scholarly journals Prospective Evaluation of Coexistence of Subclinical Hypothyroidism with Type 2 Diabetes Mellitus and Its Effect on Metabolic Profile

2021 ◽  
Vol 8 (10) ◽  
pp. 547-550
Author(s):  
Sri Krishna Appaji C ◽  
Deepak Phanindhra M ◽  
Anand Acharya

BACKGROUND Subclinical hypothyroidism is the term used to describe a condition where there is isolated elevated serum thyroid stimulating hormone level in the setting of normal serum free thyroxin levels in the absence or presence of symptoms. There is no uniformity in various studies regarding association between subclinical hypothyroidism and type 2 diabetes mellitus with regard to prevalence and change in metabolic profile. METHODS After enrolment of patients, a detailed relevant history of patients was taken and detailed clinical examination was done. All information obtained from patients was recorded in predesigned proforma. After 8 hours of fasting, serum levels of glucose, HbA1c, total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) by fully automated clinical biochemistry analyser EM 200 were checked. Serum free T3, free T4 and thyroid stimulating hormone (TSH) were measured using standard assay. RESULTS Fasting glucose was significantly higher (P = .00001) in diabetes mellitus plus subclinical hypothyroidism group than patients with diabetes mellitus (DM) and euthyroid group (156.3 + 15.77 mg / dl vs. 128.1 + 21.44 mg / dl). Fasting insulin was significantly higher (P = .00001) in diabetes mellitus plus subclinical hypothyroidism group than patients with DM and euthyroid group (3.69 + 0.82 mu / L vs. 2.36 + 0.75 mu / L). There was no significant difference between two groups regarding HbA1c. CONCLUSIONS From our study we conclude that prevalence of subclinical hypothyroidism was higher in type 2 diabetes patients than normal population and there was female predominance. Body mass index was significantly higher in subclinical hypothyroidism group and there was no significant difference between the two groups regarding duration of diabetes mellitus. Patients with subclinical hypothyroidism have poor glycaemic control. KEYWORDS Subclinical Hypothyroidism, Diabetes Mellitus, Metabolic Profile

2021 ◽  
Vol 8 (02) ◽  
pp. 103-107
Author(s):  
Salim Javeedh ◽  
Vidya T.A

BACKGROUND Thyroid disease is more common in people with diabetes mellitus than in general population. Among thyroid disorders, subclinical hypothyroidism is more common than the overt form. Hypothyroidism is associated with dyslipidaemia, hypertension and cardiac disease. Subclinical hypothyroidism has also been reported to have these features. With this background, we aimed to determine the prevalence of subclinical thyroid disorder and its influence on the metabolic profile of patients with type 2 diabetes mellitus (DM). METHODS 234 type 2 diabetes patients, 117 males and 117 females, who were previously not known to have thyroid disease, were screened for thyroid dysfunction using serum free T3, free T4, and thyroid stimulating hormone (TSH) levels. Patients were evaluated for clinical features of thyroid disease and investigated for microvascular complications of DM, dyslipidaemia and cardiac disease. Individuals with subclinical hypothyroidism were further screened for anti-thyroid peroxidase (TPO) antibodies. RESULTS In this study, subclinical hypothyroidism was present in 29 (12.4 %) of 234 type 2 diabetics; no case of subclinical hyperthyroidism was detected. 25 of these 29 patients with subclinical hypothyroidism were females. Elevated TPO antibody levels were present in 82.8 % (24 out of 29) subclinical hypothyroidism (SCH) patients. SCH was found to be associated with higher body mass index (BMI) and patients aged more than 50 years. No significant difference was found in glycaemic profile or lipid profile between patients with SCH and euthyroid subjects. There was no significant difference among SCH patients with and without microvascular complications. Left Ventricle (LV) diastolic dysfunction was present in 34.4 % of SCH patients. CONCLUSIONS SCH is common among type 2 diabetics, especially in females and most commonly due to autoimmune thyroid disease. SCH in type 2 DM is associated with a higher BMI and an older age group, but it does not seem to have an influence on glycaemic profile, lipid profile or microvascular complications of diabetes. KEYWORDS Thyroid Stimulating Hormone (TSH), Type 2 Diabetes Mellitus (T2DM), Subclinical Hypothyroidism (SCH), BMI, Anti–TPO (Thyroid Peroxidase) Antibody


Author(s):  
Arpita Jaidev ◽  
Hitesh Shah ◽  
Liggy Andrews ◽  
Bhavisha N. Vagheda

