Effect of Type 2 Diabetes Mellitus and diabetic medication on Pulmonary Function

Author(s):  
Alaa M. Hammad ◽  
Waleed Qirim ◽  
Ameen Alassi ◽  
Dana Hyassat

Background: Type 2 diabetes mellitus (T2DM) is a chronic condition with an impairing effect on multiple organs. Numerous respiratory disorders have been observed in patients with T2DM. However, T2DM e ect on pulmonary function is ff inconclusive. Aims: In this study, we investigated the effect of T2DM on respiratory function and the correlation of glycemic control, diabetes duration and insulin intake. Methods: 1500 patients were recruited for this study, 560 having T2DM for at least a year were included in the final data, in addition to 540 healthy volunteers. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% (FEF 25-75%), as well as FEV1/FVC ratio values were measured. Results: A two-sample t-test showed that z-scores produced by Al-Qerem et al.’s equations for FEV1, FVC, and FEF 25-75% were significantly lower for the T2DM group than the control group (p < 0.01). FEV1/FVC ratio in T2DM group were significantly higher (p < 0.01). Multiple linear regression analysis found that glycemic control represented by HbA1c as well as disease duration were negatively associated with pulmonary function (p < 0.01). However, insulin intake was found to have no significant correlation with the pulmonary function. Conclusion: T2DM was linked to reduced pulmonary function and was consistent with a restrictive ventilation pattern. HbA1c as well as disease duration were independent risk factors for reduced pulmonary function.

2021 ◽  
Vol 6 (2) ◽  
pp. 1444-1448
Author(s):  
Santosh Timalsina ◽  
Shishir Mahato ◽  
Sandesh Nepal

Introduction: Insulin resistance (IR) and glycemic control are two very important aspects to be considered during management of patients with Type 2 Diabetes Mellitus (T2DM). The triglyceride-glucose (TyG) index has been proposed as a simple and inexpensive parameter that correlates well with IR and glycemic control. Objectives: To explore the association of TyG index (and other TyG derived indices) with glycated hemoglobin (HbA1c) and evaluate their predictive ability for glycemic control in patients with T2DM. Methodology: This cross-sectional study comprised of 160 adult patients diagnosed with T2DM visiting the medical outpatient department of Chitwan Medical College, Bharatpur, Chitwan between July–December 2019. Socio-demographic data and anthropometric measurements were collected. Glycemic control was assessed by HbA1c. TyG index was calculated by the formula: ln [fasting TG (mg/dl) x fasting glucose (mg/dl)/2]. Receiver operating characteristic (ROC) curve analysis was performed to analyze the predictive ability of TyG-index for poor glycemic control. Results: One hundred and sixty patients (mean age: 53.6 ± 10.7 years, 55.0% males) were included in the study. Eighty (50.0%) had good glycemic control (HbA1c <7.0%). TyG index, along with TyG-BMI and TyG-WC (other TyG derived indices) were significantly increased in the poor glycemic control group. TyG index had a good predictive ability for poor glycemic control (AUC: 0.803, 95% CI: 0.731 – 0.874). A TyG cutoff ≥ 9.12 was optimal for predicting poor glycemic control, with 86.1% sensitivity and 61.5% specificity. Conclusion: TyG index could be a simple and cost-effective screening tool for assessment of glycemic control in patients with T2DM.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Juan Pablo Aitken ◽  
Carolina Ortiz ◽  
Irene Morales-Bozo ◽  
Gonzalo Rojas-Alcayaga ◽  
Mauricio Baeza ◽  
...  

