scholarly journals To study the impact of glycemic control over cardiac autonomic neuropathy in type 1 and type 2 diabetics patients using bedside tests at a tertiary care hospital

2017 ◽  
Vol 4 (3) ◽  
pp. 635
Author(s):  
Sumaiya Anjum ◽  
Suresh K.
Keyword(s):  
Glycemic Control ◽  
Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Glycemic Status ◽  
Type 2 Diabetics ◽  
The Impact

Background: Cardiac autonomic neuropathy a serious complication of diabetes and is often overlooked. It is associated with higher cardiovascular mortality and poor quality of life in diabetic individuals. The Glycemic control has been well established as the risk factor for all the diabetes related microvascular and macrovascular complications. This stresses importance of role of glycemic control over CAN in Type 1 and Type 2 Diabetics in order to stop further progression to advanced and irreversible stages. The objective was to study the impact of various demographic and other clinical factors over prevalence of CAN in type 1 and type 2 diabetic patients who are asymptomatic for CAN using bedside testsMethods: A case control comparative clinical study was undertaken comprising of 100 diabetic patients, both type 1 and type 2 with duration from 5-10 years and >10 years. The tests which were performed are deep breathing test, heart rate response to standing, hand grip test, cold pressor test, BP response to standing. Depending on these tests, patients were categorised as patients with cardiac autonomic neuropathy and without cardiac autonomic neuropathy.Results: The prevalence of cardiac dysautonomia was 68%. Type 2 diabetics had higher prevalence of cardiac dysautonomia than type 1 diabetics (p=0.025). Significant correlation was observed between cardiac autonomic neuropathy and poor glycemic status (type 1 p<0.001; type 2 p<0.001). The mean HbA1c in patients with and without CAN in type 1DM was 9.16+0.81 and 7.21+0.56 and in type 2 DM was 9.15+1.72 and 7.15+0.53 respectively. Similarly, presence of other microvascular complications increased the prevalence of CAN in both types of diabetes mellitus.Conclusions: Cardiac autonomic neuropathy is a common complication in long standing diabetes. Present results suggest that glycemic status of the diabetics is undoubtedly an important factor for the onset of cardiac dysautonomia which in turn account for high prevalence of cardiac mortality in diabetic patients. All asymptomatic diabetic patients should be evaluated for the presence of autonomic neuropathy and glycemic status should be controlled to prevent the further progression of CAN.

scholarly journals Cardiac autonomic neuropathy in diabetic patients

2019 ◽  
pp. 52-56
Author(s):  
A. A. Belyaev ◽  
O. V. Kotova ◽  
E. S. Akarachkova
Keyword(s):  
Autonomic Neuropathy ◽  
Clinical Manifestations ◽  
Cardiac Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Autoimmune Reaction ◽  
Obstructive Sleep ◽  
Key Points ◽  
Patients With Diabetes ◽  
The Impact

Cardiac autonomic neuropathy (CAN) is a common and insufficiently diagnosed complication of diabetes mellitus. This is usually due to the fact that the disease runs asymptomatically until the very late stages. The impact of CAN on patients with diabetes can be devastating, because CAN is associated with increased mortality, cardiovascular disease, chronic kidney disease. CAN prevalence: 17-66% in patients with type 1 diabetes and 31–73% in patients with type 2 diabetes. Hyperglycemia, autoimmune reaction, genetic factors, obstructive sleep apnea, and inflammation are the key points in the pathogenesis of neuropathies in diabetes, in particular, CAN. Clinical manifestations of CAN and risk factors of CAN development in patients with diabetes are considered. Early diagnosis of CAN is of vital importance for the success of therapy, as there is an assumption that denervation of cardiovascular system may be reversible if diagnosed soon after its beginning. Antioxidant, vasoactive and vitamin therapy is used in the treatment of CAN. Emphasis is placed on the use of the injection form of Neuromultivitis.

scholarly journals Evaluating the Synergistic Activity of Metformin and Apple Cider Vinegar in Type 2 Diabetics

2020 ◽  
pp. 1-7
Author(s):  
Momina Abid ◽  
Farah Ahmed ◽  
Shehla Shaheen ◽  
Zahida Memon ◽  
M. Zaman Shaikh ◽  
...  
Keyword(s):  
Glycemic Control ◽  
The Body ◽  
Diabetic Patients ◽  
Synergistic Activity ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Type 2 Diabetic Patients ◽  
Apple Cider ◽  
Type 2 Diabetic

