EFFECT OF GLYCAEMIC CONTROL ON PITUITARY GONADOTROPHINS OF TYPE 2 DIABETIC SUBJECTS IN ENUGU, NIGERIA

Glycation is considered to be the main molecular basis of several diabetic complications. Association between chronic hyperglycaemia and the development of long-term diabetic-specific complications have been reported but are yet to be completely understood. In this study, the effect of glycaemic control on pituitary gonadotrophins (FSH and LH) was evaluated in male and female diabetics in Enugu, Nigeria. Two hundred and twenty four (240) diabetic patients (92 males and 148 females) within the age range of 31 – 73 years, who were receiving treatment, were randomly recruited for the study. One hundred and thirty four (134) age- and sex-matched apparently healthy volunteers (44 males and 90 females) were recruited as the control subjects. The study subjects were grouped into three categories: Male population (40-72 years), Group A Female population (<50 years) and Group B Female population (≥50 years). The impact of glycaemic control on various parameters was evaluated by classifying the diabetic patients into 3 subgroups on the basis of their HbA1c levels: Good (HbA1c < 7%), Fair (HbA1c 7 to 8%) and (Poor HbA1c > 8 %) glycaemic status. Fasting blood sugar, HbA1c, FSH and LH were determined for all the subjects. The results obtained revealed that the male diabetics had significantly lower (p<0.05) FSH levels when compared with the control subjects. In the two groups of female diabetic subjects, the FSH levels were significantly lower (p<0.05) when compared with their respective control subjects. The glycaemic control evaluation and correlation of HbA1c with the gonadotrophins in the male diabetic population show no statistically significant results. However, in the female diabetic population, subjects with poor glycaemic status show significantly increased (p<0.001) LH levels compared to those with good glycaemic control. In addition, in group B female diabetic population, HbA1c gave significant positive correlation with both FSH (r=0.261, p=0.014) and LH (r = 0.338, p<0.001). This suggests that there is a direct relationship between HbA1c and the gonadotrophic hormones. As glycaemic control is compromised, these hormones tend to increase. This study generally reveals increasing trend in the levels of the gonadotrophins across the different glycaemic status. It can be concluded that good glycaemic control of diabetes can exert better influences on pituitary gonadotrophins.

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Sample of Aboriginal Australians, 2-hour post-load insulin concentrations are greatest between fasting plasma glucose values of 6.7-7.3 mmol/l

Diabetes and Islet Biology ◽

10.31579/2641-8975/009 ◽

2018 ◽

Vol 1 (2) ◽

pp. 01-05

Author(s):

Paul Aveyard

Keyword(s):

Blood Glucose ◽

Glycaemic Control ◽

Routine Care ◽

Systematic Sampling ◽

Control Group ◽

Diabetic Patients ◽

Glucose Levels ◽

Good Glycaemic Control ◽

Blood Glucose Levels ◽

The Impact

Background: Prevention of diabetic complications requires good glycaemic control. This study aimed to provide type 2 diabetes patients with remote active care and glycaemic control through the use of videophone technology without the need for them to attend hospital. The literature recommends additional research to study the impact of technical innovations on improved disease self-management and medical outcome. This is the only study to be conducted in Turkey concerning patient monitoring using videophone technology. The aim of the study was to establish the effectiveness of the use of videophone technology in the glycaemic control of patients with diabetes living in remote areas. Methods: This is a prospective, randomized control study using the systematic sampling method (using half ratio), in which 24 patients were chosen for the Experimental Group (EG) and another 24 for the Control Group (CG). All of the patients agreed to participate in the study. Patients in the CG received routine care, while the glycaemic control and consultations for patients in the EG were conducted using videophone technology. The patients were monitored by videophone for a total of 6 months. The HbA1c and blood glucose values recorded over the 6 month monitoring period were analyzed to determine the effectiveness of using a videophone. Results: The mean age of the individuals in the EG was 54.41 ± 8.54 years (Min=43 Max=78) and in the CG it was 57.25 ± 9.61 (Min=40 Max=77). In both groups, 50% of the individuals were men and 50% were women. When the two groups were compared, it was was found that the preprandial blood glucose levels of the diabetic patients in the EG (mean 159.48 ± 40.71mg/dl) were lower by 13.55 ± 52.89 mg / dl than the preprandial blood glucose levels of the diabetic patients in the CG (mean 173.03 ± 65.07 mg/dl). It was determined at the end of the six-month monitoring that the A1c levels of the individuals in the EG were significinatly lowered by 0.49% in total, and that the A1c levels of the individuals in the CG were higher by 0.17 % in total. Conclusions: It was shown that videophone technology can be useful in the glycaemic control of diabetic patients in Turkey.

