Study of anemia in diabetes and its association with diabetic retinopathy

Background: Anemia is an increasingly recognized entity in patients with diabetes mellitus. Reduced hemoglobin levels identify diabetic patients with an increased risk of microvascular complications.Methods: A hospital based observational prospective study was conducted in Department of medicine, J.A. Group of Hospitals, Gwalior from June 2014 to October 2015. Adults with diabetes mellitus both type 1 and type 2 were selected as subjects are included and anemia due to blood loss and anemia due to chronic kidney diseases were excluded from the study. Estimation of hemoglobin was done by using capillary method by calorimetric hemoglobinometer. Anemia was defined as hemoglobin <13 g/dl in men and <12 g/ dl in women. All the patients were examined for diabetic retinopathy and graded as none, mild, moderate, severe and proliferative retinopathy as per International clinical diabetic retinopathy disease severity scale.Results: 100 patients were enrolled as subjects. Most of the patients 26 (26%) were in the age group 46-55 years. There were 53 males and 47 females. 42%, 45% and 13% had diabetes of <5 years, 5-10 years and > 10 years duration respectively. HbA1c levels were <7.5 in 74 (74%), 7.5-10 in 23 (23%) patients and > 10 in 3 (3%) patients. Overall 67 (67%) diabetics had anemia. Out of 53 males 30 (56.6%) had anemia and amongst females, out of 47 cases 37 (78.72%) had anemia P value 0.009. Anemia was more common in patients less than 50 years 36 (70.59%) compared to31 (63.2%) with anemia in patients more than 50 years. 65 (65%) patients had diabetic retinopathy (DR). 30 (46.1%) males and 35 (53.8%) females had diabetic retinopathy. All patients with diabetic retinopathy had anemia. Among 35 (35%) patients without DR only 2 (5.71%) had anemia. P value <0.001.Conclusions: Anemia is a common accompaniment to diabetes. Anemia was more common in females and in those less than 50 years. Anemia was frequently associated with diabetic retinopathy. The high prevalence of anaemia supports regular screening for anemia, alongside that for other diabetes-related complications. This might help to delay the progression of vascular complications in these patients.

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PERBEDAAN PENGETAHUAN DAN SIKAP PASIEN DIABETES MELLITUS RAWAT INAP RUMAH SAKIT ISLAM SAMARINDA SEBELUM DAN SESUDAH KONSELING GIZI DENGAN MENGGUNAKAN MEDIA AUDIOVISUAL

Jurnal Ilmiah Manuntung ◽

10.51352/jim.v2i1.39 ◽

2017 ◽

Vol 2 (1) ◽

pp. 8

Author(s):

Siswanto Siswanto ◽

Ismail Kamba ◽

Siti Aminah

Keyword(s):

Diabetes Mellitus ◽

Public Health Problem ◽

Visual Media ◽

P Value ◽

Diabetic Patients ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Disease Mortality ◽

Before And After ◽

Patients With Diabetes

Diabetes mellitus is one of the communicable diseases that have become a public health problem, not only in Indonesia but also the world. Currently morbidity of diabetes mellitus is increasing every year, where in 2006 there were 14 million people in 2011 and ranks fourth with 773 cases. DM is also a cause of disease mortality by 5.8%. And Samarinda own particular Islamic Hospital years 2009, there were 449 patients with DM, and 2011 an increase in the 1931 patients with diabetes mellitus. To increase patients’ knowledge about diabetes and diabetic patients be directing attitudes that support or positive attitude towards keeping blood glucose levels to remain normal. Methode to use pra eksperiment with one group pretest posttest. individual conseling withAudiovisual media. There is increased knowledge about diabetes diabetic patients before and after intervention with increasing value of 3.77 (p value = 0.000) and increase in attitudes regarding diabetes mellitus diabetic patients with an increase in the value of 5,35 (p value = 0.003). There was an increase in knowledge and attitudes of patients hospitalized with diabetes mellitus hospital after islam samarinda given nutritional counseling using audio-visual media

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A Study to Evaluate the Quality of Life of Patients with Diabetes Mellitus

