scholarly journals The relation between HbA1c variability and diabetic autonomic neuropathy among type-2 diabetic patients

2022 ◽  
Vol 6 (1) ◽  
pp. 89
Author(s):  
Md Azad Hossain ◽  
Mukul Kumar Sarkar ◽  
Imtiaj Mahbub ◽  
SM Shahinul Islam
Keyword(s):  
Type 2 Diabetes ◽  
Autonomic Neuropathy ◽  
Clinical Manifestations ◽  
Diabetic Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Hba1c Variability ◽  
The Relationship ◽  
Type 2 Diabetic

Background: Diabetic autonomic neuropathy (DAN) is the most neglected major and widespread microvascular complication of type-2 diabetes mellitus, involving multiple body organs. DAN is a subtype of diabetic peripheral neuropathy.Objective: To investigate the relationship between the variability of HbA1c and diabetic autonomic neuropathy in type-2 diabetes patients.Materials and methods: This study recruited a total of 150 type-2 diabetic patients to screen for diabetic autonomic neuropathy and estimated quarterly levels of HbA1c were performed within the year before enrollment. With a noninvasive procedure, DAN was validated by careful history taking, anthropometric assessment, clinical manifestations and neurological assessment.Results: Out of 150 type- 2 diabetic patients, recruited randomly, where 81 were female and 69 were male. Among all patients 29 (19.33%) had been screened positive for DAN which showed higher HbA1c than non-DAN patients. Different autonomic neuropathic dysfunction among total diabetic patients were also studies and found that the highest prevalence of sexual dysfunction among all autonomic dysfunction prevalence which is 16.66% whereas the lowest prevalence was postural hypotension that is 6.66%. The second higher prevalence is urinary incontinence (10.66%). Abnormal sweating (9.33%) and nocturnal diarrheas (7.33%) are in third and fourth position respectively. No significant (p>0.05) differences were found in the case of BMI, sex, systolic, and diastolic blood pressure between DAN and non-DAN. Data shows a major (p<0.05) risk factor for DAN has also been the prolonged period of diabetes and older age.Conclusion: The study indicates that the increased level of HbA1c in type-2 diabetic patients is closely correlated with DAN and may be considered a potent predictor of DAN in the recruited patients.International Journal of Human and Health Sciences Vol. 06 No. 01 January’22 Page: 89-95

scholarly journals The relationship between circulating irisin levels and tissues AGE accumulation in type 2 diabetes patients

2017 ◽  
Vol 37 (3) ◽  
Author(s):  
Zhu Li ◽  
Gang Wang ◽  
Yan-juan Zhu ◽  
Chen-guang Li ◽  
Yun-zhao Tang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Type 2 Diabetic Patients ◽  
Glycation End Products ◽  
The Relationship ◽  
Type 2 Diabetic ◽  
Diabetes Patients

Advanced glycation end-products (AGEs), measured by skin autofluorescence (AF), are a factor in the development or worsening of many degenerative diseases, such as diabetes and atherosclerosis. Irisin levels have been associated with diabetes, endothelial dysfunction and atherosclerosis. The objective of the present study was to investigate whether circulating irisin levels are correlated with skin AF values in type 2 diabetes patients. A total of 362 Chinese type 2 diabetic patients and 100 age- and sex-matched healthy controls were recruited in the present study. Clinical characteristics, blood biochemistry and circulating irisin levels were measured. Skin AF was measured using an AGE reader. Circulating irisin levels were significantly lower, while skin AF values were increased in type 2 diabetes compared with controls (P<0.05 respectively). By dividing the distribution of skin AF values into tertiles, serum irisin levels gradually lowered with increasing skin AF values (P<0.05). After adjusting for covariates, multivariate stepwise regression analysis demonstrated that serum lower irisin levels were independently associated with skin AF (P=0.009). Circulating irisin levels were lower in type 2 diabetes patients compared with healthy controls. Lower levels of irisin are independently associated with elevated skin AF values, indicating that circulating irisin levels could be associated with AGEs accumulation, which is one of the reasons causing vascular complications in diabetic patients.

scholarly journals Evaluation of the Degree of Agreement of Four Methods for Diagnosing Diabetic Autonomic Neuropathy

