RERATA VOLUME TROMBOSIT DAN AGGREGASI TROMBOSIT DI DIABETES MELITUS TIPE 2

Author(s):  
Malayana Rahmita Nasution ◽  
Adi Koesoema Aman ◽  
Dharma Lindarto

Diabetes mellitus patients often have hypercoagulable blood, as evidenced by the increased coagulation, impaired fibrinolysis, endothelial dysfunction and platelet hyperactivity. Hyperactive platelet is the major determinant of pro thrombotic state in DM. By assessing the MPV and platelet aggregation, which is a marker of platelet activity, in patients with type 2 DM, it is expected to help the prediction of acute events. This research is aimed to know the differences of MPV and the aggregation of platelet between poor glycemic control as well as good the control group in type 2 DM patients. This study was conducted in cross sectional method using 22 people with good glycemic control and 28 people with poor one (glycemic control) from June to August 2013. Fasting blood samples were analyzed for CBC, HbA1c, TG and platelet aggregation. MPV and platelet aggregation value were compared between groups using independent t-test. Based on this study, there is no significant difference in MPV and platelet aggregation between groups (p=0.598, p=0.464 (1 μM), p=0.868 (2 μM), p=0.984 (5 μM), p=0.401 (10 μM)). Mean Platelet Volume (MPV) correlate significantly with platelet aggregation at 1 μM and 5μM ADP concentration in good glycemic control group (r=0.591; p=0.004 at 1 μM ADP and r=0.521; p=0.013 at 5 μM ADP). Mean platelet volume correlate significantly with the platelet aggregation at 2 μM ADP and the concentration in poor glycemic control group (r=0.405; p=0.033). There are no significant differences in MPV and platelet aggregation between groups, but there is a significant correlation between them (MPV and platelet aggregation) in the good glycemic control of the type 2 DM group

Author(s):  
Malayana Rahmita Nasution ◽  
Adi Koesoema Aman ◽  
Dharma Lindarto

Diabetes mellitus patients often have hypercoagulable blood, as evidenced by the increased coagulation, impaired fibrinolysis,endothelial dysfunction and platelet hyperactivity. Hyperactive platelet is the major determinant of pro thrombotic state in DM. Byassessing the MPV and platelet aggregation, which is a marker of platelet activity, in patients with type 2 DM, it is expected to help theprediction of acute events. This research is aimed to know the differences of MPV and the aggregation of platelet between poor glycemiccontrol as well as good the control group in type 2 DM patients. This study was conducted in cross sectional method using 22 people withgood glycemic control and 28 people with poor one (glycemic control) from June to August 2013. Fasting blood samples were analyzedfor CBC, HbA1c, TG and platelet aggregation. MPV and platelet aggregation value were compared between groups using independentt-test. Based on this study, there is no significant difference in MPV and platelet aggregation between groups (p=0.598, p=0.464 (1 μM),p=0.868 (2 μM), p=0.984 (5 μM), p=0.401 (10 μM)). Mean Platelet Volume (MPV) correlate significantly with platelet aggregationat 1 μM and 5μM ADP concentration in good glycemic control group (r=0.591; p=0.004 at 1 μM ADP and r=0.521; p=0.013 at 5 μMADP). Mean platelet volume correlate significantly with the platelet aggregation at 2 μM ADP and the concentration in poor glycemiccontrol group (r=0.405; p=0.033). There are no significant differences in MPV and platelet aggregation between groups, but there is asignificant correlation between them (MPV and platelet aggregation) in the good glycemic control of the type 2 DM group.