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i47b33157 ◽

2021 ◽

pp. 575-585

Author(s):

P. Amulya Reddy ◽

K. Saravanan ◽

A. Madhukar

Keyword(s):

Diabetes Mellitus ◽

Diabetes Management ◽

Study Data ◽

Categorical Variables ◽

P Value ◽

Diabetic Patients ◽

Physical Endurance ◽

Glucose Levels ◽

Patients With Diabetes ◽

History Of

Aim: The aim of the study was to evaluate the QOL of patients with Diabetes Mellitus. Study Design: This was a prospective, observational study. Duration of Study: The study was conducted from August 2019 to January 2021 in Yashoda Hospital, Hyderabad. Methodology: Patients of either sex with ≥1year history of diabetes willing to give the consent were included in the study. Patients of either sex with <1year history of DM, Pregnant/lactating women and patients not willing to give the consent were excluded from the study. Data on Blood glucose levels (FBS, PPBS) and HbA1C was also obtained and assessed. QOLID questionnaire was administered to the patients and assessed which consisted of a set of 34 items representing 8 domains such as Role limitation due to the physical health, Physical endurance, General health, Treatment satisfaction, Symptom botherness, Financial worries, Mental health, and Diet satisfaction). Results: A total of 200 patients were analysed in the study,108(54%) were males and 92(46%) were females. The average age of the patients was 58.5 years with majority being 51-70years (73.5%) of age. Patients with higher age and females had poor QOL compared to others. The correlation between various categorical variables with that of scores of QOL in various domains was assessed, Age of the patients influenced QOL score in various domains like RLPH (p value-0.038), PE (p value-0.0183), and SB (p value-0.0002), Gender has influenced QOL score in domains like RLPH (p value-0.0008), PE (p value-0.0106), TS (p value-0.0005) and Educational Qualification has influenced QOL score in RLPH (p value-0.0008), GH (p value-<0.0001), TS (p value-<0.0001), E/MH (p value-<0.0001). Conclusion: The results concluded that overall QOL was noticeably low in Diabetic patients especially in Women and elderly thus indicating that Diabetes management is not restricted to treatment but also requires attention on QOL of patients.

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Hypoglycemia Prevention Practice and Associated Factors Among Patients with Diabetes Mellitus Following at Public Hospitals of Central Zone, Tigray, Ethiopia, 2018

10.21203/rs.2.11704/v1 ◽

2019 ◽

Author(s):

Gebrewahd Bezabh Gebremichael ◽

Teklewoini Mariye Zemichael

Keyword(s):

Diabetes Mellitus ◽

Associated Factors ◽

Central Zone ◽

Public Hospitals ◽

P Value ◽

Diabetic Patients ◽

Binary Logistic Regression Model ◽

Cross Sectional ◽

Patients With Diabetes ◽

At Home

Abstract Background Hypoglycemia is an acute medical situation that occurs when blood sugar falls below the recommended level. Even though, hypoglycemia prevention practice in the management of diabetes mellitus is one cornerstone in controlling the effect of hypoglycemia, hypoglycemia prevention practice among patients with diabetes mellitus is insufficiently studied. Moreover, the existed scarce literature in Ethiopia revealed hypoglycemia prevention practice is inadequate. Thus, this study tried to assess hypoglycemia prevention practices and associated factors among diabetic patients. Methods Hospital-based, cross-sectional study design was employed from April one to March one 2018 in Central Zone of Tigray Regional state of Ethiopia. A total of 272 diabetes mellitus patients were selected by systematic random sampling method from study area. The collected data was checked for its completeness and then entered into Epi data version 3.1 then cleaned and analyzed using SPSS version 23. Binary logistic regression model (AOR, 95% CI and p-value < 0.05) was used to determine the predictors of hypoglycemia prevention practice. Results the mean age of respondents was 52.19 years and about 100 (63.2%) had good hypoglycemia prevention practice. Knowledge regarding hypoglycemia [AOR = 10.34; 95% CI [5.41, 19.89]], having a glucometer at home [AOR=3. 02; 95% CI [1.12, 8.12]], attitude regarding diabetes mellitus [AOR = 2.36 CI [1.26, 4.39]], being governmental employee [AOR=5. 19, 95% CI [1.63, 16.58]] and being divorced [AOR = 0.13, 95% CI [0.32, 0.53]] were found significantly associated with good hypoglycemia prevention practice. Conclusion Around two third of the study participants were found to have good hypoglycemia prevention practice. Good knowledge and favorable attitude toward diabetes mellitus, having glucometer at home, being governmental employee and divorced were found to be the predictors of good hypoglycemia prevention practice.

