scholarly journals The Status of Serum Amylase among type 2 Diabetes Patients in Pokhara

2020 ◽  
Vol 10 (2) ◽  
pp. 63-67
Author(s):  
Susma Subedi ◽  
Laxmi Shrestha ◽  
Kushum Gurung ◽  
Bibek Adhikari ◽  
Ganesh Dhakal

Introduction: Diabetes Mellitus has become one of the common metabolic disorders characterized by hyperglycemia, associated with deficiency or resistance to insulin and shows abnormality in exocrine activity of pancreas. Pancreas is mixed gland that is both an endocrine and an exocrine gland with clusters of endocrinal, islet cell dispersed among exocrine acinar cells. Defects in islets cells in diabetes effect the exocrine secretion of the pancreas. Methods: Hospital based case-control study was conducted. Total sample size was 388. Out of which 194 were known cases of type 2 diabetic patients attending Manipal Teaching Hospital for medical checkup whereas 194 were Non Diabetic individuals with age and sex matched. Self-administer question was used to collected data from case and control. Three ml fasting blood samples were collected and centrifuged. Serum amylase was analyzed by using a semi automated analyzer. All estimates data were analysis statistically by using SPSS 22.0 full version. Results: Serum amylase levels were found significantly low in diabetic patients as compared to the Non-Diabetic (r = -0.313, p-value <0.001). Similarly, present study also showed negative correlation between serum amylase levels and duration of diabetes with Non-Diabetic (r = -0.388, p <0.001). Status of serum amylase and fasting sugar level was found to different among age groups, sex and ethnic groups. Conclusions: The increasing in duration of diabetes decreases the level of serum amylase which suggests a possible exocrine-endocrine relationship in this disease. Similarly, the level of serum amylase and fasting blood sugar vary among age group, sex and ethnicity. Thus, measurement of serum amylase can be an additional informative parameter for the assessment of chronicity and progress of the illness as well as the response to therapy.

2019 ◽  
Vol 19 (6) ◽  
pp. 845-851 ◽  
Author(s):  
Sahar Ahmed ◽  
Rasha Sobh

Background:Osteoprotegerin (OPG) is a tumor necrosis factor receptor super-family member. It specifically acts on bone by increasing bone mineral density and bone volume. Recent studies have evidenced its close relation to the development of atherosclerosis and plaque destabilization. Elevated OPG level has also been associated with the degree of coronary calcification in the general population and it has been considered to be a marker of coronary atherosclerosis.Objective:The aim of this study was to determine the relation between OPG levels and Coronary Artery Calcification score (CACs) in Type 2 diabetic patients in comparison to healthy controls.Methods:Our study included 45 type 2 diabetic patients (mean age 51.7 years; 51.1% male) without evidence of previous CVD and 45 healthy age and sex matched subjects as control. All participants were subjected to full history, full examination and lab investigations. Serum OPG concentration was measured by an enzyme-linked immunosorbent assay (ELISA) and CAC imaging was performed using non contrast Multi detector CT of the heart.Results:Significant CAC (<10 Agatston units) was seen in 23 patients (51.11 %).:OPG was significantly high in diabetic patients in comparison to controls with mean 12.9±5.7 pmol/l in cases, and 8.6±0.5 pmol/l in controls (P value < 0.001).:The Coronary Artery Calcification Score (CACS) was positively correlated with age and duration of diabetes. The OPG was positively correlated with age, fasting blood sugar and duration of diabetes. The CACS showed a significantly positive correlation with OPG.Conclusion:Findings suggested that increasing in serum OPG was consistent with CAC and could be used for the early diagnosis of subclinical atherosclerosis.


KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 614-619 ◽  
Author(s):  
Sayama Hoque ◽  
MA Muttalib ◽  
Md Imtiajul Islam ◽  
Parvin Akter Khanam ◽  
Subhagata Choudhury

Background: Retinopathy is the leading cause of blindness in persons with diabetes. Strict monitoring and maintenance of normal blood glucose specially HbA1c and prevention of different risk factors can prevent and delay the diabetic retinopathy. The purpose of the study was to explore the factors influencing or related to the development of the diabetic retinopathy with spcial concern to the HbA1c levels.Materials and Methods: We studied 400 type 2 diabetic patients in this cross-sectional study which was conducted in the out-patient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of retinopathy through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, BMI) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's t-test, Chi-square test and logistic regression analysis to determine and quantify the association of diabetic retinopathy with various risk factors specially HbA1c.Results: 400 type 2 diabetic patients (male 166 and female 234) were studied. The prevalence of retinopathy was 12.3%; male 12.7%, female 12.0%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of retinopathy (4.2 vs 12.3 vs 18.1%;c2 = 12.529, p < .01). Logistic regression models of univariate analysis showed that the risk of retinopathy at HbA1c categories >7.0% was (OR = 3.22; 95% CI: 1.12-9.25) and the risk was strongly increased at the HbA1c categories 8% (OR = 5.07; 95% CI: 1.90-13.50). Advanced age (OR = 2.92; 95% CI: 1.44-5.91), longer duration of diabetes (OR = 3.08; 95% CI: 1.49-6.37), presence of hypertension (OR = 2.42; 95% CI: 1.14-5.16), FBG (OR = 1.139; 95% CI: 1.036-1.251), blood glucose 2 hours ABF (OR = 1.124; 95% CI: 1.046-1.207) and SBP (OR = 1.033; 95% CI: 1.011-1.056) had significant association with retinopathy.Conclusions: HbA1c categories >7.0% is an important risk factor for the development of retinopathy. Poor glycaemic control, advanced age, longer duration of diabetes, hypertension are other significant risk factors of diabetic retinopathy.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 614-619


Author(s):  
Aiswarya Roy Karintholil ◽  
Akshatha Rao Aroor ◽  
Joel Sabu ◽  
Joshua Chacko

Introduction: Diabetic patients are found to have reduced lung functions compared to their controls and their relationship with the duration of diabetes, glycaemic control, and Body Mass Index (BMI) is poorly characterised. Aim: To determine the correlation between the pulmonary function abnormalities with anthropometry, glycaemic control, and duration of diabetes in type 2 diabetic patients. Materials and Methods: A total of 80 type 2 diabetic patients were studied. BMI, Waist Circumference (WC), Waist-Hip Ratio (WHR), Fasting, postprandial blood sugar and glycosylated haemoglobin (HbA1c) were assessed from July to September 2018. Spirometry was done in accordance with the guidelines from the American Thoracic Society (ATS). Reduced pulmonary functions were defined as patients with restrictive (FEV1/FVC≥0.7 and FVC< 80% predicted) or obstructive (FEV1/FVC<0.7) impairment. Statistical analysis was done using ANOVA test and Karl Pearson Correlation coefficient. Results: The mean values of FEV1/FVC (0.8±0.08) and FVC% predicted (60.29±11.39) showed a restrictive pattern. FEF (25-75%) (r=0.241, p=0.031) and PEFR (r=0.245, p=0.029) positively correlated with duration of diabetes. BMI had a negative correlation with FVC% predicted (r=0.239, p=0.033). A negative correlation between FEV1% and Waist Circumference (WC) was observed (r=-0.232, p=0.038). HbA1c negatively correlated to FEV1/FVC (r=-0.227, p=0.043). Conclusion: Patients with type 2 Diabetes Mellitus (DM) were found to have an asymptomatic restrictive pulmonary impairment. Increased duration of diabetes, increased BMI, increased WC was associated with decreased lung functions in diabetics.


2018 ◽  
Vol 25 (11) ◽  
pp. 1689-1695
Author(s):  
Mazhar Hussain ◽  
Muhammad Arshad Qureshi ◽  
Abdul Qudoos Arain ◽  
Habib-Ur- Rehman

