A study of clinical profile and complications in patients with type 2 diabetes mellitus in a tertiary care centre

Background: Diabetes is the most common non-communicable disease known today. This study was conducted to assess the clinical profile and complications in patients with type 2 diabetes mellitus.Methods: A prospective study was carried out between April 2017 to April 2018 in patients attending a tertiary care hospital in Chennai. Patients with type 2 diabetes of age 25-80 years, minimum of 5 years duration were enrolled.Results: Out of 66 patients, 23(34.8%) were males whereas 43 (65.2%) were females. Mean age in this study population was 55.36 years with a standard deviation of 11.362. In present study, the mean fasting blood sugar level was 196.12±77.180, mean postprandial blood sugar level was 303.26±115.385 and the mean HbA1C levels was 10.95±2.369. 77.3% were on oral hypoglycaemic agents, 13.6% on insulin and 9.1% on combined therapy with oral hypoglycemic agents and insulin. The complications associated with diabetes found in present study were microvascular complications which include peripheral neuropathy 41(62.1%), retinopathy 31(46.96%), nephropathy 28 (42.42%). Peripheral neuropathy was found to be most commonly associated. Macrovascular complications include cardiovascular disease in 12.12% (n=8) and cerebrovascular disease in 4.54% (n=3). Autonomic neuropathy was found in 69.69% (n=46).Conclusions: The complications of DM are commonly seen in patients with poor glycaemic control. Among microvascular complications, peripheral neuropathy was most commonly seen. Autonomic neuropathy usually goes unnoticed and asymptomatic in most of the individuals. Increasing levels of HbA1c was found to be significantly correlated with neuropathy.

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PROLANIS IMPLEMENTATION EFFECTIVE TO CONTROL FASTING BLOOD SUGAR, HbA1c AND TOTAL CHOLESTEROL LEVELS IN PATIENTS WITH TYPE 2 DIABETES

Jurnal NERS ◽

10.20473/jn.v12i1.2750 ◽

2017 ◽

Vol 12 (1) ◽

pp. 88

Author(s):

Musfirah Ahmad ◽

Rini Rachmawaty ◽

Elly L. Sjattar ◽

Saldy Yusuf

Keyword(s):

Type 2 Diabetes ◽

Total Cholesterol ◽

Blood Sugar ◽

Microvascular Complications ◽

Sampling Technique ◽

Fasting Blood Sugar ◽

Cross Sectional ◽

Cholesterol Levels ◽

The Mean

Introduction: Diabetes mellitus (DM) is a global disease endemic and causing of 4.6 million deaths in the world. The Indonesian government and health insurance [BPJS Kesehatan] formulate a Chronic Disease Care Program [Program Pengelolaan Penyakit Kronis (PROLANIS)] for type 2 diabetes that aimed at controlling the glycemic status and the risk factors of macro and microvascular complications. The purpose of this study was to analyze the correlation between the implementation of PROLANIS and fasting blood sugar, HbA1c, and total cholesterol levels in patients diagnosed with type 2 diabetes at Antang and Pampang community health centers, Makassar, Indonesia. Methods: This study used descriptive correlation design with cross sectional study approach. Subjects were 40 patients diagnosed with type 2 diabetes who joined PROLANIS at PUSKESMAS Antang and Pampang, Makassar, with sampling technique used was total sampling. The data were analyzed using correlation test to assess the significance (p), the direction (+/-), and the strength of the correlation (r). The implementation of PROLANIS was measured by using the observation sheets developed based on BPJS Kesehatan criteria, while the fasting blood sugar, HbA1c, and total cholesterol levels were checked by laboratory. Results: The mean of the implementation of PROLANIS was 15.05 (SD ± 5.62), while the mean levels of fasting blood sugar, HbA1c, and total cholesterolwere as followed: 191.80 mg/dL (SD ± 85.15); 8.4% (SD ± 2.08); and 192.87 mg/dL (SD ± 45.07). Using the Spearman's rho test, the study result showed that there was a significant and negative correlation between the implementation of PROLANIS and the levels of fasting blood sugar (p= 0.001; r= -0.724), HbA1c (p= 0.001; r= -0.870), and total cholesterol (p= 0.029; r= -0.35) in patients diagnosed with type 2 diabetes at Puskemas Antang and Pampang, Makassar. Conclusions: The optimal implementation of the PROLANIS is very effective to control the levels of fasting blood sugar, HbA1c, and total cholesterol in patients type 2 diabetes.