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Study of aerobic bacterial conjunctival flora in patients with diabetes mellitus

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v5i1.7818 ◽

2013 ◽

Vol 5 (1) ◽

pp. 28-32 ◽

Cited By ~ 11

Author(s):

D Karimsab ◽

SK Razak

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Bacterial Flora ◽

Diabetic Patients ◽

Coagulase Negative Staphylococci ◽

Ocular Infections ◽

Patients With Diabetes ◽

Conjunctival Flora ◽

Normal Bacterial Flora

Introduction: Normal bacterial flora may be altered by a variety of factors. Objective: To study the aerobic bacterial conjunctival flora in patients with diabetes mellitus and to find its clinical significance by comparing the results to the conjunctival flora of non-diabetic subjects. Materials and methods: A total of 75 diabetic patients were included as cases and 25 nondiabetics as controls to compare the results. Specimens for the study of conjunctival flora were taken by rubbing sterile cotton-tipped swabs to the inferior palbebral conjunctiva. The conjunctival culture report of the patients with diabetic mellitus was compared to that of nondiabetic subjects. Results: Positive conjunctival cultures were seen in a higher percentage of patients with diabetes (unilateral and bilateral positive conjunctival cultures 34.66 % and 58.66 % respectively) compared to that in non-diabetic controls (unilateral and bilateral positive conjunctival cultures 24 % and 16 % respectively). Diabetics showed a higher proportion of coagulase negative staphylococci (45.33 %), compared to the non-diabetic group (16 %). Among the diabetic patients, positive conjunctival cultures were detected more frequently in those with diabetic retinopathy compared to those without retinopathy. A higher proportions of bilateral positive conjunctival cultures were seen in cases with proliferative diabetic retinopathy (38.63 %) in comparison to patients with no retinopathy and different stages of non-proliferative diabetic retinopathy. Conclusion: The conjunctival floral pattern with increased bacteria in diabetics is a predominant cause of many diabetes-related ocular infections. The presence of diabetic retinopathy is an indicator for increased colonization of conjunctiva, and its severity correlates with the severity of diabetic retinopathy. Nepal J Ophthalmol 2013; 5(9):28-32 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7818

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Plasminogen activator inhibitor-1 gene polymorphism as a risk factor for vascular complications in type 2 diabetes mellitus

Egyptian Journal of Medical Human Genetics ◽

10.1186/s43042-019-0018-1 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Fatma A. Khalaf ◽

Hatem R. Ibrahim ◽

Hanan M. Bedair ◽

Maha M. Allam ◽

Amr A. Elshormilisy ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gene Polymorphism ◽

