scholarly journals Relationship between HbA1c Levels with eGFR and Blood Pressure in Type 2 Diabetes Mellitus Patients in the Department of Internal Medicine Dr. Soetomo General Hospital Surabaya

2019 ◽  
Vol 2 (2) ◽  
pp. 117
Author(s):  
Alexander Tikara Sugondo ◽  
Deasy Ardiany ◽  
Djohar Nuswantoro ◽  
Pulus Budiono Notopuro
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
The World ◽  
Prevalence Of Diabetes Mellitus ◽  
Hba1c Levels

Introduction: Diabetes mellitus is a non-transmitted pandemic disease which had spreaded on a global scale. The prevalence of diabetes mellitus in the world according to the International Diabetes Federation (IDF) is 1.9% and diabetes mellitus is ranked seventh as the cause of death in the world, around 95% in the world is type 2 diabetes mellitus. According to Riset Kesehatan Dasar (Riskesdas) in 2013, the prevalence of diabetes mellitus in Indonesia is 6,9%. Type 2 diabetes mellitus that is not well controlled will increase the risk of chronic complications, both microangiopathies such as nephropathy, and macroangiopathy such as hypertension. The aim of the study was to determine correlation between HbA1c levels with eGFR (Estimated Glomerulus Filtration Rate) and blood pressure (systolic and diastolic).Methods: An analytic observational cross-sectional study, collecting the data from 94 patients with type 2 diabetes mellitus, Dr. Soetomo General Hospital, Surabaya, from January to May 2018. The variables were collected from patient’s medical records. Analysis using Spearman’s Rank Correlation test. To determine normality of the data, we use Kolmogorov-smirnov test.Results: The results showed that there are 134 (57,8%) patients with type 2 diabetes mellitus are female more than male. Patients with greater than or equal to 45 years old were 203 (87,5%) patients, more than under 45 years old. The correlation test showed that there was no significant correlation between HbA1c and systolic blood pressure (r=-0,127; p=0,054). Also there was no significant correlation between HbA1c and diastolic blood pressure (r=-0,111; p=0,093). Analysis on other factor showed a significant correlation between HbA1c and eGFR (r=0.341; p=0.000).Conclusion: There was no significant correlation between HbA1c and systolic blood pressure, also there was no significant correlation between HbA1c and diastolic blood pressure. But, there was a significant correlation between HbA1c and eGFR. This is because the data retrieval does not consider the drug consumption and therapy that has been done by the patient, as well as examination of HbA1c, serum creatinine eGFR, and blood pressure not at the same time.

scholarly journals Predictors of Glycemic Control Among Patients With Type 2 Diabetes in North West Ethiopia: a Longitudinal Study

2021 ◽  
Author(s):  
Nigusie Gashaye Shita ◽  
Ashagrie Sharew Iyasu
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Good Glycemic Control ◽  
Diabetes Patients

Abstract Background: Type 2 diabetes mellitus patients with hyperglycemia for a long period are significant causes of mortality and morbidity worldwide. Studying the predictors of glycemic control helps to minimize deaths and the development of acute and chronic diabetes complication. Hence, this study aims to assess predictors of glycemic control among patients with Type 2 diabetes in Ethiopia.Methods: A retrospective cohort study was conducted among type 2 Diabetes mellitus (T2DM) patients enrolled between December 2011 and December 2012 at Debre Markos and Felege Hiwot Referral Hospital. A total of 191 T2DM patients were included in the study meets the eligibility criteria. A generalized linear mixed model was employed. Results: The prevalence of good glycemic control among type 2 diabetes patients was 58.4% whereas 23.25% of the variation was explained in the fitted model due to adding the random effects. The significance predictors of glycemic control among patients with Type 2 diabetes at 95% confidence level were reside in rural(0.454, 0.614)), patients age 38-50, 51-59 and 60-66 years(1.267,1.776), (1.057,1.476) and (1.004, 1.403), respectively, Proteinuria Positive (1.211, 1.546), diastolic blood pressure ≥90 (1.101, 1.522), systolic blood pressure ≥140 (1.352, 1.895), creatinine (0.415, 0.660), duration per visit (0.913, 0.987), duration since diagnosis (0.985, 0.998), weight 78-88(0.603, 0.881).Conclusion: The level of glycemic control among type 2 diabetes patients was poor. Type 2 diabetes mellitus patients having higher age of the patient, higher weight, reside in rural, longer duration of T2DM since diagnosis, longer duration of type 2DM per visit, increase creatinine, positive protein urea, diastolic blood pressure≥90, and systolic blood pressure≥140 were significant predictors of poor glycemic control among type 2 DM patients. During diabetic patients follow up, clinicians should give appropriate attention to these significant variables for good glycemic control since it is the main goal of diabetes management.

