scholarly journals The Effect of Bariatric Surgery on Patients with Chronic Disease in KSMC

Author(s):  
Abdullah Ahmed Aloraini ◽  
Abdulelah Sulaiman Alsughayyir ◽  
Abdullah Khaled Alamri ◽  
Haitham Shayea Alshayea ◽  
Mohammed AlMesned

Background: Obesity is a fast-growing global epidemic; it is associated with several comorbidities, including diabetes mellitus, hypertension, and dyslipidemia. Bariatric surgery is increasingly used due to its positive impacts on most of the comorbidities such as type 2 diabetes mellitus in patients with morbid obesity as it improves glycemia, lipids,blood pressure, andinflammation. Aim: To assess the effect of bariatric surgery on diabetic and dyslipidemic patients. Method: This is a retrospective study conducted on diabetic and dyslipidemic patients who underwent bariatric surgery. The study included the data of patients from 2009 to 2018 from KSMC. SPSS was used to analyze the collected data. Results: There were 808 diabetic patients included with a mean ±SD age of 42.1±11.05 years old, and 25 dyslipidemic patients with a mean ±SD age of 45.4±8.2 years. There were 72.4% of diabetic patients and 52% of dyslipidemic patients completed the treatment. Regarding diabetic patients, the outcome of patients was significantly associated with nationality (P˂0.0001) and the mean age of patients (P˂0.0001). The mean age had a significant impact on the outcome of the diabetic patients (P=˂0.0001) and had no effect in the case of the dyslipidemic patients (P=0.37). Conclusion: Bariatric surgery has a significant impact on chronic diseases such as diabetes and dyslipidemia, with a higher impact on diabetes compared to dyslipidemia.

Author(s):  
Milena M. Cojić ◽  
Ljiljana Cvejanov-Kezunović ◽  
Jelena Stanković ◽  
Nebojša Kavarić ◽  
Maja Koraćević ◽  
...  

Some observational studies have shown that only a small number of diabetic patients achieve optimum control of glycaemia and cardiovascular risk factors. The aim of this study was to analyze whether patients with type 2 diabetes mellitus treated in primary care achieve adequate control of glycemic levels and cardiovascular risk factors. This was a retrospective, record-based, cross-sectional study that included eligible patients from 35 to 90 years old with type 2 diabetes mellitus treated in Primary Health Care Center in Podgorica. We investigated electronic records of 531 diabetic patients. The observed prevalence of type 2 diabetes mellitus among individuals between ages 35 and 90 years, was 11,84 %. Half of the patients were female. The mean age was 65,88±9,86 years. The mean value of HbA1c was 7,56±1,71. Fifty-nine percents of patients achieved optimal levels of HbA1c ≤ 7 %. Also, more than half of patients achieved target levels of blood pressure while 27.9% achieved LDL ≤ 2.6 mmol/L. Fifty percent of patients were non-smokers and 45.1 % were obese. Among patients on primary prevention only 5.7 % had met all target levels while on secondary prevention that number was even smaller 3.7 %. Our study showed that control of HbA1c and blood pressure was similar to other studies but reaching target levels of LDL was challenging for our patients. Further analysis are needed in order to discover the reasons for poor control of certain CVRF and to develop strategies for its optimal management.


Author(s):  
Hadi Bazyar ◽  
Seyed Ahmad Hosseini ◽  
Sirous Saradar ◽  
Delsa Mombaini ◽  
Mohammad Allivand ◽  
...  

