scholarly journals GLYCEMIC BEHAVIOR IN 48 HOURS POSTOPERATIVE PERIOD OF PATIENTS WITH TYPE 2 DIABETES MELLITUS AND NON DIABETIC SUBMITTED TO BARIATRIC SURGERY

2015 ◽  
Vol 28 (suppl 1) ◽  
pp. 26-30 ◽  
Author(s):  
Lucas Freitas de OLIVEIRA ◽  
Caroline Gewehr TISOTT ◽  
Diego Machado SILVANO ◽  
Camila Mafalda Mouta CAMPOS ◽  
Ricardo Reis do NASCIMENTO

Although there is no indication for surgery taking only into account the glycemic condition, results have shown that benefits can be obtained in glycemic control with bariatric surgery. Aim : To compare the glycemic behavior among type 2 diabetic and non-diabetic patients within 48 h after bariatric surgery, and clarify whether there is a reduction in blood glucose level in obese patients with diabetes before the loss of weight excess. Methods : Descriptive epidemiological study with prospective cohort design with 31 obese patients undergoing Roux-en-Y gastric bypass and sleeve gastrectomy. The patients were controlled with hemoglucotests in different periods of time: preoperative, postoperative and each 6 h after surgery for 48 h. Results : Average ambulatory blood glucose in diabetics was 120.7±2.9 mg/dl vs 91.8±13.9 mg/dl in the nondiabetic. After 48 h there was decrease in diabetics to 100.0±17.0 mg/dl (p=0.003), while the non-diabetic group did not change significantly (102.7±25.4 mg/dl; p=0.097). There were no differences between the surgical techniques. There were no death. Conclusions : Diabetic patients significantly reduced blood glucose after surgery regardless of the use of exogenous insulin or oral hypoglycemic agents.

2021 ◽  
Author(s):  
WEN-TAO LV ◽  
QIU-MEI ZHANG ◽  
XIANG-WEN MENG

To investigate the effect of sodium glucose cotransporter 2 inhibitor (SGLT-2I) on bone turnover markers in overweight and obese patients with type 2 diabetes mellitus. Methods: according to the criteria of selection and exclusion, 42 patients with overweight and obese type 2 diabetes (BMI≥25kg/m2) were selected from October 2019 to May 2020. The patients were randomly divided into experimental group and control group, there were 18 cases in the experimental group and 24 cases in the control group. The experimental group was treated with SGLT-2I, and other oral hypoglycemic agents (or insulin) were added according to the blood glucose situation. The control group received oral hypoglycemic agents (non-SGLT-2I) and/or insulin and/or glucagon-like peptide-1 receptor agonist (GLP-1 RA). Every 28 days of follow-up, medication regimen was adjusted according to blood glucose and adverse reactions of patients. Fasting venous serum of the patients was collected at the beginning and again 24 weeks later and the levels of PINP and β-CTX were detected uniformly. SPSS 21.0 was used to compare the changes of clinical indexes before and after the treatment. Results: 1. In the experimental group, PINP, HbA1c, FPG and BMI decreased (p<0.05). 2. In the control group, HbA1c, FPG and PINP decreased (p<0.05). 3. Comparison between groups after 24 weeks of treatment: there was significant difference in BMI (p<0.05).


Author(s):  
Venkateswarlu Konuru ◽  
Ram Mohan Reedy T

  Objectives: The aim of this study was to evaluate safety and efficacy of oral hypoglycemic agents in obese Type-2 diabetic patients. The objectives are to compare fasting and postprandial blood sugar (PPBS) levels, to compare body mass index (BMI) in all the groups, and to identify glycosylated hemoglobin levels and adverse drug reactions (if present) in all the groups.Method: This is a prospective observational study conducted in care diabetic center over a period of 1 year. All the patients those are receiving only oral hypoglycemic agents continuously over a period of 3 months and BMI ≥30 were enrolled. The patients receiving insulin were excluded. Patients were followed over a period of 3 months and were reviewed on visit basis (every 30 days). All the necessary information was collected into the data collection form that includes demographic details (age, gender, etc.), past medication history, current treatment charts, and their relevant laboratory reports (fasting blood sugar levels [mg/dl], PPBS levels [mg/dl], glycosylated hemoglobin A1c [HbA1c] (%), and BMI [kg/m2]).  Results: A total of 395 patients were recruited into the study and the drugs received by the population were found to be metformin+sulfonylureas (33%), metformin+pioglitazone (26%), and metformin+dipeptidyl peptidase inhibitors (DPI) (23%). A significant reduction in HbA1c was seen in all groups of patients. Adverse drug reactions observed were hypoglycemia, pedal edema, and itching distributed to drugs metformin+DPI, respectively. A significant reduction in BMI was seen in patients receiving DPI and BMI was found to be increased in other groups of patients.Conclusion: Overall, three classes of drugs were found to have similar efficacy. Sulfonylureas were commonly associated with hypoglycemia when compared to other drugs and weight reduction observed in dipeptidyl peptidase inhibitors.