Vascular Complications ◽

Plasminogen Activator Inhibitor ◽

Diabetic Patients ◽

Plasminogen Activator Inhibitor 1 ◽

Increased Risk ◽

Activator Inhibitor ◽

Pai 1

Abstract Background Diabetes mellitus (DM) can lead to microvascular and macrovascular damages through hyperglycemia that is the main cause of diabetic complications. Other factors such as hypertension, obesity, and hyperlipidemia may worsen or accelerate the others. Several studies have revealed definitive genetic predispositions to the development of type 2 diabetes mellitus (T2DM) and development of vascular complications. This study aimed to address the association between plasminogen activator inhibitor-1 (PAI-1) gene polymorphism and T2DM, and if this gene polymorphism may have a possible role in the development of vascular complications in T2DM. This study is a case control; it included 200 patients with T2DM, 117 patients had no vascular complications, and 83 had previous vascular complications (VCs). One hundred eighty volunteer blood donors were selected as a healthy control group. All patients and controls were subjected to clinical examination, and laboratory investigations included lipid profile, fasting and 2 h blood glucose, complete blood cell count, d-dimer, PAI-1, thrombin activatable fibrinolysis inhibitor (TAFI), and detection of PAI-1 gene polymorphism by real-time polymerase chain reaction (PCR). Results The most prevalent genotype of PAI-1 gene polymorphism in all studied groups, including controls, was 4G/5G with the highest allele frequency as 4G. The 4G/5G and 4G/4G genotypes were associated with increased risk of DM development as compared to 5G/5G genotype. The 4G/5G and 4G/4G genotypes also had a highly significant increased risk of VCs among diabetic patients, as compared to 5G/5G. The 4G allele also was highly associated with DM with VCs. The d-dimer TAFI, PAI-1 showed the highest levels in 4G/5G genotype followed by 4G/4G genotype. The lowest level was expressed in 5G/5G genotype in diabetic patients with and without VCs. The univariable analysis showed that genotypes 4G/5G and 4G/4G were potentially risk factors for development of VCs with T2DM patients. Conclusion This study concludes that the PAI-1 4G/5G polymorphism may be associated with T2DM and may be considered as a risk factor for development of thrombotic events. It may also help in selection and dosing of patients being treated with anticoagulant and fibrinolytic agents. Further large-scale studies are recommended to assess the possible role of environmental factors and gene interactions in the development of T2DM vascular risks.

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Coronary Stenting in Diabetic Patients: Evaluation of Immediate Procedural Success & Adverse Outcomes

University Heart Journal ◽

10.3329/uhj.v6i1.7181 ◽

1970 ◽

Vol 6 (1) ◽

pp. 3-8

Author(s):

Md Harisul Hoque ◽

Sufia Rahman ◽

Md Abu Siddique ◽

Syed Ali Ahsan ◽

CM Ahmed ◽

...

Keyword(s):

Diabetes Mellitus ◽

Clinical Success ◽

Adverse Outcomes ◽

Diabetic Group ◽

Coronary Stenting ◽

P Value ◽

Diabetic Patients ◽

Number Of Patients ◽

Increased Risk ◽

Procedural Success

Diabetes mellitus (DM) itself increases the risk of Coronary Artery Disease (CAD) by 2-4 fold and in out country we are treating a good number of patients having CAD with DM. On the other hand several studies have reported increased risk of adverse outcomes following balloon angioplasty in diabetic cases. In this situation this study had been carried out at National Institute of Cardiovascular Diseases (NICVD) cath lab to determine the immediate procedural success & in-hospital adverse outcomes in this population. In our study 100 cases were enrolled. Out of which, 40 patients had type II DM & rest were non-diabetic.Diabetic patients were compared with non- diabetic and found no major difference between the two patient group except for a higher number of LCX (Left Circumflex) lesion in the non-diabetic (25% VS 35%, P value 0.038). The lone case of renal complication came from the diabetic group. No MACE (Major Adverse Cardiovascular or Cerebrovascular Events) or death was occur in this series. Angiographic, procedural and clinical success in diabetic was 97.5%, 97.5% & 95% respectively whereas 100% found in non-diabetic group at its all segment. But this results are statistically insignificant and P value is 0.4000 for angiographic success, 0.4000 for procedural success and 0.158 for clinical success. P value for hospital stays is also insignificant i.e. 0.250 (while p value of < 0.05 was considered significant). Therefore in the setting of diabetes mellitus the outcomes of the stenting procedure are quite encouraging. Key words: Coronary Stenting; Diabetic; Outcomes DOI: 10.3329/uhj.v6i1.7181University Heart Journal Vol.6(1) 2010 pp.3-8

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Knowledge about Diabetic Retinopathy, Eye Check-up Practice and Associated Factors among Adult Patients with Diabetes Mellitus Attending at Debark Hospital, Northwest Ethiopia

10.21203/rs.2.16562/v5 ◽

2020 ◽

Author(s):

