PROFIL ASAM LAKTAT PENDERITA DIABETES MELLITUS TERKENDALI (KONTROL) DAN TIDAK TERKENDALI (KONTROL)

Lactic acid is an intermediate product of carbohydrate metabolism. Increment of plasma lactic acid level usually correlated withaerobic metabolism defect which caused by hypoperfusion or hypoxia, that can be happened in DM (Diabetes Mellitus) patients. DiabetesMellitus is a risk factor of lactic acidosis. Determination of glycated Hb (HbA1c) is a parameter to monitor the blood glucose. The aimof this study is to compare the mean lactic acid level between uncontrolled and controlled DM) patients and their correlation betweenlactic acid and HbA1c level. The research carried out by cross sectional study which was done at the Clinical Pathology Laboratory ofSardjito Hospital between September–October 2007. Inclusion criteria of samples were diabetic patients who had HbA1c examination.Statistical analysis was done by independent t test and Pearson correlation test. Twenty one patients were included in this research.They were divided into two (2) groups, group I are those who had HbA1c ≤ 7%, they consist of 10 patients, group II are patients whohad HbA1c ≥ 7.1%, they consist 11 patients. The mean of lactic acid of group I was 1.85 mmol/L and group II was 1.74 mmol/L (p = 0.574). There wasn’t any significant correlation between HbA1c level and lactic acid. (r = -0.179, p = 0.437). The mean of lacticacid level in uncontrolled DM was lower than the controlled one but not significant, and there was no significant correlation betweenHbA1c level and lactic acid. It is suggested to continue this study but with larger sample to know the correlation between lactic acid andHbA1c in DM patients who had metformin therapy.

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Aspirin, Dipyridamole and Platelet Survival in Patients with Diabetes Mellitus

Clinical Science ◽

10.1042/cs0630205 ◽

1982 ◽

Vol 63 (2) ◽

pp. 205-209 ◽

Cited By ~ 6

Author(s):

Hilary Tindall ◽

R. Colin Paton ◽

George P. McNicol

Keyword(s):

Diabetic Patients ◽

High Dose ◽

Double Blind ◽

Regeneration Time ◽

Dose Aspirin ◽

Platelet Survival ◽

Group I ◽

The Mean ◽

Group Ii ◽

High Dose Aspirin

1. Platelet survival in 27 insulin-dependent diabetic patients with severe retinopathy was studied in a double-blind cross-over trial using placebo, aspirin (990 mg/day) and a combination of dipyridamole (225 mg/day) with aspirin at two dosage levels (330 mg and 990 mg/day). 2. Twenty patients (group I) had 51Cr-labelled-platelet survival after treatment with placebo and the high-dose-aspirin/dipyridamole combination. The remaining seven patients (group II) had platelet-regeneration times measured after each of the four treatment periods. 3. Treatment of group I patients with the high-dose-aspirin/dipyridamole combination resulted in significant (P < 0·001) prolongation of platelet survival from 7·3 ± 0·2 (mean ± sem) days to 8·4 ± 0·1 days. 4. In group II patients, when compared with the mean placebo result of 7·2 ± 0·2 days, the mean aspirin-labelled-platelet-regeneration time was significantly (P < 0·01) longer only after high-dose-aspirin/dipyridamole (9·8 ± 0·5 days) but not after low-dose-aspirin/dipyridamole (8·3 ± 0·5 days) or aspirin alone (7·3 ± 0·3 days). 5. These results suggest that it may be premature to consider reducing the dose of aspirin in aspirin/dipyridamole combinations below 1 g/day when used as antithrombotic therapy.

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Thyroid Hormonal Status in Newly Diagnosed Type 2 Diabetes Mellitus

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v20i1.36851 ◽

2018 ◽

Vol 20 (1) ◽

pp. 27

Author(s):

Mohammad Shameem Al Mamun ◽

Nurun Nahar ◽

Mohammad Simoon Salekin ◽

Mohammad Mahbubur Rahman

Keyword(s):