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Adjuvant Supplementation with L-Carnitine in Diabetic Population and its effects on Lipid Parameters

10.53350/pjmhs211582017 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2017-2019

Author(s):

Rao Salman Aziz ◽

Usman Saeed ◽

Nasim Aslam Ghumman ◽

Muhammad Arshad ◽

Asif Sohail ◽

...

Keyword(s):

Diabetes Mellitus ◽

Triglyceride Level ◽

Clinical Care ◽

Diabetic Patients ◽

Healthy Population ◽

Patients With Diabetes ◽

Diabetic Population ◽

Large Discount ◽

The Impact ◽

Lipid Parameters

Background: Diabetes is a complicated disease requires continuous clinical care, to govern blood sugar. Aim: To decides the impact of management of L carentin to diabetics at the lipid profile. Methods: This study turned into performed on 120 diabetic Patients had been decided on from endocrinology and diabetes, inside decided on standards. The Patients distributed into three Strata (1st Strata of healthy population and two Strata of patients with diabetes who were on metformin and glibenclamide, one Strata took a L carnitine in a dose of 1000 mg TDS and a Strata dealing with a placebo for a period of ninety days). Results: It is observed those who are on Lcarnitine, confirmed a large discount (p <0.05) with inside the triglyceride level, at the same time as no large adjustments had been located withinside the level of cholesterol and HDL and LDL. Conclusion: These study outcomes that management of L carentin improved profile of lipid in type-2diabetic Patients. Keyword: Dyslipidemia, Diabetes mellitus (DM), l-carnitine (LC).

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Pharmacist Impact on Physician Practices Related to Diabetes Management

Advances in Social Sciences Research Journal ◽

10.14738/assrj.84.10081 ◽

2021 ◽

Vol 8 (4) ◽

pp. 560-575

Author(s):

Amina Ammar ◽

Lindsay M. Darghali ◽

Wassim Tarraf ◽

Helen D. Berlie ◽

Linda A. Jaber

Keyword(s):

Blood Pressure ◽

Diabetes Management ◽

Individual Treatment ◽

Diabetic Patients ◽

Composite Target ◽

Physician Practices ◽

Physical Presence ◽

Group A ◽

Group B ◽

The Impact

To examine the impact of a pharmacist’s physical presence on (1) the achievement of individual and combined targets for hemoglobin A1c (A1C), blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) (composite target), and (2) physician practices in relation to the American Diabetes Association (ADA) standards of medical care. Methods A retrospective, comparative study of randomly selected diabetic patients seen within an underserved primary care setting at least twice annually between June 1, 2018- December 31, 2019. Patients were allocated by whether they had received care in one of the physician-pharmacist clinics (Group A) or the physician-only clinic (Group B). Study outcomes included the proportion of patients achieving the composite and individual treatment targets for A1C, BP, and LDL-C. Results A total of 394 patients were included; Majority were underserved African Americans. The composite target was attained by 20% of participants in Group A and 13% in Group B (p=0.09). There were no statistically significant differences in achievement of individual targets between groups. A significantly higher proportion of participants in Group A achieved better control of diastolic blood pressure control (85% vs. 74%), had microalbuminuria tested (50% vs. 12%), were prescribed aspirin (43% vs. 32%), and had lower utilization of non-insulin glucose-lowering agents relative to those in Group B. Conclusion The impact of a pharmacist’s physical presence on physician practice demonstrated a general trend towards improvement in clinical outcomes related to diabetes management. Future studies are needed to further characterize the impact provided by the physician-pharmacist relationship.