Background: Dyslipidemia has a varying pattern among the male and female patients of type 2 diabetes mellitus (DM).Methods: This study was conducted in the out-patient department (OPD) of department of medicine at GMERS, Patan, Gujarat from July 2020 to December 2020 for a period of six months. Fasting blood sugar, hemoglobin A1c (FBS, HbA1c) lipid profile triacylglycerol-triglyceride, total cholesterol, low density lipoprotein cholesterol and high-density lipoprotein cholesterol (TG, TC, LDL-C, and HDLC) were measured. Statistical analyses were performed with the SPSS software program.Results: A total number of 200 type 2 DM patients (100 males and 100 females) attending to GMERS OPD were recruited in this study. Blood sugar was higher than normal in both male and female (FBS=142.44±36.21, 146.40±41.49 respectively). TG level was also higher in two groups of study subjects with female level slightly more than male (164.99±67.1and 138.21±70 respectively) with no significant difference between the groups (p>0.05).Total cholesterol and LDL-C level was within normal physiological level in both groups, where-as these levels were higher in female in comparison to male (TC=198.07±40.82 and 169.5±36.13 respectively, LDLC=118±34 and 99±27, respectively), showing significant difference between the groups (p=0.014). HDL-C was not below normal in both male (41±5.4) and female (43.99±4.31); however, HDL-C was slightly higher in female than male and the difference was significant (p=0.0129).Conclusions: Dyslipidemia was noticed in a greater proportion of female diabetic patients than male diabetic patients.


Author(s):  
Thiago Fraga Napoli ◽  
Mariana Furieri Guzzo ◽  
Douglas Kawashima Hisano ◽  
Paulo Gustavo Figueiredo Salgado Ribeiro ◽  
Vanessa Junqueira Guedes ◽  
...  

BACKGROUND: There is a debate over results obtained from type 2 diabetes mellitus (DM2) obese patients and non-DM2 patients, in reference to metabolic control and ponderal loss, after bariatric surgery. AIM: To evaluate weight loss and metabolic profile of obese patients with DM2 versus non-DM2 subjects, one and three years after bariatric surgery. METHODS: Data from 38 non-DM2 patients and 44 DM2 patients submitted to Roux-en-Y gastric-bypass were analysed retrospectively. For the pre-operatory, first and third year of post-operatory, were compared: weight, body mass index (BMI), fasting glucose (FG), high density lipoprotein (HDL) and triglycerides (TG). RESULTS: Preoperatively, both groups were statistically equivalent in regards to weight, BMI (P = 0.90) and HDL (P = 0.73). This was not the case when TG (P = 0.043) and FG (P<0.01) were analyzed. In PO1, both DM2 and non-DM2 groups showed a reduction in weight, BMI and TG, just as FG in the DM2 group (P < 0.05). HDL increased (P < 0.05) in PO1 in both groups. In the following period, between PO1 and PO3, only TG continued to decrease in the non-DM2 group (P = 0.039), while the other variables did not change. In the DM2 group mean A1c in PO3 was 6.2% +- 0.75 (P = 0.027). It was compared both group's post-operative data. HDL's and TG's variation between groups did not differ in PO1 or between PO1 and PO3. Weight in PO1 and PO3, just as BMI in PO1 and PO3, were not significantly different either. CONCLUSION: In PO1, weight loss and metabolic improvement was seen in both groups. This was sustained in PO3, with no significant weight regain or lipid/FG change. A1c found suggests a reasonable control of DM2 surgery. A trend towards a less intense weight loss could be noticed in the DM2 group (P = 0.053).


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yonghuan Bian ◽  
Changhao Liu ◽  
Zhaojiang Fu

