scholarly journals Cardiac autonomic neuropathy in diabetes mellitus

Author(s):  
Bijaya K. Behera ◽  
Vishnu K.

Background: The present study was conducted with an objective to study the prevalence of cardiac autonomic neuropathy (CAN) in patients with diabetes mellitus (DM) and its relation to duration, severity of DM, patient's age and BMI.Methods: This hospital based prospective study was conducted from August 2015 to September 2017, at M.K.C.G. Medical College Hospital, Berhampur, Odisha, India. Cross sectional study was design. A total number of 100 diagnosed patients of diabetes mellitus who were admitted in hospital or attended on OPD basis were taken for the study. Detailed history, clinical evaluation, laboratory investigations were carried out. The diagnosis of CAN was made by autonomic function tests. The CAN score of each patient was analysed. Database were generated based on age, duration of diabetes, severity of DM and BMI.Results: Out of 100 diabetic patients, 40 patients (23 males and 17 females) were selected for final analysis after excluding conditions causing cardiac autonomic neuropathy other than diabetes mellitus. All the patients were in the age group 21 to 70years. In the present study it was found that 57.5% of patients with DM had CAN and its incidence increased with severity of hyperglycemia, duration of DM, BMI and age of the patient.Conclusions: Cardiac autonomic neuropathy is a common and early complication of DM. Proper history taking to identify the symptoms related to CAN and performing simple autonomic tests in all patients of DM can identify cardiac autonomic neuropathy.

2020 ◽  
Vol 8 (1) ◽  
pp. 16
Author(s):  
Sruthi Kare ◽  
Vishwanath N. Reddy ◽  
Thejdeep Mahamkali

Background: India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Diabetic Nephropathy is a common consequence of long-standing diabetes mellitus. The development of diabetic nephropathy has a dramatic increase on the morbidity and mortality of patients with diabetes. Objective of this study was to evaluate the prevalence of microalbuminuria in patients with diabetes mellitus patients.  Methods: This cross-sectional study was conducted on T 2 diabetes mellitus patients visiting medicine OPD of R L Jalappa hospital constituent hospital of Sri Deveraj Urs Medical College, Tamaka, Kolar from May 2016 to July 2016. A total of 60 type-2 diabetes patients were enrolled in the study.Results: Average duration of diabetes among study group was 8 years and most of the patients were between 6-10 years. In type 2DM patients, microalbuminuria and glycemic control have shown a significant linear correlation with duration of diabetes (p<0.05). Also, micro albuminuria has a significant correlation with increase in level of glycosylated haemoglobin.  Conclusions: The prevalence of microalbuminuria in diabetic patients was found to be high and being a developing country; there is a dire need that microalbuminuria and HbA1c testing should be done in both, newly diagnosed as well as already diagnosed type 2DM patients as an early marker of renal risk factor.


2021 ◽  
Vol 5 (5) ◽  
pp. 01-05
Author(s):  
Gninkoun Comlan Jules ◽  
Fanou Joseph Soglo ◽  
Alassani Adebayo Sabi Cossi ◽  
Djrolo François

Background Diabetes mellitus is well known as a major risk factor for cardiovascular diseases. Cardiovascular autonomic neuropathy is one of the diabetes complications that has a major impact on cardiovascular morbidity and mortality in patients with diabetes. Aim : To determine the prevalence of cardiovascular autonomic neuropathy in patients with diabetes attending the diabetic center in Cotonou and to identify its risk factors. Materials and Methods : It was a cross-sectional study. Cardiovascular autonomic neuropathy was identified using deep breathing test, standind test and the blood pressure response to standing test (orthostatic hypotension). Chi square test was used for statistical analysis and différence was considered significant when p<0.05. Results : A total of 405 subjects were included in the study. Their mean age was 53.67±11,68 years and the mean diabetes duration was 6.66 years. The prevalence of cardiovascular autonomic neuropathy was 65.9%. Regarding the severity of the complication in neuropathic patients, 51.7% of them had an early neuropathy, 41.2% have presented a moderate neuropathy and 7.1% have presented a severe neuropathy. Factors associated with cardiovascular autonomic neuropathy were age of patients (p = 0.0002), diabetes duration (p = 0.0012), hypertension (p =0.0015), dyslipidemia (p = 0.027) and high pulsed blood pressure (p = 0.032) Conclusion : Cardiovascular autonomic neuropathy is a very frequent complication of diabetes mellitus. Unfortunately this complication of diabetes is not often explored in the patient's follow-up examination. As this complication is recognised to be associated with high cardiovascular morbidity and mortality, systematic screening can be recommanded in patients with long duration of diabetes or presenting an other cardiovascular risk factor.