Abstract Background In patients with type 2 diabetes mellitus (T2DM) the inflammatory and metabolic responses to epigallocatechin-3-gallate (EGCG) are unknown. Objectives Evaluate the impacts of EGCG on metabolic factors and some biomarkers of stress oxidative in patients with T2DM. Methods In this randomized, double-blind, placebo-controlled trial, 50 patients with T2DM consumed either 2 tablets (300 mg) EGCG (n=25) or wheat flour as placebo (n=25) for 2 months. The total antioxidant capacity (TAC), interleukin-6 (IL-6), lipid profile, mean arterial pressure (MAP), atherogenic index of plasma (AIP) were evaluated before and after the intervention. Results The finding of present study exhibited a significant increase in the serum levels of TAC after the EGCG supplementation (p=0.001). Also, in compare with control group, the mean changes of TAC were significantly higher in supplement group (p=0.01). In intervention group, a significant decrease was observed in the mean levels of triglyceride, total cholesterol, diastolic blood pressure (DBP), AIP, and MAP (p<0.05). Taking EGCG resulted in the mean changes of total cholesterol, MAP and DBP were significantly lower in compare with control group (p<0.05). Conclusions This study recommended that EGCG supplementation may be improved blood pressure, lipid profile, AIP, and oxidative status in patients with T2DM.


2020 ◽  
Vol 8 (E) ◽  
pp. 133-137
Author(s):  
Rusdiana Rusdiana ◽  
Maya Savira ◽  
Sry Suryani Widjaja ◽  
Dedi Ardinata

AIM: The aim of this study was to evaluate the effect of short-term education on glycemic control (glycated hemoglobin [HbA1c] and fasting blood sugar [FBS]) among type 2 diabetes mellitus patients attending to primary health care (PHC) in Medan Johor of North Sumatera, Indonesia. METHODS: The study was performed on type 2 diabetes mellitus patients in Johor PHC, Medan of North Sumatera, on 40 patients with type 2 diabetes mellitus. We took the samples of all the patients of type 2 diabetes mellitus who attend PHC in Medan Johor. The patients received for 3 months intervention by education. An educational course of diabetes together with exercise training and nutritional education was designed for the study population in order to increase the patients’ knowledge and attitude toward diabetes and to increase their participation in the self-monitoring of glycemic control. Samples of FBS and HbA1c were recorded for each patient at the time of the baseline survey, then health education was conducted to the diabetic patients of both sexes attending PHC. The patients received standard advice on diet management and variation about activity. We put HbA1c <6.5% as cut limit for the control of diabetes mellitus. RESULTS: All 40 type 2 diabetes patients completed the educational course. The mean of age of the samples is 62.53 years old, the mean of body mass index was 24.81 kg/m, and the mean of waist size was 92.15 cm. Before the education, the mean of FBS level was 238.83 mg/dl and the mean of Hba1c value is 8.90%. After education, the FBS was 216.88 mg/dl, the mean of HbA1c value was 8.74%. CONCLUSION: The effect of health education in Johor Public Health Care Medan city reduced glycemic control (FBS) in type 2 diabetes mellitus patients, North Sumatera, Indonesia.


2012 ◽  
Vol 56 (5) ◽  
pp. 285-290 ◽  
Author(s):  
Serdal Korkmaz ◽  
Abdulkerim Yilmaz ◽  
Gürsel Yildiz ◽  
Fatih Kiliçli ◽  
Serhat Içağasioğlu

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.


2018 ◽  
Vol 9 (2) ◽  
pp. 96-101
Author(s):  
Roksana Yeasmin ◽  
MA Muttalib ◽  
Nazneen Sultana ◽  
Md Jamil Hasan Karami ◽  
Ayatunnessa ◽  
...  

