scholarly journals Electrolyte imbalance in type 2 diabetes: a case study from the West region of Cameroon

Author(s):  
Jean Pierre D. Sayouba ◽  
Milca Asanghanwa ◽  
Abel J. Njouendou ◽  
Henri L. Kamga ◽  
Jules C. N. Assob

Background: Diabetes mellitus remains a global public health challenge despite advances in medicine, with Cameroon harboring about half a million patients. Electrolyte imbalance has been reported to contribute to the complications observed in diabetes. The aim of this study was to investigate electrolyte disturbances in type 2 diabetic (T2D) patients under follow up in two health facilities (Dschang District Hospital and Bafoussam Regional Hospital) of the West Region of Cameroon.Methods: The study involved 200 T2D patients and 50 non-diabetic control subjects. A questionnaire was used to acquire demographic, anthropometric, clinical and psychosocial data. Fasting blood samples were collected for the determination of fasting plasma glucose (FPG), glycated haemoglobin, calcium, potassium and sodium levels. The diabetic population was divided into two and three groups according to their glycated hemoglobin and FPG levels respectively. The Student’s t-test was used to compare mean values between patients and controls, while the chi square test was used to assess for differences between categorical variables. The significance level was set at 5%.Results: Almost all diabetic patients were diagnosed of hypernatremia (98%) versus 70% for the control group (p<0.001). There was no record of hyponatremia. Hypercalcemia was observed in 30% of the diabetic patients and hypocalcemia in 48%. The prevalence of hyperkalemia was comparable between patients and controls, while control subjects tended to be more hypokalemic (p=0.038). For all three electrolytes investigated, more than 70% of the imbalances were observed in patients with hyperglycemia when compared to patients having normal FPG or hypoglycemia.Conclusions: Electrolyte imbalance is common in type 2 diabetic patients from the West Region of Cameroon, especially those presenting with hyperglycemia.

2021 ◽  
Vol 12 ◽  
Author(s):  
Fuyao Yu ◽  
Bing He ◽  
Li Chen ◽  
Fengzhe Wang ◽  
Haidong Zhu ◽  
...  

ObjectiveSkeletal muscle fat content is one of the important contributors to insulin resistance (IR), but its diagnostic value remains unknown, especially in the Chinese population. Therefore, we aimed to analyze differences in skeletal muscle fat content and various functional MRI parameters between diabetic patients and control subjects to evaluate the early indicators of diabetes. In addition, we aimed to investigate the associations among skeletal muscle fat content, magnetic resonance parameters of skeletal muscle function and IR in type 2 diabetic patients and control subjects.MethodsWe enrolled 12 patients (age:29-38 years, BMI: 25-28 kg/m2) who were newly diagnosed with type 2 diabetes (intravenous plasma glucose concentration≥11.1mmol/l or fasting blood glucose concentration≥7.0mmol/l) together with 12 control subjects as the control group (age: 26-33 years, BMI: 21-28 kg/m2). Fasting blood samples were collected for the measurement of glucose, insulin, 2-hour postprandial blood glucose (PBG2h), and glycated hemoglobin (HbAlc). The magnetic resonance scan of the lower extremity and abdomen was performed, which can evaluate visceral fat content as well as skeletal muscle metabolism and function through transverse relaxation times (T2), fraction anisotropy (FA) and apparent diffusion coefficient (ADC) values.ResultsWe found a significant difference in intermuscular fat (IMAT) between the diabetes group and the control group (p&lt;0.05), the ratio of IMAT in thigh muscles of diabetes group was higher than that of control group. In the entire cohort, IMAT was positively correlated with HOMA-IR, HbAlc, T2, and FA, and the T2 value was correlated with HOMA-IR, PBG2h and HbAlc (p&lt;0.05). There were also significant differences in T2 and FA values between the diabetes group and the control group (p&lt;0.05). According to the ROC, assuming 8.85% of IMAT as the cutoff value, the sensitivity and specificity of IMAT were 100% and 83.3%, respectively. Assuming 39.25ms as the cutoff value, the sensitivity and specificity of T2 value were 66.7% and 91.7%, respectively. All the statistical analyses were adjusted for age, BMI and visceral fat content.ConclusionDeposition of IMAT in skeletal muscles seems to be an important determinant for IR in type 2 diabetes. The skeletal muscle IMAT value greater than 8.85% and the T2 value greater than 39.25ms are suggestive of IR.


