scholarly journals Pattern of anti-diabetic treatment and its relation with glycaemic control among diabetic patients in a tertiary care hospital of Bangladesh

2021 ◽  
Vol 11 (2) ◽  
pp. 90-96
Author(s):  
Nazma Akter
Keyword(s):  
Glycaemic Control ◽  
Diabetes Management ◽  
Glycosylated Hemoglobin ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Poor Control ◽  
Premixed Insulin ◽  
Cross Sectional ◽  
Oral Agents

Background: The main determinants of diabetes management, therapeutic habits and glycaemic control are likely to differ between populations. The pharmacological armamentarium to treat hyperglycaemia in type 2 diabetes mellitus (T2DM) has changed substantially over the past few years with the development of new therapeutic agents. This study evaluated relationships between pattern of pharmacological treatment and glycaemic control in patients with T2DM. Methods: This cross-sectional study was carried out among 486 T2DM patients attending the endocrinology outpatient clinic of MARKS Medical College & Hospital, Dhaka, Bangladesh during the period between July 2018 and June 2019. After obtaining written informed consent, both the treatment pattern and the degree of glycaemic control were estimated from T2DM patients. Glycosylated hemoglobin A1C (HbA1c) was determined by liquid chromatography. Glycaermic control categorized as fair control (HbA1c <7.0%), poor control (HbA1c ³7.0%- <9.0%) and very poor control (HbA1c  ³9.0%). Results: Out of 486 participants, 65.8% were females. A total 68.1% of the patients were treated with oral antidiabetic drugs (OADs) and 31.9% were treated with both insulin and oral agents. Metformin (92.4%) was the most commonly used OAD; [p=0.01]. Over one fifth (22.1%) were taking combinations of sulfonylurea and metformin [p<0.05] and 19.5% were taking combination of sulfonylurea, metformin and dipeptidyl peptidase- IV inhibitors (DPP4i); [p=0.87]. More than one fourth (25.7%) were treated with two OADs along with insulin; [p=0.05]. In this context, familiar dual OADs combination (14.2%) was metformin and DPP4 inhibitors [p=0.86]. Premixed insulin (17.1%) was the frequently used regimen among different regimen of insulin used in both OADs and insulin group [p=0.22]. More than 50% of the subjects attained fair glycaemic target of HbA1c. But 46.3% accomplished poor and very poor glycaemic control [p=0.08]. Conclusion: The study shows that the proportion of patients treated with only oral diabetic agent was high. In most instances, they were treated with two or three drus combination therapies. The proportion of patients with fair glycaemic control was higher than reports from many countries. Birdem Med J 2021; 11(2): 90-96

SOCIODEMOGRAPHIC AND ANTHROPOMETRIC PROFILE OF DIABETIC PATIENTS ATTENDING IN A DIABETIC CLINIC IN A TERTIARY MEDICAL COLLEGE AND HOSPITAL, WEST BENGAL

2021 ◽  
pp. 12-15
Author(s):  
Smarajit Banik ◽  
Sandip Saha ◽  
Sudipan Mitra ◽  
Ujjwal Pattanayak ◽  
Rajib Sikder ◽  
...  
Keyword(s):  
West Bengal ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Diabetes Clinic ◽  
Cross Sectional ◽  
Medical College ◽  
Study Participants

Background: Diabetes mellitus is one of the important causes of morbidity and mortality. With a rise in non communicable diseases in India, diabetes has become a modern epidemic showing a rising trend in West Bengal also. A large number of diabetes patients come to the diabetes clinic of our tertiary care hospital in North Bengal Medical College and Hospital, Darjeeling, West Bengal. The large proportion of patients presenting with this condition prompted us to study the Sociodemographic and Anthropometric Prole of such patients. Methods: This was a descriptive hospital based cross sectional study involving a total of 344 diabetic patients enrolled in the diabetes clinic of a tertiary care teaching hospital from December 2019 to February 2020. A self-administered questionnaire was used to collect data and was analyzed in Microsoft excel sheet and using SPSS 20.0 software. Results: Among the 344 study participants, we found that 220 (63.95%) were males and 124 (36.05%) were females. Diabetes was more common among those aged 51-60 years 108 (31.40%). Family history was present among 188 (54.65%) of the diabetic patients. Almost 160 (46.51%) patients have diabetes 1.1 – 5 years. Hypertension was present among 216 (62.79%) patients. Almost 218 (63.37%) of the patients were overweight and 84 (24.42%) were obese. Conclusions: The diabetic patients presenting to this tertiary care hospital belong lower socioeconomic strata and having limited education in their age group. There is high proportion of obesity and hypertension among them.