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Mortality Rate Due to Circulatory and Alcohol-Dependent Diseases in Different Climatic Zones of Russia

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.537 ◽

2019 ◽

Vol 7 (11) ◽

pp. 1867-1872

Author(s):

Tatiana P. Yakovleva ◽

Natalia I. Nikitina ◽

Zhanna R. Gardanova ◽

Natalia S. Mikhailova ◽

Albina V. Gaponenko ◽

...

Keyword(s):

Climatic Zone ◽

Male Population ◽

Climatic Zones ◽

Female Population ◽

Risk Of Death ◽

Average Annual Temperature ◽

Circulatory System Diseases ◽

Murmansk Region ◽

The Impact ◽

Alcohol Dependent

AIM: Evaluation of the impact of climatic factors on the formation of mortality due to circulatory diseases and a group of diseases related to alcohol consumption identified as alcohol-dependent. METHODS: The study subject was the adult population residing in different climatic zones of Russia: in the second, third and fourth zones, with different conditions: average annual temperature (5.2°C; 1-2°C; -2.0°C), snow cover duration (≤ 150 days, ≤ 180 days, ≈ 220 days) sunshine duration and the presence of polar night and polar day in the territory of the fourth climatic zone. The assessment “impact-case of death” was carried out by calculating the standardized incidence ratio (SIR) with 95% confidence intervals (CI) for circulatory system diseases (CSD) and alcohol-dependent diseases (ADD) in accordance with the international classification of diseases (ICD-X). RESULTS: The SIR of death from alcohol-dependent diseases for the female population in the 4th climatic zone (Murmansk Region) was the highest: the SIR of death from ADD 1.87; 95% CI (1.5-2.7), the SIR of death from CSD 1.3; 95% CI (1.2-2.3). For the female population in the 3rd climatic zone (Novosibirsk Region), the SIR of death has amounted to: SIRADD 1.52; 95% CI (1.2-1.87), SIRCSD 1.14; 95 CI (1.01-1.3). Living in the 3rd climatic zone was not so important for the health of the male population: the SIR of death from CSD 1.1; 95% CI (1.05-1.13); the SIR of death from ADD 0.8; 95% CI (0.65-0.98). However, living in the 4th climatic zone (Murmansk Region) poses a higher risk of death for the male population: SIRCSD 1.22 (22.0%); 95% CI (1.02-3.95); SIRADD 1.45 (45.0%); 95% CI (0.98-2.1). CONCLUSION: Living in high northern latitudes contributes to higher levels of mortality, both female and male, from circulatory and alcohol-dependent diseases.

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The Impact of Comprehensive Sanatorium Rehabilitation on Diabetes Control for Patients on 21-day Treatment Resort. Own Observations

Acta Balneologica ◽

10.36740/abal201904102 ◽

2019 ◽

Vol 61 (4) ◽

pp. 236-242

Author(s):

Agata Stachura ◽

Agnieszka Łagowska-Batyra ◽

Patrycja Gierszon ◽

Agata Smoleń

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Day Treatment ◽

Fasting Blood Glucose ◽

Study Groups ◽

Diabetes Control ◽

Diabetic Patients ◽

Health Resort ◽

Female Population ◽

The Impact

Introduction: An integral part of modern healthcare is resort medicine, which should be a continuation of hospital or outpatient treatment. The paper discusses the impact of comprehensive sanatorium rehabilitation on the maintenance of blood pressure, glycaemia and BMI among diabetic patients on a 21-day resort stay in Nałęczów. In addition, the work includes, among others, the latest diabetes control criteria recommended by the Polish Diabetes Association. Aim: The aim of the study was to assess the impact of health resort treatment on diabetes control parameters in the male and female population during 21-day sanatorium stays. Material and Methods: The study group consisted of 152 patients (76 men, 50.00%) with type 2 diabetes mellitus with an average age of 67.45 ± 7.124 years on 21-day spa stays. The study method was a retrospective and comparative assessment of patients’ results in two subgroups. The frequency of physical activity, smoking, the presence of comorbidities, the model of their treatment, and the percentage of balneological and physical procedures ordered were analyzed. Results: The results of our own research show both a decrease in systolic and diastolic blood pressure as well as fasting blood glucose and 2 hours after a meal in both study groups. The studies also showed weight reduction, which, combined with a proper diet and regular physical activity, is the beginning of a healthy lifestyle after returning from a sanatorium.

