Online ISSN: 2515-8260

Keywords : Hyperglycemia


A Study on Serum Myeloperoxidase, Apolipoprotein B and Glycated Hemoglobin Levels in Type 2 Diabetes Mellitus

Ratna Rajesh Gogulamudi, Laxmi Narayana Sripuram, Sreevani Namani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 864-870

Background: Diabetes mellitus is a clinical syndrome characterized by hyperglycemia
due to absolute or relative deficiency of insulin. Type 2 diabetes (T2D) occurs due to a
progressive decline in the ability of the pancreas to secrete enough insulin as well as
insulin resistance in insulin target tissues. The pathophysiology of T2D is characterized
by excessive accumulation of ectopic fat in the liver, pancreas, and skeletal muscles,
eventually manifesting as insulin resistance in these tissues and pancreatic beta cell
dysfunction that ultimately leads to hyperglycemia.Metabolic abnormalities such as
dyslipidemia, hyperinsulinemia, or insulin resistanceand obesity play key roles in the
induction and progression of type 2 diabetesmellitus (T2DM). Objectives: To estimate
the levels of serum myeloperoxidase, apolipoprotein B and glycated hemoglobin in type
2 diabetic patients and also in healthy controls, to observe the relationship between
serum MPO with apo B and glycated hemoglobin and also between glycated
haemoglobin with apo B in type 2 diabetic patients and healthy controls.
Materials and Methods: Case control study was done taking 30 cases of type 2 diabetes
mellitus and 30 age and sex matched healthy controls. In all the subjects, concentrations
of HbA1c, serum apo B and serum MPO were estimated. HbA1c was measured by
turbidimetric method and serum Apo B by immune turbidimetric method using semi
auto analyser CHEM 5 Plus. Serum MPO was measured by ELISA method using
ELISA reader.

An evaluation of dyslipidemia in type 2 diabetes patients: North Indian teaching hospital based study

Dr. Gautam Gupta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1020-1023

Background:Dyslipidemia was defined as a combination of high serum triglyceride ≥ 1.7
mmol/L, high serum LDL cholesterol ≥ 2.6 mmol/L and low serum HDL cholesterol <
1mmol/L for men and < 1.30 mmol/L for women. Non-HDL cholesterol ≥ 3.37mmol/Land
atherogenic index ≥ 0.11, were also considered abnormalType II diabetes mellitus (T2DM),
characterized by chronic hyperglycemia, and impaired insulin secretion and insulin
resistance. The objective of the present study was to study the lipid profile among type 2
diabetes mellitus patients.
Materials & Methods: The present study was conducted in the department of general
medicine. It comprised of 62 T2DM patients of both genders. Fasting blood sugar and lipid
profile such as serum cholesterol, serum triglycerides, HDL, LDL and VLDL was assessed.
Results and Observations:There were 31 males and females each. The mean serum
cholesterol level was 228.76 mg/dl, serum TG level was 202.6 mg/dl, HDL level was 39.8
mg/dl, LDL was 142.64 mg/dl and VLDL level was 43.5 mg/dl.
Conclusion: The diabetes has a significant role in alteration of lipoprotein levels. There is
significant alteration in lipid profile levels.

Evaluate the spectrums of spinal anaesthesia on perioperative hyperglycemia in diabetic patients undergoing lower limb surgeries

Dr. Harsh Kasliwal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2535-2541

Background: Sympathetic nervous system and hypothalamic-pituitary adrenal axis constitute the efferent pathway of the perioperative stress response. Surgical tissue trauma and stress results in activation of hypothalamic-pituitary adrenal axis, thereby causing release of corticotrophin releasing hormone (CRH) by hypothalamus. Surgery evokes stress response resulting in increased secretion of counter-regulatory hormones (catecholamines, cortisol, glucagon, and growth hormone) and excessive release of inflammatory cytokines, a state of functional insulin deficiency occurs. Hence, diabetic patients undergoing surgery further develop hyperglycemia in the intra-operative and postoperative period. Aims and Objectives: To evaluate the spectrums of spinal anaesthesia on perioperative hyperglycemia in diabetic patients undergoing lower limb surgeries. Materialand Methods: In this study, 62 diabetic (D) patients having preoperative blood glucose between 80 to 120mg/dl, undergoing lower limb orthopaedic surgery, under spinal anesthesia were included. During surgery, blood sugar was measured in capillary blood, using glucometer 10 minutes before initiation of anaesthesia, at time of surgical incision (SI), 30 min after incision and thereafter 1hourly till 4th hour after surgical incision. Statistical analysis was done using SPSS 17.0 software. Results and Observations: In our study Blood glucose (BG) value decreases till 1hr after surgical incision (SI), and then increases till 4th hour after SI. This change in blood glucose values is statistically significant at SI, 2nd hour after SI, 3rd hour after SI and 4thhour after SI. Conclusion: Therefore, hyperglycaemia is very common in surgical patients. Our study demonstrates a linkage between elevated BG and a risk of perioperative complications in diabetic and non-diabetic patients. Spinal anaesthesia blunts surgical stress response and hence, at SI, BG values decrease. But, BG values increase at other times in perioperative period owing to the regression of sensory analgesia.

