scholarly journals Impact of plasmatic lipids in glycemic control and its influence in the cardiometabolic risk in morbidly obese subjects

2009 ◽  
Vol 53 (6) ◽  
pp. 747-754 ◽  
Author(s):  
Ary Serpa Neto ◽  
Felipe Martin Bianco Rossi ◽  
Rodrigo Dal Moro Amarante ◽  
Nara Alves Buriti ◽  
Marçal Rossi
Keyword(s):  
Glycemic Control ◽  
Clinical Utility ◽  
Cardiometabolic Risk ◽  
Poor Glycemic Control ◽  
Morbidly Obese ◽  
Factor Analyses ◽  
Good Glycemic Control ◽  
Reasonable Degree ◽  
Obese Subjects ◽  
Cardiometabolic Factors

OBJECTIVES: To evaluate whether biochemical parameters are associated with a good glycemic control and to identify the occurrence of cardiometabolic risk variables. MATERIAL AND METHODS: One hundred forty Brazilians were evaluated. The subjects were characterized with regard to glycemic control as good, fair and poor and were divided into tertiles by TG and HbA1c. We use the ROC curve to determine which variables were predicted of poor glycemic control and the factor analyses to identify the domains that segregated among the risk variables. RESULTS: Fasting glucose and insulin levels, TG level, VLDL-C and HOMA-IR increased significantly across HbA1c tertiles. The best marker for identification of poor glycemic control was triglycerides. The presence of cardiometabolic abnormalities did not alter the glycemic control, but HOMA-IR was significantly higher in subjects with abnormalities. CONCLUSION: The use of TG levels offers a reasonable degree of clinical utility. In morbidly obese subjects insulin resistance is associated with individual cardiometabolic factors.

Risk of Complications With the Total Contact Cast in Diabetic Foot Disorders

2019 ◽  
pp. 193864001989592
Author(s):  
Alexandria Riopelle ◽  
Ryan LeDuc ◽  
Michael Wesolowski ◽  
Adam P. Schiff ◽  
Michael S. Pinzur
Keyword(s):  
Glycemic Control ◽  
Diabetic Foot ◽  
Retrospective Chart Review ◽  
Poor Glycemic Control ◽  
Morbidly Obese ◽  
Diabetic Patients ◽  
Good Glycemic Control ◽  
Orthopaedic Practice ◽  
Total Contact Cast ◽  
Foot Morbidity

The custom-fabricated total contact cast is commonly used in the treatment of diabetic foot disorders. This resource-consuming treatment option has been associated with iatrogenic morbidity as well as the need for urgent cast removal and inspection of the underlying limb when potential problems arise. Over a 10-year period, 381 diabetic patients had 2265 total contact cast applications by certified orthopaedic technologists, in a university orthopaedic practice, under the supervision of university faculty. Patients were stratified by glycemic control based on hemoglobin A1c levels, and obesity based on body mass index (BMI). Complications were grouped as (1) development of a new ulcer or wound, (2) new or increasing odor or drainage, (3) wound infection, (4) gangrene, (5) newly identified osteomyelitis, and (6) pain or discomfort necessitating cast change or removal. At least 1 complication was observed in 159 of 381 patients. The odds of experiencing a cast-related event for patients with a BMI greater than 30 kg/m2 was 1.55 times greater than patients with a BMI less than 25 kg/m2. As compared to patients with good glycemic control, the odds of experiencing a cast-associated complication was 1.27 times greater in patients with moderate glycemic control and 1.48 times greater in patients with poor glycemic control. The total contact cast is commonly used in the treatment of diabetic foot morbidity. Treatment-associated morbidity may well be greater than previously appreciated. Complications are more likely in patients who have poor glycemic control and are morbidly obese. This information will hopefully stimulate interest in developing commercially available nonrigid alternatives that retain the attributes of the resource-consuming rigid device, with the potential advantage of avoiding the associated morbidity. Levels of Evidence: Level IV, retrospective chart review

scholarly journals Vitamin D deficiency and cardiovascular risk in type 2 diabetes population

