scholarly journals Study of TSH level at the time of diagnosis of Hypothyroidism in patients with Diabetes Mellitus- A Retrospective Study

2020 ◽  
Vol 4 (2) ◽  
pp. 24-28
Author(s):  
Indu K.C. ◽  
S Ghimire ◽  
R Deo

Background: To evaluate the difference in the level of TSH in diabetic and non diabetic patients at the time of the diagnosis of hypothyroidism. Methods: 100 diagnosed cases of hypothyroidism, 50 with diabetes and 50 without diabetes were studied. The level of TSH at the time of diagnosis and other information were obtained from the medical records. Results: The mean TSH in patients with the history of diabetes at the diagnosis of hypothyroidism was 19.9616±26.990 and in those without the history of the diabetes was 10.4797±6.503 (p value 0.018). The females with diabetes had higher level of TSH level at the time of diagnosis of hypothyroidism than females without diabetes (p value 0.045). There was no statistically significant difference in the level of TSH in males with and without diabetes at the time of diagnosis of hypothyroidism. Conclusion: Patients with diabetes mellitus had higher level of TSH at the time of diagnosis of hypothyroidism in comparison to those without diabetes. Early identification of the raised TSH levels in diabetic patients and timely intervention will help to reduce the chances of adverse cardiovascular outcomes and diabetic kidney disease in this group of patients.

Author(s):  
P. Amulya Reddy ◽  
K. Saravanan ◽  
A. Madhukar

Aim: The aim of the study was to evaluate the QOL of patients with Diabetes Mellitus. Study Design: This was a prospective, observational study. Duration of Study: The study was conducted from August 2019 to January 2021 in Yashoda Hospital, Hyderabad. Methodology: Patients of either sex with ≥1year history of diabetes willing to give the consent were included in the study. Patients of either sex with <1year history of DM, Pregnant/lactating women and patients not willing to give the consent were excluded from the study. Data on Blood glucose levels (FBS, PPBS) and HbA1C was also obtained and assessed. QOLID questionnaire was administered to the patients and assessed which consisted of a set of 34 items representing 8 domains such as Role limitation due to the physical health, Physical endurance, General health, Treatment satisfaction, Symptom botherness, Financial worries, Mental health, and Diet satisfaction). Results: A total of 200 patients were analysed in the study,108(54%) were males and 92(46%) were females. The average age of the patients was 58.5 years with majority being 51-70years (73.5%) of age. Patients with higher age and females had poor QOL compared to others. The correlation between various categorical variables with that of scores of QOL in various domains was assessed, Age of the patients influenced QOL score in various domains like RLPH (p value-0.038), PE (p value-0.0183), and SB (p value-0.0002), Gender has influenced QOL score in domains like RLPH (p value-0.0008), PE (p value-0.0106), TS (p value-0.0005) and Educational Qualification has influenced QOL score in RLPH (p value-0.0008), GH (p value-<0.0001), TS (p value-<0.0001), E/MH (p value-<0.0001). Conclusion: The results concluded that overall QOL was noticeably low in Diabetic patients especially in Women and elderly thus indicating that Diabetes management is not restricted to treatment but also requires attention on QOL of patients.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S81-S82
Author(s):  
Kathleen A Iles ◽  
Lori Chrisco ◽  
Stephen Heisler ◽  
Booker King ◽  
Felicia N Williams ◽  
...  

