scholarly journals Prevalence and Clinical Characteristics of Nonalcoholic Liver Disease in Type 2 Diabetes Mellitus Patients: A Cross-sectional Study

Author(s):  
Lakshmi Ravansamudram Hariharan ◽  
Jayanty Venakata Balasubra Maniyan

Introduction: A refined diagnostic and classification strategy incorporating phenotypic characteristics of patients with Type 2 Diabetes Mellitus (T2DM) along with their blood glucose profile, lipid levels and evidence of Nonalcoholic Fatty Liver Disease (NAFLD) will help in identifying high risk population. Aim: To determine the prevalence and assess the clinical characteristics of NAFLD in T2DM patients from August 2016 to February 2017. Materials and Methods: This cross-sectional analysis was conducted on 100 T2DM patients with no history of alcohol intake, at the time of their screening. Physical examination and anthropometric measurements such as Body Mass Index (BMI) and Waist to Hip Ratio (WHR) were calculated. Fasting Blood Glucose (FBG), Post-Prandial Blood Glucose (PPBG), glycated haemoglobin (HbA1c), serum bilirubin, liver enzymes, lipid profile and ultrasound of the abdomen to diagnose NAFLD were done. Statistical analysis was carried out using student’s t-test and Statistical Package for the Social Sciences (SPSS) Version 19. Results: The prevalence of NAFLD in T2DM patients was 52%. The mean age was 52.27±1.82 years, with 40% males in the study cohort. There was a significant statistical correlation between the higher BMI (p<0.001), higher WHR (p=0.046), prevalence of upper body obesity (p<0.001) and the presence of NAFLD. The glycaemic control was poorer in patients with NAFLD with higher FBG (p=0.0027), PPBG (p=0.0027) and HbA1c p<0.001) than the non-NAFLD group. The serum cholesterol, triglycerides, Serum Glutamic Pyruvic Transaminase (SGPT), Serum Glutamic Oxaloacetic Transaminase (SGOT) were significantly higher in the NAFLD group. Duration of diabetes was not significantly different among the groups. Conclusion: The incidence of NAFLD is common in T2DM patients with poor glycaemic control, dyslipidaemia, and obesity being associated factors. Duration of diabetes is not a significant predictor of NAFLD.

Author(s):  
Anil Shrinivasrao Joshi ◽  
Chandrakant Gunaji Lahane ◽  
Akshay Arvind Kashid

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">To study the prevalence of silent myocardial ischaemia in asymptomatic patients with type 2 DM</span>.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The present study was conducted in the Govt. Medical College and Hospital Aurangabad. During December 2012 to November 2014 with 50 patients. It was two year cross sectional study with the patients of asymptomatic type 2 diabetes mellitus without clinical and electrocardiographic evidence of coronary artery disease. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">12 (24%) out of 50 subjects had positive TMT. It correlated with years of duration of diabetes (9 positive TMT cases with duration of diabetes more than 10 years). 5 (25%) out of 20 had serum cholesterol levels &gt;240, Number of positive TMT were higher in patients with LDL &gt;160 [5 (25%) out of 20]</span>.</p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Diabetic patients are at very high risk for cardiovascular morbidity and mortality. Early detection of IHD is very important so that pharmacological therapy, which may improve outcome, can be established. Tread mill exercise TMT being a non-invasive test with high safety, has an important role in early detection of IHD. It is recommended that TMT should be a part of routine management in asymptomatic patients with type II DM. </span></p>


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029280 ◽  
Author(s):  
Bander Balkhi ◽  
Monira Alwhaibi ◽  
Nasser Alqahtani ◽  
Tariq Alhawassi ◽  
Thamir M Alshammari ◽  
...  

ObjectivesThe purpose of this study is to measure the adherence rates of oral antidiabetic drugs (OADs) in patients with type 2 diabetes mellitus (T2DM) and assess the relationship of glycaemic control and adherence to OADs after controlling for other associated factors.DesignCross-sectional retrospective study.SettingLarge tertiary hospital in the central region of Saudi Arabia.Participants5457patients aged 18 years and older diagnosed with T2DM during the period from 1 January 2016 to 31 December 2016.Primary and secondary outcome measuresThe modified medication possession ratio (mMPR) was calculated as a proxy measure for adherence of OADs. The factors associated with OADs non-adherence and medication oversupply were assessed using multinomial logistic regression models. The secondary outcomes were to measure the association between OADs adherence and glycaemic control.ResultsMajority of patients with T2DM were females (n=3400, 62.3%). The average glycated haemoglobin was 8.2±1.67. Among the study population, 48.6% had good adherence (mMPR >0.8) and 8.6% had a medication oversupply (mMPR >1.2). Good adherence was highest among those using repaglinide (71.0%) followed by pioglitazone (65.0%) and sitagliptin (59.0%). In the multivariate analysis, women with T2DM were more likely to have poor adherence (adjusted OR (AOR)=0.76, 95% CI=0.67, 0.86) compared with men. Also, medication oversupply was more likely among patients with hyperpolypharmacy (AOR=1.88, 95% CI=1.36, 2.63), comorbid osteoarthritis (AOR=1.72, 95% CI=1.20, 02.45) and non-Saudi patients (AOR=1.53, 95% CI=1.16, 2.01). However, no association was found between glycaemic control and adherence to OADs.ConclusionThe study findings support the growing concern of non-adherence to OADs among patients with T2DM in Saudi Arabia. Decision makers have to invest in behavioural interventions that will boost medication adherence rates. This is particularly important in patients with polypharmacy and high burden of comorbid conditions.


