scholarly journals Comparison of Retinal Sensitivity by Automated Perimetry in Middle Aged Type 2 Diabetic Patients with and without Diabetic Retinopathy - A Cross-Sectional Study in a Tertiary Care Centre in West Bengal

2021 ◽  
Vol 8 (13) ◽  
pp. 835-839
Author(s):  
Abhinav Marlapati ◽  
Sambuddha Ghosh ◽  
Swati Majumdar
Keyword(s):  
Diabetic Retinopathy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Retinal Sensitivity ◽  
Automated Perimetry ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Group 2

BACKGROUND We wanted to measure and compare retinal sensitivity in central 30 degree in diabetic patients, with and without diabetic retinopathy in different stages, evaluate changes in retinal sensitivity in relation to change in HbA1c values, measure and compare GCL thickness in various stages of DR with the help of optical coherence tomography (OCT). METHODS This observational, cross-sectional study involving 100 eyes of 100 middle aged (45 - 64 years) type 2 diabetes mellitus patients (50 eyes without DR - group 1 & 50 eyes with DR - group 2) without any other ocular abnormalities was conducted in the outpatient and in-patient departments of department of ophthalmology in a tertiary care centre in West Bengal. Non-randomised sequential sampling was performed with corrected visual acuity better than or equal to 6 / 12. Fasting and postprandial blood glucose and HbA1c were estimated. Detailed ocular examination was performed using direct and indirect ophthalmoscope with + 20 D lens and slit lamp bio-microscope using + 90D lens. Retinal sensitivity was assessed by Humphrey visual field analyser by Swedish Interactive Thresholding Algorithm (SITA) standard strategy (30 - 2 programme). Spectral domain optical coherence tomography (SD OCT) was performed in all patients. SPSS version 20 has been used for the analysis. RESULTS Among DR patients, 33 had mild non-proliferative diabetic retinopathy (NPDR) (male = 15, female = 18) and 17 had moderate NPDR (male = 7, female = 10). Mean age in DR (Gr. 2) and no DR (Gr. 1) group were 52.62 and 50.74 years respectively. Mean foveal sensitivity and mean retinal sensitivity decreased significantly (P-value 0.001 and 0.002 respectively) in group 2 patients. It further decreased with increased severity of DR. Mean ganglion cell + inner plexiform layer (GC + IPL) thickness in temporal quadrant decreased in DR group compared to no DR group with significant difference between the two (P-value < 0.001). Mean retinal nerve fibre layer (RNFL) thickness was significantly reduced in DR group (P-value < 0.001). HbA1c mean in no DR (6.7 %) and DR group (8.07 %) and in mild (7.5 %) and moderate NPDR (9.17 %) shows significant association of poor control of blood sugar with severity of DR. CONCLUSIONS Retinal sensitivity decreased significantly in diabetes even without retinopathy as detected by automated perimetry. Significant decrease in retinal thickness as detected by OCT suggested that neurodegeneration occurs in diabetes even without retinopathy. So automated perimetry and OCT could be helpful in identifying persons at an early stage who are at risk of future vision loss due to diabetes. KEYWORDS Diabetic Retinopathy, Retinal Neurodegeneration, Retinal Sensitivity, Automated Perimetry, GCL + IPL Thickness, RNFL Thickness

scholarly journals Lipid profile pattern in controlled and uncontrolled diabetic patients in a tertiary care centre

2020 ◽  
Vol 8 (4) ◽  
pp. 1528
Author(s):  
Smita Gupta ◽  
Rajat Mangal ◽  
Ankit Grover
Keyword(s):  
Glycemic Control ◽  
Total Cholesterol ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Good Glycemic Control ◽  
Cross Sectional ◽  
Lipid Panel

Background: Diabetes Mellitus is a metabolic disorder characterized by hyperglycemia with disturbances of carbohydrate, lipid as well as protein metabolism virtually affecting every organ in the human body. Dyslipidemia is a group of biochemical disorders, which is frequently seen in diabetic individuals. Dyslipidemia associated with diabetes has a major role in atherosclerosis and cardiovascular complications.Methods: This cross-sectional study was conducted in diabetic patients visiting OPD of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly over a period of 6 months. A total of 320 patients were randomly selected for the study and divided into 2 groups depending on HbA1c levels.Results: BMI of controlled diabetics was 26.2±1.91 kg/m2 and of uncontrolled was 27.56±4.36 kg/m2 respectively with a statistically significant p value. Total Cholesterol levels in controlled group was 185.63±52.32 mg% and 217.83±61.33 mg% in uncontrolled group with a p value of 0.0005 which is highly significant. Same was seen in triglyceride and VLDL levels in controlled group which was 173.88±101.77 mg% and 31.5±12 mg% respectively and 203.33±83.7 mg% and 40.67±17.66 mg% in uncontrolled group respectively.Conclusions: The diabetic patients with poor glycemic control had statistically significant high values of Total Cholesterol, Triglycerides, VLDL levels and significant low HDL Levels. Good glycemic control can result in improvement in the lipid panel and the patients can be prevented from the high cardiovascular and neurological risk.