Aims: The aim of this study was to observe the effect of Apple Cider Vinegar (ACV) in combination with Metformin on the Body Mass Index (BMI) and glycemic control of newly diagnosed type 2 diabetic patients. Study Design: Single arm pre post quasi experimental clinical trial. Place and Duration of Study: Department of Medicine of a tertiary care hospital and a Diabetes and Endocrinology clinic, based in Karachi, Pakistan from April to July 2019. Methodology: A total of 30 newly diagnosed type 2 diabetic patients were enrolled in the study (Males: 17; females: 13; age range: 27-55 years) after obtaining written informed consent. The parameters of Body weight, BMI, Fasting Blood Sugar (FBS) and Hemoglobin A1c (HbA1c) of each patient were assessed before and after 12 weeks of treatment with Metformin 750 mg plus 2 tablespoons of ACV per day. The baseline and post treatment values of the aforementioned were compared with each other. Results: In all the 30 patients assessed after 12 weeks of treatment, the weight was significantly reduced from 85.66±18.30 kg. to 82.96±18.43 kg with a consequently significant change in the BMI from 29.38±5.08 kg/m2 to 28.43±5.16 kg/m2. Moreover, the glycemic control, assessed as FBS and HbA1c also showed significant reduction in the FBS (127.76±9.17 to 121.23±9.54) and HbA1c (7.14±0.29 to 6.92±0.29) after 12 weeks of treatment in all 30 patients (p<0.01). Conclusion: Apple Cider Vinegar seems to be effective therapy in combination with metformin for newly diagnosed type 2 diabetic patients in improving glycemic control as well as augmenting weight reduction.

Vitamin D & cardiac autonomic neuropathy in newly diagnosed type 2 diabetics : A pilot study

2019 ◽  
Vol 493 ◽  
pp. S283-S284
Author(s):  
R. Sharma ◽  
P. Sharma ◽  
S. Sharma ◽  
S. Ravichandran ◽  
P. Kamble ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pilot Study ◽  
Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy ◽  
Newly Diagnosed ◽  
Type 2 Diabetics

scholarly journals Comparison of Effectiveness between DPP4 inhibitors combined with Versus Other Oral Hypoglycaemic Agent(s) in Diabetic patients

2019 ◽  
Vol 30 (2) ◽  
pp. 63-70
Author(s):  
Md Shameem Haidar
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Combination Group ◽  
Diabetic Patients ◽  
Glycemic Status ◽  
Good Glycemic Control ◽  
Dpp4 Inhibitor ◽  
Number Of Patients ◽  
Inhibitor Combination

Background: Diabetes is global health burden of disease that requires life-long pharmacological and non-pharmacological management to prevent complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathy. Treatment of type 2 diabetes is based on an interplay of patient characteristics, severity of hyperglycemia and available therapeutic options. Metformin, sulfonylureas (SU) and DPP IV inhibitor are the most studied of the oral medications used worldwide. They play a prominent initial role in the type 2 diabetes treatment algorithm recommended by the several guideline. The growing evidence on new technologies and therapeutic interventions is rapidly expanding our knowledge and ability to manage diabetes and its complications; at the same time, however, it is challenge for physicians to select appropriate medication in appropriate dose for optimal patients care. Objectives: To compare the safety and efficacy of the dipeptidylpeptidase-4 (DPP-4) inhibitors combination with other oral hypoglycaemic agent(s) in patients with type 2 diabetes and inadequate glycemic control. Materials & method: Study was conducted among 600 patients over a period of 24 months. All the patients were adult male and female type 2 diabetic patients who received regular oral anti-diabetic drug(s) and duration of T2DM for one year or more were enrolled for study. Total 150 cases were selected. Patients with Type 1 DM, pregnant women with DM and who was receiving injectable antidiabetic medications were excluded from this study. Detail demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigations were done. Main outcome variable was Glycemic status (HbA1C, FBG, 2HABF). Effectiveness of drugs was evaluated by glycaemic status of the patients. Result: Maximum number of patients (38.5%) was between 31-40 years age group with mean age 37.8±9.5 years. Present study shows that, for good glycemic control, all three results (FBS, 2H ABF and HbA1c) were within targeted level in majority patients of DPP4 Inhibitor combination group. Although FBS was best result in metformin group. About 51.9% of SUs group achieved the glycemic control targets level. In case of metformin group it was in 59.8% of patients, and in combined therapy 67.1% patients shows good glycemic target. So DPP4 Inhibitor combination is better medication than other to maintain good glycemic status in type 2 DM patient, due to maximum number of patients reached all three components of result within target range. Conclusion: Diabetes is chronic illness. Good glycemic control with choosing appropriate anti-diabetic medication is pivotal for DM management. In this study it is observed that DPP4 Inhibitor combination group of drug is better than other anti-diabetic medication to maintain good glycemic status in type 2 DM patients. Bangladesh J Medicine July 2019; 30(2) : 63-70

