Online ISSN: 2515-8260

Keywords : rural setting

Association of autonomic imbalance with cardiovascular risk in diabetic patients of a tertiary care setting: An observational study

K Amrutha, Dr. JM Harsoda

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3624-3627

Background and Aims: The significant and rising incidence of type 2 diabetes and the associated vascular complications have been a growing concern. Cardiovascular complications are neglected and are the leading causes of deaths in the diabetic population. Autonomic Imbalance (AI) is a bother complication of the diabetes mellitus, related to aggravated risk of morbidity as well as mortality. Nevertheless, there are not many studies assessing this relationship and there are no studies especially of rural setting, hence we have undertaken this study for assessing the need of this association from an Indian rural setting.
Methods: A detailed questionnaire including the socio-demographic details, anthropometric data, history, clinical examination, investigations performed, and treatment undergoing was gathered from each patient. Special attention was extended for identifying the cardiovascular risk factors like hypertension, alcohol intake or smoking, family history of cardiovascular disease (CVD), Heart rate, etc.
Results: Autonomic Imbalance have been studied among the 158 diabetic patients, of which the mean age was 58 years, with male preponderance of around 58%. Good Glycaemic control was observed in one-fourth (40 patients) and 102 out of 158 of the study participants (type 2 diabetics) were hypertensives.The prevalence of autonomic imbalance identified using tests for autonomic function ranges from 50-70%, where the diagnosis of autonomic imbalance is achieved based on the outcomes of multiple autonomic tests with various components instead of a single test. The prevalence of autonomic neuropathy was on the rise as people got older.
Conclusions: Screening for autonomic function and the patient education could be the key factors among the patients with autonomic imbalance in order to prevent devastating events further.

A study to evaluate the association of HBA1C and Cardiovascular functions among the diabetic and non-diabetic population of a rural setting

K Amrutha, Dr. JM Harsoda

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3628-3633

Introduction: Diabetes Mellitus (DM) has been progressively growing in prevalence over time, with overall annualised incidence rates per 1000 people rising from 3.0 in the 1970s to 5.5 in the first decade of the 2000s. This alteration resulted in an 83.3 percent rise in the incidence of T2DM, which was higher among males when compared with females.
Materials and Methods: This a prospective observational study undertaken at a rural tertiary care setting where two patient cohorts are made, one with diabetic patients and other with non-diabetic age and gender matched individuals. The study population (Cohort A) consisted of patients with type 2 diabetes attending the Medicine and Cardiology departments from January 2019 to February 2020. The Cohort B included age and gender matched non-diabetic individuals who are the relatives and attending staff of the patients and the working staff of the hospital.
Results and Discussion: HbA1c levels of 6.5 percent or higher in diabetics were linked to an elevated risk of cardiovascular disease. Glycosylation of haemoglobin may also affect RBC membrane lipid protein interactions, increasing internal viscosity, altering the viscoelastic properties of erythrocyte membranes and lowering RBC deformability.
Conclusion: HbA1c may be a valid predictor of cardiovascular mortality and morbidity in diabetics. The data of our study suggest that the healthcare professionals must appraise the values of HbA1c in assessing the cardiovascular risks and outcomes in the diabetes patients.