2021 ◽  
Vol 12 ◽  
Author(s):  
Yu Peng ◽  
Ying-shan Liu ◽  
Min-yi Wu ◽  
Chu-na Chen ◽  
Chu-qiao Li ◽  
...  
Keyword(s):  
Autonomic Neuropathy ◽  
Diagnostic Value ◽  
Diabetic Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Diagnostic Values ◽  
Spearman’S Correlation ◽  
Type 2 Diabetic

Background: There are many methods to diagnose diabetic autonomic neuropathy (DAN); however, often, the various methods do not provide consistent results. Even the two methods recommended by the American Diabetes Association (ADA) guidelines, Ewing's test and heart rate variability (HRV), sometimes give conflicting results. The purpose of this study was to evaluate the degree of agreement of the results of the Composite Autonomic Symptom Score 31 (COMPASS-31), skin sympathetic reaction (SSR) test, Ewing's test, and HRV in diagnosing DAN.Methods: Patients with type 2 diabetes were recruited and each received the COMPASS-31, SSR, Ewing's test, and HRV for the diagnosis of DAN. Patients were categorized as DAN(+) and DAN(–) by each of the tests. Kappa consistency tests were used to evaluate the agreement of diagnosing DAN between any two methods. Spearman's correlation test was used to evaluate the correlations of the severity of DAN between any two methods. Receiver operating characteristic (ROC) analyses were used to evaluate the diagnostic value and the cutoff value of each method.Results: A total of 126 type 2 diabetic patients were included in the study. The percentages of DAN(+) results by HRV, Ewing's test, COMPASS-31, and SSR were 61, 40, 35, and 33%, respectively. COMPASS-31 and Ewing's test had the best agreement for diagnosing DAN (κ = 0.512, p &lt; 0.001). COMPASS-31 and Ewing's test also had the best correlation with respect to the severity of DAN (r = 0.587, p &lt; 0.001). Ewing's test and COMPASS-31 had relatively good diagnostic values (AUC = 0.703 and 0.630, respectively) in the ROC analyses.Conclusions: COMPASS-31 and Ewing's test exhibit good diagnostic consistency and severity correlation for the diagnosis of DAN. Either test is suitable for the diagnosis of DAN and treatment follow-up.

scholarly journals Association between Related Purine Metabolites and Diabetic Retinopathy in Type 2 Diabetic Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Jianfei Xia ◽  
Zonghua Wang ◽  
Feifei Zhang
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Uric Acid ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Purine Metabolites ◽  
The Relationship ◽  
Type 2 Diabetic

Aims. The purpose of the study was to investigate the differences of adenosine, adenine, inosine, xanthine, hypoxanthine, and uric acid concentrations in patients with type 2 diabetes mellitus and diabetic retinopathy and assess the relationship between purine metabolites and disease.Materials and Methods. The study group consisted of 114 subjects which were divided into three groups: control (n=40), type 2 diabetes without retinopathy (n=35), and type 2 diabetes with retinopathy (n=39). Levels of metabolites were measured in plasma of all participants.Results. There is a significant increase of levels of adenosine (0.94±0.17 mg/L versus0.17±0.01 mg/L,P<0.001), inosine (0.297±0.078 mg/L versus0.086±0.010 mg/L,P<0.001), xanthine (1.01±0.21 mg/L versus0.54±0.05 mg/L,P=0.009), and uric acid (70.55±3.97 mg/L versus53.81±2.36 mg/L,P<0.001) with diabetic retinopathy compared to diabetes mellitus. The levels of adenine, hypoxanthine, and xanthine oxidase did not change. Uric acid, xanthine, inosine, and adenosine correlated positively with systolic blood pressure and urea nitrogen.Conclusions. The levels of adenosine, inosine, uric acid, and xanthine may be useful for monitoring the progression of diabetic retinopathy and evaluating the treatment.

scholarly journals Hba1c Variability Has a Strong Relationship With Peripheral Sensory And Motor Neuropathy in Type-2 Diabetes Mellitus

2021 ◽  
pp. 93-100
Author(s):  
MA Hossain ◽  
MK Sarkar ◽  
I Mahbub ◽  
SMS Islam
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Microvascular Complications ◽  
Diabetic Patients ◽  
Motor Neuropathy ◽  
Type 2 Diabetic Patients ◽  
Hba1c Variability ◽  
Type 2 Diabetic