Background. Subjects with type 2 diabetes mellitus (DM2) require an adequate glycemic control to avoid diabetic complications. Currently, saliva biomarkers are used as a diagnostic tool and can be indicative of the degree of progression and control of various diseases. Several studies indicate thatα-2-macroglobulin levels are elevated in diabetic patients.Methods. 120 subjects with DM2 were enrolled and classified into two groups according to their glycemic control (percentage of glycated hemoglobin-A1c (HbA1c), <7% adequate glycemic control group; >7% inadequate glycemic control group). The relationship betweenα-2-macroglobulin levels from saliva samples and HbA1c was subsequently evaluated.Results. We found a positive correlation betweenα-2-macroglobulin and HbA1c (r=0.778andP<0.0001). Area under the receivers operating characteristic (ROC) curve ofα-2-macroglobulin indicated a positive discrimination threshold ofα-2-macroglobulin (AUC = 0.903, CI 95%: 0.847–0.959,P<0.0001) to diagnose glycemic control.Conclusions. Our data strongly suggest that the level of salivaα-2-macroglobulin is an indicator for the degree of glycemic control in diabetic patients and represents a promising alternative method to evaluate this parameter.


2022 ◽  
Vol 12 (1) ◽  
pp. 67
Author(s):  
Nai-Ching Chen ◽  
Chien-Liang Chen ◽  
Feng-Chih Shen

Background: The adequate glycemic control and risk factors for hypoglycemia in older patients with dementia and type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to analyze the status of glycemic control and determine the risk of hypoglycemia among these groups. Methods: A hospital admission record due to hypoglycemia through an emergency room with glucose supplementation in the Chang Gung Memorial Hospital was identified as a hypoglycemic event. Patients with dementia and T2DM without hypoglycemic events throughout the study period were defined as the control group. We gathered patients aged ≥65 years with a diagnosis of Alzheimer’s dementia (AD) and T2DM between 2001 and 2018 in the Chang Gung Research Database (CGRD). We extracted data included medication use, diagnoses, and biochemistry data from hospital records. Results: A total of 3877 older patients with dementia and T2DM with regular visits to the outpatient department were enrolled in this study. During the two-year follow-up period, 494 participants (12.7%) experienced hypoglycemia. Multivariable logistic multivariable regression models for hypoglycemic events showed that metformin had a protective effect (odds ratio (OR) = 0.75, p = 0.023), insulin had the highest risk (OR = 4.64, p < 0.001). Hemoglobin A1c (HbA1c) levels were not correlated with hypoglycemic events (OR = 0.95, p = 0.140). Patients with hypoglycemic episodes had a significantly higher proportion of ≥2 Charlson Comorbidity Index scores than those without hypoglycemic episodes (83.2% versus 56.4%, p < 0.001). Conclusions: Drug regimen affects hypoglycemic episodes but not HbA1c in older patients with dementia and T2DM. In addition, patients with more comorbidities experience an increased risk of hypoglycemia.


Author(s):  
Nora Wulandari ◽  
Daniek Viviandhari ◽  
Afi Seli Febriani

Glycemic control is a critical point in the management of type 2 diabetes mellitus (T2DM). The limited number of pharmacists in primary health care in Indonesia is one of the reasons that a simple alternative method is needed for managing T2DM patients. Objective: This study aimed to measure the effectiveness of an education diabetes video as a simple method of improving glycemic control of T2DM patients. Methods: This was a quasi-experimental pre-test/post-test study involving T2DM patients from one randomly selected public healthcare centre in East Jakarta. Glycated haemoglobin (A1C) levels were examined before and 12 weeks after the video intervention. Results: Thirty of T2DM patients enrolled in this study. The educational video was found to decrease the A1C level significantly (p = 0.001) from an average±SD of 7.930±1.262 to 5.517±0.614. Conclusions: This study found the educational was effective at improving the glycemic control of patients with T2DM. However, further investigation with control group still needed to confirm that the video that did it.