Background: Adiponectin is a collagen-like plasma protein secreted by adipocytes that has been suggested to play a causal role in the development of insulin resistance. Even though hypoadiponectinaemia is reported to be closely associated with obesity-related diseases such as ACVD, type 2 DM, dyslipidaemia, report from our environment is lacking. Materials and Methods: Serum adiponectin, insulin and glucose were measured in 90 type 2 diabetic and control subjects respectively. The patients were known diabetics attending the diabetic clinic at the ABUTH, Zaria. The control subjects were apparently healthy individuals within the hospital and Zaria environs. Results: Mean serum adiponectin levels were significantly lower (P<0.05) in the diabetic patients than in the control subjects. On the other hand, the mean values of insulin and glucose were significantly higher (P<0.05) in the diabetic patients than in the controls. Conclusion: Measurement of serum adiponectin as an adjunct in the biochemical assessment of type 2 DM is suggested.


2013 ◽  
Vol 10 (3) ◽  
pp. 44-47 ◽  
Author(s):  
Naval Kishor Yadav ◽  
C Thanpari ◽  
MK Shrewastwa ◽  
RK Mittal

Background Type-2 diabetes mellitus is an independent risk factor for coronary artery disease and risk of coronary disease is three to four fold increased in patients with diabetes compared with non-diabetic population and 60-80% 0f type-2 diabetics are obese. Methods This study was conducted in Nepalgunj Teaching Hospital, Kohalpur, Banke, Nepal, between 1st March, 2011 and 28th February, 2012. A total of 150 samples were taken to assess the lipid profile in type-2 diabetic patients associated with obesity and 25 obese controls for their lipid profile. Venous blood samples were taken from all the subjects in the morning after fasting overnight. Exclusion criteria included pregnancy, chronic infectious disease, heart failure; renal failure and drug allergy were confirmed from the subject’s personal physician report and a detailed history. The data was analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version. Results The mean ± SD age of diabetic patients with obesity was 53.76 ± 6.23 while the mean ± SD age of control was 49.61 ± 4.8. Out of 150 patients 105 (70%) were males and 45 (30%) were females. Among control subjects 16 (64%) were males and 9 (36%) were females. Obese type-2 diabetic patients when compared to obese control subjects showed statistically significant increase in the levels of serum total cholesterol (p ? 0.001), serum triglycerides (p ? 0.001), serum LDL-cholesterol (p ? 0.001) while serum HDL-cholesterol levels did not show statistically significant difference in the two group (p ? 0.05). Conclusion This study showed obese diabetic individuals have dyslipidemia and more prone to develop cardiovascular diseases. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 44-47 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8017


Endocrine ◽  
2021 ◽  
Author(s):  
Francesco Mozzanica ◽  
Anna Ferrulli ◽  
Stela Vujosevic ◽  
Alessandro Montuori ◽  
Arianna Cardella ◽  
...  

Abstract Purpose Scarce information on the prevalence and characteristics of olfactory disfunction (OD) in type 2 diabetic (T2D) patients are available. The aims of this study were (1) to assess the olfactory function in T2D patients and to compare it with a control group of individuals without T2D, and (2) to evaluate the differences in OD within T2D patients according to the presence of diabetic complications. Methods A group of 39 T2D patients and a control group of 39 healthy individuals were enrolled. Each subject underwent an evaluation of the olfactory performance using the Sniffing Olfactory Screening Test (SOST) and completed a questionnaire assessing the subjective perception of olfaction. According to the presence of diabetic complications, the group of T2D patients was divided into two subgroups. Non-parametric tests and regression analysis were used for statistical analysis. Results No differences in the subjective perception of olfaction were demonstrated among T2D patients (with and without complications) and controls. A significant difference for the SOST score was demonstrated among the different groups. In particular, OD was more frequent in T2D patients than in controls. In addition, OD was far more frequent in T2D patients with complications. Regression analysis did not demonstrate any significant association between OD and clinical/demographic characteristics of T2D patients. Conclusion T2D patients were more frequently affected by OD. The subgroup analysis suggested a possible relationship between OD and diabetic complications since patients with T2D diabetic complications demonstrated lower olfactory abilities than controls subjects and T2D patients without diabetic complications.