2017 ◽  
Vol 12 (2) ◽  
pp. 89
Author(s):  
Olokoba L B ◽  
Mahmud O A ◽  
Adepoju F G ◽  
Olokoba A B

<p><strong>Background: </strong>Diabetic retinopathy is a major cause of blindness worldwide. The associated loss of productivity and quality of life of the patients with diabetic retinopathy will lead to additional socioeconomic burden. This study aims to determine the level of awareness of diabetic retinopathy among diabetic patients. <strong></strong></p><p><strong>Materials and Methods: </strong>This hospital-based cross sectional study, was carried out at the Diabetic and Ophthalmology clinics of University of Ilorin Teaching Hospital, Nigeria from November 2011 to July 2012. A total of 365<strong> </strong>patients had validated, semi-structured, and interviewer-administered questionnaires to obtain information on socio-demographic characteristics, clinical information and awareness of diabetic retinopathy. <strong></strong></p><p><strong>Results: </strong>A total of 365 patients were enrolled, with age between 19 and 90 years, and a mean of 45.8 ±16.3 years. The male to female ratio was 1: 2.2. Ninety-nine respondents (27.1%) had no education. The majority (30.4%) had only primary education; 21.1% had tertiary; 14.5% had secondary while 6.8% had Quranic education. The mean duration of diabetes mellitus was 14.1 ±13.09 years. Of the 365 patients with diabetes mellitus, 279(76.4%) had heard that diabetes mellitus affects the eyes, while 86(23.6%) had not. Of those who had heard, 221(79.2%) heard it from health personnel, 45(16.1%) from radio/television, 25(9.0%) from internet, 23(8.2%) from books/newspapers, while 16(5.7%) heard from other sources.<strong></strong></p><p><strong>Conclusion: </strong>There was a high level of awareness of diabetic retinopathy amongst the patients. However, the high level of awareness of the blinding complication of diabetes mellitus did not translate to a correspondingly high level of ocular examination for diabetic retinopathy.  <strong></strong></p>


2020 ◽  
Vol 13 (2) ◽  
pp. 140-143
Author(s):  
Chandra Bahadur Pun ◽  
Sarita Tuladhar ◽  
Tirtha Lal Upadhyaya ◽  
Jamuna Gurung ◽  
Durga Dhungana

Background: Diabetes mellitus is a multisystem disease. It has multiple complications like retinopathy, neuropathy, nephropathy, diabetes ketoacidosis, and stroke. Diabetes retinopathy (DR) is one of the blinding complications of diabetes. This study was done to find out the prevalence of diabetic retinopathy among diabetic patients attending in the outpatient department (OPD) of internal medicine, Gandaki Medical College and Teaching Hospital (GMCTHRC), Pokhara, Nepal. Materials and Methods: A hospital based cross-sectional study was performed among the 200 diabetes mellitus patients attending in the medicine OPD from 15th December 2017 to 15thDecember 2018. They were referred to eye OPD of GMC. The detailed eye examination including fundus evaluation under mydriasis was done to all the patients. The diagnosis of DR was graded using the Early Treatment Diabetic Retinopathy Study classification (ETDRS). Patients having hypertension and other retinal diseases were excluded from the study. Data analysis was done using statistical package for social sciences (SPPS) version 11.20. Results: The mean age of the patients was 63.02 ±11.8 years. In our study 60.5% of the patients were male and 39.5% were female. Diabetes retinopathy was seen in 29.5% patients, of which non proliferative diabetes retinopathy (NPDR) was present in 19.5%, proliferative diabetes retinopathy (PDR) in 9.5% and 0.5% had diabetes maculopathy. Conclusion: The prevalence of DR is quite significant in the people with diabetes. Early diagnosis and management of retinopathy will help to avoid blindness due to the diabetic retinopathy.  


