A Comparison between Type-2 Diabetics and Non-Diabetics in Terms of Papillary Bleeding Index (PBI)

OBJECTIVES: The purpose of this study was to compare the Type 2 diabetes mellitus patients and non-diabetics in terms of Papillary bleeding index (PBI) of periodontal disease. METHODOLOGY: This comparative cross-sectional study was conducted during the period of November 2020 to February 2021 in three (3) tertiary care hospitals of Peshawar. The sampling technique was purposive sampling. The sample comprised 105 individuals, 56 participants in Type–2 diabetes group and 49 in non-diabetes group. Male and females, having age between 40-65 years were recruited. Each diabetic and non-diabetic were clinically examined for periodontitis. Age and sex-matched participants suffering from periodontitis without a history of diabetes as well as with good glycemic control (HbA1c) were considered as controls subjects. Glycated hemoglobulin (HbA1c) was carried out for all the participants free of cost by using Human Gmbh-Max-Planck-Ring 21-65205 Wiesbaden-Germany kit. The study was approved by the ethical committee of the Peshawar Medical College. Data was analyzed using software package SPSS version 20. RESULTS: Out of 56 diabetics, 24 subjects brushed once daily, 15 brushed twice daily, 11 brushed occasionally and 6 didn’t brush whereas in 49 non diabetics, 20 subjects brushed once daily, 13 brushed twice daily, 11 brushed occasionally and 5 didn’t brush. The clinical parameter mean (PBI) was recorded in our study. Score was 2.09 (±0.82) in diabetics and 1.02 (±0.47) in non-diabetics. P-value measured by the chi square test was significant. Spearman correlation test was performed to explore the association between the type 2 diabetes and Papillary bleeding index (PBI). CONCLUSION: We concluded that a significant difference exists between the mean PBI scores of Type 2 diabetics and non-diabetics.

Evaluation of Jinlida Granules in Improvements to Standard-Reaching Rate of Blood Glucose and Type 2 Diabetes Mellitus Symptoms: Results of Secondary Analysis From 12-Week Trial

Background The previous study found that the Jinlida could significantly reduce levels of blood glucose and enhance the lowing-glucose action of metformin. However, the role of the standard-reaching rate of blood glucose and improving clinical symptoms in Jinlida has yet to be studied. We aimed to elaborate on the efficacy of Jinlida in Type 2 diabetics who experience clinical symptoms based on secondary analysis from the 12-week trial. Methods Data were analyzed from a 12-week, randomized, placebo-controlled, study of Jinlida. The standard-reaching rate of blood glucose, total symptom score, the efficacy of single symptom, symptom disappearance rate, symptom improvement rate was evaluated. Then, the correlation of the symptom effective rate and HbA1c was analyzed. Results 192 T2DM patients were randomly allocated to receive either Jinlida or a placebo for 12 consecutive weeks. The standard-reaching rate of HbA1c (<6.5%) was 25% in the treatment group when compared to 14.9% in the control group. (P=0.046); All the symptom exhibited a change difference, comparing the treatment group to the control group after 12 weeks’ intervention. (P< 0.05); Hunger, polyuria, dry mouth, sweating and dysphoria in chestpalms-soles symptoms exhibited a change difference in the treatment group, compared to that in the control group. (P<0.05). All the symptom exhibited a significant difference in symptom improvement rate. (P<0.05). Conclusions Jinlida glandule can effectively improve clinical symptoms of type 2 diabetics including thirsty, fatigue, hunger, polyuria, dry mouth, night-sweat, dysphoria in chenstplms-soles and constipation. It can be used as an effective adjuvant treatment for T2DM who experience those symptoms. However, these findings need to be further confirmed by evidence-based medicine.

The Effects of Peanuts and Tree Nuts on Lipid Profile in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized, Controlled-Feeding Clinical Studies