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Cardiovascular Autonomic Neuropathy in Context of Other Complications of Type 2 Diabetes Mellitus

BioMed Research International ◽

10.1155/2013/507216 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

Anca Moţăţăianu ◽

Rodica Bălaşa ◽

Septimiu Voidăzan ◽

Zoltán Bajkó

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Peripheral Neuropathy ◽

Autonomic Neuropathy ◽

Microvascular Complications ◽

Demographic Data ◽

Macrovascular Complications ◽

Cardiac Autonomic Neuropathy ◽

Group A

The aim of this study was to investigate the relationship between cardiac autonomic neuropathy (CAN) and other micro- and macrovascular complications and risk factors for type 2 diabetes. We included, in this study, 149 patients with type 2 diabetes. We evaluated their cardiovascular risk factors, demographic data, and any major micro- and macrovascular complications of their diabetes. Assessments of CAN were based upon Ewing’s battery.Results. CAN was present in 38.9% of patients. In the CAN group, the duration of diabetes, BMI, systolic blood pressure, lipid levels, and HBA1c were all significantly higher than those in the other group. A significant association was found between CAN and retinopathy, peripheral neuropathy, ABI, and IMT. Multivariate logistic regression demonstrated that, in type 2 diabetes, the odds of CAN (OR (95% confidence intervals)) increase with the age of the patients (1.68 (1,4129–2.0025)), the average diabetes duration (0.57 (0.47–0.67)), cholesterol (1.009 (1.00-1.01)), HbA1c levels (1.88 (1.31–2.72)), peripheral neuropathy (15.47 (5.16–46.38)), BMI (1.12 (1.05–1.21)), and smoking (2.21 (1.08–4.53)).Conclusions. This study shows that CAN in type 2 diabetes is significantly associated with other macro- and microvascular complications and that there are important modifiable risk factors for its development.

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Overview of Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients at Royal Prima Hospital Medan Indonesia

Archives of The Medicine and Case Reports ◽

10.37275/amcr.v3i1.157 ◽

2021 ◽

Vol 3 (1) ◽

pp. 224-228

Author(s):

Riski N. Situmeang ◽

Erwin Sopacua

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Diabetic Nephropathy ◽

Blood Sugar ◽

Blood Sugar Level ◽

Mean Value ◽

Total Data ◽

The Mean ◽

Sugar Levels

Diabetes Mellitus (DM) is a chronic disease characterized by blood glucose (blood sugar) levels exceeding normal. Diabetic nephropathy is a chronic microvascular complication that often occurs in diabetics. This study presents a picture of diabetic nephropathy in type 2 DM patients at the Royal Prima Hospital in Medan. This research is a type of descriptive research. The sample from this study was the total data of patients suffering from diabetic nephropathy who met the inclusion and exclusion criteria at Royal Prima Hospital from January 1, 2020 – to December 31, 2020. The inclusion criteria for the subjects of this study were complete patient medical records, type 2 diabetes patients, urinalysis tests. (proteinuria ≥ +2), renal function examination exceeds normal values, blood urea, and creatinine. The mean age of diabetic nephropathy patients was 57.52 years and the majority were 62 men (50.8%). The average picture of urea levels in diabetic nephropathy patients is 51.8 and the average creatinine level is 1.48. The majority of patients with diabetic nephropathy do not have proteinuria. And the average blood sugar level is 267 mg/dL. In conclusion, the incidence of diabetic nephropathy is highest in patients aged 57 years. The mean value of urea level is 51.80 mg/dl, creatinine value is 1.48 mg/dl, and the average blood sugar level is 267 mg/dl. Most proteinuria was in the negative category of as many as 107 people (87%).

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Red Dragon Fruit Juice in Reducing Blood Sugar Level in Rats with Type 2 Diabetes Melitus

Strengthening Hospital Competitiveness to Improve Patient Satisfaction and Better Health Outcomes ◽

10.26911/the6thicph.05.31 ◽

2019 ◽

Author(s):

Mahendri Deayu Putri ◽

◽

Budiyanti Wiboworini ◽

Paramasari Dirgahayu ◽

◽

...

Keyword(s):

Type 2 Diabetes ◽

Blood Sugar ◽

Blood Sugar Level ◽

Fruit Juice ◽

Dragon Fruit ◽

Diabetes Melitus

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Can hematological parameters in type 2 diabetes predict microvascular complication development?