Abstract Introduction Diabetes mellitus (DM) is a critical comorbidity with burn injury due to the disrupted healing process. Previous reports have confirmed the increased rate of osteomyelitis (OM) and subsequent amputation in this cohort, however this has yet to be studied in comparison to non-diabetic patients. In this retrospective analysis, we investigate OM and amputation in both the diabetic and non-diabetic lower extremity burn populations to determine the impact of DM on these outcomes. Methods The burn registry was used to identify all patients admitted to our tertiary burn center from January 1, 2014 to December 31, 2018. Only patients with lower extremity burns (foot and/or ankle) were included. Patients with burns to additional body areas were excluded. Amputations were categorized by time from injury. Statistical analysis was performed using Student’s t test, chi-squared test, and Fischer’s exact test. Results Of the 315 patients identified, 103 had a known diagnosis of DM and 212 did not. Scald injury was the most common mechanism and average TBSA was similar. Differences were observed in average length of stay (LOS) and admission cost, with diabetics demonstrating both a higher LOS (13.7 days vs 9.2 days, p-value= 0.0016) and cost ($72,883 vs $50,500, p-value= 0.0058) (Table 1). In total, 17 patients were found to have radiologically confirmed OM within three months of the burn injury. Fifteen of these patients had a history of DM and two had no history of DM (p-value= &lt; 0.001) (Table 2). The DM OM patients were found to have a higher blood glucose level on admission (219 mg/dL vs 110 mg/dL, p-value= 0.0452). No significant difference was seen in Hgb A1c in diabetics with or without OM (9.26% vs 8.81%, p= 0.2743). Notably, when non-diabetics were diagnosed with OM, significant differences were observed in both LOS and cost in comparison to their counterparts without OM (36 days vs 9 days; p= 0.0003; $226,289 vs $48,818, p=0.0001). Of the 11 patients who required an amputation, 10 (90.9%) of these patients had comorbid DM. Conclusions DM patients with lower extremity burns are more likely to develop OM than their non-diabetic counterparts. When radiologically confirmed OM is present, DM patients have an increased rate of amputation. OM incurs significant healthcare utilization and cost in both the diabetic and non-diabetic populations.


2016 ◽  
pp. 78-85
Author(s):  
Thi Minh Phuong Phan ◽  
Dinh Thanh Truong

Background: Autoantibodies anti GAD and ICA associated to the autoimmune process of patients with diabetes. Detection of these antibodies in progessive diabeticpatients is very necessary because the presence of anti GAD and ICA can predict the progression of the disease to insulin-dependent diabetes in the future. This study was carried out with aims: (1) to define the positive rate, anti GAD and ICA level in patients with diabetes. (2) to evaluate the correlation between anti GAD and ICA with several clinical and paraclinical features of diabetic patients. Materials and method: 88 patients diagnosed of diabetes by the criteria of ADA 2014, withfasting glucose ≥ 126 mg/dL or≥ 7,0 mmol/L) and HbA1C> 6.5%. Indirect enzyme linked immunosorbent assay (ELISA) was used to measure those autoantibodies of anti GAD and ICA, kits were supplied by DRG company, Germany. Results: the anti GAD positive rate was 10.2%; mean of level of anti GAD was 1.44±0.25 U/mL. ICA positive ratewas 9.1%; mean of level of ICA was 1.44±0.12 U/mL. Positive rate with anti GAD and/or ICA was 19.3%. About the correlation between level of anti GAD, ICA with some of clinical features, we found only the statistically significant difference with p<0.05 between blur vision in the group of ICA level > 1.25U/mL with group of ICA level< 1.25U/mL. About the paraclinical features, the difference with statistical significance (p<0.05) of HbA1C>6.5% was found between the group with anti GAD> 1.05U/mLand the one with anti GAD< 1.00U/mLand also betweenthe group of ICA > 1.25 U/mL and ICA < 1.25 U/mL. Key words: autoantibody anti glutamic acid decarboxylase, islet cell autoantibodies, diabetes mellitus.


