scholarly journals Trajectory of Type 2 Diabetes in Sepsis Outcome: Impacts of Diabetic Complication Burdens, Initial Glucose Level, and HbA1c: Population-Based Cohort Study Combining with Nationwide and Hospital-Based Database

2018 ◽  
Author(s):  
Ming-Shun Hsieh ◽  
Sung-Yuan Hu ◽  
Chorng-Kuang How ◽  
Yi-Tzu Lee ◽  
Chen-June Seak ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Hospital Mortality ◽  
Diabetic Complication ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Initial Blood ◽  
Type 2 Diabetic ◽  
Hba1c Levels

Background Diabetic patients have an increased risk of infections; however, the association between type 2 diabetes and hospital outcomes of sepsis remains controversial when the diabetes severity is not considered. We examined this association using nationwide and hospital-based databases concomitantly. Methods The first part of this study was conducted using 2 nationwide databases: the Longitudinal Cohort of Diabetes Patients and the Longitudinal Health Insurance Database 2000. The diabetic complication burden was evaluated using the adapted Diabetes Complications Severity Index score (aDCSI score). In the second part, we used the hospital-based database with laboratory data, such as initial blood glucose and HbA1c levels, to make comparisons between surviving and dead patients with type 2 diabetes and sepsis. Results The nationwide study included 19,719 type 2 diabetic sepsis patients and an equal number of non-diabetic patients. The diabetic sepsis patients had an increased odds ratio (OR) of 1.14 (95% CI 1.1-1.19) for hospital mortality. The OR for mortality increased as the complication burden increased (diabetic sepsis patients with aDCSI scores of 0, 1, 2, 3, 4, and ≥5 had ORs of 0.91, 0.87, 1.14, 1.25, 1.56, and 1.77 for mortality, respectively (all P<0.001 and P for trend <0.001)). A total of 1,054 diabetic sepsis patients were included from the hospital-based database. Initial blood glucose levels in the surviving and dead diabetic sepsis patients did not differ significantly: 273.9 ± 180.3 versus 266.1 ± 200.2 (mg/dL) (P=0.095). Moreover, the surviving diabetic sepsis patients did not have a lower HbA1c (%): 8.4 ± 2.6 versus 8.0 ± 2.5 (P=0.078). Conclusions In the case of type 2 diabetic sepsis patients, the diabetes-related complication burden is the major determinant of hospital mortality rather than the diabetes itself. Contrary to popular belief, initial blood glucose and HbA1c levels may not be as important as previously thought.

scholarly journals Hospital outcomes and cumulative burden from complications in type 2 diabetic sepsis patients: a cohort study using administrative and hospital-based databases

2019 ◽  
Vol 10 ◽  
pp. 204201881987540 ◽  
Author(s):  
Ming-Shun Hsieh ◽  
Sung-Yuan Hu ◽  
Chorng-Kuang How ◽  
Chen-June Seak ◽  
Vivian Chia-Rong Hsieh ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Hospital Mortality ◽  
Laboratory Data ◽  
Diabetic Patients ◽  
Related Complication ◽  
Type 2 Diabetic Patients ◽  
Hospital Outcomes ◽  
Initial Blood ◽  
Type 2 Diabetic