Diabetes Mellitus ◽

Blood Sugar ◽

Fasting Blood Sugar ◽

Diabetic Patients ◽

Hormonal Status ◽

Thyroid Disorder ◽

Newly Diagnosed ◽

Group I ◽

Group Ii

Objectives: Diabetes mellitus and thyroid dysfunction are the two most common endocrinopathies seen in general population. The study was done to determine whether there is any co-occurence of thyroid hormonal status alternating in newly diagnosed type 2 diabetes mellitus.Patients and Methods: This Cross-sectional study which was carried out at National Institute of Nuclear Medicine and Allied Sciences and outpatient Department (OPD) of Endocrinology of Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka during the period January 2015 to July 2016. A total of 98 newly diagnosed type 2 diabetic patients (Group I) and 98 healthy individuals (Group II) were enrolled in this study purposively. After taking written consent, history of the study subjects was taken and clinical checkup was done. Age of the subjects of both the group were 30 years and above. Glycemic status of both the group was assessed by measuring fasting blood sugar, blood sugar two hours after 75 gm oral glucose and blood for HbA1C. Patients with type 1 and other form of diabetes mellitus and any condition that may impair glycemic control were excluded from the study. Thyroid hormonal status of both the group was evaluated by measuring patients’ serum TSH by Immunoradiometric Assay (IRMA) and serum FT3 and serum FT4 by Radioimmunoassay (RIA) method in NINMAS. All the data were digitized and analyzed using SPSS – 22.0 software.Results: In this study, mean age of the patients was 46.0 ± 9.7 years and 45.5 ± 7.7 years in group I and group II respectively. Male female ratio was 1:1.45 in group I and 1:1.08 in group II. Fasting blood sugar, blood sugar two hours after 75 gm oral glucose and HbA1c were significantly higher in group I than that of group II. Mean TSH, FT3 and FT4 were 2.37 ± 3.86 mIU/L, 6.35 ± 2.41 pmol/L and 15.79 ± 5.41 pmol/L respectively in group I whereas 2.28 ± 2.67 mIU/L, 6.59 ± 1.83 pmol/L and 16.25 ± 3.46 pmol/L respectively in group II. But there was no statistical significant difference between group I and group II. In group I, sixteen patients had thyroid disorder (seven had hyperthyroidism and nine had hypothyroidism). In group II, five patients had thyroid disorder (two had hyperthyroidism and three had hypothyroidism). The difference was statistically significant. Fasting blood sugar positively correlated with TSH, FT3 and FT4 in group I, similarly HbA1c correlated with TSH and FT4 but not with FT3 in group I.Conclusion: Thyroid disorder was 16.3% in newly diagnosed type 2 diabetic patients and 5.1% in normal individuals.Bangladesh J. Nuclear Med. 20(1): 27-31, January 2017

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Evaluation of Salivary Procalcitonin and Macrophage Activating Factor in Generalised Chronic Periodontitis Patients with and without Type 2 Diabetes Mellitus

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47123.15181 ◽

2021 ◽

Author(s):