2021 ◽  
Vol 6 (2) ◽  
pp. 1-11
Author(s):  
Naveen Kumar C

Clinical Relevance: Optometrists often are the first to examine previously underdiagnosed diabetic patients because of its ocular manifestations such as a change in refractive status. This study is relevant to help optometrists identify patients with diabetes using changes in pupil mydriasis as a marker. Background: This study compared the pupillary dilatation in subjects with diabetes mellitus and those without diabetes mellitus. The purpose of the study was to use this difference as a diagnostic marker for identification of diabetes in previously undiagnosed subjects who present for eye examination. Methods: An experimental study was conducted involving 40 non-diabetic and 80 diabetic subjects with or without diabetic retinopathy. Baseline pupil diameter was measured using Orbscan and Aberrometer. Mydriasis was elicited using a combination eye drop (0.8% Tropicamide and 5% Phenylephrine). Pupil diameter was measured at 15, 30, 45 and 60 minutes after the instillation of the eye drops. The difference in pupil diameter amongst the three groups was determined using factorial ANOVA to account for the effect of age. Results: There was no significant difference between the mean pupil diameter among the three groups at baseline when measured with Orbscan (p=0.187) and Aberrometer (p=0.146). There was a significant difference in the mean and mean change in pupil diameter among the three groups with either Orbscan or Aberrometer at 30, 45 and 60 minutes after the instillation of mydriatic drops. The non-diabetics have larger pupil diameter while the diabetics with retinopathy have the least pupil diameter. Conclusion: The study showed that there was a significant difference in pupil diameter between non-diabetics, diabetics without retinopathy and diabetics with retinopathy during mydriasis. Alongside a history of symptoms of diabetes, this difference could be explored as an ocular biomarker to identify previously undiagnosed diabetes in individuals who present for routine eye examination.


1989 ◽  
Vol 103 (9) ◽  
pp. 853-855 ◽  
Author(s):  
W. L. Yue

AbstractFifty insulin-dependent diabetics and 50 non-diabetics without a history of nasal disease have been studied for nasal problems including mucociliary function complicated by diabetes mellitus. For the diabetics, the mean value of nasal mucociliary clearance was considerably decreased and this was more often associated with dry noses but increased pH-values, both of which were higher than those for non-diabetics (p<0.05). As suggested in earlier literature, more aggressive nasal moistening therapy must be recommended for those patients presenting with these conditions in the light of systemic diabetic abnormalities.


2017 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Siswanto Siswanto ◽  
Ismail Kamba ◽  
Siti Aminah

Diabetes mellitus is one of the communicable diseases that have become a public health problem, not only in Indonesia but also the world. Currently morbidity of diabetes mellitus is increasing every year, where in 2006 there were 14 million people in 2011 and ranks fourth with 773 cases. DM is also a cause of disease mortality by 5.8%. And Samarinda own particular Islamic Hospital years 2009, there were 449 patients with DM, and 2011 an increase in the 1931 patients with diabetes mellitus. To increase patients’ knowledge about diabetes and diabetic patients be directing attitudes that support or positive attitude towards keeping blood glucose levels to remain normal. Methode to use pra eksperiment with one group pretest posttest. individual conseling withAudiovisual media. There is increased knowledge about diabetes diabetic patients before and after intervention with increasing value of 3.77 (p value = 0.000) and increase in attitudes regarding diabetes mellitus diabetic patients with an increase in the value of 5,35 (p value = 0.003). There was an increase in knowledge and attitudes of patients hospitalized with diabetes mellitus hospital after islam samarinda given nutritional counseling using audio-visual media


2018 ◽  
Vol 4 (1) ◽  
pp. 112-119
Author(s):  
Andika Siswoaribowo ◽  
Mateus Sakundarno ◽  
Muhammad Mu’in

Background: Diabetes Mellitus is a chronic disease that requires treatment for long periods of time so it can cause physical and psychological problems for sufferers and families (caregiver). Caregiver's role is expected to provide support for people with diabetes mellitus. Family psychoeducation is a strategy that can be applied for caregiver in overcoming problems that arise during the treatment of patients with diabetes mellitus.Objective: This study aims to determine the effect of family psychoeducation on caregiver support in the treatment of patients with diabetes mellitus type II.Methods: This research used a quasi experiment with  pre-test post-test control group design. A total of 46 caregivers and patients with diabetes mellitus were recruited puposively, with 23 respondents assigned in the experiment and control group. Caregiver support scale was used to measure caregiver support, and Hensarling Diabetes Family Support Scale (HDFSS) for measuring perception of patients toward the treatment of caregiver.  Data were analyzed using paired t-test and independent t-test. Results: Findings showed there was an increase of caregiver knowledge from 5.39 to 9.09 and an improvement of caregiver treatment from 40.30 to 67.04 after given family psychoeducation. There was a significant difference of caregiver support in the experimental and control group with p-value <0.001 (<0.05).Conclusion: Family psychoeducation can increase caregiver support in the treatment of diabetes mellitus patients. The intervention can be one of nurses interventions in the empowerment of family in improving the treatment of chronic diseases, particularly in diabetes mellitus.