2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Duong Thi Thuy Ngan ◽  
Nguyen Gia Binh ◽  
Le Thi Huong Lan ◽  
Cuc Thi Thu Nguyen ◽  
Phung Thanh Huong

Summary Background Albuminuria is the standard biomarker for the diagnosis of diabetic nephropathy (DN). However, some patients with persistent microalbuminuria still progress to chronic kidney disease, raising the question of finding a better biomarker. This study aimed to evaluate the correlation of urinary liver-type fatty acid-binding protein (L-FABP) levels with renal function and to compare the role of urinary albumin-to-creatinine ratio (ACR) with urinary L-FABP in early detection of DN in type 2 diabetic patients. Methods The cross-sectional study was done on 106 type 2 diabetic patients and 30 non-diabetic people. L-FABP was measured with the Latex enhanced immunoturbidimetric technique. Results There was a strong and negative correlation between the urine L-FABP levels and eGFR (r = -0.606, p<0.001). The urinary L-FABP levels were significantly higher (p<0.001) in the normoalbuminuria diabetic group than the non-diabetic control group. The ROC-curve analyses in the diabetic patients and the normoalbuminuria diabetic patients showed that the AUCL-FABP was remarkably higher (p<0.001) than the AUCACR. An optimal cutoff value of 5 mg L-FABP/g Cr (with the sensitivity of 98.1% and specificity of 90%) and of 4.3 mg L-FABP/g Cr (with the sensitivity of 100% and specificity of 86.67%) was set to detect DN in the diabetic patients and the normoalbuminuria diabetic patients, respectively. Conclusions The change in urinary L-FABP levels happened earlier than in urinary albumin during renal function impairment. Urinary L-FABP can be used as a better indicator than ACR for early detection of DN in type 2 diabetes.


2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Sadia Sharif ◽  
Naureen Sarwar ◽  
Bushra Nisar ◽  
Muhammad Khalid Masood ◽  
Asim Hameed

AbstractBackground:  Diabetes mellitus is an extremely common endocrine metabolic disorder that results in chronic hyperglycemia. It has effects on various tissues of the body. Due to this increased blood glucose levels considerable cellular changes occur in oral cavity as well. This field has attracted little research. The aim of the study was to analyze the changes in morphology and cytomorphometric measurements in the buccal mucosal cells of type 2 diabetic patients.Objectives:  The Objective of this study was to detect the cytological and morphological alterations of oral epithelial cells, in type 2 diabetic patients and healthy control subjects in exfoliated cytology smears, to com-pare the cytoplasmic diameter, nuclear diameter, and nucleus: cytoplasm ratio in type 2 diabetics and heal-thy control subjects and to analyze the above mentioned cellular alterations in patients with controlled and uncontrolled diabetes.Methods:  Cross-sectional analysis was performed in three groups on the bases of HbA1c levels. Group 1 was uncontrolled diabetics with HbA1C ≥ 7.0%, Gro-up 2 was well controlled diabetics with HbA1c ≤ 7.0% and Group 3 was Control healthy having HbA1C ≤ 5. 6%. Smears from normal buccal mucosa were obtai-ned from each subject and stained with Papanicolaou method. An eyepiece micrometer was used to take mean values of ND, CyD, and N: C ratio. Fifty (50) clearly defined cells were measured in each case in a step wise manner, to evade quantifying cells once more. Comparison of Nuclear Diameter (ND), Cytoplasmic Diameter (CY D) and ratio of two Diameters (N: C) among three groups was performed by using ANOVA. TUKEY’S test for post –hoc analysis was used where required.Results:  The variability in diameter of nucleus among all three sample groups showed significant p-value < 0.001.Whereas the measurement for cytoplasmic diameter between three groups was not significant (p-value 0.178). The ratio of nuclear diameter to cytoplasmic diameter calculated was significant (p-value < 0.001). Hence it proved from the results that considerably exaggerated ND and N: C ratios were seen as the glycemic control (HbA1C) is poorer.Conclusion:  The results suggested that nuclear size of buccal mucosal cells increased in type 2 diabetic pati-ents while no change was observed in cytoplasmic dimensions.


1994 ◽  
Vol 71 (05) ◽  
pp. 692-697 ◽  
Author(s):  
Paul Knöbl ◽  
Guntram Schernthaner ◽  
Christoph Schnack ◽  
Peter Pietschmann ◽  
Sylvia Proidl ◽  
...  