Sindhu Ramarao Ghorpade ◽

Vijayalakshmi Rajaram ◽

Jaideep Mahendra ◽

Burnice Nalinakumari Chelladurai ◽

Ambalavanan Namasivayam

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Chronic Periodontitis ◽

P Value ◽

Group I ◽

Significant Difference ◽

The Mean ◽

Group Ii

Introduction: Periodontitis is a polymicrobial and multifactorial oral disease and is the sixth complication of diabetes mellitus. Early diagnosis is important, and the use of non invasive biomarkers are highly useful for this purpose. The level of Macrophage Activating Factor (MAF) and Procalcitonin (ProCT) corresponds to the intensity of the inflammatory response and the severity of infection; thereby indicating that an increase in concentration or persistence of high values is considered as a prognostic indicator for severity of infection with an adverse outcome. Aim: To assess the periodontal parameters and quantify the levels of MAF and ProCT in saliva samples of generalised chronic periodontitis subjects with and without type 2 diabetes mellitus and to correlate these levels with the periodontal parameters. Materials and Methods: The study was a single centre cross- sectional study carried out at the Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India, from November 2018 to November 2019. A total of 80 subjects with generalised severe chronic periodontitis were selected and divided into two groups. Group I comprised of 40 subjects who were diagnosed with generalised chronic periodontitis without type 2 diabetes mellitus, whereas group II comprised of 40 subjects with generalised chronic periodontitis who had already been diagnosed with type 2 diabetes mellitus. Periodontal parameters such as Plaque Index (PI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) were recorded. The collected samples were subjected to molecular analysis for evaluating ProCT and MAF using Enzyme-Linked Immunosorbent assay (ELISA). Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 25.1 (Chicago, USA Inc). Student’s Independent t-test was used to compare the mean values for the variables in the control and test group. The Pearson’s correlation test was used to evaluate correlation between all the variables. The p-value <0.05 was set as the level of significance. Results: On comparing the periodontal parameters between group I and group II, there was no significant difference between the groups p-value >0.05. The mean salivary ProCT level in group I and group II was 268.76±152.78 ng/mL and 785.75±244.37 ng/mL, respectively. The mean salivary MAF level in group I and group II was 7.15±2.02 ng/mL and 26.56±9.12 ng/mL, respectively. On comparing MAF and ProCT value between group I and group II, there was a statistically significant increase in group II (p-value <0.001) and a weak correlation value with the periodontal parameters was seen. Conclusion: There was a significant difference in levels of MAF and ProCT in saliva samples of generalised chronic periodontitis subjects with and without type 2 diabetes mellitus, however the periodontal variables in each group did not correlate with MAF and ProCT.

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Comparison of Lower Limb Arterial Pulsatility and Ankle Brachial Indices (PI and ABI) in Diabetic Subjects with and Without Neuropathy

BIRDEM Medical Journal ◽

10.3329/birdem.v2i2.12309 ◽

2012 ◽

Vol 2 (2) ◽

pp. 89-92

Author(s):

Sharmistha Dey ◽

Kanta Das ◽

Shamse Ara Begum ◽

Akhtar Uddin Ahmed ◽

Abu Saleh Mohiuddin

Keyword(s):

Diabetic Neuropathy ◽

Lower Limb ◽

Pulsatility Index ◽

Ankle Brachial Index ◽

Doppler Imaging ◽

Diabetic Patients ◽

Colour Doppler ◽

Group I ◽

The Mean ◽

Group Ii

Objectives: This study was performed to find out the extent and nature of arterial flow abnormality in diabetic patients with peripheral neuropathy compared to diabetic patients without neuropathy, using duplex colour Doppler technique. Materials and method: This cross sectional study was performed on diabetic subjects in the Department of Radiology and Imaging, BIRDEM from July 2008 to May 2009. Patients were referred from Department of neurology and preventive foot care OPD, BIRDEM, for colour Doppler imaging of lower limb arteries. Total 88 consecutive diabetic patients were included in this study. Out of them 48 were diagnosed cases of diabetic neuropathy (group I) and 40 were diabetic without neuropathy (Group II). In all patients the Ankle Brachial Index (ABI) and Pulsatility Index (PI) were recorded on both left and right lower limb arteries, by using duplex colour Doppler technique. Total no. of patients were 88. 48 had neuropathy. They were 27-57 yrs of age. Result: Unpairedt test was used to find out relationship between the variables.P value <o.o5 was considered as statistically significant. The mean ABI was 1.44±0.07, ranged from 1.30 to 1.59 in group I (diabetic neuropathy) and 1.17±0.06, ranged from 1.05 to 1.26 in group II (diabetic without neuropathy). The mean ABI difference was found statistically significant (p<0.05) between group I and group II. The mean PI was 3.0±0.69, ranged from 1.18 to 3.68 and 7.97±2.29,ranged from 5.50 to 13.0 in group I (diabetic neuropathy) and group II (diabetic without neuropathy) respectively. The mean PI difference was found statistically significant (p<0.05) between group I (diabetic neuropathy) and group II (diabetic without neuropathy). Conclusion: In this study it was observed that Pulsatility Index (PI) decreased and Ankle Brachial Index (ABI) increased in diabetic neuropathic group. There was significant difference of Pulsatility Index (PI) and Ankle Brachial Index (ABI) found between diabetic subjects with and without neuropathy. So, from the finding of the present work, it can be said that diabetic neuropathy affect the arterial flow detected by non invasive duplex colour Doppler imaging may help in proper patient management and may prevent neuropathic arterial complications. But for any definine conclusion, bigger appropriate study should be done.DOI: http://dx.doi.org/10.3329/birdem.v2i2.12309 (Birdem Med J 2012; 2(2): 89-92)