Background: Peripheral neuropathic pain is a devastating complication intype 2 diabetic patients with significant morbidity and mortality. Objectives: To investigate theeffect of oral vitamin D supplementation on symptoms of peripheral neuropathic pain in type 2diabetic patients. Study Design: Prospective randomized placebo controlled trial. Setting:Diabetic Clinic of Sheikh Zayed Medical College/Hospital Rahim Yar Khan. Period: Overa period of 6 months from Jan-July 2017. Methods: 116 vitamin D deficient type 2 diabeticpatients with symptoms of peripheral neuropathic pain were divided in to two groups toprescribed either oral vitamin D3 capsule 50000IU weekly or Placebo capsule for a periodof 12 weeks. Symptoms of diabetic neuropathic pain were assessed by neuropathysymptoms score (NSS) and neuropathy disability score (NDS) while Vitamin D status wasestimated by measuring the serum total 25(OH) D concentration. The primary end pointwas changes in NSS and NDS while secondary end point was changes in HbA1C and 25(OH) D concentrations from baseline. Results: After 12 weeks of vitamin D therapy, vitaminD improved its own level in interventional group (28.5±12.5 to 48.2±15.6) vs placebo group(30.6±16.2 to31.5±12.6) with p-value (0.001). This rise was accompanied by improvementin HbAIc (8.2±1.8 to 7.5±2.2) vs Placebo (7.8±1.5 to 8.0±1.8) with p-value (0.004) and NSSscore (6.02±1.5 to 4.52±0.8) vs placebo (5.82 ±1.8 to 5.65±1.5) with p-value (0.002). Howeverno significant changes were seen in NDS in both study groups. Conclusion: Oral vitamin D3therapy has positive impact on its own status as well as symptoms of peripheral neuropathicpain in type 2 diabetic patients.


2019 ◽  
Vol 26 (09) ◽  
pp. 1471-1476
Author(s):  
Shahzad Alam Khan ◽  
Iqra Imtiaz

Background: HDL particles have several biological functions. Low levels of HDL-cholesterol are responsible for atherosclerotic disease. Type 2 diabetes is a metabolic disease of chronic etiology and low HDL‐cholesterol is frequent finding in diabetics. Levels of HDL with advancing age are inconsistent, few study show decline in HDL with increasing age while others show vice versa results. Objectives: Objective of this study was to establish an association between low HDL levels with advancing age in type 2 diabetic patients. Study Design: Cross sectional descriptive study. Setting: Diabetes Outpatient Department Nishtar Hospital Multan. Period: 6 months extending from March 2018 to August 2018. Materials and Methods: 145 patients with newly or previously diagnosed type 2 diabetes mellitus, age >35 years were considered for the study. Those diabetics who had family history of dyslipidemias (to rule out familial hyperlipidemias) were excluded. Study was started after acquiring permission from ethical committee. All the patients were evaluated for the HDL levels by getting a fasting lipid assay. Results: Out of 145 cases 78 (53.6%) were males while remaining 67 (46.4%) were female. Mean age of the patients was 57.27 + 6.91 years. Mean HDL level was 37.82 + 8.42. It was seen that HDL is low in 116/145 (80%) patients. Those diabetic patients who were < 60 (91 cases), HDL was noticed to be low in 67/91(73.62%) patients. Among patients >60 years (54 cases), HDL was identified to be low in 49/54(90.7%) patients. P-value was found out to be 0.012 Conclusion: Due to falling levels of HDL with advancing age in diabetic patients, there is increase in cardiovascular events in elderly diabetic patients. So the measures which tend to increase HDL level will also give protection against adverse cardiovascular event in elderly diabetics.


2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Sadia Sharif ◽  
Naureen Sarwar ◽  
Bushra Nisar ◽  
Muhammad Khalid Masood ◽  
Asim Hameed