2021 ◽  
Vol 16 (1) ◽  
pp. 464-474
Author(s):  
Sushant Pokhrel ◽  
Nisha Giri ◽  
Rakesh Pokhrel ◽  
Bashu Dev Pardhe ◽  
Anit Lamichhane ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Glycemic Control ◽  
High Density Lipoprotein ◽  
Vitamin D Deficiency ◽  
Density Lipoprotein ◽  
Poor Glycemic Control ◽  
Cvd Risk ◽  
Good Glycemic Control

Abstract This study aims to assess vitamin D deficiency-induced dyslipidemia and cardiovascular disease (CVD) risk in poor glycemic control among type 2 diabetes mellitus (T2DM) patients. This study was carried out among 455 T2DM patients involving poor glycemic control (n = 247) and good glycemic control (n = 208). Fasting plasma glucose (FPG) and HbA1c were measured to assess glycemic control. Cardiac risk ratio, atherogenic index plasma, and atherogenic coefficient were calculated to assess and compare the CVD risk in different groups. Patients with poor control had a significantly higher level of total cholesterol (TC), triglyceride (TG), and non-high-density lipoprotein lipase cholesterol (non-HDL-C), atherogenic variables, and lower level of high-density lipoprotein lipase cholesterol (HDL-C) as compared to patients with good glycemic control. We also observed significant negative correlation of vitamin D with lipid markers and atherogenic variables in poor glycemic control diabetic population. The serum vitamin D levels were inversely associated with HbA1c, FPG, TG, TC, and non-HDL-C. Furthermore, hypercholesterolemia, hypertriglyceridemia, and elevated non-HDL-C were the independent risks in hypovitaminosis D population. Vitamin D deficiency in poor glycemic control is likely to develop dyslipidemia as compared to vitamin D insufficient and sufficient groups. Thus, vitamin D supplementation and an increase in exposure to sunlight may reduce the risk of cardiovascular complications in diabetes.

Pre-Dialysis Glycemic Control is An Independent Predictor of Mortality Intype Ii Diabetic Patients on Continuous Ambulatory Peritoneal Dialysis

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 179-183 ◽  
Author(s):  
Mai-Szu Wu ◽  
Chun-Chen Yu ◽  
Ching-Herng Wu ◽  
Jeng Yi Haung ◽  
Mei-Lin Leu ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Glycemic Control ◽  
Serum Albumin ◽  
Poor Glycemic Control ◽  
Control Group ◽  
Diabetic Patients ◽  
Type Ii ◽  
Good Glycemic Control ◽  
Cholesterol Levels ◽  
Significant Difference

Objective To evaluate the impact of pre-dialysis glycemic control on clinical outcomes for type II diabetic patients on continuous ambulatory peritoneal dialysis (CAPO). Materials and Methods One hundred and one type II diabetic patients receiving CAPO for at least 3 months were enrolled in a single institute. The patients were classified into two groups according to status of glycemic control. In the good glycemic control group, more than 50% of blood glucose determinations were within 3.3 11.0 mmol/L and glycosylated hemoglobin (HbA 1 C) levels were within 5% -10% at all times. In the poor glycemic control group, less than 50% of blood glucose determinations were within 3.3 -11.0 mmol/L, or HbA1C levels were above 10% at least 6 months before peritoneal dialysis was started. In addition to glycemic control status, pre-dialysis serum albumin, cholesterol levels, residual renal function, peritoneal membrane function, and modes of glycemic control were also recorded. Results The patients with good glycemic control had significantly better survival than those with poor glycemic control (p < 0.01). There was no significant difference in pre-dialysis morbidity between two groups. No significant differences were observed in patient survival between patients with serum albumin above 30 g/L and those with serum albumin under 30 g/L; between those with cholesterol levels above or below 5.2 mmol/L; and between those with different peritoneal membrane solute transport characteristics as evaluated by a peritoneal equilibration test (PET). Furthermore, there was no significant difference in survival between patients who controlled blood sugar by diet and those who controlled it by insulin. Cardiovascular disease and infection are the major causes of death in both groups. Although good glycemic control predicts better survival, it does not change the pattern of mortality in diabetic patients maintained on CAPO. Conclusions Glycemic control before starting dialysis is a predictor of survival for type II diabetic patients on CAPO. Patients with poor glycemic control predialysis are associated with increased morbidity and shortened survival.