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MON-389 Fracture Risk Assessment Models for Patients With T2DM

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1815 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Andreea Maria Banica ◽

Luciana Mihaela Oprea ◽

Iuliana Ilie ◽

Viviana Elian ◽

Andra Caragheorgheopol ◽

...

Keyword(s):

Risk Assessment ◽

Hip Fracture ◽

Fracture Risk ◽

Osteoporotic Fracture ◽

Fracture Risk Assessment ◽

Diabetic Patients ◽

Major Osteoporotic Fracture ◽

Hip Fracture Risk ◽

Diabetic Population ◽

The Impact

Abstract Introduction Bone mineral density (BMD) measurement, a tool used to diagnose osteoporosis (OP) and to predict fracture risk, has not been found very useful in type 2 diabetic (T2DM) patients. They have a 69% higher fracture risk despite having higher hip and lumbar spine BMD than the non-diabetic population. The aim of this study was to examine the impact of 3 different fracture risk assessment (FRAX) models using surrogate adjustments for T2DM in predicting osteoporotic fracture risk over 10 years. Material and Methods Observational retrospective study included 98 patients with OP or osteopenia: 94 women and 4 men admitted in the National Institute of Endocrinology between 2011-2019. 50 % (n= 49) of the patients had T2DM, while the other half were non-diabetic patients. BMI, BMD, lipid profile, serum creatinine, calcium, phosphorus, 25(OH)vitamin D, HbA1c were assessed. BMD was measured on a GE Lunar osteodensitometer. The risk of major osteoporotic fracture in 10 years was assessed with FRAX adjusted for Romania. For diabetic patients, FRAX was adjusted by adding 10 years to patients’ age (model 1), by using rheumatoid polyarthritis as a substitute for T2DM (model 2) or by lowering T score with 0.5 DS (model 3). Results Non-diabetic patients had a lower BMI (p=0.001) and a lower BMD (p=0.03) than diabetic patients. A higher BMI correlated with a higher hip BMD (p=0.004). For diabetic patients, FRAX risk without adjustment was statistically significant lower than FRAX risk calculated with model 1 and 2 (p< 0.001) for both major and hip fracture risk. Unadjusted FRAX risk was lower than the one calculated with model 3 only for hip fracture risk (p<0.001). Model 1 FRAX adjustment led to a statistically significant risk of both major osteoporotic fracture (p= 0.004) and hip fracture (p=0.04) over 10 years in diabetic patients than non-diabetic patients, though diabetic patients had higher BMD. The same observation was made when FRAX was adjusted by model 2 (p=0.001) or by model 3 (p=0.001). HbA1c correlated inversely with FRAX adjusted with all three models. Discussion FRAX calculator does not include T2DM among secondary causes of OP and this precludes a proper risk assessment independent of BMD. Trabecular bone assessment (TBS) captures a larger portion of the diabetes-associated fracture risk than BMD, however TBS it is not fully independent of the BMD. We examined 3 models of adjusted FRAX in T2DM patients that showed an important increase in fracture risk prediction when adding BMD - independent risk factors into FRAX calculator. Conclusion T2DM patients have a greater risk of major osteoporotic fracture in 10 years at the same BMD compared with non-diabetic population. New models of FRAX adjusted for T2DM are needed in assessing the intervention threshold for OP/osteopenia of patients with T2DM.