Background: The role of uric acid in the progression of prediabetes to diabetes has been known. Serum uric acid has been shown to beassociated with cardiovascular disease, hypertension, and chronic kidney disease. However, conflicting data exist asregards the serum uric acid (UA) levels in type 2 diabetes mellitus, which are associated with risk factors andcomplications.Material & Methods: The present study was designed to look for any association of serum uric acid with hypertension in type 2diabetes mellitus, taking into consideration the relevant clinical, biochemical and the anthropometric data. 110 patientswith type 2 male diabetes mellitus as case and 100 healthy malecontrols were included in this study.Results: This study shows that there were significant differences in mean of age, duration of DM, exercise time, waist hip ratio, systolic blood pressure and diastolic blood pressure within case and control but no significant differences of mean BMI was found between and control. The mean age, duration of DM, exercise time, waist hip ratio, systolic blood pressure and diastolic blood pressure and BMI were (51.83±9.911 years, 6.87±5.54 years, 1.94±.831 hours, .92±.03, 140±6.75 mm of Hg,90±2.41 mm of Hg and 25.43±3.19 Kg/m2 respectively), where as in controls these were (44.81±9.66 yrs, 00 years, 1.12±.327 hours, .91±.03, 130±1.28 mm of Hg, 80±6.18 mm of Hg and 24.96±3.02 Kg/m2 respectively). This table also shows that significant differences in mean of FBS, ABF, HbA1C and S. Uric acid between case and control, but there was no significant differences of mean TG, Cholesterol, HDL and LDL. The mean of FBS, ABF, HbA1C and S. Uric acid among the cases were (8.19±2.48 mmol/L, 11.29±3.47 mmol/L, 7.96±6.04 mg%, 189.72±111.36 mg/dl, 179±43 mg/dl, 38.38±13.77 mg/dl, 102.10±35.79 mg/dl and 8.39±2.61 mg/dl respectively, on the other hand among the control these were 5.91±1.13 mmol/L, 9.19±1.95 mmol/L, 5.93±1.01 mg%, 200±104.49 mg/dl, 183±42.25 mg/dl, 38.14±5.52 mg/dl, 110±33.23 mg/dl and 5.14±.84 mg/dl respectively.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 96-101


Author(s):  
Keerthana Puli ◽  
Nikhil Kumar Vanjari

Background: The main aim of the study is to evaluate the efficacy of empagliflozin 10 mg once daily over 12 weeks as add-on therapy to metformin plus sulfonylurea in patients with type 2 diabetes mellitus with inadequate glycemic control.Methods: It is a prospective, observational, study conducted in patients of Sri Badhrakali Diabetic Center located in Warangal, Telangana, India. The efficacy of empagliflozin 10 mg was assessed by measuring the change in the glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI) at the baseline and 12 weeks, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the baseline and after 24 hours of treatment.Results: In the present study, the addition of empagliflozin to metformin and Sulfonylurea therapy for 12 weeks provided 0.87 % reduction in HbA1c. The mean changes of FPG from baseline to 12-week is -26 mg/dl. At 24 hours empagliflozin significantly reduced blood pressure with mean changes of SBP and DBP -4.147 and -1.526 mmHg respectively. The mean changes in BMI from baseline to week 12 is -0.638 kg/m2.Conclusions: Empagliflozin 10 mg provided ancillary reduction in HbA1c outside of metformin and sulfonylurea. Controlled body weight, HbA1c, blood pressure decreases diabetes progression, decreased risk of diabetic complications and reduced risk for cardiovascular disorders.


2014 ◽  
Vol 21 (06) ◽  
pp. 1174-1177
Author(s):  
Mukhtiar Hussain Jaffery ◽  
Nisar Ahmed Shah ◽  
Muhammad Sajid Abbas Jaffri ◽  
Athar Hussain Memon ◽  
Syed Zulfiquar Ali Shah

Objective: To determine the frequency of raised C-reactive protein (CRP) in patients with type 2 diabetes mellitus. Patients and methods: This cross sectional descriptive study of six months study was conducted at Liaquat University Hospital Hyderabad from March 2013 to August 2013. All diabetic patients of ≥35 years age of either gender for >01 year duration visited at OPD were evaluated for C-reactive protein and their glycemic status by hemoglobin A1c. The data was analyzed in SPSS and the frequency and percentage was calculated. Results: During six month study period, total 100 diabetic patients were evaluated for C-reactive protein. Majority of patients were from urban areas 75/100 (75%). The mean ±SD for age of patients with diabetes mellitus was 51.63±7.82. The mean age ±SD of patient with raised CRP was 53±7.21. The mean ±SD for HbA1c in patients with raised CRP is 9.55±1.73. The mean random blood sugar level in patients with raised CRP was 247.42 ± 6.62. The majority of subjects from 50-69 years of age group with female predominance (p = 0.01) while the CRP was raised in 70(70%) patients in relation to age (p=0.02) and gender (p=0.01) respectively. Both HbA1c and CRP was raised in 64.9% (p = 0.04) in patients with type 2 diabetes mellitus. The mean ±SD of CRP was 5.8±1.21 while for male and female individuals with raised CRP was 3.52±1.22 and 5.7±1.63 respectively. Conclusions: The raised CRP was observed in patients with type 2 diabetes mellitus