Diabetic peripheral neuropathy (DPN) is one of the most common long-term microvascular complications of diabetes. This study was undertaken to investigate the association of HbA1c variability with diabetic peripheral neuropathy (sensory and motor) in patients with type-2 diabetes. In this cross-sectional study, a total of 150 type-2 diabetic patients were screened for DPN and undergone quarterly HbA1c measurements during the year preceding enrolment were recruited. DPN was confirmed in patients displaying both clinical manifestations of neuropathy and neurological abnormalities assessment. Among the recruited patients, 24% (n = 36) were found to have DPN, and these patients also presented with a higher HbA1c as compared to the patients without DPN (p<0.05). In addition, the advanced age and longer duration of diabetes were important and significant (p<0.05) risk factors for peripheral neuropathy. Overall study suggests that increased HbA1c level is strongly associated with DPN (sensory and motor) in type-2 diabetic patients and could be considered as a potent indicator for DPN in the recruited patients. J. Bio-Sci. 29(1): 93-100, 2021 (June)

scholarly journals Impact of a Booklet about Diabetes Genetic Susceptibility and Its Prevention on Attitudes towards Prevention and Perceived Behavioral Change in Patients with Type 2 Diabetes and Their Offspring

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Masakazu Nishigaki ◽  
Eiko Sato ◽  
Ryota Ochiai ◽  
Taiga Shibayama ◽  
Keiko Kazuma
Keyword(s):  
Type 2 Diabetes ◽  
Genetic Susceptibility ◽  
Behavioral Change ◽  
Behavioral Changes ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
The Patient’S View ◽  
Self Administered Questionnaire ◽  
Type 2 Diabetic

Background. Offspring of type 2 diabetic patients are at a high risk of type 2 diabetes. Information on diabetes genetic susceptibility and prevention should be supplied to the offspring.Methods. A six-page booklet on diabetes genetic susceptibility and prevention was distributed to 173 patients who ere ordered to hand it to their offspring. The patients answered a self-administered questionnaire on booklet delivery and attitudinal and behavioral changes toward diabetes and its prevention in themselves and their offspring.Results. Valid responses were obtained from 130 patients. Forty-nine patients had actually handed the booklet. Booklet induces more relief than anxiety. From the patient's view, favorable attitudinal and/or behavioral changes occurred in more than half of the offspring who were delivered the booklet.Conclusion. The booklet worked effectively on attitudes and behaviors toward diabetes and its prevention both in patients and their offspring. However, the effectiveness of patients as information deliverers was limited.

Awareness of Complications in Diabetic Patients - Study in a Tertiary Care Centre in Kerala

2021 ◽  
Vol 8 (37) ◽  
pp. 3334-3338
Author(s):  
Satish Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Type 2 Diabetic Patients ◽  
Complications Of Diabetes ◽  
Type 2 Diabetic

BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes

scholarly journals Increased Urine IgM and IgG2Levels, Indicating Decreased Glomerular Size Selectivity, Are Not Affected by Dalteparin Therapy in Patients with Type 2 Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Ole Torffvit ◽  
Majid Kalani ◽  
Jan Apelqvist ◽  
Björn Eliasson ◽  
Jan W. Eriksson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Physiological Saline ◽  
Diabetic Patients ◽  
Size Selectivity ◽  
Type 2 Diabetic Patients ◽  
Once Daily ◽  
Urinary Levels ◽  
Glomerular Size ◽  
Type 2 Diabetic

Fifty-four type 2 diabetic patients with neuroischemic foot ulcers were randomised to treatment with 5000 IU of dalteparin, (n=28), or physiological saline, (n=26), once daily until ulcer healing or for a maximum of 6 months. Thirty-three patients had normo-, 15 micro-, and 6 macroalbuminuria. The urinary levels of IgM and IgG2were elevated in 47 and 50 patients, respectively. Elevated urinary levels of IgM and IgG2indicate decreased glomerular size selectivity. Urine IgM levels were associated with IGF-1/IGFBP-1 and IGFBP-1 levels. Dalteparin treatment increased urinary levels of glycosaminoglycans (P<0.001) and serum IGFBP-1 (P<0.05) while no significant effects were seen in any of the other studied parameters. In conclusion, dalteparin therapy in patients with type 2 diabetes had no effects on urinary levels of albumin, IgM, or IgG2despite significantly increased glycosaminoglycans in urine. Elevated urinary levels of IgM and IgG2might be more sensitive markers of renal disease than albuminuria in patients with type 2 diabetes and antihypertensive therapy.

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