scholarly journals Skin Autofluorescence Profile in Tunisian Subjects with and Without Metabolic Disorders

Author(s):  
Ines Khochtali ◽  
Wahid Bouida ◽  
Hamdi Boubaker ◽  
Semir Nouira ◽  
Mohsen Kerkeni

Abstract Background: The AGE Reader, as a clinical tool for non invasive assessment, measures the accumulation of advanced glycation end products (AGEs) in skin tissues shown as skin autofluorescence (SAF). AGEs Accumulation has been implicated in several diseases. There is no data about SAF profile in Tunisian population, this study aimed to assess firstly SAF profile in subjects with and without metabolic disorders and secondly to examine the association between SAF and various clinical parameters.Methods: In a cross-sectional study, we included 220 participants between 19 and 86 years of age who were subdivided in two groups: a healthy group (n=93) and patients group with metabolic disorders (n=127) contains three subgroups as following: diabetic patients (n=32), hypertensive patients (n=54) and patients with both diabetes and hypertension (n=41). Skin AGEs accumulation was measured by AGE Reader and clinical data was obtained.Results: SAF was significantly higher in patients group compared to healthy group [2.40 AU (2.10-2.60) vs. 2.00 AU (1.70-2.10) respectively; P <0.001]. Diabetic patients and hypertensive patients showed an increased level of SAF. The highest of SAF was observed in patient with both coexistence of diabetes, hypertension and dyslipidemia. SAF was associated with age, gender, BMI, duration of diabetes, HbA1c, triglyceride and obesity. Multivariate analysis showed that age and duration of diabetes were independent determinant of SAF. The ROC analysis indicated that an SAF > 2.25 AU was optimal cut-off point to predict the presence of metabolic disorders (P <0.001). Conclusion: SAF was increased in patients with diabetes and/or with hypertension and dyslipidemia. AGE Reader device is a rapid and helpful tool in clinical practice for evaluating and screening metabolic disorders in undiagnosed subjects.

2014 ◽  
Vol 6 (2) ◽  
pp. 14-17
Author(s):  
Rajeshwari Shastry ◽  
M.R. Prabha Adhikari ◽  
Sheetal D. Ullal ◽  
Shashidhar Kotian

Background: Hypertension is more common in diabetics than in non-diabetic patients. An aggressive approach to the diagnosis and treatment of hypertension in patients with diabetes is required in order to substantially reduce the incidence of both macro-vascular and micro-vascular complications. The role of diuretics in the treatment of hypertension as first line or second line drugs is a provoking debate, hence we studied the usage of diuretics and their effects on BP and glycemic control among diabetic-hypertensive patients.Methods: This cross sectional study was carried out for a period of six months in a tertiary care teaching hospital. Patients’ details such as age, gender, height, weight, comorbid diseases, blood pressure, eGFR along with duration of diabetes and hypertension and drugs prescribed for hypertension were noted. Data were analyzed using descriptive statistics.Results: A total of 336 diabetic-hypertensiveswith a mean age of 64.55±9.51 years were included. Fortyfive patients were on diuretics,two (4.4%) of whom were on diuretic monotherapy, 16 (35.6%) on two drug combinations (Diuretic + ACEI or ARB), 21 (46.7%) on three drug combinations (diuretics + ARB & BBs or diuretic + ACEI & BB or diuretic + ARB &CCB) and six (13.3%) were on four drug combinations (diuretics + ARB, CCB & BB). Among the patients on diuretic combination therapy BP was well controlled in 23 (51%) patients and the glycemic control was comparable to those not on diuretics.Conclusion: In the present study the usage of diuretics was consistent with the guidelines. About 13% of diabetic-hypertensive patients were on diuretic treatment. The control of BP in patients on diuretics was not satisfactory, but there was no worsening of glycemic control compared to other antihypertensive therapy. This shows that low dose thiazides in combination with other antihypertensives can be safe in diabetic-hypertensive patients however their efficacy needs further scrutiny. DOI: http://dx.doi.org/10.3126/ajms.v6i2.10582Asian Journal of Medical Sciences Vol.6(2) 2015 15-18


2021 ◽  
pp. 33-35
Author(s):  
Manish Kumar ◽  
Syed Yousuf Faisal ◽  
Sudhir Chandra Jha ◽  
Debarshi Jana

Introduction: Both diabetes mellitus and hypertension are aspects of metabolic syndrome. Objectives: The aim of this study was to determine the relationship between serum magnesium level with resistant hyperlipidemia in a group of diabetic and hypertensive patients. Patients And Methods: The present cross- sectional study was carried out on 90 hypertensive and diabetic patients in Medicine Department of DMCH, Laheriasarai, Bihar, (45 hypertensive and 45 diabetic patients). Included patients had high triglyceride levels despite 8 weeks of treatment with lipid-lowering agents. Results: There was an inverse signicant relationship between serum magnesium and triglyceride levels in diabetic patients (P=0.002, r=-0.458), however, this correlation was not signicant in hypertensive patients (P=0.754, r=0.048). Conclusion: This study showed, serum magnesium may affect triglycerides levels in diabetic patients, however, our nding requires further investigation with larger population


