of these 94 patients 43 (45.7%) were male. Mean HbA1c was 7.90% (1.4) and 69 (73.4%) patients had uncontrolled diabetes mellitus. Overall, the compliance of checking HbA1c was 58.5%. In uncontrolled diabetes mellitus patients, the compliance of checking HbA1c was 45% and in controlled diabetes mellitus patients the compliance was 96%. Conclusion: The compliance of checking HbA1c is inadequate in diabetic inpatients. The considerable prevalence of diabetes and the benefits of timely interventions in diagnosed patients to prevent complications suggest the need for a comprehensive awareness among the doctors for checking HbA1c. doi: https://doi.org/10.12669/pjms.37.1.2814 How to cite this:Aziz A, Ali SA. Compliance of checking HbA1c in a tertiary care hospital of Pakistan. Pak J Med Sci. 2021;37(1):142-145.  doi: https://doi.org/10.12669/pjms.37.1.2814 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.


1970 ◽  
Vol 4 (1) ◽  
pp. 17-25 ◽  
Author(s):  
S Nahar ◽  
MZ Rahman ◽  
M Ullah ◽  
BC Debnath ◽  
N Sultana ◽  
...  

Background: People with metabolic syndrome are twice as likely to die from, and three times as likely to have a heart attack or stroke compared with people without the syndrome. People with metabolic syndrome have a five-fold greater risk of developing type 2 diabetes. We investigated the prevalence of metabolic syndrome in patients with newly diagnosed diabetes mellitus. Methods: It was a cross sectional study. The study was conducted in Department of Biochemistry, Sylhet MAG Osmani Medical College, Sylhet & Diabetic Hospital, Sylhet. The study was conducted From July 2008 to June 2009 among 200 patients with newly diagnosed type 2 diabetic patients with age >20 years. Along with blood glucose, different components of metabolic syndrome was assessed, i.e. serum triglyceride level, serum HDL level, blood pressure and waist circumference. Results- Prevalence of metabolic syndrome was 73.5% according to NCEP-ATP III criteria, 81.0% according to modified NCEP-ATP III criteria, 82.5% according to modified WHO criteria and 61.0% according to IDF criteria. All variables other than waist hip ratio and fasting blood sugar had statistically significant higher mean values among patients with metabolic syndrome than patients without metabolic syndrome. Conclusion: It may be concluded that prevalence of metabolic syndrome is considerable in newly diagnosed type 2 diabetic patients in our population. The considerable prevalence of metabolic syndrome in our population is implicative of an alarming risk of cardiovascular disease in future. Keywords: Metabolic syndrome; Type II diabetes mellitus. DOI: http://dx.doi.org/10.3329/cardio.v4i1.9385 Cardiovasc. J. 2011; 4(1): 17-25


2021 ◽  
Vol 8 (37) ◽  
pp. 3334-3338
Author(s):  
Satish Kumar

BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes


2017 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Siswanto Siswanto ◽  
Ismail Kamba ◽  
Siti Aminah

Diabetes mellitus is one of the communicable diseases that have become a public health problem, not only in Indonesia but also the world. Currently morbidity of diabetes mellitus is increasing every year, where in 2006 there were 14 million people in 2011 and ranks fourth with 773 cases. DM is also a cause of disease mortality by 5.8%. And Samarinda own particular Islamic Hospital years 2009, there were 449 patients with DM, and 2011 an increase in the 1931 patients with diabetes mellitus. To increase patients’ knowledge about diabetes and diabetic patients be directing attitudes that support or positive attitude towards keeping blood glucose levels to remain normal. Methode to use pra eksperiment with one group pretest posttest. individual conseling withAudiovisual media. There is increased knowledge about diabetes diabetic patients before and after intervention with increasing value of 3.77 (p value = 0.000) and increase in attitudes regarding diabetes mellitus diabetic patients with an increase in the value of 5,35 (p value = 0.003). There was an increase in knowledge and attitudes of patients hospitalized with diabetes mellitus hospital after islam samarinda given nutritional counseling using audio-visual media


Author(s):  
Dhivya K ◽  
Yogarajan K ◽  
Shanmugarajan T S

ABSTRACTObjective: Periodontitis, a chronic inflammatory disease characterized by destruction of the periodontal ligament and alveolar bone is the sixthcomplication of diabetes mellitus. Periodontal treatment that reduces gingival inflammation aids in the control of hyperglycemia. Therefore, thepresent study was designed to determine the effect of treating chronic periodontitis with oral antibiotics azithromycin and metronidazole on the levelof serum glycated hemoglobin in type-II diabetic patients.Methods: This prospective observational study was carried out in the dental department of a tertiary care hospital for 9 months. Clinical andbiochemistry reports of 90 patients were collected in designed case report forms. All statistical analyses were performed using IBM Statistical Packagefor Social Sciences 17 and Graph Pad Prism 7.0.Results: Significant reduction in all the clinical and dental parameters was comparatively higher in patients who received azithromycin than inpatients who received metronidazole and scaling and root planning alone.Conclusion: Periodontal therapy with oral azithromycin can be employed as a supportive strategy for the management of diabetes mellitus.Henceforth, prevention and control of periodontal disease along with antibiotics must be considered an integral part of glycemic control. However,due to the lesser sample size in this study, further investigations are required to confirm the effect of periodontal therapy on systemic diseases.Keywords: Periodontitis, Azithromycin, Metronidazole, Glycemic control, Diabetes mellitus.