2016 ◽  
Vol 9 ◽  
pp. CMED.S38077 ◽  
Author(s):  
Wafaa AlSaggaf ◽  
Mohammed Asiri ◽  
Balgees Ajlan ◽  
Alaa Bin Afif ◽  
Roaa Khalil ◽  
...  

Aim To compare the effect of different treatment regimens (oral hypoglycemic agents [OHGs], insulin therapy, and combination of both) on glycemic control and other cardiometabolic risk factors in type 2 diabetes mellitus (T2DM) patients in Saudi. Subjects and Methods Patients with T2DM, but no serious diabetic complications, were randomly recruited from the diabetes clinics at two large hospitals in Jeddah, Saudi Arabia, during June 2013 to July 2014. Only those without change in treatment modality for the last 18 months were included. Blood pressure and anthropometric measurements were measured. Treatment plan was recorded from the patients' files. Fasting blood sample was obtained to measure glucose, HbA1c, and lipid profile. Results A total of 197 patients were recruited; 41.1% were men and 58.9% were women. The mean (±SD) age was 58.5 ± 10.5 years. Most patients (60.7%) were on OHGs, 11.5% on insulin therapy, and 27.7% were using a combination of insulin and OHGs. The mean HbA1c was lower in patients using OHGs only, compared with means in those using insulin, or combined therapy in patients with disease duration of #10 years ( P = 0.001) and also in those with a longer duration of the disease ( P < 0.001). A lower mean diastolic and systolic blood pressure was found among patients on insulin alone ( P < 0.01). No significant differences were found in lipid profiles among the groups. Conclusion Insulin therapy, without adequate diabetes education, fails to control hyperglycemia adequately in Saudi T2DM patients. There is a challenge to find out reasons for poor control and the ways as to how to improve glycemic control in T2DM.


2021 ◽  
Vol 6 (1) ◽  
pp. 79-86
Author(s):  
Fef Rukminingsih ◽  

Diabetes mellitus (DM) type 2 is a chronic and progressive clinical syndrome, characterized by polyuria, polydipsi and polyphagy accompanied by increased blood glucose or hyperglycemia. Management of type 2 diabetes mellitus in patients with HbA1C values > 9% is by administering insulin or a combination of insulin with oral hypoglycemic agents. This study aims to determine the suitability of the type and dose of insulin in type 2 DM patients in the Outpatient Pharmacy Installation of St. Elisabeth Hospital Semarang. This research is a descriptive observational study using retrospective data. The data were obtained from the medical records of Universal Health Coverage participant patients with type 2 diabetes mellitus in the Outpatient Pharmacy Installation of St. Elisabeth Hospital Semarang, who only received insulin therapy in January 2020, is 26-65 years old, and has examination results for fasting blood glucose, post prandial blood glucose and HbA1C (examination results for the last 6 months). The results showed that 57 patients consisted of 29 (50.88%) male patients and 28 (49.12%) female patients. A total of 47 (82.46%) patients were more than 45 years old. A total of 38 patients (66.67%) received combination insulin and all patients had HbA1C values> 9%. The suitability of using insulin based on the type of insulin was 68.42% and most of the patients (80.70%) received inappropriate insulin doses.