2020 ◽  
Vol 8 (1) ◽  
pp. 16
Author(s):  
Sruthi Kare ◽  
Vishwanath N. Reddy ◽  
Thejdeep Mahamkali

Background: India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Diabetic Nephropathy is a common consequence of long-standing diabetes mellitus. The development of diabetic nephropathy has a dramatic increase on the morbidity and mortality of patients with diabetes. Objective of this study was to evaluate the prevalence of microalbuminuria in patients with diabetes mellitus patients.  Methods: This cross-sectional study was conducted on T 2 diabetes mellitus patients visiting medicine OPD of R L Jalappa hospital constituent hospital of Sri Deveraj Urs Medical College, Tamaka, Kolar from May 2016 to July 2016. A total of 60 type-2 diabetes patients were enrolled in the study.Results: Average duration of diabetes among study group was 8 years and most of the patients were between 6-10 years. In type 2DM patients, microalbuminuria and glycemic control have shown a significant linear correlation with duration of diabetes (p<0.05). Also, micro albuminuria has a significant correlation with increase in level of glycosylated haemoglobin.  Conclusions: The prevalence of microalbuminuria in diabetic patients was found to be high and being a developing country; there is a dire need that microalbuminuria and HbA1c testing should be done in both, newly diagnosed as well as already diagnosed type 2DM patients as an early marker of renal risk factor.


2019 ◽  
Vol 9 (1) ◽  
pp. e07-e07
Author(s):  
Pardis Kaveh ◽  
Afsaneh Malekpour Tehrani ◽  
Saeid Mardani

Introduction: Both diabetes mellitus and hypertension are aspects of metabolic syndrome. Objectives: The aim of this study was to determine the relationship between serum magnesium level with resistant hyperlipidemia in a group of diabetic and hypertensive patients. Patients and Methods: The present cross-sectional study was carried out on 90 hypertensive and diabetic patients who referred to outpatient university clinic in Shahrekord (45 hypertensive and 45 diabetic patients). Included patients had high triglyceride levels despite 8 weeks of treatment with lipid-lowering agents. Results: There was an inverse significant relationship between serum magnesium and triglyceride levels in diabetic patients (P=0.002, r=-0.458), however, this correlation was not significant in hypertensive patients (P=0.754, r=0.048). Conclusion: This study showed, serum magnesium may affect triglycerides levels in diabetic patients, however, our finding requires further investigation with larger population.


2020 ◽  
Author(s):  
Adeladlew Kassie Netere ◽  
Eyayaw Ashete ◽  
Eyob Alemayehu Gebreyohannes ◽  
Sewunet Admasu Belachew

Abstract Background: Insulin is an effective therapeutic agent in the management of diabetes but it is also sensitive to external environment. Consequently, diabetic patients’ adherence to insulin delivery recommendations is critical to its effectiveness. Lack of knowledge, skill, and irrational practices on appropriate insulin delivery techniques can result in therapeutic failure and increased costs of therapy. The aim of this study was to evaluate the knowledge, skills, and practices of insulin storage and injection technique of patients. Methods : An interview-based cross-sectional study was conducted in conveniently selected participants in Northwest Ethiopian primary hospitals from March 1 to May 30, 2019. Knowledge levels were assessed with right or wrong responses and practice was measured by administering a 4-point Likert scale structured questionnaire through face-to-face interviews. Finally, a five-point observational (demonstration) techniques checklist assessed patients’ skills. Results: Among 194 patients approached, 166 participants completed the survey with a response rate of 85.6 %. From these participants, 54.8% were males and the mean age was 38.46±13.8 years . The overall patients’ median knowledge and practice levels on insulin storage and handling techniques were moderately adequate (64.3%) and fair (55.4%), respectively. In patients’ skill assessments, 94.6% showed injection sites, 70% indicated injection site rotations, and 60.75% practiced injection site rotations. Education (p<0.001), duration of insulin therapy (p=0.008) and duration of diabetes (p=0.014) had a significant effect on patients’ knowledge level. Education (p<0.001), occupation (p<0.001), duration of insulin therapy (p=0.001), duration of diabetes (p=0.036) and patients’ knowledge levels (p<0.001) were found to have a significant effects on the patients’ practice level. A Mann-Whitney U test also disclosed that residency, ways to get insulin and mocked injection technique during first training had significant effects on patients’ knowledge levels. Conclusion: The current study revealed that patients had moderately adequate knowledge and fair practice levels on insulin storage and handling techniques. Moreover, patients missed important insulin administration skills. Healthcare professionals and stakeholders can play important roles in educating patients thereby improving the knowledge, practice, and administration techniques of patients.