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Study of the difficult glycemic control in relation to autoantibodies present among patients of Type 1 Diabetes mellitus (Glutamic acid decarboxylase autoantibodies GADA- Islet cells cytoplasmic autoantibodies ICA- Insulin autoantibodies IAA)

QJM ◽

10.1093/qjmed/hcaa052.040 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M S Hamed ◽

M Samy ◽

H Mahmoud ◽

N Yehia

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Glycemic Control ◽

Hba1c Level ◽

Group I ◽

Study Population ◽

Group Ii ◽

Type 1 Dm ◽

Diabetes Autoantibodies

Abstract Background Type 1 DM is sub-divided into type 1A (immune-mediated) and type 1B (other forms of type 1 DM that include virus-triggered autoimmune response, genetic factors and idiopathic). It is widely recognized that the presence of two or more auto-antibodies has a high sensitivity and specificity for rapid progression to insulin dependency within 5 years. It is hypothesized that the difficult glycemic control among some type 1 diabetic patients is attributed to the presence of diabetes-autoantibodies. Aim This study was designed to assess the relationship between the presence of diabetes autoantibodies and the poor glycemic control developed by patients who receive more than 100 insulin units per day and yet they are not controlled i.e. HbA1c > 7%, elevated plasma glucose level on frequent monitoring although they are non-obese and strictly stuck to healthy diet and exercise, and whether the number of positive autoantibodies affect the glycemic control or not. Methods This study was conducted on 60 patients 30 males and 30 females, they were all subjected to full history taking, anthropometric measurements, clinical examination and laboratory assessment in the form of C-peptide, fasting blood glucose, 2 hours post-prandial blood glucose, HbA1c level, serum GADA level, serum ICA level and serum IAA level. The patients were classified according to presence of diabetes autoantibodies into two groups; Group I consisted of 6 patients (10%) with negative auto-antibodies and Group II consisted of 54 patients (90%) with positive auto-antibodies, Group II was further classified according to the number of positive diabetes autoantibodies into 3 sub-groups, Group II a: Formed of 9 patients with 1 positive autoantibody (16.7% of the study population). Group II b: Formed of 12 patients with 2 positive autoantibodies (22.2% of the study population) and Group II c: Formed of 33 patients with 3 positive autoantibodies (61.1% of the study population). Results HbA1c level was significantly higher in group II than group I (11.85 ± 1.61% vs. 8.52 ± 0.41%, p = 0.000). Similarly it was higher in group IIc than group IIb than group IIa (12.25 ± 1.48% vs. 11.57 ± 1.59% vs. 10.78 ± 1.73%, p = 0.038).Moreover HbA1c was significantly higher in patients with positive GADA, patients with positive ICA and those with positive IAA than those with negative GADA, negative ICA and negative IAA (p = 0.000, p = 0.000, p = 0.012 respectively). The total number of insulin units per day was significantly higher in group II than group I (109.83 ± 7.77 U/day vs. 100.83 ± 1.83 U/day, p = 0.007). The duration of diabetes mellitus was significantly higher in group I than group II (10.17 ± 1.94 years vs. 8.11 ± 2.20 years, p = 0.033). By doing the multivariate regression analyses we found that HbA1c level, total number of insulin units per day and the duration of developing diabetes mellitus were significant predictive factors for the presence of diabetes autoantibodies (p = 0.007, p = 0.033 and p = 0.043 respectively). Conclusion The presence of diabetes autoantibodies affect the glycemic control represented by HbA1c level; also it affects the total number of insulin units per day used by the patients; the more the presence of diabetes autoantibodies, the higher the HbA1c level, the more insulin units required by patients to control their glycemic state.