Diabetic Peripheral Neuropathy: article review

Ghadeer Mohammed Alaidarous, Thamir Abid Y Khayyat, Manal Mohammadsadiq S Qnadeli

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 3369-3381

Diabetic peripheral neuropathy (DPN) is a common complication of both type 1 and type 2 diabetes affecting over 90% of the diabetic patients. Due to the toxic effects of hyperglycemia there is development of this problem. It is classically characterized by significant deficits in tactile sensitivity, vibration sense, lower-limb proprioception, and kinesthesia. Painful DPN has been shown to be associated with significant reductions in overall quality of life, increased levels of anxiety and depression, sleep impairment, and greater gait variability. Hence DPN is often inadequately treated, and the role of improving glycemic control in diabetes. Major international clinical guidelines for the management of DPN recommend several symptomatic treatments. First-line therapies include tricyclic antidepressants, serotonin–noradrenaline reuptake inhibitors, and anti- consultants that act on calcium channels. Other therapies include opioids and topical agents such as capsaicin and lidocaine. The objectives of this paper are to review current guidelines for the pharmacological management of DPN

PREVALENCE OF DIABETES MELLITUS AND HYPERTENSION AMONG PATIENTS UNDERGOING DENTAL IMPLANT TREATMENT - A HOSPITAL BASED ASSESSMENT

Vaishnavi Devi. B Priya lochana Gajendran Delphine Priscilla Antony. S

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3308-3324

The aim of this study is to retrospectively analyse the prevalence of diabetes mellitus and hypertension among patients undergoing  dental implant treatment in a dental hospital. All the patients reported in the month of June 2019 to March 2020 for implant placement was chosen for the study. Implant placement data of patients with diabetes mellitus and hypertension was collected from the dental hospital record system. Result data was tabulated in excel and statistical analysis was done using Statistical Software for the Social Sciences (SPSS) software. The non parametric Chi square test was done for statistical analysis. The prevalence of diabetes mellitus in patients undergoing implant placement is 4.2%, hypertension is 2.2% and coexisting diabetes mellitus and hypertension is 1.7% with a higher incidence in the male population and more common in the age group of 40 to 60 years. Knowledge about the prevalence of these conditions will be helpful to the clinician for proper management setup and precise diagnosis before implant therapy can prevent surgical and postoperative complications resulting in long term success of dental implants

CLINICAL CHARACTERISTICS OF NON-DIABETIC HYPERGLYCEMIA PATIENTS TREATED IN INTENSIVE CARE

Amaliah .; Satriawan Abadi; Andi Makbul Aman; Syakib Bakri; Hasyim Kasim; Khalid Saleh; Himawan Sanusi; Fabiola.M.S. Adam; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2644-2657

Background of study: Hyperglycemia often occurs in critically ill patients even without a history of diabetes. Hyperglycemia, in hospital, according to the American Diabetes Association (ADA) is defined as a condition in which blood glucose levels are ≥140 mg/dl and HbA1c ≤6.5, without any prior diabetes history. Hyperglycemia results from an endocrine and metabolic response to stress. Studies and literature regarding hyperglycemia in non-diabetic patients in Indonesia are deemed limited, especially case studies of non-diabetic hyperglycemia in intensive care and the prevalence of hyperglycemia related to age, sex, metabolic risk (obesity, hypertension, dyslipidemia), history of parenteral nutrition, history of corticosteroids use, and disease diagnosis.
Methods: The present study is a retrospective descriptive study using medical record data of patients at the HCU, ICU, Brain Center, and CVCU PJT Wahidin Sudirohusodo Hospital in August 2020 - October 2020. This study involved 90 non-diabetic subjects in intensive care. The inclusion criteria were based on the ADA criteria for non-diabetic hyperglycemia in the hospital.
Results: This study involved 44 non-diabetic hyperglycemic patients and 46 non-diabetic patients without hyperglycemia with a mean age of 53.5 years in non-diabetic hyperglycemic subjects and 57.7 years old in subjects without hyperglycemia. Non-diabetic hyperglycemia subjects with obesity (34.1%), hypertension (61.5%), and dyslipidemia (46.9%). Subjects with hyperglycemia with a history of corticosteroid use (95%). Based on the diagnosis of the disease when the subject was in intensive care, the subject with a diagnosis of CHD had hyperglycemia (36.8%), stroke with hyperglycemia (58.8%), and other diagnoses (infection, tumor, postoperative, and trauma) accompanied by hyperglycemia (57, 1%).