SummaryDiabetes mellitus is associated with disturbances of the haemostatic system, which might contribute to the development of diabetic vascular disease. We investigated the effect of metabolic improvement by insulin therapy on the haemostatic system in 61 patients with type 2 diabetes mellitus and secondaxy sulfunyluiea failure compared with 45 healthy control subjects matched for age, sex and BMI. Median age was 65, median diabetes duration 10 years. Median HbA1c (10%) and fructosamine (4.0 mM) levels were elevated before induction of therapy and decreased significantly within 6 months of insulin treatment to 7.5% and 3.0 mM, respectively (p <0.0001). Compared with control subjects, median plasma levels of fibrinogen (317 vs 286 mg/dl), coagulation factor VII activity (1.1 vs 0.89 U/1), von Willebrand factor (1.6 vs 1.3 U/1), D-dimer (105 vs 86 jug/1), protein C:Ag (1.24 vs 0.95 U/1), total protein S:Ag (1.15 vs 0.91 U/1), and antithrombin III activity (1.17 vs 1.08 U/1) were significantly elevated. Levels of free protein S were not different from control values. No significant decline of coagulation parameters could be recorded during insulin therapy. Patients with diabetic vasculopathy had higher levels of D-dimer than those without (133 vs 76 μg/1 before, 109 vs 88 μg/1 during therapy), whereas the other haemostatic parameters were not different. Our data indicate a significant activation of the coagulation system in diabetic patients with secondary failure to sulfonylurea drugs, with signs of a prethrombotic state and endothelial cell disturbance. Induction of insulin therapy results in a significant improvement of glycaemic and lipid metabolism, but the persisting enhanced activity state of the haemostatic system might contribute to the increased cardiovascular mortality of type 2 diabetic patients.


2021 ◽  
pp. 59-60
Author(s):  
Maniazhagu Dharuman

The purpose of study was to nd out the effects of isolated and combined effects of aerobic dancing and resistance training on resting pulse rate of type-2 diabetic patients. To achieve the purpose of the study, 60 type 2 diabetic patients with the age of 40-45 years from Karaikudi town, Sivaganga District, Tamilnadu were selected as subject at random. The study was formulated as pre and post test random group design, in which sixty subject were divided into four equal groups. The experimental group-1 (n=15, AD) underwent aerobic dancing, experimental group-2 (n=15, RT) underwent resistance training, experimental group – 3 (n=15, COM-T) underwent combined practice of aerobic dancing and resistance training and group-4 (n=15, CG) served as a control group. In this study, three training programme were adopted as independent variable, i.e., aerobic dancing, resistance training and combined training. The resting pulse rate was chosen as dependent variable. It was tested by number of beats per minute, scores recorded in number. The collected pre and post data was critically analyzed with apt statistical tool of analysis of co-variance. The Scheffe's post hoc test was used to nd out pair-wise comparisons between groups. The results of the present study proved that the three training interventions have signicantly altered the resting pulse rate.


2004 ◽  
Vol 287 (3) ◽  
pp. H1225-H1231 ◽  
Author(s):  
Lucilla D. Monti ◽  
Claudio Landoni ◽  
Emanuela Setola ◽  
Elena Galluccio ◽  
Pietro Lucotti ◽  
...  

We evaluated the influence of chronic hypertriglyceridemia and endothelial dysfunction on myocardial glucose uptake (MGU) in Type 2 diabetic patients without coronary heart disease. Patients were divided into two groups according to fasting triglyceride (TG) levels: 5.4 ± 1.1 and 1.5 ± 0.3 mmol/l for high- and normal-TG groups, respectively. Five subjects were assigned to the high-TG group and 11 to the normal-TG group. Age, gender, body mass index, systolic and diastolic blood pressure, glucose, insulin, HbA1c, cholesterol, and HDL cholesterol were similar in the two groups, whereas free fatty acid (FFA) levels were higher in the high-TG group basally and at the end of the clamp. Furthermore, five healthy subjects were subjected to the same protocol and used as the control group. MGU was assessed by using 18F-labeled 2-fluoro-2-deoxy-d-glucose under hyperglycemic-hyperinsulinemic conditions. Basal endothelin-1 and nitric oxide levels were significantly higher in the high-TG group than in the normal-TG and control groups, and cGMP and maximal postischemic vasodilation were significantly decreased in the high-TG group compared with the normal-TG and control groups. However, significant alterations were found in the same parameters in the normal-TG group compared with the control group. By the end of the hyperglycemic clamp, in the high-TG group, MGU was ∼40 and 65% of that in the normal-TG and control groups. MGU negatively correlated with TG, FFA, and endothelin-1, whereas a positive correlation was found with cGMP and maximal postischemic vasodilation. In conclusion, increased TG and FFA levels are risks, in addition to Type 2 diabetes mellitus, for myocardial insulin resistance, endothelial dysfunction, and alteration of nitric oxide/cGMP levels.


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