2021 ◽  
Author(s):  
Manal M. Alem

Abstract BackgroundType 2 diabetes mellitus (DM), gout, and asymptomatic hyperuricemia are inter-connected pathologies. Glycemic control (GC), involving a range of treatments is central to the management of DM, whereas allopurinol continues to be the most widely recommended urate lowering agent. Allopurinol has been shown to possess anti-oxidant properties: this study explores the favorable potential effect of allopurinol on glucose homeostasis.MethodsThis is an observational study with a cross-sectional design performed on patients with type 2 diabetes mellitus (DM), recruited from centers in Saudi Arabia. Patients were divided into two groups; allopurinol users; (for gout or asymptomatic hyperuricemia) and matching control patients. Patient demographics, co-morbid conditions, biochemical tests, and pharmacological treatments were extracted from electronic records to investigate the effect of allopurinol therapy on Glycemic control (GC), as assessed by glycated haemoglobin (HbA1c as primary endpoint), and on parameters of glycaemic variability (GV) (secondary endpoints).ResultsA total of 194 patients with type 2 DM were recruited (97 in both groups). The two groups were matched for age and sex: mean age: 59.4 years, 73% males in the allopurinol group vs 59.6 years, 73% males in the control group. Allopurinol, daily dose 100 mg, was prescribed for 77% of the patients, with median duration of 39.5 months treatment. HbA1c values were; 6.90% (6.20, 7.80) in the allopurinol group vs 7.30% (6.60, 8.40) in the control group (P=0.010). Parameters of GV were calculated from 3 consecutive fasting blood sugar (FBS) readings: variability independent of the mean (VIM) was 0.140 in the allopurinol group vs 0.987 in the control group (P<0.001).ConclusionConcomitant low-dose allopurinol therapy in patients with type 2 DM was associated with modest but significant improvements in GC and GV.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Fanglin He ◽  
Zhanlin Zhao ◽  
Yan Liu ◽  
Linna Lu ◽  
Yao Fu

Purpose. To investigate the impact of disease duration on the ocular surface during the course of type 2 diabetes mellitus compared with nondiabetic controls. Methods. One hundred twenty diabetic patients were divided into three groups according to disease duration: less than 5 years, 5–10 years, and over 10 years. All eyes were imaged using a corneal topographer (Oculus Keratograph 5M). Tear film measurements and meibography were also recorded. Meibomian gland changes were scored from 0 to 6 (meiboscore). Results. The noninvasive breakup time first (NIKBUT-1st) and noninvasive breakup time average (NIKBUT-avg) were significantly shorter in the over 10 years diabetic group compared with the control group (P=0.0056  and  P=0.010, resp.). Tear meniscus height (TMH) was significantly lower in the over 10 years diabetic group compared with the control group (P=0.0016) and the 5 years group (P=0.0061). We also found that more patients in the over 10 years diabetic group showed bulbar and limbal hyperemia compared with the control group (bulbar hyperemia: P=0.049; limbal hyperemia: P=0.026). The meiboscore in the over 10 years diabetic group was significantly higher compared with the other three groups (P<0.05). Bulbar hyperemia showed a significant negative correlation with NIKBUT-1st in the over 10 years diabetic group (r=−0.35  and  P<0.05). Conclusion. Ocular surface damage in long-term type 2 diabetes is more severe than that in patients with shorter disease duration.


Author(s):  
Hamidreza Torabi ◽  
Mohsen Saberi Isfeedvajani ◽  
Majid Ramezani ◽  
Seyed-Hashem Daryabari

Purpose: The aim of this study was to assess the correlation of hemoglobin A1c (HbA1c) levels with choroidal thickness in patients with type 2 diabetes mellitus (DM) using spectral domain optical coherence tomography (SD-OCT). Methods: In this prospective case series, 180 eyes from 90 patients with type 2 DM were classified into three study groups based on HbA1c values: group 1 included patients with good glycemic control (HbA1c ≤ 7%), group 2 included patients with moderate glycemic control (HbA1c between 7% and 8%), and group 3 included patients with poor glycemic control (HbA1c ≥ 8%). Additionally, 50 eyes from 25 non-diabetic subjects were enrolled to group 4 as a control group. Sub-foveal, nasal, and temporal choroidal thickness were measured and compared. Results: Mean central, nasal, and temporal choroidal thicknesses in diabetic patients (247.80, 238.63, and 239.30.


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