scholarly journals Clinical Prole of Chronic Heart Failure in Hospitalized Type 2 Diabetic Patients

2018 ◽  
Vol 6 (1-2) ◽  
pp. 67-70
Author(s):  
Shahana Parveen ◽  
AMB Safdar ◽  
Faria Afsana ◽  
AKM Mohibullah ◽  
Ramendra Nath Sarker

Objective: To see the clinical profile of chronic heart failure in hospitalized type 2 diabetic subjects. Method: This cross-sectional study was carried out on a total of 100 type 2 diabetic patients with chronic heart failure, in the Department of Cardiology, BIRDEM, over a period of six months between July to December 2012. Results: The mean age of the study subjects was 60.9 ± 11.7 years with male to female ratio being roughly 2:1. The mean duration of diabetes mellitus was 9.15 years. Among the study subjects 72% were on insulin and 18% on oral hypoglycemic agents; 10% were on combined insulin and oral hypoglycemic agent. Dyspnea and cough were invariably present. About 88% subjects had edema, 39% raised JVP, and 13% murmur. Bilateral basal crepitation was found in 56% cases. While mean fasting blood glucose (FBG), postprandial blood glucose (PPBG) level and HbA1C were 10 mmol/l, 16.7 mmol/l and 9.9% respectively, mean serum creatinine was 2.07 mg/dl. Among study subjects, raised ESR (48%), elevated WBC count (50%) and raised BNP level (64.6%) were seen. Chest X- ray revealed cardiomagaly (70%), reticulonodular shadow in both lung fields (11%) and septal thickening (15%). ECG findings of the patients were old infarct (72%), IHD (66%), RV hypertrophy (40%) and arrhythmia (17%). Most common echocardiographic findings of the subjects were regional wall motion abnormalities (78%), Mild LV systolic dysfunction (64%) with Grade-I diastolic dysfunction being 70% and moderate to severe pulmonary arterial hypertension being 40%. Conclusion: Raised BNP level, presence of old infarct in ECG and regional wall motion abnormalities in echocardiography are the common clinical findings among patients with chronic heart failure. Ibrahim Card Med J 2016; 6 (1&2): 67-70

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 465-P
Author(s):  
EVA STOLARIKOVA ◽  
JAN KOPECKY ◽  
JIRI VELEBA ◽  
KATERINA VELEBOVA ◽  
LENKA BELINOVA ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Dan Xu ◽  
Owain Chandler ◽  
Cleo Wee ◽  
Chau Ho ◽  
Jacquita S. Affandi ◽  
...  

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a relatively novel class of drug for treating type 2 diabetes mellitus (T2DM) that inhibits glucose reabsorption in the renal proximal tubule to promote glycosuria and reduce blood glucose levels. SGLT2i has been clinically indicated for treating T2DM, with numerous recent publications focussing on both primary and secondary prevention of cardiovascular and renal events in Type 2 diabetic patients. The most recent clinical trials showed that SGLT2i have moderately significant beneficial effects on atherosclerotic major adverse cardiovascular events (MACE) in patients with histories of atherosclerotic cardiovascular disease. In this review and analysis, SGLT2i have however demonstrated clinically significant benefits in reducing hospitalisation for heart failure and worsening of chronic kidney disease (CKD) irrespective of pre-existing atherosclerotic cardiovascular disease or previous heart failure history. A meta-analysis suggests that all SGLT2 inhibitors demonstrated the therapeutic benefit on all-cause and cardiovascular mortality, as shown in EMPAREG OUTCOME study with a significant decrease in myocardial infarction, without increased stroke risk. All the above clinical trial recruited type 2 diabetic patients. This article aims to postulate and review the possible primary prevention role of SGLT2i in healthy individuals by reviewing the current literature and provide a prospective overview. The emphasis will include primary prevention of Type 2 Diabetes, Heart Failure, CKD, Hypertension, Obesity and Dyslipidaemia in healthy individuals, whom are defined as healthy, low or intermediate risks patients.


2017 ◽  
Vol 8 (1) ◽  
pp. 47-51
Author(s):  
Md Towhidur Rahman ◽  
AS Mohiuddin ◽  
Md Mofazzal Sharif ◽  
Jafreen Sultana ◽  
Fahmida Yeshmine ◽  
...  