Background: The association between type 2 diabetes and hospital outcomes of sepsis remains controversial when severity of diabetes is not taken into consideration. We examined this association using nationwide and hospital-based databases. Methods: The first part of this study was mainly conducted using a nationwide database, which included 1.6 million type 2 diabetic patients. The diabetic complication burden was evaluated using the adapted Diabetes Complications Severity Index score (aDCSI score). In the second part, we used laboratory data from a distinct hospital-based database to make comparisons using regression analyses. Results: The nationwide study included 19,719 type 2 diabetic sepsis patients and an equal number of nondiabetic sepsis patients. The diabetic sepsis patients had an increased odds ratio (OR) of 1.14 (95% confidence interval 1.1–1.19) for hospital mortality. The OR for mortality increased as the complication burden increased [aDCSI scores of 0, 1, 2, 3, 4, and ⩾5 with ORs of 0.91, 0.87, 1.14, 1.25, 1.56, and 1.77 for mortality, respectively (all p < 0.001)]. The hospital-based database included 1054 diabetic sepsis patients. Initial blood glucose levels did not differ significantly between the surviving and deceased diabetic sepsis patients: 273.9 ± 180.3 versus 266.1 ± 200.2 mg/dl ( p = 0.095). Moreover, the surviving diabetic sepsis patients did not have lower glycated hemoglobin (HbA1c; %) values than the deceased patients: 8.4 ± 2.6 versus 8.0 ± 2.5 ( p = 0.078). Conclusions: For type 2 diabetic sepsis patients, the diabetes-related complication burden was the major determinant of hospital mortality rather than diabetes per se, HbA1c level, or initial blood glucose level.

scholarly journals Study on the prevalence of dyslipidemia in type 2 diabetes mellitus

2019 ◽  
Vol 6 (3) ◽  
pp. 786
Author(s):  
Eda Dayakar ◽  
C. Sathya Sree ◽  
E. Sanjay
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Type 2 Diabetic

Background: Diabetes mellitus is a common health problem globally. Dyslipidaemia is a major risk factor to develop cardiovascular disease in diabetics. They present study was undertaken to find out the prevalence of dyslipidaemia in type 2 diabetic patients.Methods: The present study was a cross sectional study consisting of 46 (23 male and 23 female) known type 2 diabetes mellitus patients. Age, gender, duration of diabetes, body mass index (BMI) was recorder in all the diabetic patients.  Fasting blood glucose levels, total cholesterol, triglycerides, HDL, LDL, VLDL levels were measured using standard methods and recorded.Results: The average total cholesterol, triglycerides, LDL, HDL and VLDL were 200±42mg/dl, 169.62±89.79mg/dl, 132.45±36.38mg/dl,39.1±16.6mg/dl and 35.85±17.09mg/dl respectively. The incidence of occurrence of hypercholesterolemia was 58.6% and hypertriglyceridemia 36.9%. Increased levels of LDL were observed in 30 (65.2%) patients and reduced HDL was observed in 43 (93.4%) patients. The incidence rate of dyslipidaemia was higher in female diabetic patients when compared to male diabetic patients.Conclusions: Awareness on the dyslipidaemia and its risk factors should be provided to the type 2 diabetic patients as they are more prone to get cardiovascular disease and lipid profile also should be monitored regularly along with blood glucose levels.

scholarly journals Does type 2 diabetic osteoporotic patients present more periodontal risks than non-osteoporotic patients? An evaluation with mandibular cortical index (Klemetti)

2018 ◽  
Vol 17 ◽  
pp. e181211
Author(s):  
Wladimir Gushiken de Campos ◽  
Gonzalo André Montesinos ◽  
Rosa Cristina Peinado Agudo ◽  
Kaisermann Costa ◽  
Luciana Munhoz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bone Loss ◽  
Periodontal Disease ◽  
Diabetic Patients ◽  
Mineral Density ◽  
Cortical Index ◽  
Increased Risk ◽  
Type 2 Diabetic ◽  
Mandibular Cortical Index