Author(s):  
Supriya Singh ◽  
Arpita Suri ◽  
Maheep Sinha ◽  
Bushra Fiza

Background & Objectives:  Adenosine modulates insulin action on various tissues and its concentration in tissues is affected by Adenosine Deaminase (ADA) levels. ADA is an enzyme involved in purine metabolism and is considered to be a marker of T cell activation. Immunological disturbances in type 2 diabetic individuals have an association with cell mediated responses and inappropriate T-lymphocyte function. Hence, the study was undertaken to determine the levels of Serum ADA activity in patients of type 2 DM and its correlation with parameters of glycemic profile such as Fasting blood sugar (FBS) and Glycated Haemoglobin. Material and Methods- A total of 100 patients diagnosed for type 2 DM visiting the Outpatient Department of General Medicine and Endocrinology at Mahatma Gandhi Medical College & Hospital, Jaipur were enrolled for the study based on predefined inclusion and exclusion criteria. Blood samples were collected for all enrolled patients and analysed for the investigations like Serum BSF, HbA1c and Serum ADA. Results- In the study, BSF, mean HbA1c and serum ADA level was significantly higher in diabetic group in comparison to control group (p=0.000). The diabetic group was subdivided on the basis of HbA1c levels, HbA1c ≤ 8% as good glycemic control and HbA1c > 8% as poor glycemic control. BSF, mean HbA1c and serum ADA levels were observed to be significantly higher in poor glycemic control group as compared to that of good glycemic control. A significant positive correlation between S. ADA and HbA1c activity was also seen (r= 0.388). Conclusion- Increased ADA level can be used to determine the glycemic status in the patients of type 2 DM and serve as a marker for insulin resistance. Hence, by analysing ADA levels in diabetes, glycemic control and insulin resistance can be assessed. Raised ADA levels can be an early indicator of progressive diabetic change and help to take preventive measures for the development of diabetic complication and thereby improving the outcome of the disease. Keywords- Diabetes Mellitus, Adenosine Deaminase, Glycated haemoglobin


1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 179-183 ◽  
Author(s):  
Mai-Szu Wu ◽  
Chun-Chen Yu ◽  
Ching-Herng Wu ◽  
Jeng Yi Haung ◽  
Mei-Lin Leu ◽  
...  

Objective To evaluate the impact of pre-dialysis glycemic control on clinical outcomes for type II diabetic patients on continuous ambulatory peritoneal dialysis (CAPO). Materials and Methods One hundred and one type II diabetic patients receiving CAPO for at least 3 months were enrolled in a single institute. The patients were classified into two groups according to status of glycemic control. In the good glycemic control group, more than 50% of blood glucose determinations were within 3.3 11.0 mmol/L and glycosylated hemoglobin (HbA 1 C) levels were within 5% -10% at all times. In the poor glycemic control group, less than 50% of blood glucose determinations were within 3.3 -11.0 mmol/L, or HbA1C levels were above 10% at least 6 months before peritoneal dialysis was started. In addition to glycemic control status, pre-dialysis serum albumin, cholesterol levels, residual renal function, peritoneal membrane function, and modes of glycemic control were also recorded. Results The patients with good glycemic control had significantly better survival than those with poor glycemic control (p < 0.01). There was no significant difference in pre-dialysis morbidity between two groups. No significant differences were observed in patient survival between patients with serum albumin above 30 g/L and those with serum albumin under 30 g/L; between those with cholesterol levels above or below 5.2 mmol/L; and between those with different peritoneal membrane solute transport characteristics as evaluated by a peritoneal equilibration test (PET). Furthermore, there was no significant difference in survival between patients who controlled blood sugar by diet and those who controlled it by insulin. Cardiovascular disease and infection are the major causes of death in both groups. Although good glycemic control predicts better survival, it does not change the pattern of mortality in diabetic patients maintained on CAPO. Conclusions Glycemic control before starting dialysis is a predictor of survival for type II diabetic patients on CAPO. Patients with poor glycemic control predialysis are associated with increased morbidity and shortened survival.