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Belayneh Kefale Gelaw ◽  
Abdela Mohammed ◽  
Gobezie Temesgen Tegegne ◽  
Amsalu Degu Defersha ◽  
Muluneh Fromsa ◽  
...  

The objective of this study was to determine the magnitude of nonadherence and its contributing factors among diabetic patients attending the diabetic clinic in Adama Hospital.Methods.This descriptive cross-sectional study was carried out among patients with diabetes mellitus attending the diabetes mellitus clinic of Adama Referral Hospital. Every other patient was selected and data regarding their medication adherence was collected using a structured interview. Data analysis was carried out using SPSS-16.Result.The response rate from this study was 98.3%. A total of 270 patients were interviewed; 51.5% were males. A total of 68.1% of the patients included in the study were married. 14% were younger than 40 years, and 50% were between 40 and 60 years. 21.8% of the participants ascribed their nonadherence to forgetting to take their medications. Patients with duration of diabetes≤5 years (82.07%) were more compliant to their medication than those with>5 years (60.8%), which was found to be statistically significant(P=0.003). Insulin, 47%, and glibenclamide plus metformin, 43.7%, were the most commonly prescribed mono- and combination therapies, respectively. Common comorbid conditions include hypertension, 148 (54.82%), and visual impairment, 89 (32.96%). The proportion of male patients adherent to their antidiabetic medications was found to be lower than 69.78% compared to the female patients (74.81%), but the difference was not statistically significant(P>0.05).Conclusion.Most diabetic patients are currently being managed with the most effective available drugs. However the result from this study indicates that the desired blood sugar level could not be controlled and maintained adequately. This was because of poor adherence to the prescribed drug regimen and poor knowledge and practice of successful self-management.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
A. Majjad ◽  
Y. Errahali ◽  
H. Toufik ◽  
J. H Djossou ◽  
M. A. Ghassem ◽  
...  

Introduction. A variety of musculoskeletal disorders (MS) have been associated with diabetes mellitus (DM). This study aimed at assessing the prevalence and associated factors of MS disorders in Moroccan diabetic patients. Methods. A cross-sectional study enrolled consecutive patients with DM. We recorded demographic features of patients and characteristics of DM. MS disorders and vascular complications were assessed by clinical examinations and investigations. Associated factors of MS disorders were assessed by univariate and multivariate analyses. Result. 376 subjects were included; 84.6% had type 2 DM. The participants’ median age was 54 years [45–62]; 41% had one or more vascular complications. 34.4% had one or more MS disorders. Osteoarthritis was present in 19.4% of patients. Hand disorders were seen in 14.4%. Shoulder capsulitis was present in 12.5%. Long duration of diabetes and dyslipidemia were associated with increased prevalence of hand abnormalities (P=0.017; P=0.019, respectively). Age and dyslipidemia were associated with shoulder capsulitis (P=0.019; P=0.047, respectively). Female gender, overweight, and nephropathy were associated with increased odds of osteoarthritis (P=0.009, P=0.004, and P=0.032, respectively). Conclusion. MS disorders are frequent in this population and associated with various factors. HbA1c level does not appear to be associated with development of MS disorders.