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Assessment of Left Atrial Volume Index in the Patients with ACS in Adults

Academia Journal of Medicine ◽

10.47008/ajm.2020.3.1.6 ◽

2020 ◽

Vol 3 (1) ◽

pp. 23-26

Author(s):

Niranjan Reddy R ◽

Shashanka Chunduri

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Family History ◽

Positive Family History ◽

Volume Index ◽

Left Ventricular Ejection ◽

Group I ◽

The Mean ◽

Group Ii ◽

The Difference

Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death universally. The present study was conducted to assess LA volume index (LAVI) in the patients with ACS in adults.Subjects and Methods: The present study was conducted on120 adult patients diagnosed with ACS of both genders in narayana medical college hospital from May 2016 toOctober 2016. Patients were divided into 2 groups of 60 each. Group I patients had LAVI > 34 ml/m2 and group II patients had LAVI ≤ 34 ml/m2. The LV systolic function was analyzed by Simpson’s disc volumetric method. The LAV was assessed by the biplane area‑length method from apical 4‑chamber and 2‑chamber views.Results: The mean BMI in group I patients was 26.7 kg/m2 and in group II was 26.1 kg/m2, AW STEMI in group I was seen in 30 patients and in group II in 32, IW + PW STEMI in 6 and 4 patients in both groups respectively, IW STEMI in 5 and 4 patients respectively, NSTEMI in 4 and 3 patients respectively and UA in 15 and 17 patients respectively. Risk factors were diabetes mellitus in 32 and 27 patients respectively, hypertension in 41 and 40 patients respectively, smoking in 43 and 38 patients respectively, alcohol in 30 and 35 patients respectively and positive family history in 12 and 16 patients respectively. The difference was non- significant (P> 0.05). The mean LAVI at admission in group I was 38.1 and in group II was 27.2, after 1 month was 40.2 and 28.1 in both groups, after 6 months was 39.1 and 27.9 in both groups and after 12 months was 42.7 and 25.3 in both groups respectively. The difference was significant (P< 0.05).Conclusion:Authors conclude that LAVI was found to be the independent predictor of mortality than left ventricular ejection fraction on multivariate regression analysis. Common risk factors in patients with ACS were diabetes mellitus, hypertension, smoking, alcoholism and positive family history. Patients with LAVI of value >34 ml/m2 were associated with increased comorbidities.

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EVALUATION OF SERUM-FREE IRON AND GLYCATED HEMOGLOBIN IN UNCONTROLLED TYPE-II DIABETIC PATIENTS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i1.15330 ◽

2016 ◽

Vol 10 (1) ◽

pp. 306

Author(s):

R Kamalam ◽

Ganesan Nalini ◽

M Anbazhagan

Keyword(s):

Diabetes Mellitus ◽

Glycated Hemoglobin ◽

Statistical Significance ◽

Elevated Serum ◽

Free Form ◽

Diabetic Patients ◽

Free Iron ◽

Serum Free ◽

Group I ◽

Group Ii

ABSTRACTObjective: Diabetes mellitus (DM) is a common health problem in the world. Free iron may contribute to the pathogenesis and progress of thisdisease and its complication. Iron causes hyperinsulinemia by decreasing the insulin uptake and metabolism by hepatocytes. Elevated iron stores arecommonly found in insulin resistance. Iron in its free form is known to induce oxidation of biomolecules by producing harmful hydroxyl radicals. Inthis study, we aimed to estimate and compare the serum levels of free iron in diabetes and healthy individuals.Methods: This study included 244 subjects in two groups. Group-I comprised 204 subjects with DM and Group-II comprised 40 healthy subjects. Bloodsugar, free iron, and glycated hemoglobin were analyzed in blood samples using standard kits. The results of all the parameters were expressed asmean±standard deviation. Student t-test was done to assess the statistical significance between two groups. The association between the parameterswas studied by Pearson correlation.Results: In this study, we found a significant increase in serum free iron in Group-I (p<0.01) when compared with Group-II. A significant correlationbetween the serum free iron and glycated hemoglobin (r=0.59; p<0.001) and fasting blood sugar (r=0.43; p<0.001).Conclusion: The elevated serum free iron in uncontrolled diabetes may contribute to oxidative stress which may be associated with complicationsof diabetes.Keywords: Free iron, Glycated hemoglobin, Hyperinsulinemia, Diabetes mellitus.

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A STUDY ON THE PREVALENCE OF CARDIAC AUTONOMIC NEUROPATHY IN DIABETIC PATIENTS – A HOSPITAL BASED STUDY.