scholarly journals Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals

2018 ◽  
Vol 35 (1) ◽  
Author(s):  
Iqra Arshad ◽  
Sara Mohsin ◽  
Sana Iftikhar ◽  
Tahseen Kazmi ◽  
Luqman F. Nagi
Keyword(s):  
Insulin Therapy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Early Initiation ◽  
P Value ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Creative Commons ◽  
Oral Medications ◽  
Tertiary Care Hospitals

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic. Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17. Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years). Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe. How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.237 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.

scholarly journals DIABETIC RETINOPATHY;

2018 ◽  
Vol 25 (08) ◽  
pp. 1256-1260
Author(s):  
Nasir Ahmad Chaudhary ◽  
Samreen Hameed ◽  
Muhammad Sultan Ul Moazzam ◽  
Sarmad Zahoor ◽  
Sidrah Latif ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Predictive Value ◽  
Tertiary Care ◽  
Retinal Disease ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Retinal Examination ◽  
Tertiary Care Hospitals ◽  
Hba1c Levels

Background: Diabetic retinopathy is one of the most common complications ofdiabetes affecting more than 1/4th of the diabetics and is also the leading cause of blindness inmany parts of the globe. Regular fundoscopic examination for screening is a routine practicein tertiary care hospitals but is not available in the primary care centers. This necessitatesthe development of a reliable screening tool which will allow for early referral of those withcomplications to the specialist centers. Objective: To determine the predictive value of HbA1clevels for the presence of diabetic retinopathy. Study Design: A cross-sectional study. Setting:Diabetic Clinic of Mayo Hospital, Lahore. Period: 04 months, January to April 2017. Method:75 diabetic patients who presented in Diabetic clinic were investigated for HbA1c levels andfundoscopic evaluation was done to detect retinal changes. Results: Out of 75 patients, 35(46.7%) were female, 40 (53.3%) were male. Median age of the patients was 51 years. All patientshad HbA1c levels more than 6.0% and 62% patients had detectable changes on fundi while therest had no detectable retinal disease despite elevated HbA1c levels. Positive predictive value(PPV) of elevated HbA1c levels for the presence of diabetic retinal changes was calculated tobe 62.66%. Conclusion: All the patients who had retinal disease on fundoscopy had HbA1clevels of more than 6.0% (PPV = 62.66) which means that elevated HbA1c levels warrant afundoscopic retinal examination to rule out diabetic retinopathy.

16 - Low Prevalence of Fibrate Use in Established Diabetic Retinopathy at a Tertiary Care Centre: A Cross-Sectional Study

2019 ◽  
Vol 43 (7) ◽  
pp. S7
Author(s):  
Justin Morein ◽  
Jeffrey L. Mahon ◽  
Artem Uvarov ◽  
Tamara Spaic ◽  
Irene Hramiak ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Low Prevalence

scholarly journals A study of serum C peptide levels in newly detected diabetic patients in tertiary care hospital

2021 ◽  
Vol 8 (5) ◽  
pp. 679
Author(s):  
Balakrishna Teli ◽  
Prabhu S. ◽  
Sneha Biradar
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Study Data ◽  
P Value ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Cross Sectional ◽  
C Peptide ◽  
Medical College ◽  
Endogenous Insulin

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The deficiency of C-peptide in type 1 DM or its excess in type 2 DM leads to the development of disorders which includes the cardiovascular, nervous, excretory and other systems. The present study is done to assess the serum C-peptide levels in newly detected diabetic patients and its significance in classification of diabetes and deciding about management.Methods: This cross sectional study was conducted within the hospitals attached to Bangalore medical college and research institute. 65 newly detected diabetes patients who gave consent for study and satisfy the inclusion criteria were included in the study. Data was collected using semi structured questionnaire, clinical examination and relevant investigations. Statistical analysis was performed using SPSS software. A p value of <0.05 was considered significant.Results: C-peptide levels showed that 34 (52.3%) subjects had C-peptide levels >2 followed by 10 (15.4%) subjects having 0.1 to 0.6, 9 (13.8%) subjects having 1 to 2, 6 (9.2%) subjects each having 0.6 to 1 and <0.1.Conclusions: Serum C-peptide levels are useful as an index of endogenous insulin production. Low C-peptide levels need insulin treatment due to poor insulin reserve. Majority of the subjects, who had low serum C-peptide levels also had low BMI suggesting a positive correlation between C-peptide levels and BMI.

scholarly journals Placental thickness and its correlation with estimated foetal weight: a cross-sectional study in a tertiary care centre in South India