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.


Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 454-457
Author(s):  
Arpita Chakraborty ◽  
M.Mukhyaprana Prabhu ◽  
Weena Stanley

Introduction and Aim:Atherosclerotic cardiovascular disease (ASCVD)and Framingham score (FRS) are two important scores used for the prediction of coronary events in an individual.Both of these scores do not account for certain known predisposing factors such as BMI, duration of diabetes, LDL cholesterol and glycemic index levels among type 2 diabetes mellitus (T2DM) subjects. So, this study aims to assess whether addition of any of these important risk factors might help in improving these scoring systems in T2DM patients. Methodology: Our study is a cross-sectional study which included 320 T2DM patients without CAD and 120 T2DM patients with CAD. Duration of T2DM, BMI, glycated hemoglobin and fasting lipid profile values of the T2DM patients were recorded from the Laboratory information system. Results: IBM Statistical Package for the Social Sciences (SPSS) 16 version was used for statistical analysis. T2DM patients with CAD had more years of duration of T2DM than the patients without CAD and a significant association was found (p=.045*). A strong significant positive correlation was observed between FRS score and duration of T2DM in diabetic patients with CAD (r=.331, p=<.0001*). Conclusion:Our observations imply that inclusion of important parameter such as duration of T2DM might improve in better calculation of these risk scores in T2DM patients. Future studies are needed to assess the performance of existing risk scores by including important parameter such as duration of diabetes which might help in improving these scoring systems in T2DM patients.


2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Esti Oktaviani Purwasih

ABSTRAKDiabetes melitus (DM) tipe 2 yaitu penyakit gangguan metabolik ditandai kenaikan gula darah karena penurunan sekresi insulin oleh sel beta pankreas dan atau ganguan resistensi insulin.Penelitian ini bertujuan untuk mengidentifikasi hubungan antara kadar glukosa darah puasa dengan tingkat stres pada penderita diabetes melitus (DM) tipe 2. Jenis penelitian adalah deskriptif korelasi dengan pendekatan cross sectional. Variabel independen dalam penelitian ini yaitu tingkat stres. Sedangkan variabel dependen dalam penelitian ini yaitu kadar glukosa darah puasa. Penelitian dilakukan di Puskesmas Maos dan Klinik Graha Amanah Maos bulan Maret 2017. Sampel diambil dengan total sampling, berjumlah  60 responden yang menderita DM tipe 2 minimal 1 tahun, memiliki kadar GDP 130 mg/dl, dan tidak memiliki penyakit komplikasi seperti gagal ginjal kronis, dan kanker.Hasil analisis data menggunakan spearman rho didapatkan tidak terdapat hubungan antara kadar glukosa darah puasa dan tingkat stres (p value = 0,137). Kata Kunci: Diabetes Mellitus Tipe 2, Glukosa Darah Puasa, Tingkat Stres. ABSTRACTType 2 diabetes mellitus (DM ) is a metabolic disease that characterized by an increasing of  blood  glucose because of decreasing insulin secretion by pancreatic beta cells and or insulin resistance disorders.This research aimed to identify the relationship between fasting blood glucose (FBG) level and stress level in patients with  type 2 diabetes mellitus (DM). The research design was descriptive correlation with cross sectional approach. The independent variable in this study was stress level. The dependent variable in this study was fasting blood glucose level. The study was at Maos Community Health Center and Graha Amanah Clinic in March 2017.The sample was total sampling. These were 60 respondents who diagnosed  type 2 diabetes mellitus at least 1 year, had FBG level 130 mg / dl, and did not have complications such as chronic kidney failure , and cancer.The results of data analysis by using spearman rho found that there was no correlation between fasting blood glucose level and stress level (p value = 0.137). Keywords: Type 2 Diabetes Mellitus, Fasting Blood Glucose, Stress Level.


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