2018 ◽  
Vol 3 (2) ◽  
pp. 72
Author(s):  
Setyoadi Setyoadi ◽  
Heri Kristianto ◽  
Siti Nur Afifah

Diabetes mellitus is a disease that required good self-management. Noncompliance in diet and meal plans cause the instability of blood glucose levels. Nutrition education calendar method can improve knowledge and ability to consume food that matches the number, hours and types with dietary adjustments listed in the calendar diet. This study aimed to determine the effect of nutrition education calendar method on blood glucose levels of patients with type 2 diabetes mellitus in Community Health Center Pakis Malang. Pre-experimental design one group pretest-posttest with purposive sampling was conducted in this study and sample obtained as many as 21 people. Blood glucose levels were measured before and after the nutrition education calendar methods. Compliance in using calendar method with the observation sheet. Statistical analysis values obtained by Wilcoxon, the p-value of 0.007 (p <0.05). The results of the analysis, 16 respondents showed a decrease in blood glucose levels and 5 respondents experienced an increase in blood glucose levels after the given intervention. It can be concluded that there are differences between blood glucose levels before and after nutrition education calendar method. Differences in blood glucose levels can be influenced by controlling diet respondent in accordance with the calendar method in education, but also antidiabetic drugs, and sports. Should be added to the control group to determine objectively the effect of nutrition education on the calendar method.


2019 ◽  
Vol 6 (3) ◽  
pp. 786
Author(s):  
Eda Dayakar ◽  
C. Sathya Sree ◽  
E. Sanjay

Background: Diabetes mellitus is a common health problem globally. Dyslipidaemia is a major risk factor to develop cardiovascular disease in diabetics. They present study was undertaken to find out the prevalence of dyslipidaemia in type 2 diabetic patients.Methods: The present study was a cross sectional study consisting of 46 (23 male and 23 female) known type 2 diabetes mellitus patients. Age, gender, duration of diabetes, body mass index (BMI) was recorder in all the diabetic patients.  Fasting blood glucose levels, total cholesterol, triglycerides, HDL, LDL, VLDL levels were measured using standard methods and recorded.Results: The average total cholesterol, triglycerides, LDL, HDL and VLDL were 200±42mg/dl, 169.62±89.79mg/dl, 132.45±36.38mg/dl,39.1±16.6mg/dl and 35.85±17.09mg/dl respectively. The incidence of occurrence of hypercholesterolemia was 58.6% and hypertriglyceridemia 36.9%. Increased levels of LDL were observed in 30 (65.2%) patients and reduced HDL was observed in 43 (93.4%) patients. The incidence rate of dyslipidaemia was higher in female diabetic patients when compared to male diabetic patients.Conclusions: Awareness on the dyslipidaemia and its risk factors should be provided to the type 2 diabetic patients as they are more prone to get cardiovascular disease and lipid profile also should be monitored regularly along with blood glucose levels.


Author(s):  
Pallavi Sharma ◽  
Bhavani Raina ◽  
Anuradha Bharti

Background: Diabetes mellitus is a common metabolic disorder which is characterized by elevated blood sugar level. It is a major cause of blindness in our country, which is preventable and treatable, if healthy practice and knowledge regarding this disease is applied. The study was undertaken to assess the knowledge, attitude and practice of Diabetic Retinopathy, amongst diabetic patients attending eye OPD in GMC Jammu.Methods: 300 patients diagnosed with diabetes mellitus attending eye OPD, over a period of 10 months, in GMC Jammu, were incorporated in this study. Self administered questionnaires were used to assess knowledge, practice and attitude of diabetic retinopathy amongst the diabetic patient, after their due consent.Results: This study incorporated 300 diabetic patients out of which 168 (56%) were males and 132 (44%) were females. Most of the patients (70%) were aware of the fact that diabetes can cause eye disorders. 67.33% believed that they should go for regular eye check-ups. 79.33% agreed that timely intervention can delay the complications in diabetic eye disease.Conclusions: Diabetes can lead to serious ocular complications which can be prevented by appropriate awareness and optimistic attitude and good approach towards the disease.


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