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.6.1150 ◽

2019 ◽

Vol 35 (6) ◽

Author(s):

Erhan Onalan ◽

Nevzat Gozel ◽

Emir Donder

Keyword(s):

Type 2 Diabetes ◽

Microvascular Complications ◽

Hematological Parameters ◽

Diabetic Patients ◽

Healthy Controls ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

The Mean ◽

The Difference

Objective: To examine potential associations between neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, mean platelet volume (MPV), HbA1c and microvascular complications in diabetic patients from a cost-effectiveness perspective. Methods: One hundred patients with type 2 diabetes attending our outpatient unit between May 2018 and October 2018 were included, and 100 healthy individuals served as the control group. A retrospective file search was performed to collect information on hemoglobin, mean platelet volume (MPV), glycosylated haemoglobin (HbA1c), hematocrit (Hct), neutrophil and lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelets (Plt), platelet/lymphocyte ratio (PLR), and microvascular complications (neuropathy, retinopathy, nephropathy). Results: Demographic and laboratory data were retrospectively controlled between diabetes (n=100) and healthy control (n=100) groups. The mean age in diabetic patients and healthy controls was 56.34 and 36.68 years, respectively. The mean NLR in diabetics and healthy controls was 2.48 and 2.11, the difference in NLR being significant (p=0.002). MPV in diabetics and controls was 8.54 and 8.53, respectively, and the difference was not significant (p=0.93). PLR was also similar, i.e. 149.7 and 145.3 in diabetics and healthy controls (p=0.067). With respect to microvascular complications, retinopathy was found to be significantly associated with MPV and NLR (p=0.015, and p=0.051), and nephropathy showed a significant association with NLR (p=0.027) among diabetics. In contrast with the two other microvascular complications, no significant association between neuropathy and NLR could be detected, while PLR and neuropathy was significantly associated (p=0.003). Conclusion: Microvascular complications may be associated with certain hematologic parameters, as suggested by comparisons both between diabetics and healthy individuals and within the group of diabetic individuals. We believe that hematologic parameters such as hematocrit, MPV, NLR, and PLR, which can be obtained through a simple complete blood count, may be utilized as cost-effective predictors of diabetic microvascular complications. Further prospective studies with larger sample size are required to better delineate these associations. doi: https://doi.org/10.12669/pjms.35.6.1150 How to cite this:Onalan E, Gozel N, Donder E. Can hematological parameters in type 2 diabetes predict microvascular complication development? Pak J Med Sci. 2019;35(6):1511-1515. doi: https://doi.org/10.12669/pjms.35.6.1150 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Prevalence of Charcot arthropathy in Type 2 diabetes patients aged over 50 years with severe peripheral neuropathy: A retrospective study in a Tertiary Care South Indian Hospital

Indian Journal of Endocrinology and Metabolism ◽

10.4103/ijem.ijem_257_17 ◽

2018 ◽

Vol 22 (1) ◽

pp. 107 ◽

Cited By ~ 6

Author(s):

Dharmadas Salini ◽

Kumar Harish ◽

Pillay Minnie ◽

KarimasseryR Sundaram ◽

Bal Arun ◽

...

Keyword(s):

Type 2 Diabetes ◽

Retrospective Study ◽

Peripheral Neuropathy ◽

Tertiary Care ◽

Charcot Arthropathy ◽

South Indian ◽

Diabetes Patients

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Impairment of microvascular blood flow in patients with type 2 diabetes and cardiovascular autonomic neuropathy

Diabetes Mellitus ◽

10.14341/dm12372 ◽

2021 ◽

Vol 24 (1) ◽

pp. 32-44

Author(s):

T. A. Zelenina ◽

V. V. Salukhov ◽

A. B. Zemlianoi ◽

S. G. Zheleznjak ◽

O. A. Klitsenko

Keyword(s):