scholarly journals THE ASSOCIATION BETWEEN ASYMPTOMATIC BACTERIURIA AND GLYCEMIC CONTROL IN TYPE 2 DIABETES MELLITUS

2018 ◽  
Vol 24 (3) ◽  
pp. 247 ◽  
Author(s):  
Reni Marlina ◽  
Ricke Loesnihari ◽  
Santi Syafril
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Asymptomatic Bacteriuria ◽  
Poor Glycemic Control ◽  
Good Glycemic Control ◽  
Cross Sectional ◽  
Symptomatic Urinary Tract Infection ◽  
Type 2 Dm ◽  
Urinary Glucose

The incidence of infection often occurs in patients with Diabetes Mellitus (DM) due to hyperglycemia that causes dysfunction of chemotaxis, phagocytic activity, malfunction of neutrophils and glycosuria. It is followed by other complications that lead to the malfunction of the bladder. Highly urinary glucose level is an exellent medium for pathogenic microorganisms growth. Asymptomatic Bacteriuria (ASB) is a risk factor for symptomatic urinary tract infection spontaneously or due to urinary catheters. This study aimed to analyze the association between the incidence of ASB of type 2 DM and glycemic control. The study was conducted during June-August 2016 with a cross-sectional method. Subjects were type 2 DM patients with age ≤60 years, who were treated in the Endocrinology Out-Patient Clinic of the Adam Malik Hospital. HbA1c was measured by Indiko automatic analyzer. Its association with urine culture results was analyzed. A total of 50 samples were enrolled, consisting of 25 females, and 25 males, with 19 having an exellent glycemic control (HbA1c <7%) and 31 with poor glycemic control (HbA1c ≥7%). Thirteen positive ASB were found, 5 with good glycemic control and 8 with poor glycemic control. Statistical analysis revealed a nonsignificant association between glycemic control and culture results (p = 1.000). Somers’d did not show a significant association between glycemic control and the incidence of ASB (p=0.968, d=-0.005). However, significant differences in culture results between gender, in which the ASB were found in samples of four females and two males (p=0.004). Somers’d revealed a significant association between culture results and gender (p=0.001; d=-0.360). Most of the bacteria found were Gram-negative. There was no significant association between glycemic control with an incidence of ASB. However, gender had significant differences in the incidence of ASB, which occurred more frequently in DM females than males. Urinalysis should be performed in patients with type 2 DM with ASB. However, further study was needed to analyze the relationship between glycemic control with the incidence of ASB and other factors that might affect the incidence of ASB.

Impact of glycemic control on treatment efficacy and safety during nabpaclitaxel plus gemcitabine therapy in unresectable pancreatic cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 337-337
Author(s):  
Junko Tauchi ◽  
Akira Shinohara ◽  
Ken Ohashi ◽  
Taro Shibuki ◽  
Gen Kimura ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Glycemic Control ◽  
Dose Intensity ◽  
Progression Free Survival ◽  
Poor Glycemic Control ◽  
Cancer Center ◽  
Control Group ◽  
Unresectable Pancreatic Cancer ◽  
Good Glycemic Control ◽  
Significant Difference