2019 ◽  
Author(s):  
Gebrewahd Bezabh Gebremichael ◽  
Teklewoini Mariye Zemichael

Abstract Background Hypoglycemia is an acute medical situation that occurs when blood sugar falls below the recommended level. Even though, hypoglycemia prevention practice in the management of diabetes mellitus is one cornerstone in controlling the effect of hypoglycemia, hypoglycemia prevention practice among patients with diabetes mellitus is insufficiently studied. Moreover, the existed scarce literature in Ethiopia revealed hypoglycemia prevention practice is inadequate. Thus, this study tried to assess hypoglycemia prevention practices and associated factors among diabetic patients. Methods Hospital-based, cross-sectional study design was employed from April one to March one 2018 in Central Zone of Tigray Regional state of Ethiopia. A total of 272 diabetes mellitus patients were selected by systematic random sampling method from study area. The collected data was checked for its completeness and then entered into Epi data version 3.1 then cleaned and analyzed using SPSS version 23. Binary logistic regression model (AOR, 95% CI and p-value < 0.05) was used to determine the predictors of hypoglycemia prevention practice. Results the mean age of respondents was 52.19 years and about 100 (63.2%) had good hypoglycemia prevention practice. Knowledge regarding hypoglycemia [AOR = 10.34; 95% CI [5.41, 19.89]], having a glucometer at home [AOR=3. 02; 95% CI [1.12, 8.12]], attitude regarding diabetes mellitus [AOR = 2.36 CI [1.26, 4.39]], being governmental employee [AOR=5. 19, 95% CI [1.63, 16.58]] and being divorced [AOR = 0.13, 95% CI [0.32, 0.53]] were found significantly associated with good hypoglycemia prevention practice. Conclusion Around two third of the study participants were found to have good hypoglycemia prevention practice. Good knowledge and favorable attitude toward diabetes mellitus, having glucometer at home, being governmental employee and divorced were found to be the predictors of good hypoglycemia prevention practice.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Magdy ElSharkawy ◽  
Mohamed Mostafa ◽  
Mohamed Ezzat

