Online ISSN: 2515-8260

Keywords : type 2 diabetes


“ASSESSMENT OF VITAMIN B12 STATUS IN TYPE 2 DIABETIC SUBJECTS”

Dr. Kapil Shrivatsava, Dr. Sushma BJ .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2646-2650

Background: The increasing incidence of type-2 diabetes is a serious health issue worldwide. Its prevalence is associated with poor diet and unhealthy lifestyle choices, and it is characterised by high blood glucose levels that need to be controlled by medication. Metformin is the recommended and most effective first-line drug for type-2 diabetes but its use has also been linked to vitamin B12 deficiency, which increases the risk of peripheral nerve damage.
Aim and Objectives: The aim of the study is to estimate serum levels of Vitamin B12 levels in subjects with Type 2 Diabetes Mellitus. The objectives of the study include to estimate the prevalence of Vitamin B12 deficiency in Type 2 Diabetic subjects and to compare the serum levels Vitamin B12 in Type 2 Diabetic Subjects with or without metformin.
Materials and Methods: We included a total of 140 type 2 Diabetic subjects on metformin therapy for more than 3 years and 60 non-diabetics and non-metformin users. Serum levels of Vitamin B12 was estimated by Chemiluminescence Immuno Assay method.  Serum Vitamin B12 levels of >300 pg/mL was defined as normal, 200-300 pg/mL insufficient and <200 pg/mL as deficient.
Results: We studied a total of 140 type 2 Diabetic metformin users and 60 non-metformin and non-diabetic subjects. We evaluated vitamin B12 levels in both. We found that 6.4% of metformin users had vitamin B12 deficiency, followed by 20.7% had insufficient Vitamin B12 levels and 72.8% had normal vitamin B12 status. Similarly, among non-metformin users 3.33% had deficient vitamin B12 levels, 16.3% had insufficient levels and 80% had normal vitamin B12 levels.
Discussion and Conclusion: Routine screening of Serum Vitamin B12 levels, complete hemogram, and neuropathy status should be done in all diabetic patients at the beginning of metformin therapy, and every 1-2 years thereafter. If any diabetic patient is found to be having low levels of Vitamin B12, they should be well supplemented with the Vitamin before start of metformin therapy.

Glycemic Variability Measures Derived from CGMs in Pancreatic Diabetes and Type 2 Diabetes Mellitus

1Rajesh Kumar Padhi, 2Susant Mishra, 3Abhay Sahoo, 4Monalisa Khuntia, 5Hariballav Mahapatra .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3243-3252

Background: Using continuous glucose monitoring, compare glycemic variability (GV) indices between patients with fibrocalculous pancreatic diabetes (FCPD) and type 2 diabetes mellitus (T2D) (CGM).
Methods: We calculated GV indices in 61 patients with FCPD and T2D who were matched for HbA1c and diabetes duration. The CGM-derived measures of GV (SD, mean amplitude of glycemic excursion [MAGE], continuous overall net glycemic action [CONGA], absolute means of daily differences [MODD], M value, and coefficient of variance [percent CV]) and hypoglycemia (time spent below 70mg/dL, AUC below 70mg/dL, glycemic risk assessment diabetes equation hypoglycemia, Low Blood Glucose Index), and hyperglycemia (time spent above 180mg/dL at night [TSA > 180], AUC above 180mg/dL [AUC > 180], glycemic risk assessment diabetes equation hyperglycemia, High Blood Glucose Index [HBGI], and J index).The relationship between GV indices and HbA1c, diabetes duration, and demographic and biochemical data was also investigated.
Results: Except for M value, all of the CGM-derived GV parameters (SD, MAGE, CONGA, MODD, and percent CV) were substantially greater in the FCPD group than in the T2D group (P<0.05). The FCPD group had significantly greater levels of hyperglycemia (TSA >180, AUC >180, HBGI, and J index) than the T2D group (P<0.05). The levels of hypoglycemia in the two groups were not significantly different. In both groups, all hyperglycemia markers had a favourable connection with HbA1c.
Conclusions: T2D is linked to lower GV, whereas FCPD is linked to higher GV. Higher postprandial glycemic excursions were discovered in patients with FCPD, which could have treatment implications.

Clinical profile of non-alcoholic fatty liver disease in type 2 diabetic patients

Dr.Anil Kumar, Dr.Vinay Durgad,Dr.Raghu Nandan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 454-458

NAFLD may progress through three different stages, from hepatic steatosis to steatohepatitis and finally to cirrhosis. Hepatic steatosis represents simple increase in accumulation of fat in liver, without evidence of inflammation or liver damage. Inflammation and liver damage is however present in steatohepatitis. NAFLD was defined as any degree of fatty liver in the absence of alcohol intake. NAFLD, if present, was classified based on standard ultrasonographic criteria as: Grade 1 (mild steatosis): slightly increased liver echogenicity with normal vessels and absent posterior attenuation. Prevalence of high Waist circumference, which is important marker of central obesity, according to ATP III guidelines for male waist circumference is(≥102 cms) & for female is (≥88 cms) consider as central obesity. In our study,14(58.33%)males patients had waist circumference is ≥102cms &25(96.15%)females patients had waist circumference is ≥88cms. Mean waist cicumference in male were 102.58cms & in female were 96.5cm