Author(s):  
Reni Marlina ◽  
Ricke Loesnihari ◽  
Santi Syafril

The incidence of infection often occurs in patients with Diabetes Mellitus (DM) due to hyperglycemia that causes dysfunction of chemotaxis, phagocytic activity, malfunction of neutrophils and glycosuria. It is followed by other complications that lead to the malfunction of the bladder. Highly urinary glucose level is an exellent medium for pathogenic microorganisms growth. Asymptomatic Bacteriuria (ASB) is a risk factor for symptomatic urinary tract infection spontaneously or due to urinary catheters. This study aimed to analyze the association between the incidence of ASB of type 2 DM and glycemic control. The study was conducted during June-August 2016 with a cross-sectional method. Subjects were type 2 DM patients with age ≤60 years, who were treated in the Endocrinology Out-Patient Clinic of the Adam Malik Hospital. HbA1c was measured by Indiko automatic analyzer. Its association with urine culture results was analyzed. A total of 50 samples were enrolled, consisting of 25 females, and 25 males, with 19 having an exellent glycemic control (HbA1c <7%) and 31 with poor glycemic control (HbA1c ≥7%). Thirteen positive ASB were found, 5 with good glycemic control and 8 with poor glycemic control. Statistical analysis revealed a nonsignificant association between glycemic control and culture results (p = 1.000). Somers’d did not show a significant association between glycemic control and the incidence of ASB (p=0.968, d=-0.005). However, significant differences in culture results between gender, in which the ASB were found in samples of four females and two males (p=0.004). Somers’d revealed a significant association between culture results and gender (p=0.001; d=-0.360). Most of the bacteria found were Gram-negative. There was no significant association between glycemic control with an incidence of ASB. However, gender had significant differences in the incidence of ASB, which occurred more frequently in DM females than males. Urinalysis should be performed in patients with type 2 DM with ASB. However, further study was needed to analyze the relationship between glycemic control with the incidence of ASB and other factors that might affect the incidence of ASB.


2017 ◽  
Vol 4 (2) ◽  
pp. 311 ◽  
Author(s):  
Abdul Wahid ◽  
Girish C. Verma ◽  
C. P. Meena ◽  
A. R. Pathan

Background: Hypomagnesemia has been proposed as a novel factor implicated in the pathogenesis of poor glycemic control and diabetic complications. Aim of the present study is to study serum magnesium level in patients with type 2 DM and to find the correlation between serum magnesium levels, HbA1c and diabetic complications.Methods: 100 patients with Type 2 DM (50 males and 50 females) who were diagnosed on the basis of ADA criteria or taking treatment for Diabetes were included in the study. All patients underwent tests for serum magnesium level, fasting blood sugar, postprandial blood sugar, HbA1c and also target organ evaluation for Diabetes. A detailed history and examination was also done.Results: There was significant difference in the prevalence of hypomagnesemia (34% vs 6%) and serum magnesium levels (1.59±0.187 versus 1.78±0.126, p <0.0001) between diabetics and control group. FBS (172.17±30.55 versus 137.06±37.76, p<0.0001), PPBS (243±61.21 versus 195.84±59.1, p = 0.0003) and HbA1C (8.42±1.292 versus 7.04±0.956, p<0.0001) were significantly higher in hypomagnesemic diabetics as compared to normomagnesemic diabetics. Significant proportion of hypomagnesemic diabetics were suffering from retinopathy as compared to normomagnesemic diabetics (47.06% versus 19.70%, p = 0.0042). Diabetic nephropathy, neuropathy, hypertension and IHD were also higher in hypomagnesemic diabetics as compared to normomagnesemic diabetics, but insignificant.Conclusions: Prevalence of hypomagnesemia in Type 2 diabetics was 34%. Diabetics with hypomagnesemia had poor glycemic control. Hypomagnesemia was significantly associated with diabetic retinopathy.  