scholarly journals Study of thyroid dysfunction in type 2 diabetes mellitus

2020 ◽  
Vol 7 (12) ◽  
pp. 1815
Author(s):  
Mausam Jain ◽  
Pramod R. Jha ◽  
Gaurang Patel
Keyword(s):  
Diabetes Mellitus ◽  
Glycaemic Control ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Type Ii Diabetes Mellitus ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Long Duration

Background: Aim was to study prevalence of thyroid dysfunction in type II diabetes mellitus (T2DM) patients.Methods: The present study was a cross sectional observational study, which focused on cases of diabetes mellitus. Study was conducted in Departments of Medicine, SBKS MI & RC, a tertiary care centre for a period of 6 months. All the patients of T2DM were included. Total of 263 patients were enrolled which involved indoor, outpatient and diabetic clinic attending patients. A detailed history taking, clinical examination and relevant investigations (Hb%, Total count, platelet count, serum creatinine, FBS, PP2BS, HbA1C, S.TSH, F.T3 and F.T4). Appropriate statistical analytics were used and important correlations and conclusions were drawn.Results: A study of thyroid dysfunction (TD) in T2DM patients which included 263 diabetic patients, out of them 67 had thyroid dysfunction. Out of these 67 patients 43 were female and 24 were male. This suggests that female was more prone to thyroid dysfunction than males. Out of 67 TD patients, 42 were above the age of 50 year. So, as the age increases the prevalence of TD also increases thyroid dysfunction also depends on the glycaemic control of the patients. Out of 67 patients 22 patients had>8.0 HbA1C level. In our study we found that as the glycaemic control became poorer the prevalence of TD increase in hypothyroid but not in hyperthyroidism.Conclusions: Following conclusions were drawn from this study TD is more common in female than male, more after the age of 50 year, in T2DM patients. Hypothyroidism is more common with poor glycaemic control and long duration of T2DM patients. But for hyperthyroidism data which we evaluated was not significant and further conclusion bigger study is needed.

scholarly journals Knowledge, attitude and practice among diabetic patients visiting a tertiary care hospital in Bangalore, Karnataka

2020 ◽  
Vol 7 (8) ◽  
pp. 3100
Author(s):  
Vindhya Polineni ◽  
Supriya Acharya
Keyword(s):  
Diabetes Care ◽  
Communicable Disease ◽  
Good Practice ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice ◽  
Diabetic Care

Background: Diabetes mellitus is a chronic non-communicable disease which has become the epidemic of the 21st century.  According to WHO 1.6 million deaths were estimated to be directly caused by diabetes in the year 2016 and attributed to be the seventh leading cause of death in the world. Objective of the study was to assess the knowledge, attitude, practice about diabetic care among the diabetic patient, and to assess the association between KAP of diabetic care and socio-demographic factors.Methods: Cross-sectional study was done with purposive sampling for 4 months, on 62 sample size. Data collection tool was the KAP questionnaire which was adapted a study by Herath HMM.Results: Out of 66 participants, 34 (51.5%) had good knowledge about diabetes, 27 (40.9%) and 5 had poor knowledge (7.6%), 16 had positive attitude about diabetes care (24.2%) and 50 (75.8%) had negative attitude, 47 had good practice about diabetes care (71.2%) and 19 (28.8%) of them had bad practice.Conclusions: Though majority of the study participants had good to moderate knowledge (92.4%), their attitude was negative (75.8%) and the knowledge level did not fully reflect into the attitude and practices (71.2%). This suggests there is a gap in the knowledge, attitude and practice.

scholarly journals Assessment of the Awareness among Diabetic Patients of Their Risk for Oral Disease as Complication Associated With Diabetics

2019 ◽  
Vol 2 (9) ◽  
pp. 217-222
Author(s):  
Kavya G ◽  
Mayur Nath T Reddy ◽  
Radhika Muthukuru
Keyword(s):  
Diabetes Mellitus ◽  
Oral Health ◽  
Tertiary Care ◽  
Oral Disease ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Oral Diseases ◽  
Cross Sectional ◽  
Oral Manifestation ◽  
Dental Patients