337 Background: Diabetes mellitus (DM) and hyperglycemia have been widely considered to be associated with the risk of pancreatic cancer. However, the aim of this study was to evaluate the relationship between glycemic control and the efficacy or safety in pancreatic cancer pts receiving treatment with nab-Paclitaxel (nab-PTX) plus Gemcitabine (GEM). Methods: We retrospectively reviewed 285 pts with unresectable pancreatic cancer with nab-PTX plus GEM as the first-line chemotherapy from December 2014 to March 2017 at the National Cancer Center Hospital East, Kashiwa, Japan. The pts were divided into two groups, average blood glucose level during the period of chemotherapy was less than 160 mg/dL (Group GC: Good glycemic control group) and more than 160 mg/dL (Group PC: Poor glycemic control group). Results: A total of 285 pts were enrolled. Median age was 66 years (range: 26-84) and males/females: 180/105, PS (0-1/2-3): 272/13, stage (III/IV): 77/208. There were 226 pts in GC group and 59 pts in PC group. No significant differences were seen in the overall survival between Group GC and PC (median: 16.1 months vs. 13.8 months, p = 0.344) and in the progression free survival between the two groups (median: 7.5 months vs. 8.2 months, p = 0.862). The incidence rate of grade 2-3 chemotherapy-induced peripheral neuropathy (CIPN) was significantly higher in Group PC compared with Group GC (Group GC 28.3%, Group PC 45.8%, p = 0.010). Univariate and multivariate analyses identified glycemic control as significant independent factors associated with the incidence of grade 2-3 of CIPN (Odds ratio 2.182, 95% CI 1.20-3.96, p = 0.010). There was no significant difference in the relative dose intensity of nab-PTX between two groups (median, 56.6% in group GC, 56.5% in group PC, p = 0.952). Conclusions: Glycemic control during the chemotherapy with nab-PTX plus GEM in unresectable pancreatic cancer was not associated with OS. The incidence of severe CIPN was higher in pts with poor glycemic control compared with good glycemic control.

scholarly journals Correlation of serum lipid profile and glycemic control parameters in patients with type 2 diabetes mellitus

2018 ◽  
Vol 8 (2) ◽  
pp. 110-116
Author(s):  
Emina Panjeta ◽  
Radivoj Jadrić ◽  
Mirsad Panjeta ◽  
Jozo Ćorić ◽  
Amela Dervišević
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Lipid Profile ◽  
Diabetes Mellitus Type 2 ◽  
Diabetes Mellitus Type ◽  
Poor Glycemic Control ◽  
Atherogenic Index ◽  
High Density Lipoproteins ◽  
Good Glycemic Control

Introduction: Diabetes mellitus type 2 has become a global health-care problem of modern society due to a pronounced increase of prevalence to pandemic proportions and vascular complications. At present, glycated hemoglobin (HbA1c) is widely accepted as a measure of glycemic control in established diabetes. The aim of this study was to analyze the lipid profile in serum of patients with diabetes mellitus type 2, and its relationship with HbA1c levels. Methods: The observational cross-sectional study included 60 diabetic patients, 30 men, and 30 women, age 32–94 years. Patients were assigned into two groups based on HbA1c values; Group 1: HbA1c ≤ 7% (good glycemic control) and Group 2: HbA1c > 7% (poor glycemic control). We analyzed the concentration of glucose, HbA1c, and lipid profile including total cholesterol levels, triglycerides (TAG), low-density lipoproteins (LDL), and high-density lipoproteins (HDL). Results: Significantly lower values of glucose concentration, TAG and the ratio TAG/HDLc were obtained in the group of patients with good glycemic control. (p < 0.0005) Patients with good glycemic control had lower values of Castelli 1 and Castelli 2 index, and atherogenic index of plasma, compared to patients with poor glycemic control, but this difference was not significant. (p > 0.005) Our study revealed a significant positive correlation between HbA1c and triglyceride level (r = 0.375; p = 0.003) and HbA1c and ratio triglyceride/HDLc (r = 0.335; p = 0.009). Conclusion: HbA1c can also be used as a predictor of dyslipidemia in type 2 diabetics in addition to as a glycemic control parameter.

scholarly journals Correlation between Serum Magnesium Levels and HbA1C in Type 2 Diabetes Mellitus