Author(s):  
Amiroh Kurniati ◽  
Tahono Tahono

Diabetes Mellitus (DM) type 2 is a metabolic disease that prevalence increasing. A chronic hyperglycemia with poor glycemic control can stimulate oxidative stress, which will continue to occurrence of complications in the kidneys characterized by the presenceof microalbuminuria can be measured by the ratio of urinary albumin creatinine ratio (UACR) and the change in estimated glomerular filtration rate (eGFR). The aims of this study was to know the correlation between the UACR with HbA1c value and eGFR in patients with type 2 DM by finding them out. This study used cross sectional research design. Subjects were patients with type 2 DM who attend control in Endocrinology Subdivision of Internal Medicine Departement and perform blood and urine tests in Clinical Pathology Laboratory in Dr. Moewardi Hospital Surakarta in August 2013. To determine the pattern of the data distribution, the researchers used KolmogorovSmirnov test, and to analyse the result used Spearman (r) correlation with p<0.05 and confidence interval 95%. Statistical analysis using Spearman correlation test (r), significant when p<0.05 with 95% confidence intervals. From 68 samples examined the mean age is 60.9 year old, with equal participants for male and female (34 subjects each). Most subjects were in poor glycemic control group (72.1%) and in the range of microalbuminuria (44.1%). There was a significant correlation between UACR with HbA1c and eGFR in type 2 DM patient (r=0.412, p=0.000; and r= -0.270, p=0.02, respectively). Based on this study it can be concluded that increased UACR were associated with worsened glycemic control and were characterized by higher levels of HbA1c and its eGFR value would be lower. Further analysis requires further research with a larger sample size and more attention to the factors that may affect the related examination


2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 337-337
Author(s):  
Junko Tauchi ◽  
Akira Shinohara ◽  
Ken Ohashi ◽  
Taro Shibuki ◽  
Gen Kimura ◽  
...  

337 Background: Diabetes mellitus (DM) and hyperglycemia have been widely considered to be associated with the risk of pancreatic cancer. However, the aim of this study was to evaluate the relationship between glycemic control and the efficacy or safety in pancreatic cancer pts receiving treatment with nab-Paclitaxel (nab-PTX) plus Gemcitabine (GEM). Methods: We retrospectively reviewed 285 pts with unresectable pancreatic cancer with nab-PTX plus GEM as the first-line chemotherapy from December 2014 to March 2017 at the National Cancer Center Hospital East, Kashiwa, Japan. The pts were divided into two groups, average blood glucose level during the period of chemotherapy was less than 160 mg/dL (Group GC: Good glycemic control group) and more than 160 mg/dL (Group PC: Poor glycemic control group). Results: A total of 285 pts were enrolled. Median age was 66 years (range: 26-84) and males/females: 180/105, PS (0-1/2-3): 272/13, stage (III/IV): 77/208. There were 226 pts in GC group and 59 pts in PC group. No significant differences were seen in the overall survival between Group GC and PC (median: 16.1 months vs. 13.8 months, p = 0.344) and in the progression free survival between the two groups (median: 7.5 months vs. 8.2 months, p = 0.862). The incidence rate of grade 2-3 chemotherapy-induced peripheral neuropathy (CIPN) was significantly higher in Group PC compared with Group GC (Group GC 28.3%, Group PC 45.8%, p = 0.010). Univariate and multivariate analyses identified glycemic control as significant independent factors associated with the incidence of grade 2-3 of CIPN (Odds ratio 2.182, 95% CI 1.20-3.96, p = 0.010). There was no significant difference in the relative dose intensity of nab-PTX between two groups (median, 56.6% in group GC, 56.5% in group PC, p = 0.952). Conclusions: Glycemic control during the chemotherapy with nab-PTX plus GEM in unresectable pancreatic cancer was not associated with OS. The incidence of severe CIPN was higher in pts with poor glycemic control compared with good glycemic control.


2017 ◽  
Vol 03 ◽  
pp. 42
Author(s):  
Ni Putu Tesi Maratni ◽  
Dwijo Anargha Sindhughosa ◽  
I Gusti Ayu Mardewi ◽  
Ida Bagus Amertha Putra Manuaba ◽  
Made Ratna Saraswati ◽  
...  

The amount of glycosylated hemoglobin (HbA1c) reflects the long-term glycemic control of patients with diabetes. HbA1c also predicts the risk for the development of diabetic complications such as cardiovascular disease (CVD). Patients with type-2 diabetes and the characteristic of dyslipidemia are frequently found. Also, dyslipidemia plays as an independent risk factor for CVD. This study was aimed to evaluate the relationship between glycemic control status with serum individual lipid profiles and lipid ratios in patients with type-2 diabetes. This cross-sectional study consisted of 80 patients. Depending on the HbA1c level, the patients were divided into two groups, good glycemic control group (HbA1c < 7.0%, n = 15) and poor glycemic control group (HbA1c ≥ 7.0%, n = 65). The association of HbA1c with individual lipids (TC, TG, HDL-C, LDL-C, Non- HDL-C) and lipid ratios (TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, monocyte/HDL-C) were analyzed. The value of individual lipids and lipid ratios did not correlate with HbA1c level (p-value ≥ 0.05). Parameters of individual lipids and lipid ratios were not independently associated with poor glycemic control, which was analyzed by logistic regression. ROC analysis found both LDL-C and LDL-C/HDL-C were not accurate to be used as a prognostic indicator of poor glycemic control in patients with type-2 diabetes (p = 0.155, p = 0.297, respectively). The present study found that there was no association between individual lipids and lipid ratios with glycemic control status.