2017 ◽  
Vol 5 (3) ◽  
pp. 316-318 ◽  
Author(s):  
Serdar Olt ◽  
Sabri ÖzdaÅŸ ◽  
Mehmet Åžirik

AIM: To investigate the effect of bariatric surgery on HbA1c and serum cortisol levels in morbidly obese patients without type 2 diabetes mellitus.MATERIALS AND METHODS: Twenty-nine patients who underwent sleeve gastrectomy and whose body mass index was> 40 were included in the present study. Patients' files were reviewed retrospectively. Those with diabetes mellitus and those with age <18 were excluded from the study. Pre-operative and 1-year post operative data were documented. The obtained data were analysed by SPSS statistical program.RESULTS: The mean age of the patients was 27.4 ± 8.4. 5 of the patients were male, and 24 were female. The mean body mass index of the patients was 44 ± 2.3. 1 patient [3.4%] had hypertension. Four patients [13.7%] had gastroesophageal reflux disease. The number of smokers was 7 [24.1%], and the number of alcohol users was 3 [10.3%]. There was a statistically significant decrease in HbA1c, body mass index values after operation [p value <0.01], but cortisol was not different [p value = 0.72].CONCLUSION: In this present study we found that bariatric surgery caused a significant decrease in HbA1c levels in non-diabetic patients, suggesting that bariatric surgery may prevent Type 2 Diabetes Mellitus in obese patients.


2020 ◽  
Vol 16 ◽  
Author(s):  
Zahra Mazloum Khorasani ◽  
Vahid Roshan Ravan ◽  
Sepideh Hejazi

Objectives: Diabetes is the most common metabolic disease in primary health care. The prevalence and severity of diabetes can be influenced through lifestyle modification. This study was aimed to identify the prevalence of sleep disorders as a modifiable lifestyle factor among diabetic patients. Materials and Methods: This cross‐sectional study was conducted on 190 patients with type 2 diabetes mellitus who referred to the Internal Medicine Clinic of the Ghaem Hospital, Mashhad, Iran from 2016 to 2017. A demographic questionnaire and the Pittsburgh Sleep Quality Assessment questionnaire (sleep disorder was defined as scores higher than 5) was filled for each subject. Blood tests including haemoglobin A1 C (Hb A1C), fasting blood sugar (FBS) and 2 hour post prandial glucose as well as the assessment of blood pressure, body mass index (BMI) were performed for all patients. Data were analysed using the statistical package for social sciences (SPSS) version 16. Results: Age of the patients (male to female ratio was 71/119s) was 56.31 ± 7.37 years. BMI more than 25 kg/m2 was observed in 145 (76.3%) of patients . Mean Pittsburgh Sleep Quality Assessment score was 7.48 ± 4.11. Fifty‐one (26.8%) patients were good sleepers and 139 (73.2%) were poor sleepers. There was a significant relationship between sleep disorder and age (p=0.019) and female gender (p=0.017) but no other variables including level of education, occupation, HbA1 C, FBS, 2 hour post prandial glucose, systolic and diastolic blood pressure. Discussion: Sleep disorders were common among type 2 diabetic patients especially women. It is recommended that sleep disorders should be screened in diabetic patients. Treatment and prevention of sleep disorders through sleep hygiene education including recommendation to have normal nocturnal sleep should be focused by practitioners in type 2 diabetic patients especially women. Appropriate measures should be taken to manage sleep disorders by weight control in this population.


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