scholarly journals The effect of OMEGA-3 polyunsaturated fatty acids on ambulatory blood pressure monitoring parameters in patients with type 2 diabetes mellitus and cardiovascular autonomic neuropathy

2019 ◽  
Vol 22 (1) ◽  
pp. 62-69
Author(s):  
Victoria A. Serhiyenko ◽  
Boris N. Mankovsky ◽  
Ludmila М. Serhiyenko ◽  
Aleksandr A. Serhiyenko
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Fatty Acids ◽  
Type 2 Diabetes Mellitus ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Time Index

Background: Cardiovascular autonomic neuropathy (CAN) in type 2 diabetes mellitus (T2DM), which is characterized by lesion of nerve fibers in parasympathetic and sympathetic nervous system is one of the leading causes of heart arrhythmias and an independent risk factor for cardiovascular mortality in patients with T2DM. Therefore, the problem of effective treatment of CAN is particularly relevant. Aims: To analyze the effect of long-chain polyunsaturated fatty acids (-3 PUFAs) on ambulatory blood pressure monitoring parameters in patients with T2DM and CAN. Materials and methods: 36 patients with T2DM and confirmed CAN were divided into two groups. First group received hypoglycemic therapy (n=15, control) for three months; patients in group 2 (n=21) in addition were administered 1 capsule/q.d. of -3 PUFAs for three month. Results: Treatment with -3 PUFAs led to significant decrease of the diastolic blood pressure (DBP) (p0,01), diastolic blood pressure load (p0,05), time index of DBP (p0,05) during the day; DBP (p0,05), diastolic blood pressure load (p0,05), time index of DBP (p0,05), SD DBP (p0,01) during the night (compared to the control group). Conclusions: The study showed that prescription of -3 PUFAs for three month was effective in decreasing diastolic blood pressure and its parameters among patients with T2DM and CAN.

Abstract 11267: LX4211, a Dual Inhibitor of Sodium-Glucose Cotransporters 1 and 2, Reduces Systolic Blood Pressure in Patients With Type 2 Diabetes Mellitus and Moderate to Severe Renal Impairment

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Pablo Lapuerta ◽  
Paul Strumph ◽  
Philip Banks ◽  
Ikenna Ogbaa ◽  
Brian Zambrowicz ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Impairment ◽  
Systolic Blood Pressure ◽  
Severe Renal Impairment ◽  
Postprandial Glucose ◽  
Dual Inhibitor

