Altered structural changes of podocytes, glomerular basement membrane in patients with type 2 diabetes mellitus

2021 ◽  
Vol 8 (3) ◽  
pp. 198-201
Author(s):  
Shantharam V ◽  
Raghavendra K

Diabetic nephropathy is a one of the microvascular complication in patients with type 2 diabetes mellitus due to increased production of free radicals and decreased levels of anti oxidants. The seviority of the disease totally depends on due to damage of foot process of podocytes. Hence, we need to evaluate the altered structural changes of podocytes, glomerular basement membrane in patients with type 2 diabetes mellitus. A total 60 type 2 diabetes mellitus patients were included in the present study and again sub classified into 2 types (Normoalbuminuria 30, Microalbuminuria 30) based on their urinary ACR. Basic laboratory investigations and radio graphical data were collected from the all subjects. A statistical was performed by using SPSS Version 21.0 and P value considers < 0.05 is statistically significant. The significantly elevated levels of plasma FBS, PPBS, Serum Urea, Creatinine, Uric Acid and HbA1c, Urinary albuminuria observed in type 2 diabetes mellitus with microalbuminuria when compared to normoalbuminuria. The radiographical data showed a significantly damaged foot process of podocytes and glomerular basement membrane are observed in patients with microalbuminuria when compared to normoalbuminuria. The increased levels blood sugar and HbA1c, Urinary Albuminuria directly indicates the damage of podocytes and glomerular basement membrane in the kidney. This study suggest continuous monitoring of these parameters may helpful for progression of type 2 diabetes mellitus complications.

Author(s):  
Shantharam V ◽  
Raghavendra K

Type 2 Diabetes mellitus (T2DM) is a syndrome of disorders characterized by hyperglycemia caused due to a relative or absolute deficiency of insulin, decreased glucose utilization. The metabolic derangements in diabetes lead to secondary complications that affect multiple organ systems particularly on kidney. For early detection of kidney damage in T2DM patients are important by using certain type of urinary proteins. We aimed to evaluate the glomerular basement membrane damage and leaking of structural proteins in among different stages of type 2 diabetes mellitus patients. A total 150 type 2 diabetes mellitus patients were included in the present study and again sub classified into 2 types (Normoalbuminuria 50, Microalbuminuria 50) based on their urinary ACR and also included 50 age, gender matched healthy controls. The FBS, PPBS, Urea, Creatinine, HbA1C, Urinary Albumin was analysed by using laboratory standard methods and Urinary Adiponectin was measured by using were collected from the all subjects. A statistical was performed by using SPSS Version 21.0 and P value considers < 0.05 is statistically significant. The significantly elevated levels of plasma FBS, PPBS, Serum Urea, Creatinine, HbA1c, Urinary albuminuria and Urinary Adiponectin observed in two groups of type 2 diabetes mellitus when compared to healthy controls. The Urinary Adiponectin was positively correlated with blood sugar levels and urinary albumin in two groups of diabetes mellitus. The data showed a significantly damaged foot process of podocytes and glomerular basement membrane leads to leaking of certain urinary proteins.The elevated levels of Urinary Proteins and HbA1c, Urinary Albuminuria directly indicate the damage of podocytes and glomerular basement membrane in the kidney. These studies suggest continuous monitoring of these parameters may helpful for progression of type 2 diabetes mellitus complications.


2021 ◽  
pp. 57-59
Author(s):  
Hakimuddin Malvi ◽  
Syed Maqsood Husain

Background: India has been recognized as the diabetes capital of the world by the year of 2025 Hypertension is a signicant danger factor for cardiovascular infection, stroke and ischemic coronary illness. Objective: The aim of this paper is prevalence of hypertension amid patients with type 2 diabetes mellitus- at a tertiary level hospital in central India. Methods: Present work is hospital based cross-sectional study was conduct in Chirayu Medical College & Hospital, Bhopal. The study population consisted of total 300 subjects. Data obtained directly from patients and patients medical les, and the following data were included in the study . Results: The results showed that the after using chi-square test we found that hypertension was signicantly higher p value(<0.05) among female patients (69%),patients with long duration diabetes (77%)10 years and more, also it was signicantly higher among patients with current smokers (69%). Conclusion: In this study the prevalence of hypertension is increasing in patient with T2DM. Hypertension was the most danger factor for micro vascular and macro vascular confusion of T2DM.