2019 ◽  
Vol 8 (4) ◽  
pp. 1347
Author(s):  
Goldy S. J. ◽  
Sheba Rosatte Victor ◽  
Bewin Oral J. ◽  
Adaline Thangam ◽  
Usha Christopher ◽  
...  
Keyword(s):  
Past History ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
P Value ◽  
Additional Parameter ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Foetal Development ◽  
Cross Sectional ◽  
Placental Thickness

Background: The placenta is a multifaceted organ which modulates and modifies the maternal environment resulting in foetal development. It could be assumed that a healthy placenta culminates in a healthy foetus. Hence the morphometric analysis of a placenta during sonogram is inevitable. The aim of the study was to estimate the relationship between placental thickness and estimated foetal weight.Methods: The study was a cross-sectional study and included 450 antenatal women attending the department of Obstetrics and Gynaecology, Tirunelveli Medical College from May 2013 to May 2014. These women had regular cycles with a known Last menstrual period and a singleton foetus. After ethics committee approval, meticulous history including age, parity, demographic factors and past history were recorded. After obtaining consent, these women underwent placental thickness measurement between 14-40 weeks of pregnancy.Results: In the study mean placental thickness between the ranges of 11-49mm was 28.7mm and mean estimated foetal weight was 1.421kilogram. The correlation between the two was 0.943. Hence the positive correlation between the placental thickness and foetal weight is confirmed (p value <0.001).Conclusions: Determining the estimated foetal weight is an important reason for doing a sonogram, especially in third trimester. Placental thickness measured at the level of umbilical cord insertion can serve as an additional parameter in estimating foetal weight in addition to the foetal parameters, since there is a linear correlation between placental thickness and foetal weight.

“A Cross Sectional Study to Evaluate Association Between the Duration of Diabetes and Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients in A Tertiary Care Centre”

2021 ◽  
Vol 8 (2) ◽  
pp. 62-66
Author(s):  
Dr. Sneha Murade ◽  
Dr. Amrut Swami ◽  
Dr. Anil Singh ◽  
Dr. Vikas Khamkar ◽  
Dr. Shruti Swami
Keyword(s):  
Diabetic Retinopathy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Department Of Ophthalmology ◽  
Patients With Diabetes ◽  
Lifestyle Related Diseases

Introduction: The numbers of people affected with lifestyle related diseases are increasing every day, diabetes being one of the major contributors to the increasing morbidity and mortality in the world. Diabetic retinopathy is one the complications of diabetes which is thought to be associated with the duration of diabetes, we conducted this study to evaluate the same. Methods: This study was conducted at Department of Ophthalmology. Total 100 cases were selected for the study and patient data was collected and analysed. Duration of diabetes and its association with diabetic retinopathy was studied. Results: There were 62 males (62%), most of the participants were more than 60 years of age (54%). Majority of the patients had diabetes for 5 to 10 years (44%) followed by 1 to 5 years (34%) and 0 – 1 year (22%). On FFA examination, majority of the patients had no any diabetic retinopathy (52%) while rest 48 patients had retinopathy (48%). Significant association was seen between the duration of diabetes and presence of diabetic retinopathy. (p=0.002). Conclusion: We found a significant association between the duration of diabetes and diabetic retinopathy. It is important that in patients with diabetes who are not diagnosed as retinopathy by ophthalmoscopy, FFA should be done.

scholarly journals Prevalence of insulin induced lipodystrophy in patients with diabetes mellitus in a tertiary care centre: a cross sectional study

2019 ◽  
Vol 8 (4) ◽  
pp. 710
Author(s):  
Shravani Bezawada ◽  
Anuradha H. V. ◽  
Pramila Kalra
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care ◽  
Insulin Injection ◽  
Cross Sectional Study ◽  
Diabetes Mellitus Type 1 ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Lifestyle Modifications ◽  
Tertiary Care Centre ◽  
Cross Sectional

Background: Diabetes Mellitus is a spectrum of common metabolic disorders whose management mainly lies in treating the patients with oral hypoglycaemic drugs and insulin along with the dietary and lifestyle modifications. Lipodystrophy is the most neglected adverse drug effect caused by injecting insulin. The main objective of this study was to assess the prevalence of lipodystrophy at the insulin injection sites in patients suffering from diabetes mellitus (Type 1 and Type 2).Methods: A cross-sectional study was conducted in the Department of Endocrinology on 250 diabetic patients taking insulin injections based on inclusion and exclusion criteria. The demographic features and anthropometric measurements were noted. Insulin injection sites were examined clinically by inspection and palpation for presence of swelling like lipodystrophy, injection marks and signs of allergy like erythema etc. Lipodystrophy was graded from 0-3 and denoted as lipohypertrophy or lipoatrophy. The results were tabulated and presented accordingly.Results: In this study, out of 250 patients 17 (6.8%) patients presented with insulin induced lipodystrophy. Lipohypertrophy was the most common presentation and only one case presented with lipoatrophy.Conclusions: It can be concluded from the present study that lipodystrophy which is an important adverse effect due to insulin injection needs to be monitored regularly in every patient taking insulin for better control of glucose levels.

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