Study of fasting & PP C- peptide & its correlation with HbA1c in T2 Diabetes mellitus in population of Uttarakhand

We aimed to provide correlation of Fasting & PP C-peptide with HbA1C in patients of T2 Diabetes Mellitus.: 50 patients admitted in IPD of Medicine department in Shri Mahant Indresh Hospital from April-August 2021. Serum samples taken for fasting & PP C-peptide and HbA1C for patients of T2 Diabetes Mellitus and run on VITROS 5600/7600 which is based on dry chemistry. : We took 50 patients who were T2DM then we did fasting C peptide & PP C-peptide and HbA1c. Out of 50, 15 were females &35 were males. Out of 50, 45 patients had raised HbA1C maximum around 8-10.Mean & SD for fasting C-Peptide for males was 1.346±1.070 & for females 2.442±2.57.Mean & SD for Post prandiol C-Peptide for males was 4.208±5.020 & for females 2.993±2.130.It was significant for fasting C- Peptide with P value 0.0371 and non significant for PP C peptide with p value 0.3731.: Insulin secretion estimated by measurement of Fasting C-Peptide was either normal or raised in newly diagnosed T2DM subjects in my study indicating predominant role of insulin resistence in the etiology. Further research can explore the exact contribution of insulin resistence and insulin secretory defects in this area.

Repercussão de dietas inflamatórias nas desordens endócrinas de pacientes com diabetes mellitus

Introdução: O diabetes mellitus é uma doença crônica não transmissível em que há desordens endócrinas e metabólicas, como estresse oxidativo e processos inflamatórios em decorrência da hiperglicemia. Esses processos inflamatórios têm origem multifatorial, dentre eles, a alimentação inadequada. Neste sentido, o objetivo dessa revisão foi discutir as desordens endócrinas do diabetes mellitus e sua relação com o índice inflamatório da dieta. Metodologia: Foi realizada uma revisão narrativa a partir da busca de artigos publicados nas bases de dados Pubmed, Science Direct, SciELO e Cochrane Library, utilizando os descritores “Diabetes Mellitus”, “Inflammation”, “Insulin Resistence”, “Oxidative Stress” e “Inflammatory Diet”. Resultado: Estudos científicos sugerem que alguns componentes da dieta causem estresse oxidativo e inflamação, o que por sua vez repercute no quadro clínico de indivíduos com diabetes. É possível detectar que dietas baseadas no estilo de vida ocidental, com uma alimentação rica em carne vermelha, açúcares refinados, bebidas industrializadas e alimentos processados, são considerados estimuladores positivos da elevação dos níveis de biomarcadores inflamatórios, a exemplo da PCR, TNF-α e interleucinas. Conclusão: existe uma possível relação entre a presença do diabetes mellitus e uma alimentação pró-inflamatória, sendo necessário mais estudos acerca do tema abordado.

Ghrelin, resistin and insulin in obese diabetic women in Wad-Madani, Sudan

Background: Obesity in the Sudan is increasing at alarming rate with the tendency of reaching an epidemic proportion in women. It is commonly associated with type 2 diabetes (T2D). Some adipokine hormones such as resistin are associated with obesity. Objectives:. To study how the levels of resistin, ghrelin and insulin are associated with obesity,fat distribution and (T2D) and to ascertain any interrelationships between them. Subjects and methods: 150 women, age ≥18 years old, resident in Wad-Madani town, Sudan were participated in the study. They were divided into 3 groups according to body mass index ( BMI) value: I (normal weight), II (overweight) and III (obese diabetic). Fasting serum resistin and ghrelin concentrations were measured using ELISA method. Insulin levels were determined by radioimmunoassay(RIA). Results: The mean±SD levels of resistin 5.80±4.91ng/mL,Ghrelin107.60±26.67pg/M and Insulin 11.92±8.54mLU/ml in obese diabetic were found to be greater than in normal or overweight women.In normal weight values were 3.07±2.15 ng/ mL 83.30±13.38pg/mL, and 6.62±6.77mLU/ml for resistini, ghrelin and Insulin, respectively. Values for overweight women 3.64±2.63 pg/mL 90±17.35 pg/mL and 8.13±7.54 mLU/ml for resistin, ghrelin and insulin respectively. Conclusions and recommendations: Increased BMI, waist circumference (WC) and hormones (ghrelin and resistin) were associated with insulin resistance.Further studies are needed to accept or refute these findings. Keywords: Obesity; BMI; WC; T2D; ghrelin; resistin; insulin resistence (IR).