2019 ◽  
Vol 12 (2) ◽  
pp. 1001-1007
Author(s):  
Sandeep Kumar ◽  
Ajay Kumar ◽  
Mohammad Mustufa Khan

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by hyperglycemia due to insufficient secretion or action of insulin.Elevated oxidative stress and diminished antioxidants may play an important role to develop T2DM and its complications. Aldose reductase (AR) enzyme plays a key role in the reduction of glucose to sorbitol by Polyol pathway. To estimate the AR activity and malondialdehyde (MDA) levels and in patients with T2DM. In this case-control study, a total number of 60 subjects (30 T2DM and 30 age-matched controls) wererecruited.Fasting blood sugar (FBS), Post-Prandial blood sugar (PPBS), AR activity and MDA levels were estimated in all the subjects. The AR activity was estimated by nicotinamide adenine dinucleotide phosphate hydrogen (NADPH) oxidation method. The plasma MDA levels were estimated by the thiobarbituric acid reactive substance (TBARS) method. For Statistical analysis, all the data were compared between the two groups by using unpaired t-test. Pearson correlation coefficient was calculated among T2DM. A P value <0.05 was considered as statistically significant for all data analyzed. The mean of FBS, PPBS, AR activity, and MDA levels were found significantly high in T2DM as compared to controls (P<0.001, P<0.001, P<0.001, P<0.001, respectively). A significant positive correlation was found between FBS and PPBS among T2DM (r=0.71, P<0.01). However, There was no significant correlation found between AR activity and MDA level among T2DM (r=0.002, P>0.05). Results showed thatthe mean of FBS, PPBS, AR activity, and MDA levels were found significantly higher in T2DM than controls. There was no significant correlation found between AR activity and MDA level among T2DM.


Author(s):  
Swapnil Jain ◽  
C. L. Nawal ◽  
Amandeep Singh ◽  
Radhey Shyam Chejara ◽  
Sagar Barasara ◽  
...  

Background: Diastolic dysfunction in patients suffering from diabetes mellitus represents an earlier stage in the natural history of cardiomyopathy. This study was done to assess the left ventricular diastolic dysfunction in recently diagnosed (<5yr) Type 2 Diabetes Mellitus by Echocardiography and also to determine association of glycemic status (by HBA1c levels) with left ventricular diastolic dysfunction (LVDD).Methods: An observational descriptive study involving 100 diabetic patients, taken on first come first serve basis after applying inclusion and exclusion criteria. In all the subjects, other than routine investigations, HbA1c was estimated and echocardiography was done to evaluate LVDD.Results: Mean value of HbA1c in the study was 8.31+ 1.408 %. 63 out of 100 subjects had LVDD. There was significant positive correlation between HbA1c and LVDD (p value <0.001). As HbA1c increased, severity of LVDD increased. In this study, as BMI increased, HbA1c and LVDD increased & both findings were statistically significant (p value =0.001).Conclusion: Our study indicates that myocardial damage in patients with diabetes affects diastolic function before systolic function &higher HbA1C level is strongly associated with presence of LVDD. Patients should be advised strict control of diabetes in order to reduce the risk for developing LVDD which is a precursor for more advanced disease.Keywords: Diabetes mellitus, Diastolic dysfunction, BMI, HbA1c


2021 ◽  
pp. 20-22
Author(s):  
Shajahan Shajahan ◽  
Koneru Sri Lahari ◽  
P. Kiranmai

BACKGROUND:Type 2 Diabetes Mellitus is a major non-communicable disease resulting from insulin resistance and is associated with cardiovascular,neurological and renal complications.Recent studies show association of hyperuricemia and Diabetes Mellitus.Uric acid increases oxidative stress that leads to vascular dysfunction and high intra glomerular pressure leading to renal complications.High serum creatinine is an indicator of renal compromise. OBJECTIVES: To evaluate serum uric acid and serum creatinine levels in type 2 diabetes mellitus patients and to find association between them. METHODOLOGY: The study was conducted in Osmania general hospital. Fifty cases of established Type 2 Diabetes Mellitus formed the study group and 50 normal healthy individuals formed the control group. Serum uric acid, Fasting Blood Glucose (FBS) and serum creatinine were estimated by colorimetric enzymatic methods on Beckman coulter AU5800.Mean values were compared in cases and controls using student t- test.Study group was further studied under 2 subgroups with serum Uric acid < 7 mg/dl and ≥7 mg/dl.In these 2 subgroups the association of Serum uric acid with FBS and creatinine was analysed statistically. RESULTS: Serum uric acid were found high in cases(7.63+/- 3.36)as compared to controls(4.48+/- 1.09) p value < 0.001.Serum creatinine were also high in cases(1.59+/- 1.39 )as compared to controls ( 0.87+/- 0.29) p value <0.005.Study subgroup with serum uric acid ≥7 mg/dl was associated with high creatinine and high fasting blood sugar levels when compared to subgroup with serum uric acid <7 mg/dl. CONCLUSION: Our study showed increased serum uric acid and serum creatinine levels in cases when compared to controls.There was significant association between high serum uric acid and high creatinine levels in cases.Therefore,it is important to measure serum uric acid and serum creatinine levels in diabetics for early detection of renal pathology.