PRESCRIPTION PATTERN STUDY IN TYPE 2 DIABETES MELLITUS IN DIABETIC OUT PATIENTS AT PRIVATE CLINIC

Dr. Bharti N. Karelia Dr. Kiran G.Piparva Dr. Parulben A. Patel

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 79-87

Aim: To evaluate drug utilization pattern of antidiabetic drug in type-2 diabetic patients
attending at private diabetes clinic. So that, this information can be used in assessment of
quality of care provided as well as to facilitate the rational use of drugs in populations
Objective: To evaluate the current trends of prescribing patterns of antidiabetic drug in type
2 diabetic patients
Material and Methods: An observational prospective study undertaken at diabetes clinic from January 2015 to April 2016 after approval from institutional ethic committee. Total 600 patients of type 2 diabetes mellitus were enrolled. Data related to demographic details of the patient (age, gender and BMI, occupation, social status), past history, family history, personal history, all investigations, drug treatment and adverse drug reaction were recorded in suitable case record form. Follow up was carried out for all patients every 3rd, 6th, 9th and 12th month visit for glycaemic control. Data were entered into Microsoft excel 2010 and analysed by descriptive statistics (percentage, mean, standard deviation) and chi square test.
Results: Out of 600 patients, 58.67% were males and 41.33% were females. The mean age of the patients was 51.85 ± 4.24 years. Hypertension (31%) was most common co-morbid illness.Most common complaint was weakness (18.33%). Majority prescriptions had fixed dose combination (FDC) of two antidiabetic drugs (93.2%). Most commonly prescribed FDC was of sulfonylureas (Gliclazide) and Biguanide group (Metformin)in 552(92%). Average number of drugs per encounter was 3.02, 0.3 % drug was prescribed by generic name, 4.17% drug was antibiotic, 7.7% drug was injectable medicine, 14.27% drugs was prescribed from national list of essential medicine and 11.35% drugs were prescribed from WHO essential list of medicine. Fixed dose combinations were prescribed in 57.27% of patients. Glycaemic controlled was observed in 32.84 % patients.
Conclusion: Sulfonylurea and Biguanide combination most commonly used to treat type 2 DM and among them Gliclazide and Metformin combinations was most commonly prescribed.

Prevalence of Refractive Errors in Type 2 Diabetic Patients in Northern India

Kumari Ragni; Srivastava Mrinal Ranjan; Janarthanan Salai Dhavamathi; Awasthi Anan Aanchal; Dubey Gaurav; Chandra Mahesh; Kumari Vibha; Avinash V Prabhu; Garg Pragati; Janardhanan Rajiv

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 91-98

To determine the prevalence of refractive errors among the type 2 diabetic population through a community-based study conducted in Lucknow.
Background of the study: Diabetes prevalence is on the increase rapidly the epidemic proportions during development as well as the world developed. Refractive error in the diabetic population is considered a leading cause of visual impairment.
Methods: A total of 437 patients (> 40 years old) with type 2 diabetes were examined via complete eye screening tests, including objective autorefraction. Spherical equivalent refractions of both eyes were reported. Data collected include age, gender, general medical information, and serum biochemistry.
Results: The mean refraction was −0.84 ± 2.59 D. Prevalence rates were determined for astigmatism (63.8%), hyperopia (1.4%) & myopia (0.2%). 34.6% of the patients were emmetropic. Age is an essential factor for all refractive errors. Correlation showed that every increase of one year of age and one percent of HbA1c is associated with 0.05 D (P = 0.003) and 0.14D (P = 0.04) shift in hyperopia, respectively.
Conclusions: This study provides epidemiological data on refractive errors in a North Indian diabetic population in Lucknow, India. The astigmatism prevalence is higher than the reported rates in the diabetic population compared to hyperopia and myopia. The second major finding was emmetropia.Refractive errors, Type 2 diabetes, Prevalence, Community-based stud

Assessment Of The Knowledge Diabetic Retinopathy Among Patients With Type 2 Diabetes At Makkah, Saudi Arabia 2019. Cross-Sectional Study

Adel Saeed Ali Alzahrani, Nawaf Suhaim Al-Atiani

European Journal of Molecular & Clinical Medicine, 2019, Volume 6, Issue 1, Pages 543-556

1. Background
Diabetic retinopathy (DR) is a well-known complication of diabetes mellitus (DM) and a major cause of
vision loss. Increased knowledge of DR is crucial for the prevention and early diagnosis of the disease and
preservation of vision, diabetes mellitus is a disorder, characterized by an imbalance in blood glucose
levels. The prevalence of diabetes mellitus is increasing globally.The global diabetes prevalence in 2019 is
estimated to be 9.3% (463 million people), rising to 10.2% (578 million) by 2030 and 10.9% (700 million)
by 2045. Long term, continuous hyperglycemia leads to vasculature-related disorders, including those
affecting the eyes, such as retinopathy, diabetes mellitus is an endocrine disease with chronic elevation in
blood glucose levels. If not managed, it can lead to multi-organ damage also diabetes mellitus is a
metabolic disease that is characterized by distortion in the metabolism of carbohydrates, lipids, and
proteins and involves hyperglycemia. Diabetes mellitus has different types. Several complications are
associated with diabetes including diabetic retinopathy.
This study aimed: This study aims to assess the knowledge of diabetic retinopathy and compliance with
diabetic retinopathy patients in Makkah, Saudi Arabia.
Methods: cross-sectional study was conducted among the diabetic population from May to September 2019
in Makkah, Saudi Arabia. The patients were selected randomly from the general population visiting the
Makkah diabetic center and primary healthcare clinics in Makkah. A self-administered questionnaire was
distributed to assess the knowledge of diabetes and its complication diabetic retinopathy. Our total
participants were (300)
Results: Conclusion: The level of knowledge regarding diabetic retinopathy among participants with
diabetes type 2 in Makkah is relatively high. However, participants’ motivation to attend an ophthalmology
clinic for an eye assessment was poor in the study, thus delay early diagnosis and management.