Author(s):  
Lineo Maja ◽  
Thabiso Masia ◽  
Kabelo Binyane ◽  
Maseabata Ramathebane

Objective: To investigate if diabetic and hypertensive patients were being adequately counselled by pharmacy personnel about their medication, disease states and lifestyle modifications at Lesotho defence force (LDF) clinic in Maseru.Methods: A cross-sectional study was conducted among diabetic and hypertensive patients treated at LDF clinic in Maseru from March to May 2017. A semi-structured questionnaire was used to collect data in a face-to-face interview with patients. Microsoft Excel 2010 was used to analyse collected data.Results: The study population consisted of 222 participants; 22 (28.2%) of diabetic. respondents had inadequate knowledge of diabetes mellitus complications and 56 (71.8%) had no knowledge of complications. 153 (78.8%) of hypertensive respondents had inadequate knowledge of hypertension complications and 33 (17.1%) had no knowledge of complications. 56 (25.2%) had adequate knowledge of lifestyle modifications of diabetes mellitus and hypertension and 164 (73.9%) had inadequate knowledge. 182 (82.0%) had adequate knowledge of their anti-hypertensive and anti-diabetic medicines names, 20 (9.0%) had inadequate knowledge and 20 (9.0%) had no knowledge. 63 (28.4%) had adequate knowledge of their medicines strengths, 17 (7.7%) had inadequate knowledge and 142 (64.0%) had no knowledge. 199 (89.6%) respondents had adequate knowledge of dosing frequency and 20 (9.0%) had inadequate knowledge.Conclusion: Hypertensive and diabetic patients’ knowledge about medication, disease states and lifestyle modifications were inadequate due to poor patient counselling on such aspects by pharmacy personnel at LDF clinic in Maseru.


1970 ◽  
Vol 5 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Md Omar Ali ◽  
Shelina Begum ◽  
Noorzahan Begum ◽  
Taskina Ali ◽  
Sultana Ferdousi

Background: Diabetes mellitus is a major public health problem with increasing incidence worldwideand long term complications of various organs including lungs. The magnitude of the complicationsof this disease is related to its duration. Objective: To observe PEFR and FEF25-75 in type 2 diabeticmale and their relationship with duration of the disease. Methods: This cross sectional study wascarried out in the Department of Physiology, BSMMU, Dhaka, from 1st July 2007 to 30th June 2008 on60 type 2 diabetic, non smoker, male of 40-60 years old. For comparison, 30 age, BMI and socioeconomicstatus matched apparently healthy non diabetic subjects were also studied. Based on the duration ofdisease, diabetic patients were divided into B1 (5-10 years) and B2 (10-20 years). PEFR and FEF25-75 ofall the subjects were measured by an electronic spirometer. Data were analyzed by One way ANOVA,Unpaired Student's 't' and Pearson's correlation coefficient tests. Results: The mean percentage ofpredicted values of PEFR and FEF25-75 in non diabetic male were within normal ranges. But, both theparameters were significantly (p<0.001) lower in both the groups of type 2 diabetic male compared tothose of non diabetic male. Again, the PEFR and FEF25-75 were lower in the patients of longer durationcompared to those of shorter duration but the differences were not significant. However, PEFR wasnegatively correlated and FEF25-75 was positively correlated with shorter duration of diabetes and therelationships were nonsignificant. On the other hand, both the parameters were negatively correlatedwith longer duration of diabetes while only PEFR showed significant (p<0.01) relationship. Conclusion:The PEFR and FEF25-75 may be lower in type 2 diabetic male, which are inversely related to theduration of the disease.Key words: PEFR; FEF25-75; Diabetes Mellitus.DOI: 10.3329/jbsp.v5i1.5413J Bangladesh Soc Physiol. 2010 June; 5(1): 14-19


Author(s):  
Mohammad Bagherniya ◽  
Sayyed Saeid Khayyatzadeh ◽  
Ali reza Heidari Bakavoli ◽  
Gordon A Ferns ◽  
Mahmoud Ebrahimi ◽  
...  

