scholarly journals Clinical Features, Biochemical Profile, and Response to Standard Treatment in Lean, Normal-Weight, and Overweight/Obese Indian Type 2 Diabetes Patients

2021 ◽  
Vol 17 (2) ◽  
pp. 68-74
Author(s):  
Ahmad Faraz ◽  
Hamid Ashraf ◽  
Jamal Ahmad

BACKGROUND: Much evidence is available on the relationship between type 2 diabetes mellitus (T2D) and obesity, but less on T2D in lean individuals. AIM: This study was conducted in 12,069 T2D patients from northern India to find out which clinical and biochemical features are related to lean, normal weight, and overweight/obese T2D patients. METHODS: The study was conducted at two endocrine clinics in northern India as a retrospective cross-sectional study. The records of all patients who attended these clinics from January 2018 to December 2019 were screened. After screening 13,400 patients, 12,069 were labelled as type 2 diabetes mellitus according to the criteria of the American Diabetes Association, 2020, and were included in the study. The patients were subdivided into the three groups by their body mass index (BMI): lean (BMI < 18), normal weight (BMI = 18-22.9), overweight/obese (BMI ≥ 23). The study evaluated how the three subgroups responded to standard diabetes management, including antidiabetic medication and lifestyle interventions. RESULTS: Of a total of 12,069 patients 327 (2.7%) were lean, 1,841 (15.2%) of normal weight, and 9,906 (82.1%) overweight/obese. Lean patients were younger, but had more severe episodes of hyperglycemia. All three subgroups experienced significant improvements in glycemic control during follow-up; HbA1c values were significantly lowered in the overweight/obese group during follow-up compared with baseline. CONCLUSIONS: While overweight/obese patients could benefit from the improvements in glycemic control achieved by lowering HbA1c, lean and normal-weight patients had more severe and difficult-to-control hyperglycemia.

Author(s):  
Saad Alresayes ◽  
Modhi AlDeeb ◽  
Nawwaf AlHamoudi ◽  
Fawad Javed ◽  
Fahim Vohra ◽  
...  

It is hypothesized that under optimal glycemic control (GC), there is no difference in the survival of implants placed in the zygomatic bone of edentulous patient with and without type-2 diabetes mellitus (T2DM). Purpose: The aim was to assess the influence of GC on survival of implants placed in the zygomatic bone of edentulous patient with and without T2DM at 10-years’ follow-up. Twenty patients with T2DM (10 with poorly- and 10 with well-controlled T2DM) and 12 patients without T2DM were included. Hemoglobin A1c (HbA1c) levels were recorded and demographic data was collected from all participants. Peri-implant inflammatory parameters (plaque index [PI], probing depth [PD], crestal bone loss [BL] and gingival index [GI]) were measured in all patients. Group comparisons were done and P-values, which were less than 0.01 were indicative of statistical significance. Twenty and 12 male patients with and without T2DM, respectively were included. Among patients with T2DM, 10 and 10 individuals had poorly- and well-controlled T2DM, respectively.  The mean HbA1c levels were significantly higher in patients with poorly- (9.2 ± 0.7%) compared with well-controlled T2DM (4.8 ± 0.3%) (P&lt;0.01) and non-diabetic individuals (4.6 ± 0.3%) (P&lt;0.01). The crestal BL on the mesial (P&lt;0.01) and distal (P&lt;0.01) surfaces, PD (P&lt;0.01), PI (P&lt;0.01), and GI (P&lt;0.01) were significantly higher around all zygoma implants placed in patients with poorly-controlled T2DM compared with patients with well-controlled T2DM and patients without T2DM. These clinicoradiographic parameters were comparable around zygoma implants placed in patient with well-controlled T2DM and in subjects without T2DM.  Optimal glycemic control is essential for the long-term stability of zygomatic plants in patients with T2DM.


2021 ◽  
Author(s):  
Pablo Romakin ◽  
Donald Wilson ◽  
Sabiha Khan ◽  
Masoud Mohaammadnezhad

Abstract Background: Glycemic control is the centre in diabetes management. In patients with type 2 diabetes mellitus (T2DM), glycemic control is associated with clinical determinants. The aim of this study was to determine the proportion of poor glycemic control level and its clinical determinants among T2DM patients.Methods: This retrospective cross-sectional study was conducted on the medical records of T2DM patients attending diabetes clinics at the three selected health centres in Suva, Fiji. Patients who met the following criteria were included in the study: adult T2DM >18 years old registered during 2011 to 2016; on treatment for >1year; had >4 clinic visits and; had a recent HbA1c result in 2017. Logistic regression analysis was performed. A p value of <0.05 was considered as significant.Results: There were 200 female (59.2%) and 138 male (40.8%) T2DM patients included in this study with a mean age of 56.5 years (SD = + 9.9). Majority have poorly controlled random blood sugar (RBS), 67.1% and fasting blood sugar (FBS), 63.0%. Two-thirds (65.4%) had co-morbidities. The proportion of poor glycaemic control (HbA1c <7%) was 77.2% with mean HbA1c of 8.6% (+ 2.04). RBS, FBS, cholesterol, estimated glomerular filtration rate (eGFR) and diastolic blood pressure (DBP) were significant (p<0.05) determinants of poor glycaemic control.Conclusions: This study identified clinical determinants of T2DM patients that are highly associated with glycemic control. Health care workers managing T2DM patients should address these clinical determinants in order to achieve glycemic control.


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