Abel Sinshaw Assem ◽

Mebratu Muusew Tegegne ◽

Destaye Shiferaw Alemu ◽

Asamere Tsegaw Woredekal ◽

Tsehay Kassa Tefera

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Northwest Ethiopia ◽

Good Knowledge ◽

Eye Disease ◽

Diabetic Patients ◽

Duration Of Diabetes ◽

Patients With Diabetes ◽

History Of ◽

Eye Examination

Abstract Background: Routine eye examination plays a vital role in detecting diabetic retinopathy in its earliest stage before the onset of blindness. Patients’ knowledge about the nature and the consequences of diabetic retinopathy and routine eye checkup helps for timely identification and early treatment. However, there is limited evidence on knowledge of patients with diabetes mellitus on diabetic retinopathy and their eye check-up practices in Ethiopia. The aim of this study was to assess knowledge about diabetic retinopathy, eye check-up practice and associated factors of diabetic retinopathy among adult diabetic patients at Debark hospital, Northwest Ethiopia. Methods: Institution based cross-sectional study was conducted at Debark hospital, Northwest Ethiopia, from April 20/2018- May 20/2018. A pretested interviewer administered structured questionnaire was used to collect data among 230 diabetic patients aged 18 years and above. Data were entered in to Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable binary logistic regression analyses were done. Odds ratio with 95% confidence level was determined and variables with p–value of < 0.05 were considered as statistically significant. Result: Out of 238 sample 230 were participated, among this, 119 (51.7%) were males. The mean age of the respondents was 49 (SD ±17.6) years. One hundred nine (47.4%) participants had good knowledge and 91 (39.6%) had good eye check-up practice. Urban residence [AOR= 2.65;95% CI: 1.16-6.07)]), monthly income of 3501-8000 birr [AOR=4.54;(1.31-15.7)], type II diabetes mellitus [AOR=3.9;(1.6-9.6)], duration of diabetes (6-12 years[AOR=4.4;(1.4-13.5)]), history of eye disease [AOR=5.5;(2.3-13.0)] were associated with good knowledge. Similarly, longer duration of diabetes (13-25 years [AOR=3.77; (1.05-13.5)]) and history of eye disease [AOR=2.47; (1.09-5.62)] were associated with good eye check-up practice. Conclusion: The proportion of good knowledge about diabetic retinopathy among diabetic patients at Debark hospital was fair (47.4%) and good eye check-up practice (eye examination at least once in the past year) was low (39.6%). Longer duration of diabetes and history of eye disease were identified as positive factors for good knowledge and eye check-up practice. Knowledge and regular eye check-up practice needs to be enhanced through provision of appropriate health education.

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CLINICAL STUDY OF RETINOPATHY IN PATIENTS WITH DIABETES MELLITUS TYPE 1 AND TYPE 2 AND ITS ASSOCIATION WITH RISK FACTORS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i10.668 ◽

2019 ◽

Vol 3 (10) ◽

Author(s):

Dr Kalpana Singh ◽

Dr Dhiraj Balwir ◽

Dr Jeetendra Singh ◽

Dr Ruchita Raikar

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Multivariate Logistic Regression Analysis ◽