AIM: To assess the awareness of diabetic patients of their risk for oral disease as complication associated with diabetics. 
 INTRODUCTION: Diabetes mellitus is a metabolic disorder characterized by hyperglycemia due to defective secretion or activity of insulin. Type II diabetes is a common disorder with concomitant oral manifestation that impacts dental care Evidence shows that many patients are unaware about effects of diabetes mellitus on oral health.  METHODOLOGY: A cross sectional descriptive survey was conducted among adult dental patients attending a tertiary care hospital of Bangalore city. A total of 172 patients were included in the study. The tool used to conduct the survey was a close-ended self-administered 14-item questionnaire. Self-rate oral health was assessed using a 4 point scale as good, average, bad and don’t know. RESULT: A total of 172 subjects, among them 120 (69.7%) were males and 52 (30.3%) were females. Among 172 subjects, 87(50%) were aware that diabetics are more prone to oral diseases .91(52%) of the study subjects did not know that diabetes effects gingiva.91(52%) of individuals knew diabetes causes delay in wound healing. 81% of the subjects, self-rated their mouth as good. CONCLUSION: Diabetic patients are less aware of their risk for dental diseases. Thus, it is necessary for dental professionals and related government agencies to promote awareness of the relationship between diabetes mellitus and oral health in order to prevent harmful complications on oral health

scholarly journals Study of awareness of insulin usage in diabetics attending NRI Medical College and General Hospital

2017 ◽  
Vol 7 (1) ◽  
pp. 59
Author(s):  
Jagadeesh A. ◽  
Ravi Shankar K. ◽  
Krishnakanth K.
Keyword(s):  
Insulin Therapy ◽  
Tertiary Care ◽  
Disease Process ◽  
Type Ii Diabetes Mellitus ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Diabetes Treatment ◽  
Cross Sectional ◽  
High Blood Glucose ◽  
Family History Of Diabetes

Background: India had 69.2 million diabetic patients. Insulin is an important part of diabetes treatment, but one-third of patients fail to take their insulin as prescribed, and many adults intentionally skip their doses. Since, diabetes treatment continues for lifetime, there is a need to assess the knowledge and understanding of patients in relation to their disease process and its management.Methods: A cross sectional, observational, knowledge and attitude survey were carried on patients with type II diabetes mellitus who are taking insulin therapy and attended medicine diabetes OPD in tertiary care Hospital during the period of April 2017 to Dec 2017. 200 diabetic patients’ ≥18 years of age who were willing to respond to the study questionnaire were interviewed.Results: Total of 200 study participants were interviewed using structured questionnaires, almost 75 (37.5%) of the respondents were age group of 41 - 50 years. 109 (54.5 %) male, 67 (33.5%)Hindus, 121 (60.5 %) married,79 (39.5%) were primary school, 120 (73.8%) were family history of diabetes, duration of treatment1-3 years 72 (31.5 %), 160 (63%) of the study subjects know about diabetes is high blood glucose, 119(59.5%)of subjects know complications of diabetes, 165(82.5%) were know about insulin used for diabetes, 115 (57.5%) of patients know other substitute for insulin, 94 (47%) of the study subjects have knowledge of complications of insulin therapy, 85 (42.5) were know different types of insulin preparations, 141 (70.5%) were know insulin is mandatory in some patients,159 (79.5%) were understood the route of administration of insulin.Conclusions: The finding of present study showed that, diabetes patients had average knowledge and less favourable attitude among diabetic patients toward insulin therapy.

scholarly journals A cross-sectional observational study on drug utilisation pattern, prevalence and risk factors for the development of diabetic nephropathy among type 2 diabetic patients in a south indian tertiary care hospital

2020 ◽  
Vol 11 (1) ◽  
pp. 93-108
Author(s):  
Madhavi Mannam ◽  
Lavanya Nalluri ◽  
Dhanalakshmi Pinnika ◽  
Mounika Pothuraju ◽  
Ravindrababu Pingili ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Nephropathy ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
South Indian ◽  
Type 2 Diabetic