2020 ◽  
Vol 1 (2) ◽  
pp. 136-144
Author(s):  
Madhavi Kondeti ◽  
Thejaswini Lalitha ◽  
Sathyam Durgam ◽  
Anuswaru M
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Serum Magnesium ◽  
Poor Glycemic Control ◽  
Good Glycemic Control ◽  
Mean Values ◽  
Group A

Background and Objective: Type 2 Diabetes Mellitus is a chronic disease resulting from acomplex inheritance, environmental interaction along with risk factors such as obesity andsedentary life style. Magnesium has been stated to have potential role in improving insulinsensitivity and preventing diabetes related complications. Hypomagnesaemia is proposed as oneof the factor in the pathogenesis of diabetic complications. The aim of our study is to estimatethe correlation between serum Magnesium levels and the level of Glycemic control (HbA1c) inpatients with Type 2 Diabetes Mellitus.Methods: This is an observational study conducted in SVRRGGH and SVMC, Tirupati, AndhraPradesh which included 94 patients with type 2 Diabetes mellitus of more than 5 years duration.These patients were divided into 2 groups based on level of Diabetic control. Group A included30 patients with HbA1c below 7.0mg/dL (good glycemic control) and Group B included 64patients with HbA1c above 7.0mg/dL (poor glycemic control). In both the groups SerumMagnesium levels were estimated.Results: Mean Serum Magnesium levels in Group A was 2.280±0.3955mg/dL while in Group Bit was 2.087±0.5834 mg/dL with a p-value 0.0379 (<0.05) which is statistically significant. Inour study though the mean values of serum Magnesium are within normal reference range, meanvalues of serum Magnesium levels in patients with poor glycemic control(HbA1c>7.0) arestatistically low as compared to patients with good glycemic control (HbA1c <7.0).Discussion: It has been reported that Serum Magnesium levels are lower in uncontrolleddiabetics when compared to controlled diabetics and also serum magnesium levels vary withtreatment for diabetes. In our study, although the mean values of serum magnesium in bothgroups are within Normal reference range (1.7-2.2mg/dL), they are statistically low in groupwith poor glycemic control (HbA1c >7.0mg/dL) when to group with good glycemic control(HbA1c< 7.0mg/dL).Thus this gives an insight into the association of hypomagnesaemia andlevel of diabetic control.Conclusion: This effective comparative study of deals with varying Magnesium levels inspecific diabetic therapies and analysed the effect of urinary magnesium detected inHypermagnesuria with Magnesium supplementation.

ASSOCIATION OF SERUM FERRITIN WITH GLYCEMIC CONTROLAMONG TYPE 2 DIABETIC PATIENTS

2021 ◽  
pp. 34-36
Author(s):  
Mallam Srikanth Goud ◽  
Sohil Sharda ◽  
Gangurde Bhushan Daulatrao
Keyword(s):  
Glycemic Control ◽  
Serum Ferritin ◽  
Blood Donation ◽  
Tertiary Care ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Strong Positive Correlation ◽  
Good Glycemic Control ◽  
Positive Correlation ◽  
Iron Stores

Introduction: Serum ferritin is a marker for iron stores and is an acute phase reactant. Its role in pathogenesis of Diabetes is suggested by improvement in insulin sensitivity and insulin secretion with frequent blood donation and decreased iron stores. Objective of the present study is to determine correlation of serum ferritin with glycemic control. Material and Methods: This analytical cross sectional study was conducted at a tertiary care centre of southern India, including 50 diabetic patients with good glycemic control and 50 patients with poor glycemic control. Results: Mean serum ferritin level of diabetics was signicantly lower in diabetics with good glycemic control (119.07±58.99 ng/ml) as compared to those with poor glycemic control (331.11±140.69 ng/ml). Serum ferritin showed strong positive correlation (p <0.001)with the duration of diabetes (r = 0.651) and HbA1C (r = 0.828). Conclusion: Serum ferritin levels were higher in diabetic individuals with poor glycemic control and serum ferrition showed strong positive correlation with glycemic control (HbA1C). Serum ferritin may be used as marker for screening poor glycemic control and patients at high risk of developing complications.

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