AbstractBackground:  Diabetes mellitus is an extremely common endocrine metabolic disorder that results in chronic hyperglycemia. It has effects on various tissues of the body. Due to this increased blood glucose levels considerable cellular changes occur in oral cavity as well. This field has attracted little research. The aim of the study was to analyze the changes in morphology and cytomorphometric measurements in the buccal mucosal cells of type 2 diabetic patients.Objectives:  The Objective of this study was to detect the cytological and morphological alterations of oral epithelial cells, in type 2 diabetic patients and healthy control subjects in exfoliated cytology smears, to com-pare the cytoplasmic diameter, nuclear diameter, and nucleus: cytoplasm ratio in type 2 diabetics and heal-thy control subjects and to analyze the above mentioned cellular alterations in patients with controlled and uncontrolled diabetes.Methods:  Cross-sectional analysis was performed in three groups on the bases of HbA1c levels. Group 1 was uncontrolled diabetics with HbA1C ≥ 7.0%, Gro-up 2 was well controlled diabetics with HbA1c ≤ 7.0% and Group 3 was Control healthy having HbA1C ≤ 5. 6%. Smears from normal buccal mucosa were obtai-ned from each subject and stained with Papanicolaou method. An eyepiece micrometer was used to take mean values of ND, CyD, and N: C ratio. Fifty (50) clearly defined cells were measured in each case in a step wise manner, to evade quantifying cells once more. Comparison of Nuclear Diameter (ND), Cytoplasmic Diameter (CY D) and ratio of two Diameters (N: C) among three groups was performed by using ANOVA. TUKEY’S test for post –hoc analysis was used where required.Results:  The variability in diameter of nucleus among all three sample groups showed significant p-value < 0.001.Whereas the measurement for cytoplasmic diameter between three groups was not significant (p-value 0.178). The ratio of nuclear diameter to cytoplasmic diameter calculated was significant (p-value < 0.001). Hence it proved from the results that considerably exaggerated ND and N: C ratios were seen as the glycemic control (HbA1C) is poorer.Conclusion:  The results suggested that nuclear size of buccal mucosal cells increased in type 2 diabetic pati-ents while no change was observed in cytoplasmic dimensions.


Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Jawariea Ali ◽  
Sheikh Sajjad Ali ◽  
Muhammad Imran ◽  
Tuba Tariq ◽  
Umair Mahmood ◽  
...  

Objective: To find association between antidiabetic treatment and the type of obesity in type 2 diabetic patients. Methods: The study was conducted in National Institute of Diabetes & Endocrinology (NIDE), Karachi, over a period of 6 months, ie. from January to June, 2018. It was an observational analytical study, for which 59 patients were selected via non-probability sampling, as per inclusion and exclusion criteria. Data was collected through detailed history, examination. A database was developed and analyzed on SPSS 17. A p- value <0.05 was taken as statistically significant. Results: Fifty nine patients fulfilling the inclusion criteria were included in this study. While 30 (50.8%) had generalized obesity, 29 (49.2%) were not having generalized obesity. Further it was observed that 35 (59.3%) had abdominal obesity, while 24 (40.7%) were not having abdominal obesity. A total of 39 (66.1%) were on insulin, while 20 (43.9%) were not on insulin. Finally, 41 (69.5%) were on oral hypoglycemic drugs, while 18 (30.5%) were not on oral hypoglycemic drugs. P-values were not significant for the study parameters. Conclusion: There is no association between antidiabetic treatment and type of obesity in type 2 diabetic patients. Key Words: Diabetes, obesity, body mass index, insulin, oral hypoglycemic drugs How to Cite: Ali J, Ali S.S, Imran S, Tariq T, Mahmood U, Iqbal J. Association of antidiabetic treatment with the type of obesity in type 2 diabetic patients. Esculapio.2020;16(04):97-100.


2019 ◽  
Vol 9 (1) ◽  
pp. 2-7
Author(s):  
Prabin Kumar Karki ◽  
Santosh Timalsina ◽  
Sanat Chalise ◽  
Anita Yadav ◽  
Ashish Kumar Bhattarai