Background: Patients with diabetic peripheral neuropathy (DPN) have distal, symmetrical form of the disorder characterized by numbness, burning feet, pins-and-needles sensations and lightning pain. This study was designed to find out the difference between 2 Dimentional (D)-Brightness (B) mode high resolution ultrasonographically measured cross sectional areas of median nerve in type 2 diabetic patients with peripheral neuropathy and those of non-diabetic healthy adult subjects.Methods: This case-control study was done on 180 subjects aged 27-67 years in the department of Radiology and Imaging, BIRDEM from January 2012 to December 2013. Out of them 90 diabetic patients with peripheral neuropathy diagnosed electrophysiologically by nerve conduction study (NCS) were considered study group and age, sex and weight compatible 90 healthy subjects were considered as control group. Measurement of cross sectional areas of median nerve was performed first by the investigator himself purposefully, consecutively and subsequently confirmed by a radiologist in the department of Radiology and Imaging, BIRDEM, who did not know the subjects’ condition to eliminate bias. The major axis, minor axis and the cross sectional areas (CSA) of the median nerve were measured at the carpal tunnel.Results: In this study, the mean cross sectional areas (mm2) of median nerve healthy subjects was 7.78±1.00 mm2 and in diabetic patients with peripheral neuropathy was 13.67±2.97 mm2. The difference mean CSA of median nerve of diabetic subjects with peripheral neuropathy and control subjects were statistically significant (p<0.05) in unpaired ‘t’ test.Conclusion: This study showed that there is a significant difference between the cross sectional areas of median nerve in diabetic subjects with peripheral neuropathy and healthy adult subjects. The mean cross sectional areas of median nerve were increased in diabetic patients with peripheral neuropathy compared to control group.Birdem Med J 2018; 8(1): 47-51


2013 ◽  
Vol 10 (3) ◽  
pp. 44-47 ◽  
Author(s):  
Naval Kishor Yadav ◽  
C Thanpari ◽  
MK Shrewastwa ◽  
RK Mittal

Background Type-2 diabetes mellitus is an independent risk factor for coronary artery disease and risk of coronary disease is three to four fold increased in patients with diabetes compared with non-diabetic population and 60-80% 0f type-2 diabetics are obese. Methods This study was conducted in Nepalgunj Teaching Hospital, Kohalpur, Banke, Nepal, between 1st March, 2011 and 28th February, 2012. A total of 150 samples were taken to assess the lipid profile in type-2 diabetic patients associated with obesity and 25 obese controls for their lipid profile. Venous blood samples were taken from all the subjects in the morning after fasting overnight. Exclusion criteria included pregnancy, chronic infectious disease, heart failure; renal failure and drug allergy were confirmed from the subject’s personal physician report and a detailed history. The data was analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version. Results The mean ± SD age of diabetic patients with obesity was 53.76 ± 6.23 while the mean ± SD age of control was 49.61 ± 4.8. Out of 150 patients 105 (70%) were males and 45 (30%) were females. Among control subjects 16 (64%) were males and 9 (36%) were females. Obese type-2 diabetic patients when compared to obese control subjects showed statistically significant increase in the levels of serum total cholesterol (p ? 0.001), serum triglycerides (p ? 0.001), serum LDL-cholesterol (p ? 0.001) while serum HDL-cholesterol levels did not show statistically significant difference in the two group (p ? 0.05). Conclusion This study showed obese diabetic individuals have dyslipidemia and more prone to develop cardiovascular diseases. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 44-47 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8017


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 841-841
Author(s):  
Nadia Ben Amor ◽  
Faten Mahjoub ◽  
Olfa Berriche ◽  
Henda Jamoussi

Abstract Objectives The aim of our work was to assess the nutritional status and to determine the prevalence of undernutrition in type 2 diabetic patients hospitalized in a center specializing in Nutrition, Diabetology and Metabolic Diseases. Methods This is a descriptive cross-sectional prospective study, which involved 40 type 2 diabetic patients, aged 18 and over, hospitalized in department A of the National Institute of Nutrition and Food Technology. The assessment of nutritional status was carried out using clinical means (kinetics of weight loss, a dietary survey, anthropometric measurements, impedancemetry, Nutritional Risk Score 2002 for those under 70 years old and the Mini Nutritional Assessment from 70 years old) and biological (albuminemia). The positive diagnosis of malnutrition was selected according to the criteria of the High Authority of Health of 2019 for adults under 70 years, and of 2007 for elderly subjects. Results The mean age was 59.6 ± 11.59 years old. The average duration of diabetes was 10.83 ± 8.03 years. The mean level of glycated hemoglobin was 11.03 ± 1.97% and the Body Mass Index was 28.88 kg/m² with extremes ranging from 14.6 to 40.9 kg/m². Weight loss was noted in 48% of patients. Calorie intake was low in 30% of the patients. Protein and mono-unsaturated fatty acid low intake was noted in respectively 28% and 70% of patients. More than half of patients had deficiency in vitamin C, D, B12 and B9 as well as in zinc, calcium, magnesium and cooper. Iron and vitamin B12 low intake was more prevalent in patients with malnutrition (p = 0.043 and p = 0.003 respectively). The mean serum albumin was 37.58 ± 2.93 g/l with ranges ranging from 27.2 to 43.8 g/l. Malnutrition was diagnosed in 25% of patients and in half of the cases, it was severe. Conclusions Patients with type 2 diabetes mellitus are at high risk of malnutrition with a high prevalence of dietary intakes deficiencies. Funding Sources 1. HAS. Diagnostic de la dénutrition de l'enfant et l'adulte. Service de bonnes pratiques professionnelles, 2019. 2. HAS. Stratégie de prise en charge en cas de dénutrition protéino-énergétique chez la personne âgée. Service des recommandations professionnelles. Avril 2007. 3. Anses. Actualisation des repères du PNNS: élaboration des références nutritionnelles. Saisie n° 2012-SA-0186. Avis de l'Anses. Rapport d'expertise collective. Décembre 2016.


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