PREVALENCE OF DIABETES MELLITUS AMONG PATIENTS VISITING DIFFERENT OUTPATIENT DEPARTMENTS(OPDs) OF A PRIVATE DENTAL COLLEGE HOSPITAL, CHENNAI, INDIA - A RETROSPECTIVE STUDY

Vaishnavi Devi. B, Pratibha Ramani, Delphine Priscilla Antony. S

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3300-3316

Diabetes mellitus is a group of physiological dysfunctions characterised by increased blood
glucose level resulting directly from insulin resistance or impaired insulin secretion leading to
micro and macrovascular complications. The oral complications of diabetes mellitus includes
increased incidence of dental caries, dry mouth, burning mouth syndrome and periodontitis.
Assessment of blood glucose levels is essential prior to any specialised procedure to avert any
further oral and systemic complications. Screening of diabetes mellitus condition has become
a necessity in developing countries and study of this nature will have enormous public health
impact. The aim of this study is to assess the prevalence of diabetes mellitus in patients visiting
different outpatient departments of private dental college hospital, Chennai. All the cases
referred from the month of June 2019 to March 2020 for random blood sugar tests were
chosen for the study. Data was collected from the dental hospital record system. Result data
was tabulated in excel and imported to SPSS for correlation and association. P<0.05 was
considered to be the level of statistical significance in this study. Within the limits of the
present study, diabetes mellitus prevalence in random blood sugar tested patients is 33.3 %
with a higher male incidence and more prevalent among the age group of 41 to 60 years.
Knowledge about the prevalence of diabetes mellitus in the patients visiting dental hospital will
be helpful to the clinician to prevent any further complications before any specialised
procedure.

Advanced Glycation End-Products In Diabetes Complications

Anush N; Bineesh C. P.; Jeena Gupta; Pranav Kumar Prabhakar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 2190-2198

Diabetic complications, such as, retinopathy, nephropathy lead to blindness and end stage renal failure respectively, various neuropathies, and ultimately increased mortality. While the exact mechanisms that lie behind the pathological changes associated with diabetes remain obscure, however, it is widely believed that chronic or intermittent hyperglycemia may alter various metabolic pathways at the tissue level, for instance, increased flux through the polyol and the hexosamine pathways as well as a persistent activation of protein kinase C (PKC). Reducing sugars such as glucose and fructose may react non-enzymatically through their carbonyl groups with free amino groups of proteins (commonly the Ɛ amino group of lysine) to form a Schiff base intermediate which then rearranges to a more stable structure known as Amadori product. The Amadori products generated by the aforementioned Maillard reaction may then undergo further reactions, including dehydration, oxidation and rearrangement resulting in the irreversible formation of heterogeneous advanced glycation end products (AGEs)

KNOWLEDGE AND AWARENESS OF DENTAL STUDENTS IN MANAGING HYPERGLYCEMIC PATIENTS INDICATED FOR EXTRACTION

Prabhav Kumar Iyer; Dr. Deepika Rajendaran; Dr. Sarvana Dinesh S.P

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 660-676

Hyperglycemia is a condition in which there is an increase in the blood glucose level of the person. It is one of the most common systemic conditions in middle aged Indians. It is important for a dentist and dental students to be aware of the condition especially while performing invasive procedures as delayed wound healing, coma and hypoglycemic shock are some of the most common complications encountered in some patients. Hence, it is important to know about this condition to prevent any kind of medical emergency on a dental chair. The aim of the study was to assess the knowledge and attitude of dental students while managing hyperglycemic patients indicated for extraction. This study was carried out in a self administered questionnaire format among the students of a dental university. The questionnaire was created on an online platform called “Survey Planet” and was filled by 100 students. The questionnaire consisted of the major aspects of knowledge on hyperglycemia and how students will manage the patient before performing the extraction procedure on them. Based on the tabulated results, it was seen that dental students have greater knowledge towards dealing with hyperglycemic patients indicated for extraction. 64% said that they can perform extraction on a hyperglycemic patient. 93% said that they would test an elderly patient to check their blood glucose level before the procedure. 72% were aware of the management of hyperglycemia. 45% of the participants said that they would do the treatment only after the patient consulted a physician. 11% said that they would deny the treatment. 82% of the participants said that they would keep the appointment for the extraction in the morning. Thus we can conclude that dental students have good knowledge and attitude toward managing hyperglycemic patients indicated for extraction