Background: Type 2 diabetes mellitus was found to be associated with metabolic disorders, particularly abnormal glucose and lipid metabolism. Dietary food choices may have profound effects on blood lipids. The primary objective of this study was to examine the effects of peanuts and tree nuts intake on lipid profile in patients with type 2 diabetes.Methods: According to preferred reporting items for systematic reviews and meta-analysis guidelines, we performed a systematic search of randomized controlled clinical trials and systematic reviews published in PubMed, Web of Science, Embase, Scopus, and Cochrane library, from inception through June 2021. Studies in populations with type 2 diabetes, which compare nuts or peanuts to a controlled-diet group were included. We used the mean difference with 95% CIs to present estimates for continuous outcomes from individual studies. In addition, we used the GRADEpro tool to evaluate the overall quality of evidence.Results: Sixteen studies involving 1,041 participants were eligible for this review. The results showed that peanuts and tree nuts supplementation did not induce significant changes in low-density lipoprotein-cholesterol (LDL-C) (mean difference = −0.11; 95%CI: −0.25 – 0.03, p = 0.117) and high-density lipoprotein-cholesterol (HDL-C) (mean difference = 0.01; 95%CI: −0.01 – 0.04, p = 0.400) in patients with type 2 diabetics. In addition, we found that peanuts and tree nuts intake may cause a significantly reduction in total cholesterol (TC) (mean difference = −0.14; 95%CI: −0.26 – −0.02, p = 0.024) and triglyceride (TG) (mean difference = −0.10; 95%CI: −0.17 – −0.02, p = 0.010). In the subgroup analysis, a significantly greater reduction in TC was observed in studies which duration was &lt;12 weeks (mean difference = −0.22; 95%CI: −0.37 – −0.08, p = 0.002). The quality of the body of evidence was “moderate” for TC and TG, the quality of evidence for LDL-C and HDL-C were “low.”Conclusion: Our findings suggest that consuming peanuts and tree nuts might be beneficial to lower TC concentration and TG concentration in type 2 diabetics subjects. Furthermore, peanuts and tree nuts supplementation could be considered as a part of a healthy lifestyle in the management of blood lipids in patients with type 2 diabetes. Given some limits observed in the current studies, more well-designed trials are still needed.

Frequency of non-alcoholic fatty liver disease (NAFLD) and its associated risk factors among Type-2 diabetics

Objectives: To determine the frequency of Non-Alcoholic Fatty Liver Disease (NAFLD) and its associated risk factors among Type-2 Diabetic patients. Methods: This cross-sectional study was conducted in Diabetic Clinic of Shaikh Zayed Postgraduate Medical Institute Lahore from September 2019-February 2020. Type-2 diabetics regardless of age were divided into two groups, one with fatty liver disease and the other without this, evaluated by Abdominal Ultrasonography and were further evaluated by measurement of BMI, obesity, HbA1c and lipid profile. Exclusion criteria were patients having history of or currently taking alcohol, chronic Liver Disease of any cause and intake of hepatotoxic drugs. Qualitative measures were compared between groups by using Chi-square test. Binary logistic regression was used to see the association of factors with fatty liver disease. P-value ≤ 0.05 was considered significant. Results: A total of 185 subjects were included in the study with the mean age of 53.0±9.0 years. About 54.6% patients were diagnosed to have fatty liver disease. When compared the cases with and without fatty liver disease, age and HDL cholesterol had no significant difference between groups while other measures like BMI, TGs & cholesterol levels, ALT and AST were significantly higher among cases with NAFLD. BMI >24.5, HbA1c >7.0 and ALT >40.0 can predict NAFLD among Type-2 diabetic patients with 96.8% accuracy. Conclusion: There is high prevalence of NAFLD among Type-2 diabetic patients and strong association between Type-2 diabetics with NAFLD and risk factors like; obesity, high HbA1c, hyperlipidemia and high ALT. Therefore, early recognition by ultrasonography in high risk patients and intervention like life style modification, maintenance of healthy weight, obesity prevention, treatment of dyslipidemia and good glycemic control should be achieved in such subjects and can prevent NAFLD. doi: https://doi.org/10.12669/pjms.38.1.4968 How to cite this:Ali A, Amin MJ, Ahmed MU, Taj A, Aasim M, Tabrez E. Frequency of non-alcoholic fatty liver disease (NAFLD) and its associated risk factors among Type-2 diabetics. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4968 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Effects of Metronidazole as an Adjunct to Non-Surgical Periodontal Therapy on Insulin Resistance in Type 2 Diabetics

Treating periodontitis with metronidazole (MET) as an adjunct to scaling root planing (SRP) is suggested to have inconsistent effects on insulin resistance (IR) in type 2 diabetes mellitus (T2DM). This paper will present the effects of MET, in addition to SRP, on the homeostatis model assessment of IR (HOMA-IR). A three-arm clinical trial was conducted and analyses were performed on T2DM participants with periodontitis (n = 74) who completed follow-up visits at 3 and 6 months after the intervention. The observed between-group and within-group mean changes in IR were found using ANOVA with repeated measures, followed by a post-hoc analysis, and a p-value of ≤0.05 was considered significant. Between-group analyses showed no difference in the HOMA-IR at 3 months, but at 6 months the difference was significant (p = 0.046). Within-group analyses showed that the HOMA-IR was significantly reduced in both test groups (p ≤ 0.05) over the period of time. Adjunct use of MET may result in a sudden short-term lowering of the HOMA-IR level within 3 months that may not be retained over 6 months when compared to the sustained lowering of the HOMA-IR levels in T2DM when intervened with SRP without MET.