Aim: This study aim was to evaluate if patients with type 2 diabetes and osteoporosis have an increased risk of periodontal disease (horizontal and vertical bone loss) when compared to diabetic patients without osteoporosis. Additionally, to assess if patients with diabetes and osteoporosis have a greater risk of reduction of bone mineral density in the mandible, expressed by mandibular cortical index (MCI) when compared to diabetic patients without osteoporosis. Methods: 59 patients (39 diagnosed with type 2 diabetes and osteoporosis; 20 diagnosed with type 2 diabetes and without osteoporosis) were selected. Type 2 diabetes was previously diagnosed by glycated hemoglobin examination and osteoporosis by peripheral dual-energy x-ray absorptiometry. Mandibular cortical index, as well as the presence of vertical and horizontal bone loss was verified on panoramic radiographs. Adjusted odds ratio analyses were performed on presence of periodontal disease and MCI considering the effect of osteoporosis. Results: Absence of statistical significance between variables was found. Conclusions: There is no difference between the risk of periodontal disease or low MCI among osteoporotic and non-osteoporotic type 2 diabetic patients.

scholarly journals Effect of hypothyroidism on lipid profile of type 2 diabetic patients

2020 ◽  
Vol 7 (5) ◽  
pp. 754
Author(s):  
Damanpreet Singh ◽  
Gurinder Mohan ◽  
Arshdeep Bansal
Keyword(s):  
Type 2 Diabetes ◽  
Lipid Profile ◽  
Diabetic Complication ◽  
Control Group ◽  
P Value ◽  
Diabetic Patients ◽  
Study Group ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Background: Hypothyroidism is an endocrine disorder resulting from deficiency of thyroid hormones, and Diabetes is a metabolic disorder that share the phenotype of hyperglycaemia. Both the endocrinopathies have been found to be associated with dyslipidaemia and atherosclerosis that result into various complications. Our aim was to assess the difference of dyslipidaemia in patients suffering from hypothyroidism with diabetes as compared to diabetes alone.Methods: Study was conducted in department of medicine in SGRDIMSR, Sri Amritsar. A total of 120 patients were enrolled for the present study, the one who presented to hospital from January 2018 to August 2019 diagnosed with diabetes mellitus type 2. The patients were divided into two groups. 60 patients having type 2 diabetes without hypothyroidism (control group). 60 patients having type 2 diabetes with hypothyroidism (study group). Fasting lipid profile were performed in both the groups and were analysed for the study.Results: Dyslipidaemia was seen more in study group as compared to control group with mean cholesterol of 488.3(±144.43) and mean triglyceride levels of 354.30(±128.57) in study  group as compared to control group with mean cholesterol and triglyceride levels of 179.7(±81.47) and 177.08(±118.18) with p-value of 0.001 and 0.01 respectively which were significant. Also, obesity and diabetic complication were more in patients of dual endocrinopathies as compared to diabetes alone which were also significant statistically.Conclusions: From our study it is concluded that type 2 diabetes with hypothyroidism causes more dyslipidaemia as compare to type 2 diabetes alone. So proper screening of thyroid profile of type 2 diabetic patients and its correction helps in achieving better lipidemic control which further prevent complications.

scholarly journals Increased H2S synthesizing activity in plasma correlated to fasting blood glucose levels: A study in type 2 diabetes patients

2016 ◽  
Vol 7 (6) ◽  
pp. 6-10
Author(s):  
Pinaki Saha ◽  
Sayantan Dasgupta ◽  
Sukla Nath ◽  
Pradipta Ghosh ◽  
Santanu Sen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Small Sample ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Major Health Problem ◽  
Type 2 Diabetic ◽  
Diabetes Patients

Background: Diabetes mellitus is a major health problem not only in India but worldwide. Our country presently is undergoing an epidemic stage of this non-communicable disease.Though several etiological background of type 2 diabetes has been well explained, yet a number of recent literatures suggested a potential role H2S producing enzymes in the etiology and management of this metabolic disorder.Aims and Objectives: Our aim was to elucidate the relationship of H2S synthesizing activity in plasma and fasting blood glucose in type 2 diabetic patients. Materials and Methods: Sixty-two newly diagnosed type 2 diabetes patients and equal number of non-diabetic controls were included in the study. Enzymatic activity of synthesizing H2S in plasma was estimated following methods described earlier with further modification and standardization in our laboratory. All other parameters were estimated by using standardized kits.Results:  FBG, PPBG, HbA1C, Fasting Insulin,  H2S synthesizing activity in plasma in patients are significantly higher (p< 0.05) than the corresponding values in healthy controls H2S synthesizing activity in plasma is positively correlated with fasting plasma glucose and the correlations is significant(p=0.05).Conclusion: Our study though a pilot study with a small sample size, has elucidated that the values of H2S synthesizing activity in plasma are significantly elevated in type 2 diabetic patients and this may help researchers to develop H2S modifying agents and enzyme inhibitors which may open up new horizon in the treatment modalities of type 2 diabetes mellitus.Asian Journal of Medical Sciences Vol.7(6) 2016 6-10