10.36106/ijsr/6303302 ◽

2021 ◽

pp. 8-11

Author(s):

Tridip Kumar Das ◽

Rintu Barman

Keyword(s):

Diabetes Mellitus ◽

Autonomic Neuropathy ◽

Autonomic Function ◽

Diabetic Autonomic Neuropathy ◽

Cardiac Autonomic Neuropathy ◽

Diabetic Patients ◽

Group Iii ◽

Duration Of Diabetes ◽

Group I ◽

Group Ii

Background: Diabetic Autonomic Neuropathy (DAN) is a serious and common complication of diabetes. Despite its relationship to an increased risk of cardiovascular mortality and its association with the multiple symptoms and impairments, the signicance of diabetic autonomic neuropathy has not been fully appreciated. DAN can manifests in a spectrum of things, ranging from resting tachycardia and xed heart rate (HR) to development of “silent” myocardial infarction.The prevalence of CAN is variable based on published studies and ranges from 2% to 91% in type I diabetes mellitus (T1DM) and 25% to 75% in type 2 diabetes (T2DM). This signicant variability can likely be attributed to the lack of a uniform 2 diagnostic criteria as well as underdiagnosis in the typical hospital setting. Aim And Objectives :To study the prevalence of cardiac autonomic neuropathy in hospital admitted diabetic patients. Materials And Methods : 60 diabetic patients were taken for the study of which 48 were males and 12 were females.The study was carried out in tertiary care teaching hospital in North east India after clearance from institutional ethics committee. Subjects were divided according to duration of diabetes as Group I : 0 – 5 years(24 patients), Group II : 6 – 9 years(24patients), Group II I: 10 years or more(12 patients). Then special interest was taken to nd out cardiac autonomic neuropathy and all the 5 tests were carried out in each of the patients to detect cardiac autonomic neuropathy and were divided into 3 groups. Group I ( normal autonomic function test), group II ( early DAN), group III ( denitive DAN ). Results : In the present study it has been observed that out of 24 (40%) cases of diabetes mellitus in the 0 – 5 year duration group, 4 cases (16.7%) are having autonomic neuropathy, out of 24 cases in the duration group 6 – 9 years, 10 cases (41.7%) are having autonomic neuropathy and in the duration group ≥ 10 years, 8 cases out of 12 (66.7%) showing neuropathy. In the present study prevalence of diabetic autonomic neuropathy out of 60 number of patients taken it was seen as: 38 cases (63.3%) with normal autonomic function tests placed in group I, 12 cases (20%) with only cardiac parasympathetic damage or early DAN were placed in group II and 10 cases (16.7%) with both cardiac parasympathetic and sympathetic damage or denitive DAN were placed in group III. So out of 60 diabetic patients, 22 patients (36.7%) showed abnormal cardiovascular reex in the present study. Conclusion: It has been observed from the present study that duration of diabetes mellitus is directly proportional to development of cardiac autonomic neuropathy.

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Clinical Profile of Diabetes Mellitus in Children and Adolescents under Eighteen Years of Age

Ibrahim Medical College Journal ◽

10.3329/imcj.v1i1.2889 ◽

2008 ◽

Vol 1 (1) ◽

pp. 11-15 ◽

Cited By ~ 4

Author(s):

Fauzia Mohsin ◽

Bedowra Zabeen ◽

Rahelee Zinnat ◽

Kishwar Azad ◽

Nazmun Nahar

Keyword(s):