Background Serum high-sensitive C-reactive protein (hs-CRP) concentrations independently predict the development of diabetes, metabolic syndrome and cardiovascular disease. However, the impact of dietary factors on serum high-sensitive C-reactive protein concentrations in diabetic patients has received limited attention. We aimed to investigate the association between dietary factors and high-sensitive C-reactive protein , among diabetic patients with and without hypertension and healthy subjects. Methods In this cross-sectional study, diabetics with ( n = 325) and without hypertension ( n = 599) and healthy individuals ( n = 1220) were recruited in Mashhad, Iran. Dietary intake was assessed by 24-h recall. Biochemical parameters including serum high-sensitive C-reactive protein were measured using standard protocols. Stepwise multiple regression analysis was used to predict whether serum high-sensitive C-reactive protein concentration was associated with dietary constituents. Results High-sensitive C-reactive protein was significantly higher among hypertensive and non-hypertensive diabetic patients compared with healthy subjects ( P < 0.001). The dietary intake of zinc + 6.4% and calcium −3.4% and body mass index +3.9% explained approximately 13.7% of the variation in serum high-sensitive C-reactive protein among diabetic hypertensive patients. Approximately 9.7% of the variation in serum high-sensitive C-reactive protein in diabetic non-hypertensive patients could be explained by body mass index, and intake of sodium, iron and cholesterol. In the healthy subjects, approximately 4.4% of the total variation in serum high-sensitive C-reactive protein concentration could be explained by cholesterol consumption and waist circumference. Conclusion Serum high-sensitive C-reactive protein concentrations were found to be a significant predictor for hypertensive and non-hypertensive diabetic subjects. There was a significant association between dietary factors include zinc, iron, sodium and cholesterol and serum high-sensitive C-reactive protein, while there was an inverse association between dietary calcium and serum high-sensitive C-reactive protein in diabetic hypertensive individuals.


Author(s):  
Tirthankar Mukherjee ◽  
SR Sneha ◽  
NS Vinayaka

Introduction: Diabetes is a multisystem disorder with well known complications involving various organs in the body. The presence of abundant connective tissue and microvasculature raises the possibility that lung may also be affected in diabetes. Aim: To evaluate the pulmonary function parameters in patients with diabetes mellitus and to determine their correlation with glycaemic control, duration of diabetes and other microvascular complications. Materials and Methods: This is a cross-sectional study done between September 2018 and March 2019. A total of 300 type 2 diabetic patients, aged 30-70 years, with duration of diabetes more than 1 year, were included in the study. Thorough history was taken regarding the duration of diabetes and symptoms of the complications. All of them were evaluated for diabetic microangiopathies: nephropathy (by 24 hour urinary protein excretion), retinopathy (by direct ophthalmoscopy) and neuropathy (by clinical examination). Glycosylated Haemoglobin (HbA1c) was measured as an indicator of glycaemic control. Spirometry and single breath diffusion capacity for carbon monoxide were performed on all the subjects. Pulmonary Function Test (PFT) parameters of each subject were compared with the normal values. Unpaired t-test and one-way analysis of variance (ANOVA) were used. Correlation and regression studies were used to find out the strength of association between Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO) and the following: the duration of disease, HbA1c and presence of other microvascular complications. Results: Pulmonary function parameters like Forced Expiratory Volume in first second (FEV1), Forced Vital Capacity (FVC), Peak Expiratory Forced Rate (PEFR) and DLCO were below the normal values in 53% of diabetic patients included in the study. Majority of them had a restrictive ventilation pattern. The diffusion capacity corrected for Alveolar Volume (VA) as measured by DLCO/VA was significantly reduced in those with longer duration of diabetes and in those with other microvascular complications. However, the poor lung functions had no correlation with the HbA1C values. Conclusion: This study demonstrated that lungs are indeed affected in patients with type 2 diabetes. The presence of extrapulmonary microangiopathy and duration of the disease may predict the incidence and the severity of the lung function abnormality.


2020 ◽  
Vol 10 (1) ◽  
pp. e07-e07
Author(s):  
Kamal Khademvatani ◽  
Zahra Yekta ◽  
Mirhosein Seyed Mohammadzad ◽  
Shahriar Khanahmadi ◽  
Roghaiyeh Afsargharehbagh ◽  
...  

Introduction: Klotho allele status is associated with increased risk of cardiovascular diseases, diabetes and hypertension. Objectives: To determine if serum klotho level was lower among diabetic and hypertensive patients compared to control group. Patients and Methods: This was a cross-sectional study of 90 participants. Thirty pure diabetic patients and 30 participants with pure hypertension were compared with the healthy control group. Multiple logistic regressions were used to examine the association between serum klotho and diabetes and hypertension. We also tested the cut off point of serum klotho to predict hypertension and diabetes by using ROC (receiver operating characteristic) curve. Results: The level of serum klotho was significantly lower in diabetic and hypertensive patients. Participants with higher klotho were less likely to have diabetes and hypertension [OR: 0.48, 95% CI (0.22-0.81)] even after adjustment for covariates. ROC curve for diabetes and hypertension indicated 0.8 area under the curve which was statistically significant. Conclusion: This study found that serum klotho was associated with lower odds of diabetes and hypertension. Further longitudinal studies are necessary to confirm this finding.


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