2021 ◽  
Vol 8 (1) ◽  
pp. 14-19
Author(s):  
Lukatul Khoiriyah ◽  
Ramli Effendi ◽  
Thia Oktiany

The level of family knowledge is a very important factor in the actions of families of people with Diabetes Mellitus, behavior based on knowledge will be easier to carry out than those not based on knowledge. Diabetes Mellitus is a disease that requires proper and immediate treatment efforts because it can cause complications such as heart disease, kidney failure, and damage to the nervous system. One way to overcome the effects of Type 2 Diabetes Mellitus is by applying a diet. This study aims to determine the relationship between the level of family knowledge with efforts to prevent complications of type 2 diabetes mellitus in the work area of Babakan Puskesmas, Cirebon Regency. This research method uses descriptive correlational, this research uses cross section research. The population is all families with type 2 Diabetes Mellitus in the work area of Babakan Puskesmas in Cirebon Regency as many as 144 respondents and sampling using Purposive Sampling obtained 60 respondents. The instruments used were questionnaire sheets, and data analysis using chi-square test that is the significance value α = 0.1. The results of the above study indicate between the level of family knowledge and prevention of complications of type 2 diabetes mellitus in getting p-value = 0.04, because the p-value of 0.04 <0.1 then Ho is rejected and Ha is accepted which means there is a relationship between the level of family knowledge and prevention of complications of type 2 diabetes mellitus in the work area of Babakan Health Center, Cirebon Regency.


2021 ◽  
Vol 8 (1) ◽  
pp. 7-13
Author(s):  
Anisa ◽  
Nonok Karlina ◽  
Ahmad Syaripudin

Diabetes mellitus is a disease that has clinical signs and symptoms due to chronic declining function. Type 2 diabetes mellitus always increases every year as much as 9.3% of people. Patients with type 2 diabetes mellitus are required to always be routine control, but patients with diabetes mellitus will experience stress caused by various stressors, to reduce these problems interventions need to provide self-efficacy to patients and coping strategies are also needed so that patients are able to adapt to their stress in order to create coping strategies the good one.The purpose of this study was to determine the relationship of self-efficacy with coping strategies in patients with type 2 diabetes mellitus who use insulin in the Polyclinic of Waled District Hospital Cirebon. This type of research uses descriptive correlational with cross sectional approach. Sampling using purposive sampling technique amounted to 34 respondents. The instrument used was a questionnaire. Analysis of data using rank test speraman.Place of research in Waled District Hospital Cirebon in July 2020. The results showed that most respondents' self-efficacy in the high category (58.8%) and coping strategies were mostly in the good category (61.8%). Spearman rank test results P value <a and r <1 then H0 = rejected means that there is a strong and positive relationship between self-efficacy and coping strategies in patients with type 2 diabetes mellitus in the Polyclinic of Waled District Hospital Cirebon (P value = 0,000: a = 0 .05 r = 0.719). It is expected that nurses should provide more motivation and support to patients with type 2 diabetes mellitus and educate about the importance of coping strategies


2019 ◽  
Vol 29 (5) ◽  
pp. 339-351
Author(s):  
Tingting Liu ◽  
Jung Eun Lee ◽  
Jing Wang ◽  
Song Ge ◽  
Changwei Li