Diabetic nephropathy is the leading cause of the end-stage renal disease (ESRD) worldwide, and it is estimated that ~ 20% of type 2 diabetic patients reach ESRD during their lifetime. The objective of the present study was to assess the drug utilization pattern, risk factors, and prevalence of diabetic nephropathy in patients with type 2 diabetes mellitus in a south Indian tertiary care hospital. A cross-sectional observational study was conducted on 613 subjects (254 with and 359 without diabetic nephropathy). Prevalence of diabetic nephropathy was measured, and risk factors for the development of diabetic nephropathy were determined by calculating odds ratios using graph-pad prism statistical software, and drug utilization pattern was assessed. Nephropathy was significantly higher in subjects who are married (98.8%, OR, 3.903; 95% CI, 1.125-13.54, P=0.0211),  poorly educated (61%, OR, 0.3670;95%CI, 0.2635-0.5112, P<0.0001), house wives (44.4%, OR, 0.5492; 95% CI, 0.3432 - 0.8789, P=0.0120), rural residents (51.2%, OR, 0.3943; 95% CI, 0.2820-0.5513, P<0.0001) and risk factors were hypertension (37.44%, OR, 4.131; 95% CI, 2.687-6.350, P<0.0001), other diseases (36.51%, OR, 4.963; 95% CI, 3.202 -7.692, P<0.0001), Endocrine diseases (9.53%, OR, 2.460; 95% CI, 1.433- 4.224, P=0.0009), history of CVD (7.90%, OR, 17.20; 95% CI, 7.049- 41.95, P<0.0001), HbA1c (36.1%, OR, 3.380; 95% CI, 2.157- 5.295, P<0.0001), low HDL (23%, OR, 0.5961; 95% CI, 0.3572 - 0.9947 , P=0.0470), high FBS levels (29.3%, OR, 6.111; 95%CI, 1.283 -29.10, P=0.0113), high triglyceride levels (39.8%, OR, 0.6077; 95%CI, 0.3878 -0.9523, P=0.0293), high serum creatinine (28.3%, OR, 154.3; 95% CI, 37.92- 627.7, P<0.0001), duration of T2DM(5-10years 39.8%, OR, 2.653;95% CI, 1.778 - 3.958, & > 10 years 37%, OR, 3.606 ; 95% CI, 2.362-5.504, P<0.0001), physical inactivity(64.9%, OR, 0.5188;95% CI, 0.3727-0.7220 , P<0.0001), soft drinks occasionally (31.9%, OR, 2.253; 95% CI, 1.531-3.315, P<0.0001), habit of taking tea /coffee twice without sugar(42.3%, OR, 1.845; 95% CI, 1.094 to 3.112, P=0.0208) were significant risk factors for development of nephropathy. Metformin (47.05%), a combination of Glimepiride and Metformin (30.71%), a combination of insulin isophane and insulin regular (29.41%), teneligliptin (10.45%), insulin regular (9.80%) were the anti-diabetic medications mostly given to the T2DM patients with nephropathy. The present study revealed that the risk factors for the development of diabetic nephropathy were multiple.

scholarly journals Echocardiographic evaluation of diastolic dysfunction in diabetes mellitus without covert cardiac involvement

2018 ◽  
Vol 5 (2) ◽  
pp. 289
Author(s):  
Nalin Kumar Mahesh ◽  
Anil Kumar ◽  
Niket Verma ◽  
Keshavamurthy Ganapathy Bhat ◽  
Dharmender Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Systolic Dysfunction ◽  
Tertiary Care ◽  
Armed Forces ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Cross Sectional ◽  
Army Personnel ◽  
Study Participants

Background: Diabetic patients develop systolic and diastolic dysfunction without even associated coronary artery disease. But diastolic dysfunction is more prevalent in diabetic patients than systolic dysfunction and usually occurs before onset of symptoms. Recognition of early diastolic dysfunction is likely to make management better and avoids progression of cardiac dysfunction. This study was conducted in patients of Diabetes mellitus without other comorbidities.Methods: The present study which is cross sectional and was carried out among outpatients and inpatients of tertiary care hospital of Armed forces and involved army personnel and their dependents and sample size was 100 patients.Results: The prevalence of diastolic dysfunction among our study participants was found to be 36%. Diastolic dysfunction was found to be significantly higher among elderly individuals (60%) when compared to young study participants. (p<0.0001). Prevalence of diastolic dysfunction was found to be non-significantly higher among males and with longer duration of diabetes as compared to lesser duration and female gender.Conclusions: Diastolic dysfunction, evaluated by echocardiography, was found to be fairly prevalent (36%; 95% CI = 27-45%) among individuals with type 2 diabetes mellitus. Poor Glycaemic control and increasing age were found to be significantly associated with presence of diastolic dysfunction among individuals with diabetes mellitus. 

scholarly journals Study of serum uric acid levels in type 2 diabetes mellitus in tertiary care hospital in south Gujarat

2021 ◽  
Vol 8 (11) ◽  
pp. 1633
Author(s):  
Mit Panchani ◽  
Neha Dutt ◽  
Vandana Dhangar ◽  
Vinod Dandge
Keyword(s):  
Diabetes Mellitus ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Tertiary Care ◽  
Serum Markers ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Cross Sectional ◽  
Complications Of Diabetes ◽  
Potential Biomarker