scholarly journals Retinopathy in Newly Diagnosed Type 2 Diabetics with a special stress on the importance of glycemic control

2014 ◽  
Vol 14 (1) ◽  
pp. 39-42
Author(s):  
Rashi Khare ◽  
Narender S Senger
Keyword(s):  
Glycemic Control ◽  
Microvascular Complications ◽  
Medical Science ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Major Health Problem ◽  
Mortality And Morbidity ◽  
Type 2 Diabetics ◽  
Special Stress

Background: Diabetes mellitus (DM) is a major health problem with long-term microvascular and macrovascular complications responsible for the majority of its mortality and morbidity. The development and progression of diabetic complications are strongly related to the degree of glycemic control. The purpose of this study was to study, the incidence of retinopathy in newly diagnosed diabetics and its association with various risk factors with a special stress on role of HbA1c levels. Methods: We analysed 300 newly diagnosed type2 diabetics (diagnosed within 6 months). Patients were subject to detailed history, examination (including retinal examination), and investigations including serum creatinine, urinary micro-albumin, 24 hours urinary protein, HbA1c and ultrasonography. Results: Incidence of retinopathy in newly diagnosed type 2 diabetics was 30% (91/300). With increase in HbA1c, the incidence of retinopathy increased. All results were statistically proven. Conclusion: Incidence of retinopathy in newly diagnosed type2 diabetics is as high as 30%. Glycemic control is the an important factor contributing to development of this microvascular complications in diabetic patients. DOI: http://dx.doi.org/10.3329/bjms.v14i1.16535 Bangladesh Journal of Medical Science Vol.14(1) 2015 p.39-42

scholarly journals Cardiovascular Autonomic Neuropathy and Early Atherosclerosis in Adolescent Type 1 Diabetic Patient

2015 ◽  
Vol 3 (4) ◽  
pp. 681-688 ◽  
Author(s):  
Soha M. Abd El Dayem ◽  
Ahmed A. Battah ◽  
Abo El Magd El Bohy
Keyword(s):  
Coronary Artery ◽  
Autonomic Neuropathy ◽  
Clinical Laboratory ◽  
Cardiovascular Autonomic Neuropathy ◽  
Stepwise Multiple Regression ◽  
Cardiac Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Laboratory Assessment ◽  
Early Atherosclerosis

AIM: To evaluate cardiovascular autonomic neuropathy (CAN) in type 1 Diabetics and to detect its relation to coronary artery calcification.PATIENTS AND METHODS: It is a cross sectional study included 62 diabetics and 30 controls. Clinical, laboratory assessment and 24 Hr holter were done for all patients and controls and coronary artery calcium (CAC) scoring by multisclice CT was done for all patients only. T-test, Mann Whitney U test, and stepwise multiple regression were used for statistical analyses.RESULTS: CAC score was positive in 8.1 % of patients. Heart rate variability (HRV) was significantly lower in diabetics. All parameters of HRV were insignificantly lower in diabetics with positive CAC score. Patients with microalbuminuria had a significantly lower HRV. HRV had a significant correlation with age of patients, duration of disease, HbA1, and Qtc in diabetics.CONCLUSION: Percentage of arrhythmia and early atherosclerosis is high in adolescent type 1 diabetic patients. CAN is associated with early atherosclerosis. Cardiac autonomic neuropathy is associated with older age, longer duration, and poor glycemic control and microalbuminuria.

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