Abstract Background and Aims Microalbuminuria is one of the early presentations of diabetic kidney disease that may progress to macroalbuminuria, progressive loss of glomerular filtration rate and eventually end stage renal disease. Early recognition and management of microalbuminuria can avert irreversible complications. Antihypertensive medications and antihyperlipidemic medications are medications that have been used to control diabetic nephropathy, but the reports of some side effects limited the usage of some of these drugs in diabetic patients. Pentoxifylline is an anti-inflammatory medication that have been experienced for clinical trials in diabetic patients with diabetic kidney disease. Effect of Pentoxifylline on albuminuria has been evaluated in several studies with different outcomes where a significant decrease in albuminuria in the Pentoxifylline group compared with placebo was the final conclusion. The aim of our study is the assessment of the value of Pentoxifylline addition in diabetic patients. Method Of 90 patients aged between 20 and 55 years old with a history of diabetes mellites type II for more than 5 years with normal serum creatinine and had a spot urinary albumin/creatinine ratio of &gt; 300 mg/g on two consecutive measurements with HBA1C &lt; 7% and lacking any history of glomerular disease, immunological, malignant nor cardiovascular disease in the previous 6 months nor using pentoxifylline for the past 3 month attending Ain Shams University clinics in Egypt from October 2017 to September 2018, 61 patients were eligible and randomly assigned in prospective, randomized, parallel-group, non-blind study after obtaining written informed consent from studied patients into 2 groups either the Pentoxifylline group (n = 30) receiving 400 mg thrice daily for 6 months or Ramipril group (n = 31) receiving 2.5 mg once daily on the same schedule. Blood samples and single first morning void urine samples were collected before breakfast after an 8–12 hours overnight fast. Plasma glucose, HbA1c, serum Creatinine, AST, ALT, and urinary protein / Creatinine levels were measured. All biochemical analyses were performed. Participants were followed up after 1, 3 and 6 months during the treatment period to evaluate the outcome Results Highly Statistically significant differences were noted as regard the reduction of the proteinuria levels at the same measurement points in both groups where the mean ranges of proteinuria in group 1 were found to be 2.2±1, 1.8±0.7, 1.4±0.6 mg\g at the start of the study, 3 and 6 month later respectively while in group 2 the mean range was found to be 2.6±1.2, 2±0.8, 1.6±0.7 mg\g with marked reduction of 20.6% after 3 month and 37.6% after 6 month from the start of the trial in group 1 in contrast to 20.7% and 40.2% respectively in group 2, also the effect of both drugs on the level of HbA1c has been studied in both group, in group 1 there was no reduction in the level of HbA1c after 6 month of drug administration in contrary to group 2 which showed a reduction of 4% where these results were found to be statistically significant in group 2 only. we also found statistically significant differences in both groups as regard the decline in eGFR throughout the trial duration which was 4% in group 1 and 6% in group 2. Conclusion We concluded that Pentoxifylline has a promising role as an antiproteinuric agent in comparison with ACEI from our statistical analysis of the study data with a more decline in eGFR throughout the trial duration in the study population using ACEI in comparison to Pentoxifylline. Due to restrictions of the study design these observations need further confirmation by prospective studies. Figure (1) showing comparison between both groups as regard the level of proteinuria and its reduction rate over 6 months Figure (2) showing eGFR levels at 0, 6 months in both groups Figure (3) showing comparison between both groups as regard HbA1C at baseline and after 6 months.


2018 ◽  
Vol 12 (02) ◽  
pp. 225-231 ◽  
Author(s):  
Ruby Ramya Vincent ◽  
Devapriya Appukuttan ◽  
Dhayanand John Victor ◽  
Aruna Balasundaram

ABSTRACT Objective: Oxidative stress (OS) refers to the disequilibrium between free radicals and antioxidant defense mechanisms and is significantly implicated in the pathogenesis of chronic degenerative and inflammatory diseases such as chronic periodontal disease (CP) and diabetes mellitus (DM). This study aimed to evaluate the total antioxidants capacity (TAOC) and total oxidants status (TOS) in the gingival crevicular fluid (GCF) in CP participants with type II DM. Materials and Methods: A total of 80 participants were allotted into four groups as follows: Group 1: Generalized CP (GCP) without type II DM (n = 20); Group 2: GCP with type II DM (n = 20); Group 3: Type II DM without CP (n = 20); and Group 4: Systemically and periodontally healthy (PH) (n = 20). Clinical parameters such as plaque index, gingival index, probing pocket depth, and clinical attachment level were recorded. Pooled GCF was collected followed by the estimation of TAOC, TOS, and OS index (OSI) using Erel O Colorimetric analysis. Results: The clinical parameters recorded showed the statistically significant difference (P < 0.001) between the groups. The mean TAOC value was the highest in PH group. The mean TOS and OSI were higher in Group 1, 2, and 3 participants when compared to the PH participants. All the biochemical parameters evaluated showed a statistically significant difference (P < 0.001) between groups. Conclusions: The study further validates the use of OSI as a marker for periodontal disease activity and emphasizes the role of OS in the pathogenesis of Type II diabetic patients with the chronic periodontal disease.


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