Although cognitive dysfunction is related to type 2 diabetes mellitus (T2DM), the concept has not yet been well defined. The purpose of this study was to define the concept of cognitive dysfunction in persons with T2DM and examine its defining attributes, antecedents, and consequences. Literature was retrieved from 2008 to 2018 by systematically searching the PubMed, CINAHL, and PsycINFO databases. Based on 37 included studies, three defining attributes were identified: cognitive dysfunction is a recognized or unrecognized symptom, is characterized by a subtle decline in one or more cognitive domains, and is accompanied by pronounced structural changes observed in brain imaging. One major antecedent was diabetes-related or diabetes-specific pathological changes. Consequences included interference with diabetes self-management, nonadherence to recommended self-management behaviors, and a higher risk of having hypoglycemic events. The concept analysis provides a theoretical foundation that can be used to guide evaluations and interventions related to cognitive dysfunction in individuals with T2DM.


2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Oliva Suyen Ningsih ◽  
Kornelia Romana Iwa ◽  
Maria Getrida Simon ◽  
Kataria Anastasia Sinar

The prevalence of diabetes mellitus in Manggarai Regency in 2019 is 535 people and some of them have diabetic foot ulcers. Patients with diabetic foot ulcers had a higher risk of falling than others.This study was to determine the risk factors for diabetic foot ulcers and the risk of falls in patients with type 2 diabetes mellitus. A quantitative study using a cross-sectional study was conducted at BLUD RSUD dr. Ben Mboi  in April-June 2020 (n = 51).The sampling technique used was purposive sampling with a questionnaire of diabetic foot screening and risk stratification form and Morse scale. Logistic regression results showed that there was a significant relationship between claudication (AOR: 8.409, 95% CI 1.664-42.500, p value 0.010), history of previous diabetic foot ulcers (AOR: 5,680, 95% CI 1,151-28,035, p value 0.033) with diabetic foot ulcers. There was a significant relationship between hypertension (AOR: 0.152, 95% CI 0.028-0.834, p value 0.030), diabetic foot ulcers (AOR: 11.392, 95% CI 1.277-101.651, p value 0.029) with the risk of falling for patients with type 2 diabetes mellitus.  Assessment of the risk of diabetic foot ulcers and the risk of falls should be done in patients with diabetes mellitus with or without neuropathy peripheral


2017 ◽  
Vol 24 (02) ◽  
pp. 221-227
Author(s):  
Ghazanfar Ali Sandhu ◽  
Ghulam Abbas Tahir ◽  
Zaheer Ahmad ◽  
Aqeel Maqsood Anjum

Diabetes Mellitus is a rapidly increasing problem which is contributing tochronic illnesses like Cerebrovascular, Cardiovascular, Diabetic Retinopathy and End StageKidney Disease. These dreaded complications can be prevented if treated early. In patientswith diabetes mellitus type 2, microalbuminuria is an independent and strong risk factor forcardiovascular mortality & morbidity and diabetic nephropathy. If diagnosed early, diabeticnephropathy can be treated at this stage. Angiotensin converting enzyme inhibitors (ACEInhibitors) and Angiotensin Receptor Blockers (ARBs) are effective in prevention and treatmentof microalbuminuria. Material & Methods: Study Design: randomized controlled trial. Setting:medical department, allied hospital, Faisalabad. Duration of study: Feb 2013 to July 2013.Sample size: 60 (30 in each group). Sampling technique: Non-probability consecutivesampling. Results: 60 patients were included in the study. 28(46.7%) were males and 32(53.3%)were females. Mean age of study population was 50.15±7.27 years. Albumin creatinine ratio(mcg/mg) at start of study was 193±67.5 in Losartan potassium group and 209.5±72.00 inlisinopril group (independent sample t-test p value=0.302). Albumin creatinine ratio (mcg/mg) at 12 weeks of study was 36.33±54.68 in Losartan potassium group and 72±83.42 inlisinopril group (independent sample t-test p value = 0.056). Paired sample t test applied toboth treatment groups and p value was found to be 0.0001 which is highly significant for bothgroups and shows that both drugs are effective in reducing microalbuminuria in both groups.Microalbuminuria was reduced significantly in 26 patients (86.7%) in Losartan potassiumgroup and 20 patients (66.7%) in lisinopril group (p-value=0.067). Conclusion: It has beenconcluded from this study that lisinopril and Losartan potassium, both significantly reducemicroalbuminuria in type 2 diabetes mellitus and there is no statistically significant difference inefficacy of these two drugs in reducing microalbuminuria in type 2 diabetes mellitus.


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