P279 Subclinical left ventricular dysfunction in patients with insulin resistence and hypovitaminosis D

Introduction Patients with subclinical left ventricular diastolic and systolic dysfunction are at risc of future cardiac events. Insulin resistance (IR) has been reported to be a strong risk factor for cardiovascular disease (CVD). Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction and vitamin D deficiency is also associated with increased risk of CVD, including hypertension, heart failure, and ischemic heart disease. Aim The aim has been to explore association of IR and vitamin D deficiency with subclinical left ventricular disfunction. Method The study consisted of 79 patients divided into two groups according IR, evaluated at baseline by the homeostasis model assessment method (HOMA-IR). v The HOMA1-IR index was calculated by the formula: HOMA1-IR = fasting plasma insulin (µU/ml) x fasting plasma glucose (mmol/L). The HOMA2-IR index was obtained by the program HOMA Calculator (free) download Windows version. The cut-off values for IR were: HOMA1-IR > 2.7 and HOMA2-IR > 1.8; group of 41 patients, and group od 38 patients without of IR. Parameters of left atrial and ventricular geometry were estimated by echocardiography. Tissue Doppler velocities were measured from medial and lateral annulus (e, a, s) including isovolumic contraction velocity (IVCv) and E/e Global longitudinal strain (GLS) was derived from two-dimensional speckle-tracking. Results In IR group level of 25-OH-D was deficient in 25 (61.2%), insufficient in 10 (25%) and sufficient in 6 (13.8%) patients and significantly lower compared to control group (46.8 ± 25.5 vs 61.5 ± 33.8, p < 0.001). Importantly, 25-OH-D was associated with global longitudinal strain (r= −0.21, <0.05). Values of GLS (-19.9 ± 2.8 vs -26.6 ± 2.9; p < 0.001) and IVCv (0.07 ± 0.02m/s vs 0.09 ± 0.03m/s; p < 0.05) were significantly lower and E/e (9.11 ± 2.24 vs 7.18 ± 1.65; p < 0.001) significantly higher in group of patients with IR. Conclusion The results showed that insulin resistence is asociated with subclinical LV diastolic and systolic dysfunction. Level of 25-OH-D was significantly lower in patients with insulin resistence suggests that vitamin D deficiency may have a certain contribution to the development of myocardial dysfunction in these patients. Fortunately insulin resistance and vitamin D deficiency are a modifiable risk factors; the reduction of insulin resistance and increase the level of 25-OH-D may reduce CV risk in this group of patients.

Chronic Effect Various Type of Exercises to Fasting Blood Glucose and Insulin Resistance

Exercise is non-pharmacological management for Diabetes Mellitus (DM) type-2. Previous study found that both eerobic and interval training improved insulin resistance. The aim of this study was to analyze the chronic effect various type of exercises to fasting blood glucose (FBG) and insulin resistance in DM type-2 model rats. It was an experimental study, twenty male Wistar rats, age 8 weeks, weight 150-180 gram as the object. Rats were given high fed diet for 4 weeks then injected streptozocin dose 30 mg/kgBB in citrate buffer pH 4.5 i.p, and 45 mg/kgBB at the following week. Groups were divided into i.e moderate continous training (MCT), severe continous training (SCT), slow interval training (SIT), and fast interval training (FIT). All groups were treated with ran on the treadmill three times a week for 8 weeks. Fasting blood glucose and fasting insulin were checked before and after intervention. Insulin resistance was determined by calculating HOMA-IR. Data analized with paired t-test (p<0,05). The results shown that all group significantly decreased fasting blood glucose and insulin resistance (p <0,05) after eight weeks exercise except insulin resistance in MCT group. Fasting blood glucose and insulin resistence post-test was found lowest in SIT groups in this study. In conclucions chronic effect of aerobic continous and aerobic interval in various intensity can decrease fasting blood glucose and insulin resistance in DM type-2 rat model. Slow interval training was the best exercise model to decrease insulin resistance.