Diabetes Mellitus ◽

Age Of Onset ◽

Key Words Diabetes Mellitus ◽

Key Words Diabetes ◽

Diabetes Group ◽

Group Iii ◽

Group I ◽

The Mean ◽

Group Ii

A total number of 125 patients with diabetes mellitus (DM) under eighteen years of age were admitted in the Paediartic department of BIRDEM hospital between January 2001 to October 2002. Eighty-eight patients (71%) were newly detected. Female to male ratio was 3:1. Out of the total admission 38 (30.4%) patients had type 1 DM (group 1), 37 (29.6%) patients had fibrocalculous pancreatic FCPD diabetes (group II), 48 (38.4%) patient had malnutrition modulated diabetes mellitus MMDM (group III) and 2 (1.6%) patients had type 2. Mean age of onset was 9±3.9 yrs in group I and 13±2.3 yrs in group II and group III. All groups had very high glucose and HbA1c value at presentation. The mean fasting glucose (mmol/l) was 19±7.14, 22.39±9 and 19.54±7.9 in group I, group II and group III respectively. The Mean HbA1c (%) value in the three groups was 14.4±2.7, 16.72±2.26 and 15.27±3.05 respectively. FCPD patients had poorest glycaemic status. Acute complications were more common in type 1 patients. Twelve (31.5%) patients had diabetic ketoatin DKA and two (5%) patients had hypoglycaemia in group I. Chronic complications were present in all three groups. MMDM patients had highest rate of complications. which was present in 2.6%, 21.6% and 33.3% patients in group I, group II and group III respectively. The rate of microalbuminuria was 5.3%. 10.8% and 18.8% in the three groups respectively. The rate of neuropathy was 2.6%, 16.2% and 20.8% in the three groups respectively. Among the associated problems skin infection, pulmonary tuberculosis and bilateral parotid swelling were common. Malnutrition was present in 66%, 86% and 100% in group I, group II and group III respectively. Majority (50% in group I, 91.6% in group II and 100% in group III) of our patients came from poor socio-economic background. Ibrahim Med. Coll. J. 2007; 1(1): 11-15 Key words: Diabetes mellitus doi: 10.3329/imcj.v1i1.2889

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Assessment of Acute Kidney Injury in Patients Undergoing Elective Coronary Angiography and Percutaneous Coronary Intervention

Cardiovascular Journal ◽

10.3329/cardio.v5i1.12227 ◽

2012 ◽

Vol 5 (1) ◽

pp. 37-43

Author(s):

ABMM Alam ◽

M Moniruzzaman ◽

MB Alam ◽

N Islam ◽

F Khatoon ◽

...

Keyword(s):

Serum Creatinine ◽

Contrast Media ◽

Creatinine Level ◽

Ace Inhibitor ◽

Kidney Injury ◽

Coronary Intervention ◽

Group I ◽

Percutaneous Coronary ◽

The Mean ◽

Group Ii

Background: CIN has gained increased attention in the clinical setting, particularly during cardiac intervention but also in many other radiological procedures in which iodinated contrast media are used. There is at present good clinical evidence from well-controlled randomized studies that CIN is a common cause of acute renal dysfunction.Methodology: This was a prospective study conducted among the patients who underwent coronary angiography and percutaneous coronary intervention in the Department of Cardiology, Dhaka Medical College Hospital during January 2010 to December 2010. A total of 111 patients age range from 25 to 75 years were included in the study. Serum creatinine level at baseline and at the end of 48 hours was done in all these patients. Study population was divided into two groups according to development of acute kidney injury (AKI). Group-I = AKI, Group II = Not developed AKI. Results: AKI developed 11.7% of the study patient. DM and Preexisting renal insufficiency were significantly higher in group I patients. HTN was (61.5% Vs 44.9%) higher in group I but not significantly. History of ACE inhibitor/ARB, NSAID intake and LVEF <40% were significantly higher in group I patients. The mean±SD volume of CM (Contrast Media) were 156.9±44.8 ml and 115.4±30.0 ml in group I and group II respectively, which was significant. The mean±SD of serum creatinine after 48-72 hours of CAG/PCI was 1.4±0.37 mg/dl and 1.1±0.2 mg/dl in group I and group II respectively. The serum creatinine level increased significantly (p<0.05) after 48-72 hours of CAG/PCI in group I. In group II, S. creatinine level increased but not significant (p>0.05). Impaired renal function was found 76.9% and 2.0% in group I and group II respectively. DM, HTN, preexisting renal insufficiency, ACE inhibitor/ARB, NSAIDs, contrast volume (>150 ml), eGFR (<60 ml/min/ 1.73m2) and LVEF (<40%) are significantly (p0.05) associated for CIN development.Conclusion: CIN is an iatrogenic but preventable disorder results from the administration of contract media. Although rare in the general population, CIN occurs frequently in patients with underlying renal dysfunction and diabetes. In patients with pre angiographic normal renal function, the prevalence is low but in pre-existing renal impairment it may pose a serious threat. Thus risk factors are synergistic in their ability to predispose to the development of CIN. A careful risk-benefit analysis must always be performed prior to the administration of contrast media to patients at risk for CIN. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12227 Cardiovasc. j. 2012; 5(1): 37-43

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