P Value ◽

Systemic Complications ◽

Female Ratio ◽

Number Of Patients ◽

Patients With Diabetes

Aim: To study the relationship between severity of diabetic retinopathy (PDR or NPDR) and systemic complications of diabetes mellitus such as Neuropathy, Nephropathy or Cardiovascular manifestation as hypertension. Methods and Materials: This prospective observational study of 100 patients suffering from diabetic retinopathy. Such patients were recruited as a part of the study and further examined for any other systemic abnormality as neuropathy, nephropathy or hypertension. Statistical Analysis: Chi square test, univariate and multivariate logistic regression analysis was performed. P value < 0.05 was taken as significant. Results: Male: Female ratio of presence of diabetic retinopathy was 2.13: 1. The rate of proliferative diabetic retinopathy (PDR) was 1.47 % in persons who had diabetes for less than 5 years to 7.35 % in persons who had diabetes more than 15 years. In our study, it was seen that nephropathy was present in 35.71 % cases with PDR as compared to 8.93% of cases with Non proliferative diabetic retinopathy (NPDR). Conclusion: Our study showed that there is a significant correlation between severity of retinopathy and duration in type 2 Diabetes mellitus patients. Maximum number of patients with Diabetes mellitus having cardiovascular involvement, had hypertension (68%).In patients suffering from neuropathy as a complication of DM, maximum number of patients had diabetic foot (56%).It was seen that the severity of diabetic retinopathy had some association with presence of nephropathy. Also it can be postulated that patients with severe NPDR and PDR have high risk of developing nephropathy than patients suffering with mild and moderate NPDR. Hence it can be recommended that all patients of diabetes mellitus suffering from clinically significant neuropathy, nephropathy or hypertension as a complication of diabetes should always be screened for presence of retinopathy. Further studies with larger sample size are to be conducted to further look into this association. Keywords: Diabetic retinopathy, Diabetic nephropathy, diabetic neuropathy, complications

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Risk factors for eye complications in patients with diabetes mellitus: development and progression

Eastern Mediterranean Health Journal ◽

10.26719/2000.6.2-3.313 ◽

2000 ◽

Vol 6 (2-3) ◽

pp. 313-325

Author(s):

M. El Shazly ◽

M. Zeid ◽

A. Osman

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Diabetic Retinopathy ◽

Case Control Study ◽

Case Control ◽

Diabetic Patients ◽

Patients With Diabetes ◽

Control Study

A multicentre case-control study was conducted to identify and quantify risk factors that may influence the development and progression of diabetic retinopathy. A total of 200 diabetic patients with nonproliferative retinopathy were compared with 400 diabetic patients without any eye complications with regard to the development of diabetic retinopathy. They were also compared with 200 diabetic patients with major eye complications to study the progression of diabetic eye complications. Results showed that the progression of diabetic eye complications was preventable since all the variables significantly affecting the process of progression, except type of diabetes, were avoidable

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In Hospital Frequency of Heart Failure in STEMI after Thrombolysis in Patient with Diabetes

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i1131245 ◽

2021 ◽

pp. 66-71

Author(s):

Abdul Mueed ◽

Nandlal Rathi ◽

Shazia Kazi ◽

Raj Kumar Sachdewani ◽

. Shahzad ◽

...

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Heart Disease ◽

Previous History ◽

P Value ◽

Diabetic Patients ◽

Chi Square ◽

St Segment Elevation ◽

Patients With Diabetes ◽

End Stage

Objective: To determine the frequency of heart failure after thrombolysis in STEMI patients with diabetes mellitus. Methodology: Through a prospective study we have enrolled all the diabetic patients who presented with acute ST-Segment Elevation Myocardial Infarction (STEMI) having age more than 35 years and less than 70 years who underwent pharmacological revascularization both males and females were included in this study. Patients with previous history of revascularization, end stage kidney, liver or heart disease, known advanced valvular heart disease, pregnant women, and those who develop serious complication related to streptokinase were excluded from our study. Echocardiography was done immediately after thrombolysis then after 3 days and then before discharge of the patients to determine the frequency of heart failure. Baseline and clinical data were entered and analysed using SPSS and a chi square test and p-value ≤0.05 was considered as significant. Results: A total of 175 patients were finally analysed and most of them were males as compared to females, 63.42% (N = 111) vs. 36.57% (N = 64), respectively. Mean age and SD of the patients was 55.90±10.49 years and mean duration of DM was 12.95±8.40 years. The overall frequency of heart failure in patients with post-STEMI was 56% (N = 98) and their mean ejection fraction was 38.46±8.20%. Frequency of heart failure in diabetic post-STEMI thrombolysed patients was significantly observed higher with increased age, increased duration of diabetes mellitus, hypertension, and smoking (p≤0.05). Conclusion: High prevalence of heart failure was observed in diabetic patients admitted with acute STEMI and underwent thrombolysis. The burden is even higher in males having age more than 55 years.

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