Background: Diabetes mellitus has become one of the biggest health problems of this era. The resultant microvascular and macrovascular complications add to significant amount of morbidity and mortality. Urine microalbumin is considered as an early marker for microvascular compli­cations among diabetic patients. The aim of this study was to find out the prevalence of microalbuminuria among type 2 diabetic patients attending Kathmandu Medical College and its relation with glycemic control, age, sex, duration of diabetes. Methods: A total of 208 previously diagnosed type 2 diabetic patients at­tending medical outpatient department of Kathmandu Medical College, Sinamangal were included in the study over a period of 1 year (October 2017 - September 2018). Fasting and 2-hour postprandial venous blood for blood glucose and HbA1c measurement and early morning urine sam­ple (after overnight fast) was collected for detection of microalbuminuria. Statistical analysis was done using SPSS version 23. Results: The prevalence of microalbuminuria among the study population (mean age: 54.22 ± 11.76 years, mean HbA1c: 7.62 ± 1.53 %) was 42.8%. Microalbuminuria had significant correlation with HbA1c and duration of diabetes (p<0.001), but not with age, sex and type of medication. There was positive correlation between urine microalbumin and fasting and post-prandial blood glucose. Conclusions: Our present study found high prevalence of microalbumin­uria among diabetic patients with poor glycemic control. It is suggested that tighter glycemic control with regular urine microalbumin testing should be integral part of diabetic management plan to prevent long term complications such as diabetic nephropathy


2019 ◽  
Vol 9 (3) ◽  
pp. 79-83
Author(s):  
Chandra Kala Rai ◽  
Nimesh Poudel

 Background: Type 2 diabetes mellitus (T2DM) is one of the most common metabolic disorders to the current generation. It usually leads to multi-system­ic complications such as cardiovascular diseases, proteinuria, micro albumin­uria, retinopathy, hypertension, ischaemic changes and chronic kidney disease. These complications increase the morbidity and mortality of patients. The pro­longed hyperglycemia leads to vascular damage. It causes insufficient blood flow to the cardiac muscles which may cause myocardial or cardiac ischaemia. The aim of this study was to find out the prevalence of hypertension and isch­aemic ECG changes in T2DM patients attending Kathmandu Medical College. Methods: Total 360 type 2 diabetic patients were included. Blood pressure was measured and electrocardiogram (ECG) was recorded by 12 leads ECG. Statistical analysis was done using SPSS version 16. p<0.05 was considered to be statistically significant. Results: The mean age of the patients was 66.88 ± 1.52 years, age ranging from 40 – 95 years. In this study 168 patients (46.66%) had systolic hyperten­sion, 204 patients (56.67%) had diastolic hypertension and 126 (35%) had both systolic and diastolic hypertension. About 103 (28.61%) showed ECG changes in hypertensive patients. Only 4 (1.11%) non- hypertensive had ECG changes. This study showed statistically significant relation of hypertension and isch­aemic ECG changes in type 2 diabetes mellitus cases with p- value 0.03. Conclusions: There is a high prevalence of hypertension among T2DM pa­tients. In these patients, there is a statistically significant association between hypertension and ischaemic ECG changes.


KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 662-667 ◽  
Author(s):  
Md Imtiajul Islam ◽  
Sayama Hoque ◽  
Rehana Khatun ◽  
Md Zulfikar Ali ◽  
Md Saiful Islam ◽  
...  

Background: Macrovascular complications cause much of the serious morbidity and mortality in patients with diabetes. The aim of the study was to determine the prevalence and risk factors of different macrovascular complications among type 2 diabetic patients.Materials and Methods: We studied two fifty cases of type 2 diabetic patients in this cross-sectional study which was conducted in the out-patient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of coronary heart diseases (CHD), stroke and peripheral vascular diseases (PVD) through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, body mass index) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used logistic regression analysis to determine and quantify the association of CHD, stroke and PVD with various risk factors. Results: Two hundred and fifty cases of type 2 diabetic patients (male 129 and female 121 were studied. The prevalence of macro-vascular complications was 28.8%. Among them CHD was 21.2% (95% CI: 16.13- 26.27%), stroke in 8.4% (95% CI: 4.96-11.84%) and PVD in 7.2% (95% CI: 4-10.4%). Logistic regression models showed that macrovascular complications were more common in females; the risk increased significantly with age, longer duration of diabetes, lacking of physical exercise, presence of hypertension, HbA1c, Fasting Blood Glucose (FBG) and blood glucose 2 hours ABF.Conclusions: CHD is the most common macrovascular complication among type 2 DM patients. Advanced age, longer duration of diabetes, hypertension, poor glycaemic control, lacking of physical exercise etc. are significant risk factors of macrovascular complications in type 2 diabetic patients.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 662-667


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