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Diabetes in the Context of Stroke (Local Study)

International Neuropsychiatric Disease Journal ◽

10.9734/indj/2021/v16i330173 ◽

2021 ◽

pp. 1-5

Author(s):

Magda Mostafa ◽

Mohamad Aladlany ◽

Mohamad Sherif ◽

Mohammed Abbas

Keyword(s):

Cardiovascular Complications ◽

Cerebrovascular Diseases ◽

Cerebral Stroke ◽

Diabetic Patients ◽

Stroke Severity ◽

Base Line ◽

Local Study ◽

Established Risk Factor ◽

Group B ◽

The Impact

Background: Cerebrovascular diseases (CVD), including stroke, are considered as a high burden heath issue around the world. Diabetes is a well-established risk factor for stroke that affects both severity and outcome. Objectives: The objective of this study is to evaluate cerebral stroke in diabetic patients and the impact of diabetes mellitus on the severity and outcome of all types of strokes. Patients and Methods: This study included 500 patients with the first attack stroke who were classified into two groups; Group A: 404 diabetic patients & Group B: 96 non-diabetic patients. All patients were diagnosed clinically and with base line CT (Computed Tomography) brain and stroke severity was evaluated by NIHSS within 24 hours of admission. Results: The mean NIHSS in the diabetic cases was 10.35 ± 2.51 which was statistically significant higher as compared with the non-diabetic cases (7.25 ± 1.02) (P <0.001). The percentage of cases with infarction stroke was higher in the diabetic group, however it did not detect major dissimilarity between the 2 groups. Conclusion: Cardiovascular complications including cerebral strokes occur in higher rates in diabetic patients as compared with the non-diabetic. The outcomes of cerebral strokes were worse as compared with the non-diabetic.

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Impact of Use Frequency of a Mobile Diabetes Management App on Blood Glucose Control: Evaluation Study (Preprint)

10.2196/preprints.11933 ◽

2018 ◽

Author(s):

Josep Vehi ◽

Jordi Regincós Isern ◽

Adrià Parcerisas ◽

Remei Calm ◽

Ivan Contreras

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Diabetes Management ◽

Blood Glucose Control ◽

Evaluation Study ◽

High Blood Glucose ◽

Group A ◽

Control Evaluation ◽

Group B ◽

The Impact

BACKGROUND Technology has long been used to carry out self-management as well as to improve adherence to treatment in people with diabetes. However, most technology-based apps do not meet the basic requirements for engaging patients. OBJECTIVE This study aimed to evaluate the effect of use frequency of a diabetes management app on glycemic control. METHODS Overall, 2 analyses were performed. The first consisted of an examination of the reduction of blood glucose (BG) mean, using a randomly selected group of 211 users of the SocialDiabetes app (SDA). BG levels at baseline, month 3, and month 6 were calculated using the intercept of a regression model based on data from months 1, 4, and 7, respectively. In the second analysis, the impact of low and high BG risk was examined. A total of 2692 users logging SDA ≥5 days/month for ≥6 months were analyzed. The highest quartile regarding low blood glucose index (LBGI) and high blood glucose index (HBGI) at baseline (t1) was selected (n=74 for group A; n=440 for group B). Changes in HBGI and LBGI at month 6 (t2) were analyzed. RESULTS For analysis 1, baseline BG results for type 1 diabetes mellitus (T1DM) groups A and B were 213.61 (SD 31.57) mg/dL and 206.43 (SD 18.65) mg/dL, respectively, which decreased at month 6 to 175.15 (SD 37.88) mg/dL and 180.6 (SD 40.47) mg/dL, respectively. For type 2 diabetes mellitus (T2DM), baseline BG was 218.77 (SD 40.18) mg/dL and 232.55 (SD 46.78) mg/dL, respectively, which decreased at month 6 to 160.51 (SD 39.32) mg/dL and 173.14 (SD 52.81) mg/dL for groups A and B, respectively. This represents a reduction of estimated A1c (eA1c) of approximately 1.3% (P<.001) and 0.9% (P=.001) for T1DM groups A and B, respectively, and 2% (P<.001) for both A and B T2DM groups, respectively. For analysis 2, T1DM baseline LBGI values for groups A and B were 5.2 (SD 3.9) and 4.4 (SD 2.3), respectively, which decreased at t2 to 3.4 (SD 3.3) and 3.4 (SD 1.9), respectively; this was a reduction of 34.6% (P=.005) and 22.7% (P=.02), respectively. Baseline HBGI values for groups A and B were 12.6 (SD 4.3) and 10.6 (SD 4.03), respectively, which decreased at t2 to 9.0 (SD 6.5) and 8.6 (SD 4.7), respectively; this was a reduction of 30% (P=.001) and 22% (P=.003), respectively. CONCLUSIONS A significant reduction in BG was found in all groups, independent of the use frequency of the app. Better outcomes were found for T2DM patients. A significant reduction in LBGI and HBGI was found in all groups, regardless of the use frequency of the app. LBGI and HBGI indices of both groups tend to have similar values after 6 months of app use.