Type 2 Diabetes ◽

Blood Flow ◽

Autonomic Neuropathy ◽

Diabetic Foot ◽

Microvascular Complications ◽

Cold Test ◽

Microvascular Blood Flow ◽

Diabetic Patients ◽

History Of

BACKGROUND: Diabetic autonomic neuropathy is the reason for early morbidity and mortality on diabetic patients. The pathology not only cardiac innervation but microvascular is presented.AIMS: We estimated the parameters of skin microvascular blood flow in accordance with cardiovascular autonomic neuropathy (CAN) staging in diabetic patients. We also assessed other risk factors of CAN in patients with diabetes.MATERIALS AND METHODS: We included 76 patients with type 2 diabetes in the study (24 patients with resent-onset diabetes and/or diabetes without microvascular complications, 26 with diabetic sensorimotor neuropathy (SMN) and 26 with SMN and previous history of diabetic foot amputation). The SMN was diagnosed on the basis of patients complaints, anamnesis and data of clinical neurological examinations. CAN was detected using several cardiovascular autonomic reflex tests (CART) as a gold standard of diagnosis: the tilt-table test, a deepbreathing and Valsalva Maneuver, handgrip test, cold-stress vasoconstriction. According to the Toronto Diabetic Neuropathy Expert Group Recommendation all patients was separated on the groups: CAN 0 (all CARTs were normal), CAN 1 (possible/early CAN — one abnormal CART was presented), CAN 2 (definite/confirmed CAN –at least two abnormal CARTs were found), CAN 3 (severe/advanced CAN — in the cases of orthostatic hypotension in addition to CARTs abnormalities). Microvascular blood flow of skin at the nail roller of fingers skin was valuated at rest as well as in functional cold test by the method of High-frequency Ultrasonic Dopplerography using the “Minimax Doppler K” device (LLC JV “Minimax”, St. Petersburg, Russia).RESULTS: CAN 1 was found in 8% diabetic patients without microvascular complications, 42 and 21% patients with SMN and diabetic foot amputations respectively. CAN 2 was diagnosed in 27% patients with SMN and 58% patients history of diabetic foot amputations. CAN 3 in 8% and 19% cases in patients with SMN and history of diabetic foot amputations respectively. The parameters of microvascular blood flow at rest were significantly decreased in patients with confirmed/severe CAN in comparison with early staging of CAN and patients without CAN (Vm=2.5±0.66 sm/sec vs. 4.4±0.54 sm/sec and 5.1±1.01 sm/sec respectively; p=0.0033). The abnormal result of cold test was detected in 94% patients with confirmed/ severe CAN and 26% patients with CAN 1.CONCLUSIONS: This investigation has demonstrated in a cohort with type 2 diabetes patients with/without SMN and with/ without history of previously foot amputations that decrease the Vm (the variable of microvascular blood flow assessed by High-frequency Ultrasonic Dopplerography) lower than 2.4 sm/sec is associated with 6.4 times increased likelihood of confirmed/severe CAN as well as positive cold test result. That the patients with positive cold test results were 28.6 times more likely have confirmed/severe CAN.

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STUDY OF PREVALENCE AND CLINICAL PROFILE OF NEPHROPATHY AND RETINOPATHY IN TYPE 2 DIABETES PATIENTS AT TERTIARY CARE CENTER, UDAIPUR

10.36106/gjra/0100380 ◽

2021 ◽

pp. 6-8

Author(s):

Yash Salil Patel

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Diabetic Nephropathy ◽

Microvascular Complications ◽

Tertiary Care ◽

Positive Family History ◽

Diabetic Patients

Microvascular complications of Type 2 Diabetes Mellitus (T2DM), (retinopathy and nephropathy) have a similar etiopathogenetic mechanism besides genetic predisposition. Even though these two complications frequently co-exist, their frequency varies. The association of these two signicant complications and their coexistence needs a relook. To study prevalence of retinopathy and nephropathy in Type 2 diabetes mel Aim: litus. Comparison of diabetic retinopathy and nephropathy in Type 2 diabetes mellitus and its correlation of diabetic retinopathy and nephropathy with duration of illness and various risk factors that affects development, progression and severity of diabetic retinopathy and nephropathy. 100 diabetic patients were taken up for study for a period of one year meeti Methodology: ng the criteria for the present study. Detailed history was taken from patient and meticulous examination was done of all patients with special emphasis on renal and ophthalmic symptoms. Clinical data and investigation prole was tabulated. Statistical analysis was done. Among 100 patients, 22 had diabetic retinopathy. Among patients with diab Results & Conclusion: etic retinopathy, 68.18% patients had positive family history. Among 100 patients, 32 had diabetic nephropathy, mean FBS was 207 mg%, PPBS was 317.8 mg% and mean HbA was 9.2%. Among patients with diabetic retinopathy, mean FBS was 211 mg%, PPBS was 324.9 1c mg%, HbA was 9.5%. From this study it is found that diabetic nephropathy starts earlier than retinopathy. In this study 1c hypertension was found to accelerate progression into nephropathy and retinopathy.

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