scholarly journals The effect of comorbidities on glycemic control among Colombian adults with diabetes mellitus: a longitudinal approach with real-world data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manuel Urina-Jassir ◽  
Lina Johana Herrera-Parra ◽  
Juliana Alexandra Hernández Vargas ◽  
Ana María Valbuena-García ◽  
Lizbeth Acuña-Merchán ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Early Onset ◽  
National Registry ◽  
Real World Data ◽  
Logistic Regression Models ◽  
Statistical Interaction ◽  
Longitudinal Approach

Abstract Background Achieving an optimal glycemic control has been described to reduce the incidence of diabetes mellitus (DM) related complications. The association between comorbidities and glycemic control remains unclear. Our aim is to evaluate the effect of comorbidities on glycemic control in people living with DM. Methods A retrospective longitudinal study on data from the National Registry of Chronic Kidney Disease from 2014 to 2019 in Colombia. The outcome was poor glycemic control (PGC = HbA1c ≥7.0%). The association between each comorbidity (hypertension (HTN), chronic kidney disease (CKD) or obesity) and PGC was evaluated through multivariate mixed effects logistic regression models. The measures of effect were odds ratios (OR) and their 95% confidence intervals (CI). We also evaluated the main associations stratified by gender, insurance, and early onset diabetes as well as statistical interaction between each comorbidity and ethnicity. Results From 969,531 people at baseline, 85% had at least one comorbidity; they were older and mostly female. In people living with DM and CKD, the odds of having a PGC were 78% (OR: 1.78, CI 95%: 1.55-2.05) higher than those without CKD. Same pattern was observed in obese for whom the odds were 52% (OR: 1.52, CI 95%: 1.31-1.75) higher than in non-obese. Non-significant association was found between HTN and PGC. We found statistical interaction between comorbidities and ethnicity (afro descendant) as well as effect modification by health insurance and early onset DM. Conclusions Prevalence of comorbidities was high in adults living with DM. Patients with concomitant CKD or obesity had significantly higher odds of having a PGC.

scholarly journals The Effect of Comorbidities on Glycemic Control Among Colombian Adults With Diabetes Mellitus: a Longitudinal Approach With Real-world Data

2021 ◽  
Author(s):  
Manuel Urina-Jassir ◽  
Lina Johana Herrera-Parra ◽  
Juliana Alexandra Hernández Vargas ◽  
Ana María Valbuena-García ◽  
Lizbeth Acuña-Merchán ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Regression Models ◽  
National Registry ◽  
Mixed Effects ◽  
Real World Data ◽  
Logistic Regression Models ◽  
Longitudinal Approach

Abstract Background: Achieving an optimal glycemic control has been described to reduce the incidence of diabetes mellitus (DM) related complications. The association between comorbidities and glycemic control remains unclear. Our aim is to evaluate the effect of comorbidities on glycemic control in people with DM.Methods: A retrospective longitudinal study on data from the National Registry of Chronic Kidney Disease from 2014 to 2019 in Colombia. The outcome was poor glycemic control (PGC = HbA1c ≥7.0%). The association between each comorbidity (hypertension (HTN), chronic kidney disease (CKD) or obesity) and PGC was evaluated through multivariate mixed effects logistic regression models. The measures of effect were odds ratios (OR) and their 95% confidence intervals (CI). We also evaluated statistical interaction between each comorbidity and ethnicity. Results: From 969,531 people at baseline, 85% had at least one comorbidity; they were older and mostly female. In people with DM and CKD, the odds of having a PGC were 78% (OR: 1.78, CI 95%: 1.55-2.05) higher than those without CKD. Same pattern was observed in obese for whom the odds were 52% (OR: 1.52, CI 95%: 1.31-1.75) higher than in non-obese. Non-significant association was found between HTN and PGC. The association of interest was statistically modified by ethnicity (afro descendant). Conclusions: Prevalence of comorbidities was high in adults with DM. Patients with concomitant CKD or obesity had significantly higher odds of having a PGC.

STUDY OF OUTCOME OF CHRONIC KIDNEY DISEASE IN DIABETIC PATIENTS IN THANJAVUR MEDICAL COLLEGE HOSPITAL

2021 ◽  
pp. 17-20
Author(s):  
S.Hema Akilandeswari ◽  
K. Rajkanth ◽  
S. Janani
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Medical College Hospital ◽  
Diabetic Patients ◽  
Type I ◽  
Strong Positive Correlation ◽  
College Hospital ◽  
Medical College