Abstract Background Our study attempted to observe the value of periodontal curettage combined with root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes. Methods There involved 72 patients with type 2 diabetes mellitus complicated with moderate-to-severe chronic periodontitis who were diagnosed and treated in our hospital from January 2019 to December 2019. The patients enrolled were randomly divided into four groups using a computer-generated table: root planing and periodontal curettage combined group (n = 18), root planning group (n = 18), periodontal curettage group (n = 18) and cleansing group (n = 18). Blood glucose, plaque index (PI), gingival index (GI), probing depth (PD), attachment loss (AL), serum levels of inflammatory factors (Tumor Necrosis Factor Alpha [TNF- α] and hypersensitive C-reactive protein [hs-CRP]) were observed before and after treatment. The collecting dates were analyzed by the chi-square χ 2 test, repeated measurement analysis of variance, or t-test according to different data types and research objectives. Results Before treatment, there was no significant difference in PI, GI, PD and AL among the four groups (P> 0.05), while after 3-month treatment, the levels of PI, GI, PD and AL in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, with both root planing group and periodontal curettage group significantly lower than cleansing group (P< 0.05). The fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin in the combined group, root planing group, periodontal curettage group and cleansing group were significantly lower than those before treatment (P < 0.05). Before treatment, there was no significant difference in TNF- α and hs-CRP among the four groups (P> 0.05), but the levels of TNF- α and hs-CRP in the four groups decreased significantly after 3-month treatment (P< 0.05). The levels of TNF- α and hs-CRP in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, and those in the root planing group and periodontal curettage group were significantly lower than those in the cleansing group (P< 0.05). Conclusion The combination therapy of periodontal curettage and root planing exerted beneficial effects on moderate-to-severe chronic periodontitis in patients with type 2 diabetes mellitus, which holds the potential to maintain the level of blood glucose and improve the quality of life of the patients.


2021 ◽  
Vol 71 (1) ◽  
pp. 24-29
Author(s):  
Rachma Putri Nariswari ◽  
Gwenny Ichsan Prabowo ◽  
Hermina Novida ◽  
Nurina Hasanatuludhhiyah

Introduction: Type 2 diabetes mellitus is caused by decreased tissue sensitivity to insulin. The prevalence of diabetes in the world has almost doubled since 1980, from 4.7% to 8.5% in adult population. Early diagnosis and treatment aimed at normalizing glycemic control are very important. The objective of this study was to evaluate and compare glycemic control of metformin and glimepiride in monotherapy of type 2 diabetes mellitus patients at Islamic Jemursari Hospital Surabaya. Method: This was a retrospective observational study using secondary data (medical record), include glycemic control (RPG) before and two months after receiving therapy of outpatients’ type 2 diabetes mellitus with metformin or glimepiride therapy in 2018. 96 samples were found that fit the inclusion criteria. The data were analyzed by Mann-Whitney test. Result: Most patients were female, aged 50-69 years old, and dosage of metformin therapy 1500 mg/day or glimepiride therapy 2 mg/day. There was no significant difference (p>0.05) of glycemic control (RPG) of metformin compared to glimepiride therapies in type 2 diabetes mellitus patients at Islamic Jemursari Hospital Surabaya in 2018. Conclusion: Metformin and glimepiride were not significantly different in glycemic control (RPG). There were patients with RPG >200 mg/dl after two months of metformin or glimepiride therapy.  


2018 ◽  
Vol 33 (4) ◽  
pp. 175-185 ◽  
Author(s):  
Gerard Marshall Raj ◽  
Jayanthi Mathaiyan ◽  
Mukta Wyawahare ◽  
Rekha Priyadarshini

Abstract Background This work aimed to evaluate the influence of single nucleotide polymorphisms (SNPs) in the SLC47A1 (922-158G>A; rs2289669) and SLC47A2 (−130G>A; rs12943590) genes on the relative change in HbA1c in type 2 diabetes mellitus (T2DM) patients of South India who are taking metformin as monotherapy. It also aims to study the effects of these SNPs on the dose requirement of metformin for glycemic control and the adverse effects of metformin. Methods Diabetes patients on metformin monotherapy were recruited based on the eligibility criteria (n=105). DNA was extracted and genotyping was performed with a real-time PCR system using TaqMan® SNP genotyping assay method. The HbA1c levels were measured using Bio-Rad D-10™ Hemoglobin Analyzer. Results After adjusting for multiple comparisons (Bonferroni correction) the difference found in the glycemic response between the “GG” genotype and “AG/AA” genotype groups of the SLC47A2 gene was not significant (p=0.027; which was greater than the critical value of 0.025). Patients with “GG” genotype showed a 5.5% decrease in HbA1c from baseline compared to those with the “AG/AA” genotype (0.1% increase). The SNP in the SLC47A1 gene also did not influence the glycemic response to metformin (p=0.079). The median dose requirements based on the genotypes of the rs12943590 variant (p=0.357) or rs2289669 variant (p=0.580) were not significantly different. Similarly, there was no significant difference in the occurrence of adverse effects across the genotypes in both the SLC47A1 (p=0.615) and SLC47A2 (p=0.309) genes. Conclusions The clinical response to metformin was not associated with the SNPs in the SLC47A1 and SLC47A2 genes coding for the multidrug and toxin extrusion protein (MATE) transporters. Furthermore, the studied SNPs had no influence on the dose requirement or adverse effects of metformin.


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