Author(s):  
Mohammed I. M. Ahmed

Background: The level of awareness of diabetic retinopathy is considered an important factor for early diagnosis and management of diabetic retinopathy. This study aimed to assess the level of awareness of diabetic retinopathy among patients with diabetes mellitus in Khartoum, Sudan. Methods: This cross-sectional study was conducted among diabetic patients attending Zeenam and Abdullah Khalil Diabetic Centers between June and September 2018. A convenience sample of diabetic patients was used. Information on the sociodemographic characteristics of the patients, patients’ knowledge, compliance with available treatments, and routine eye examinations was collected using a semi-structured questionnaire. Patients were also asked about the barriers that may interfere with a regular eye examination. Results: A total of 200 patients were enrolled and 94 (47%) of them were female; 13% of the respondents were diagnosed with diabetic retinopathy, 31.5% were hypertensive, and 13.5% had hyperlipidemia. Additionally, 88.5% of the patients were aware that DM can affect their eyes and 87% had never been diagnosed with diabetic retinopathy. Although around 83% thought that diabetic retinopathy could lead to blindness, only 35.5% of them had undergone fundus examination by ophthalmologists. Moreover, 39% of the participants had irregular diabetes follow-up and 43% monthly follow-up. Only 31% went for regular eye check-up; however, their compliance with routine retinal assessment was poor, with a total of 72.5% of participants assuming that they have good vision and need not get their eyes checked up regularly. The chief factor that was related to increased awareness of diabetic retinopathy in the study was the level of education. Conclusion: Although a large proportion of diabetic patients in Khartoum are aware that diabetes mellitus can affect their eyes, regular retinal assessment of patients was poor, thus hindering early diagnosis and management.


2020 ◽  
Vol 2 (1) ◽  
pp. 14-18
Author(s):  
Adnan Khan ◽  
Tajamul Ahmad ◽  
Nadia Afridi ◽  
Madiha Anees ◽  
Bilal Khan

Introduction: A fall may be defined as a loss of balance, resulting in coming to rest on the ground or on another object below knee level. Fear of all or Basophobia is a condition of concern towards falls and natural fear of unable to stand or walk. Since the identification of the post-fall syndrome, fear of fall is considered the major health issue among elderly population. Therefore, this study was conducted to measure the level of fear of fall and factors which might contribute to it. Material & Methods: It was a cross sectional study conducted to measure the level of fear of fall among the diabetic patients of Hayatabad Medical Complex Peshawar. According to the inclusion criteria, participants who had age more than 40 years and diabetic history of more than 2 years were included in the study. We measured the fear of fall with age, gender and duration of diabetes mellitus. Convenient sampling technique was used for the recruitment of the participants. Data was collected by self-repored questionnaires and was analyzed by SPSS 20.0 version. Results: A total of 306 participants, 164 (53.59%) males and 142 (46.40%) female with a mean age 56.02 ± 9.68 years (mean ± sd) were recruited. The level of fear of all was high in diabetic patients in which 222 (72.5%) participants showed high, 48 (15.7%) moderate and 36 (11.8%) low concerns. Conclusion: Fear of fall is a common problem in both male and female population having diabetes mellitus. It is one of the major concerns among patients with diabetes. It has a positive relation with age, duration of DM, and insulin intake.


2021 ◽  
Author(s):  
Md. Shahed Morshed ◽  
Abdullah Al Mosabbir ◽  
Mohammad Sorowar Hossain

AbstractThe current coronavirus disease 2019 (COVID-19) outbreak was reported to cause significantly higher mortality and morbidity among patients with diabetes mellitus (DM). Although Bangladesh is amongst the top 10 countries with diabetic people, data on these patients with COVID-19 is scarce from this region. This study aimed to illustrate the clinical features and outcomes of hospitalized patients with COVID-19 and DM in Bangladesh while comparing survivors and deceased.This retrospective cross-sectional study was conducted among RT-PCR confirmed COVID-19 patients with pre-existing Diabetes Mellitus in a specialized COVID-19 hospital in Bangladesh. Data from hospital records were analyzed.Among 921 RT-PCR confirmed COVID-19 admitted during the study period, 231 (∼25%) patients with pre-existing DM (median age 60 years) were included in the analysis. The death rate among all hospitalized patients (with and without DM) was 2.8% compared to 11.3% among diabetic patients. The median hospital stay was 13 days (IQR 10.5, 17.0) for survivors and five days (IQR 2.0-8.3) for the deceased. The clinical features were not significantly different between survivors and the deceased. However, deceased patients had significantly lower blood oxygen level (85% vs 93%, p <0.001), and higher neutrophil-lymphocyte ratio (7.9 vs 4.5, p 0.003) and serum ferritin (946.0 vs 425.0 ng/ml, p 0.03). Glycemic status was poor in both groups.This study would help identify a subgroup of diabetic patients with COVID-19 who are at higher risk of in-hospital death and improve clinical decision making.


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