Background: Diabetes Mellitus is one of the common causes of Chronic Kidney Disease which usually leads to end-stage kidney disease. Thus this study was planned to nd out the outcome of CKD in DM, disease progression, appropriate management and the complications. Methods: A cross sectional study among Diabetes Mellitus patients with Chronic Kidney Disease attending the Department of Nephrology and Department of Medicine in Thanjavur Medical College Hospital during the period of July and August 2018. The duration of study period was 2 months. All patients who attended the outpatient department (OPD) and in-patients departments with Type I and Type II diabetes mellitus associated with chronic kidney disease, on any line of management were included in this study. A total of 101 patients were included. Statistical Package for Social Sciences (SPSS for Windows V20) was used for data analysis. Results: Poor glycemic control, albuminuria, hypertriglyceridemia (greater than 150), increase in LDLlevels (greater than 100), BMI (greater than or equal to 25), poor BP control and a longer duration of diabetes mellitus had a strong positive correlation with decrease in eGFR less than 60 ml/min. Glycemic control, weight reduction and adequate BPcontrol retard the progression of CKD. Conclusion: Albuminuria and decline in eGFR both are independent risk factors for diabetic CKD and are strong predictors of morbidity and mortality from a major vascular event, especially cardiovascular complications and stroke.

scholarly journals Prevalence of chronic kidney disease stages 3-5 among patients with type 2 diabetes mellitus in Bangladesh

2017 ◽  
Vol 11 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Muhammad Abdur Rahim ◽  
Palash Mitra ◽  
Hasna Fahmima Haque ◽  
Tasrina Shamnaz Samdani ◽  
Shahana Zaman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Significant Risk ◽  
Duration Of Diabetes

Background and objectives: Diabetes mellitus is one of the most common causes of chronic kidney disease (CKD). The prevalence of CKD in type 2 diabetes mellitus (T2DM) in Bangladesh is not well described. The present study aimed to find out the prevalence of CKD stages 3-5 and its risk factors among selected Bangladeshi T2DM patients.Methods: This cross-sectional study was conducted in BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital, Dhaka, Bangladesh from July to December 2015. Diagnosed adult T2DM patients were consecutively and purposively included in this study. Pregnant women, patients with diagnosed kidney disease due to non-diabetic etiology, acute kidney injury (AKI), AKI on CKD and patients on renal replacement therapy were excluded. Age, gender, body mass index (BMI) and laboratory parameters were recorded systematically in a predesigned data sheet. Diagnosis of CKD and its stages were determined according to Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines 2012 and estimated glomerular filtration rate (eGFR). Estimated GFR was calculated by using Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (CG) and Chronic Kidney Disease Epidemiology (CKDEPI) creatinine based formula.Results: A total of 400 patients with T2DM of various durations were enrolled in the study. Out of 400 patients, 254 (63.5%), 259 (64.75%) and 218 (54.5%) cases had CKD stages 3-5 according to MDRD, C-G and CKD-EPI equations respectively. CKD was significantly more common in females (p<0.001) and in cases with long duration of diabetes (?5 years; p=0.007). CKD stages 3-5 were significantly associated with hypertension (?2=5.2125, p =0.02) and good control of diabetes (HbA1c <7%) as evidenced by higher proportion of CKD in them (73.3%) compared to those with poor glycemic control (52.1%).Conclusions: More than half of T2DM patients had CKD stages 3-5. Female gender, duration of diabetes and hypertension were significant risk factors and should be emphasized for the prevention of CKD in T2DM. Glycemic control may not reduce CKD in diabetes.IMC J Med Sci 2017; 11(1): 19-24

scholarly journals Study of correlation between adequacy of dialysis and glycemic control in patients of type 2 diabetes mellitus with chronic kidney disease stage 5

2020 ◽  
Vol 8 (4) ◽  
pp. 1366
Author(s):  
Samrat Mitra ◽  
Sanghita Barui
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Random Blood Sugar

Background: The adequacy of haemodialysis in patients of type 2 diabetes mellitus with chronic kidney disease stage 5 depends on several clinical as well as laboratory parameters. Previous studies from Western literature have identified several clinical and laboratory markers for predicting adequacy of dialysis. There is a dearth of literature regarding the same in Indian patient populace. Authors aimed to find correlation, if any, between glycemic control and adequacy of dialysis in this cohort of patients.Methods: A set of 200 patients of type 2 diabetes mellitus who have undergone hemodialysis at a tertiary care hospital were included in the study. Random blood sugar (RBS), Glycated hemoglobin (HbA1c) were measured at admission. After 4 hours of dialysis, the urea reduction ratio (URR) and Kt/V was measured for each patient. The correlation coefficient as well as linear equation of the association between these variables were calculated. Standard statistical method and software were used in the process.Results: The study revealed a linear negative correlation between the variables RBS, HbA1c and URR as well as Kt/V. This suggests the importance of pre dialysis glycemic control in patients undergoing hemodialysis.Conclusions: Authors formulate the hypothesis that glycated hemoglobin and random blood sugar at admission correlate well with the outcome and adequacy of dialysis in patients of stage 5 chronic kidney disease undergoing haemodialysis.  Good glycemic control (HbA1c <6.5 % and RBS <120 mg/dL) have shown to be important predictive markers of adequate dialysis. The hypothesis needs to be tested with a larger study.

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