Background: The need for early indicators of diabetic complications is essential to prevent late complications and their deleterious effects. There is a need for sensitive serum markers that are associated with diabetes and its complications. Estimation of these parameters helps in early intervention, thereby delaying the chronic complications of diabetes in the early stages. Hyperuricemia has been shown to be linked to a number of diseases and conditions including gout, hypertension, cardiovascular disease, myocardial infarction, stroke and renal disease. Uric acid has long been associated with delayed complications of diabetes mellitus. This study was conducted on 357 patients of diabetes mellitus to investigate the significance of serum uric acid levels and its correlation with it.Methods: This is an observational cross-sectional study carried out amongst 357 patients with T2DM attending out-patient department as well as indoor patients under medicine department at Surat Municipal Institute of Medical Education and Research (SMIMER) Hospital, of south Gujarat.Results: There is highly significant association seen between HbA1c (glycated hemoglobin) and uric acid levels in present study (p<0.001). There is significant association seen between fasting blood sugar (FBS) levels and uric acid levels in the study (p=0.0253).Conclusions: There is increase in uric acid levels in diabetic patients with increased levels of HbA1c. Thus, serum uric acid may serve as a potential biomarker of the deterioration of glucose metabolism. 

Glycemic control and its associated factors among patients with diabetes mellitus: a cross-sectional study in Bangladesh

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hasan Mahmud Reza ◽  
Towhid Hasan ◽  
Marjia Sultana ◽  
Md. Omar Faruque
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Cross Sectional Study ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Content Type

Purpose Diabetes mellitus is becoming a growing concern worldwide. Hence, the purpose of this study is to assess the magnitude of poor glycemic control and to identify the determinants of poor glycemic control among diabetic patients attending a tertiary care hospital in Bangladesh. Design/methodology/approach This cross-sectional study was conducted among 732 diabetes patients seeking care at the outpatient department of Bangladesh Institute of Health Sciences Hospital, Dhaka, Bangladesh. Information, including glycemic status, was collected from patients’ medical records using a structured questionnaire. Findings About 87.6% of the patients were found to have poor glycemic control (glycosylated hemoglobin = 7%). Variables that were significant in bivariate analysis were put into a multivariate model where the factors associated with poor glycemic control were patients aged 41–60 years (odds ratio (OR)=2.26; 95% confidence interval (CI): 1.19–4.32, p = 0.013), suffering from diabetes for > 7 years (OR = 1.84; 95% CI: 1.12–2.99, p = 0.015), using insulin (OR = 2.34; 95% CI: 1.23–4.47; p = 0.010) or diet alone (OR = 0.20; 95% CI: 0.05–0.80, p = 0.023) as a type of diabetes treatment and proper use of medicine (OR = 0.37; 95% CI: 0.17–0.82, p = 0.015). Originality/value The high prevalence of poor glycemic control among diabetic patients is evident; therefore, strategic management and proper attention focusing on the predictors of poor glycemic control are necessary to reduce the long-term complications of diabetes.

scholarly journals Awareness of Diabetic Eye Diseases in Diabetic Patients

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1953-1960
Author(s):  
Mahalakshmi K ◽  
Anuradha Krishnan P
Keyword(s):  
Diabetic Retinopathy ◽  
Microvascular Complications ◽  
Tertiary Care ◽  
Study Participant ◽  
Educational Status ◽  
Eye Diseases ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Participants

The study aims to assess the awareness of diabetic eye disease among diabetic patients. Diabetes mellitus is a rapidly growing global concern that may cause several complications. The ophthalmic complications that diabetic patients are prone to are diabetic retinopathy, cataract, and glaucoma. One of the most common microvascular complications of diabetes is diabetic retinopathy. The study is a community-based cross-sectional descriptive study involving 100 diabetic patients who visited a tertiary care hospital, Saveetha Medical College who gave consent for the study. Ethical clearance was obtained from the Institutional Review Board (IRB). The 100 study participants filled up a structured questionnaire with 26 questions that were validated by two experts in the field. The age, gender, educational status, occupation, duration of diabetes, undergoing treatment, associated risk factors, awareness regarding diabetes caused ophthalmic complications, their knowledge on how important regular eye check-ups are for the diabetic patients, and whether they are aware that it could cause blindness. The questionnaire also assessed their practice patterns for regular eye check-ups. The results were presented in the form of text, pie charts, tables, and figures. 86% of the study participants knew that diabetes could cause eye diseases. 8% knew that diabetes could cause cataract. 65% knew that diabetes could cause glaucoma.70% knew that diabetes could cause diabetic retinopathy. These results were compared to the results of similar research papers. Though there is awareness amongst the majority of the study participants, the practice pattern shows that 54% of the study participant do not go for regular eye check-ups. More community awareness is required for better efficiency to prevent treatable blindness in India.

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