Introduction: Selective sodium-glucose cotransporter 2 (SGLT2) inhibitors target only the kidney, and they have reduced efficacy when patients with type 2 diabetes mellitus (T2DM) have renal impairment (RI). LX4211 blocks sodium and glucose absorption in the gastrointestinal tract by inhibition of SGLT1, and it enhances urinary sodium and glucose excretion in the urine through inhibition of SGLT2. The dual SGLT1/2 action of LX4211 was anticipated to reduce systolic blood pressure (SBP) in addition to improving glucose control in the setting of RI. Methods: This analysis explored the effect of LX4211 on SBP in a clinical trial of patients with T2DM and moderate to severe RI. Patients (N=31) were randomly assigned to be treated with LX4211 (400 mg, N=16) or placebo (N=15) qd for 7 consecutive days. Postprandial glucose levels after a standard high glucose meal served as the primary measure of pharmacodynamic activity. Baseline and Day 8 trough SBP measures were each an average of 3 seated assessments. Results: Mean baseline characteristics included age 66.4 years, estimated glomerular filtration rate (eGFR) 43.4 mL/min/1.73 m 2 , and SBP 130.9 mmHg. Postprandial glucose area under the curve (sampled from pre-dose to 4 hours post meal) was reduced from Baseline to Day 7 by 169.3 mg*hr/dL on LX4211 compared to placebo (p=0.003). Day 8 SBP reductions were 11.4 mmHg on LX4211 and 0.0 mmHg on placebo (p=0.045 for difference between groups). Patients with greater RI (eGFR <45 mL/min/1.73 m2) treated with LX4211 (N=6) had a 10.5 mmHg SBP reduction compared to 0.3 mmHg on placebo (N=9). The difference between seated and standing SBP did not change with LX4211 (0.0 mmHg change, Day 8 vs. Baseline). There were no reports of hypotension, hypovolemia, no serious adverse events, and no patient discontinued due to an adverse event. Mild hypoglycemia was reported in 1 LX4211 patient compared to 2 placebo patients. Conclusions: LX4211 may reduce SBP and enhance glycemic control in T2DM patients with moderate to severe RI.

scholarly journals Management of patients with type 2 diabetes mellitus in the Grand-Aides Program

2019 ◽  
Vol 10 (3) ◽  
pp. 1
Author(s):  
Rebekah M. Compton ◽  
Kimberly S. Bednar ◽  
Peggie E. Donowitz ◽  
M. Norman Oliver
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Emergency Department ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Diastolic Blood Pressure ◽  
Home Visit ◽  
Ed Visits

Objective: To evaluate the Grand-Aides Program for patients with type 2 diabetes mellitus (T2DM) according to the variables of body weight, blood pressure, medication adherence, and hospital consultation and readmissions.Methods: Patients ages 18 years or older with a past medical history of T2DM, hypertension (HTN), and/or obesity and who were recently seen in the emergency department (ED) or recently admitted to the hospital were eligible to enroll in the Grand-Aides Program. Eligible patients were identified after hospital or ED discharge and were asked to enroll in the in-home based program from March 2016 through June 2018. In-home visit protocol was defined prior to patient enrollment with intense in-home visits during the first weeks of enrollment followed by monthly visits for the duration of enrollment in the program. In-home visit frequency was adjusted on as needed basis so that patients at higher risk for ED visits or hospitalization were seen more frequently. In-home visits were performed by trained Grand-Aide who for the purpose of this study was a certified nursing assistant (CNA). The Grand-Aide underwent eighty hours of didactic training which included visit protocols, visit schedules, and data collection. The one-on-one in-home patient with every visit were supervised by a registered nurse (RN) or nurse practitioner (NP) via video or telephone contact near the conclusion of the visit. Active patients at the University of Virginia Family Medicine clinic were eligible for enrollment. Fifty-seven patients with T2DM worked with Grand-Aides for three months and an additional forty-eight T2DM patients worked with Grand-Aides for twelve months. Emergency department visits, all 30-day hospital readmissions, as well as blood pressure readings, medication adherence, weights, and glycated hemoglobin (HbA1c) were compared with the prior twelve months.Results: Systolic (p < .001) and diastolic (p < .01) blood pressures decreased (p < .01) at 1 year. At baseline 56 percent of the patients had a systolic blood pressure of >130 mmHg despite treatment; after 12 months, 48 percent of these were < 130. In those whose baseline diastolic blood pressure was > 90 mmHg, 100 percent had diastolic blood pressure < 90 mmHg at 1 year. Medication adherence by ARMS test at 1 year was 94 percent. Despite trending downward, weight and HbA1c did not change significantly. In the preceding, 58 percent had at least one ED visit, which was reduced by 50 percent (p < .01) with Grand-Aides; 30-day all-cause readmissions reduced by 50 percent to 6.3 percent. Conclusions: The Grand-Aides program was associated with a significant change in blood pressure control, high medication adherence and reductions in ED visits and readmissions that compare favorably with published comparative data. For systems “at risk” for preventable increased health care expense burden, the Grand-Aides program can result in significant savings.

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