2021 ◽  
Vol 16 (1) ◽  
pp. 464-474
Author(s):  
Sushant Pokhrel ◽  
Nisha Giri ◽  
Rakesh Pokhrel ◽  
Bashu Dev Pardhe ◽  
Anit Lamichhane ◽  
...  

Abstract This study aims to assess vitamin D deficiency-induced dyslipidemia and cardiovascular disease (CVD) risk in poor glycemic control among type 2 diabetes mellitus (T2DM) patients. This study was carried out among 455 T2DM patients involving poor glycemic control (n = 247) and good glycemic control (n = 208). Fasting plasma glucose (FPG) and HbA1c were measured to assess glycemic control. Cardiac risk ratio, atherogenic index plasma, and atherogenic coefficient were calculated to assess and compare the CVD risk in different groups. Patients with poor control had a significantly higher level of total cholesterol (TC), triglyceride (TG), and non-high-density lipoprotein lipase cholesterol (non-HDL-C), atherogenic variables, and lower level of high-density lipoprotein lipase cholesterol (HDL-C) as compared to patients with good glycemic control. We also observed significant negative correlation of vitamin D with lipid markers and atherogenic variables in poor glycemic control diabetic population. The serum vitamin D levels were inversely associated with HbA1c, FPG, TG, TC, and non-HDL-C. Furthermore, hypercholesterolemia, hypertriglyceridemia, and elevated non-HDL-C were the independent risks in hypovitaminosis D population. Vitamin D deficiency in poor glycemic control is likely to develop dyslipidemia as compared to vitamin D insufficient and sufficient groups. Thus, vitamin D supplementation and an increase in exposure to sunlight may reduce the risk of cardiovascular complications in diabetes.


2016 ◽  
Vol 50 (3) ◽  
pp. 127-131 ◽  
Author(s):  
M Bhanukumar ◽  
Prasanna KH Ramaswamy ◽  
Naveen K Peddi ◽  
Vineetha B Menon

ABSTRACT Aims The objective of the study was to determine the mean platelet volume (MPV) and platelet distribution width (PDW) in subjects with type 2 diabetes mellitus (type 2 DM) compared to subjects without type 2 DM and their correlation with fasting blood glucose, glycosylated hemoglobin (HbA1c), and duration of type 2 DM respectively. Materials and methods A prospective analytical case—control study was conducted involving 50 subjects with type 2 DM and 50 subjects without type 2 DM. The mean and standard deviation were estimated for both the groups separately and independent Student's “t”-test was used for evaluating the significant difference. The statistical evaluation was carried out at 95% confidence level. Results Mean MPV and PDW in case group was significantly higher compared to control group (p < 0.005). Fasting blood glucose, HbA1c, and duration of type 2 DM did not significantly alter MPV or PDW. Conclusion The study concludes that MPV and PDW are significantly increased in patients with type 2 DM compared to patients without type 2 DM. Platelet volume indices are an important, simple, and cost-effective tool that should be used and explored extensively, especially in countries, such as India, for predicting the possibility of impending acute vascular events in patients with type 2 DM. Clinical significance This analytical method helps us to use MPV and PDW as early markers of vascular thrombosis. How to cite this article Bhanukumar M, Ramaswamy PKH, Peddi NK, Menon VB. Mean Platelet Volume and Platelet Distribution Width as Markers of Vascular Thrombosis in Type 2 Diabetes Mellitus. J Postgrad Med Edu Res 2016;50(3):127-131.


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