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The Impact of Sex and Gender on Heart-Brain Axis Dysfunction: Current Concepts and Novel Perspectives

Canadian Journal of Physiology and Pharmacology ◽

10.1139/cjpp-2020-0391 ◽

2020 ◽

Author(s):

Carlotta Baroni ◽

Vincenzo Lionetti

Keyword(s):

Age Of Onset ◽

Treatment Strategies ◽

Organ Injury ◽

Sex And Gender ◽

Male Population ◽

Female Population ◽

Determining Factors ◽

Gender Based ◽

And Gender ◽

The Impact

The Heart-Brain Axis (HBA) recapitulates all the circuits that regulate bidirectional flow of communication between heart and brain. Several mechanisms may underlie the interdependent relationship involving heterogeneous tissues at rest and during specific target organ injury, such as myocardial infarction, heart failure, arrhythmia, stroke, mood disorders or dementia. In-depth translational studies of the HBA dysfunction under single-organ injury should include both male and female animals to develop sex/gender-oriented prevention, diagnosis and treatment strategies. Indeed, sex and gender are determining factors since females and males exhibit significant differences in terms of susceptibility to risk factors, age of onset, severity of symptoms and outcome. Despite most studies have focused on the male population, we have conducted a careful appraisal of the literature investigating HBA in females. In particular, we have i) analysed sex-related heart and brain illnesses, ii) recapitulated the most significant studies simultaneously conducted on cardio- and cerebrovascular systems in female population, iii) hypothesised future perspectives for the development of gender-based approach to HBA dysfunction. Although sex/gender-oriented research is at its infancy, the impact of sex on HBA dysfunction is opening unexpected new avenues for managing health of female subjects exposed to risk of lifestyle multi-organ disease.

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Glycaemic Control Impact on Renal Endpoints in Diabetic Patients on Haemodialysis

International Journal of Nephrology ◽

10.1155/2015/523521 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6

Author(s):

Danielle Creme ◽

Kieran McCafferty

Keyword(s):

Glycaemic Control ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Poor Glycaemic Control ◽

Number Of Patients ◽

Weight Gains ◽

Before And After ◽

Patients With Diabetes ◽

The Impact

Objective. To identify the number of haemodialysis patients with diabetes in a large NHS Trust, their current glycaemic control, and the impact on other renal specific outcomes.Design. Retrospective, observational, cross-sectional study.Methods. Data was collected from an electronic patient management system. Glycaemic control was assessed from HbA1c results that were then further adjusted for albumin (Alb) and haemoglobin (Hb). Interdialytic weight gains were analysed from weights recorded before and after dialysis, 2 weeks before and after the most recent HbA1c date. Amputations were identified from electronic records.Results. 39% of patients had poor glycaemic control (HbA1c > 8%). Adjusted HbA1c resulted in a greater number of patients with poor control (55%). Significant correlations were found with interdialytic weight gains (P<0.02,r=0.14), predialysis sodium (P<0.0001,r=-1.9), and predialysis bicarbonate (P<0.02,r=0.12). Trends were observed with albumin and C-reactive protein. Patients with diabetes had more amputations (24 versus 2).Conclusion. Large number of diabetic patients on haemdialysis have poor glycaemic control. This may lead to higher interdialytic weight gains, larger sodium and bicarbonate shifts, increased number of amputations, and possibly increased inflammation and decreased nutritional status. Comprehensive guidelines and more accurate long-term tests for glycaemic control are needed.

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