Author(s):  
Shruti Vihang Brahmbhatt ◽  
Bhagya M. Sattigeri

Background: Diabetes is a major public health problem both in developing and non-developing countries across the world. It is a chronic disease, which in long term causes several complications resulting in poly pharmacy for its management. Hence, this study was determined to analyze the drug utilization pattern for the management of type 2 diabetes with complications.Methods: A prospective, observational and non-interventional study was carried out in 100 diabetic patients with one or other complications admitted in medicine wards at Dhiraj Hospital. Patients who signed informed consent form were only included in the study. All the data were recorded from patients’ case files and analyzed.Results: Result of total 100 patients, maximum number 52 (52%) were falling in group of 61-70 kg and only 2 (2%) in 81-90 kg. Out of 100 diabetic patients, 40 (40%) were managed with insulin in addition to oral antidiabetic agents, 37 (37%) were managed with only Oral Hypoglycemic Agents (OHA) and 23 (23%) were managed with only insulin. The most commonly prescribed oral antidiabetic group of drug was Biguanides in 60 (60%) and most prescribed insulin was short acting Insulin in 40 (40%) patients.Conclusions: The diabetic patients are more prone to cardiovascular and other complications leading to a co morbid condition. The poly pharmacy is likely to occur in diabetic patients suffering with secondary complications. Therefore, intense blood sugar control with proper education can prevent the co morbid state and finally helps in reducing the economic burden.


2019 ◽  
Vol 3 (2) ◽  
pp. 19
Author(s):  
Ririn Puspadewi

The purpose of this research is to find out how the fluctuation of outpatients’ blood-glucose concentrations of type 2 diabetic patients who receive combination therapy of the oral antihiperglicemic drugs (gliclazide-metformin) in DR. Sardjito Hospital. The research was conducted using an analysis-descriptive design employing a number of medical-records of patients with diabetes mellitus to collect the glucose content data. Data derived from the medical records is the data of each patient’s blood-glucose content during six months, beginning  from March to August 2002. The results give that profile of the glucose concentrations in fasting condition and 2 hours postprandial condition who recieve combination therapy of the oral antidiabetic (gliclazide-metformin) can reach out for normal concentration.


2019 ◽  
Vol 19 (1) ◽  
pp. 100-107 ◽  
Author(s):  
Hamideh Vahid ◽  
Shokoufeh Bonakdaran ◽  
Zahra Mazloum Khorasani ◽  
Lida Jarahi ◽  
Hassan Rakhshandeh ◽  
...  

Background: Experimental studies have reported beneficial effects of Capparis spinosa L., a perennial shrub from the Capparidaceae family, on the glycemic status and serum lipids in diabetic animals. Objective: The aim of the present randomized triple-blind placebo-controlled clinical trial was to investigate the safety and efficacy of C. spinosa oxymel on blood glucose, lipid profile, and other diagnostic indexes of metabolic syndrome in patients with poorly controlled type 2 diabetes. Method: The C. spinosa oxymel was prepared by adding hydroalcoholic extract of C. spinosa fruit to simple oxymel (a mixture of grape vinegar and lactulose). Thirty diabetic patients with metabolic syndrome whose glycemic status was not controlled despite receiving full doses of oral hypoglycemic agents did not want to start insulin therapy and were randomly allocated to three groups to receive placebo, simple oxymel, or C. spinosa oxymel (10 mL/thrice daily for 3 months). All patients continued conventional therapy with hypolipidemic, antihyperlipidemic, and antihypertensive drugs during the study. Results: C. spinosa oxymel significantly decreased the body weight and body mass index at the end of the study compared to the baseline. While the patients in the placebo and simple oxymel groups displayed further increase in the level of FBG or PPBG, administration of C. spinosa oxymel inhibited the progression of hyperglycemia. Nevertheless, there was not a significant difference between placebo and intervention groups regarding HbA1c at the end of the study. C. spinosa oxymel had no significant effect on the serum cholesterol but inhibited the progression of hypertriglyceridemia during the study. There were no significant changes in creatinine, microalbuminuria, AST, ALT, and ALP values following C. spinosa treatment, suggesting that it had no unwanted effects on kidney and liver function. Conclusion: The results suggest that although C. spinosa oxymel cannot enhance the effects of hypoglycemic and hypolipidemic drugs, it can prevent further increase of blood glucose and triglycerides in patients with poorly controlled diabetes.


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