scholarly journals Evaluation of Different HbA1c Levels to Assess the Risk of Peripheral Neuropathy Among Type 2 Diabetic Patients Along With Other Conventional Risk Factors

2017 ◽  
Vol 42 (2) ◽  
pp. 95-103 ◽  
Author(s):  
Sayama Hoque ◽  
M A Muttalib ◽  
Md. Imtiajul Islam ◽  
Taslima Akber Happy
Keyword(s):  
Risk Factors ◽  
Blood Glucose ◽  
Peripheral Neuropathy ◽  
Large Scale ◽  
Fasting Blood Glucose ◽  
Significant Risk ◽  
Diabetic Patients ◽  
Type 2 Diabetic ◽  
Hba1c Levels

This cross sectional study was carried out in the outpatient department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Bangladesh (BIRDEM) General Hospital, Dhaka, to explore the factors influencing or related to the development of the diabetic peripheral neuropathy (DPN) with specific concern to the HbA1c levels. A total of 400 patients with type 2 diabetic were selected to collect information on socio-demographic, blood pressure, anthropometry and lipid profile. Glycaemic status was assessed by HbA1c and plasma glucose levels. Prevalence of DPN was 16.8%, with male 10.8% and female 20.9%. Increased HbA1c categories above 7.0% were significantly associated with increased prevalence of DPN (9.2 Vs. 10.5 Vs 26.5%; ?2 = 19.446, p = .000). Logistic regression models showed that the risk of DPN was strongly increased at the HbA1c categories ?8% (OR = 3.57; 95% CI: 1.75-7.26). Advanced age (OR = 1.97; 95% CI: 1.12-3.47), longer duration of diabetes (OR = 1.81; 95% CI: 1.02-3.19), lacking of physical exercise (OR = 2.60; 95% CI: 1.47-4.58), female gender (OR = 2.17; 95% CI: 1.21-3.89), fasting blood glucose (OR = 1.153; 95% CI: 1.058-1.255) and blood glucose 2 hours after breakfast (OR = 1.096; 95% CI: 1.029-1.168) were significant risk factors of DPN. However, there is need of a large scale community based prospective study to validate the results.

An Approach to diabetic ketoacidosis in an emergency setting.

2020 ◽  
Vol 15 ◽  
Author(s):  
Dario Pitocco ◽  
Mauro Di Leo ◽  
Linda Tartaglione ◽  
Emanuele Gaetano Rizzo ◽  
Salvatore Caputo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Blood Glucose Concentration ◽  
Diabetic Complication ◽  
Emergency Setting ◽  
Online Activity

Background: Diabetic Ketoacidosis (DKA) is one of the most commonly encountered diabetic complication emergencies. It typically affects people with type 1 diabetes at the onset of the disease. It can also affect people with type 2 diabetes, although this is uncommon. Methods: Research and online content related to diabetes online activity is reviewed. DKA is caused by a relative or absolute deficiency of insulin and elevated levels of counter regulatory hormones. Results: Goals of therapy are to correct dehydration, acidosis and to reverse ketosis, gradually restoring blood glucose concentration to near normal. Conclusion: Furthermore it is essential to monitor potential complications of DKA and if necessary, to treat them and any precipitating events.

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