Online ISSN: 2515-8260

Keywords : HbA1c


Correlation Between Hemoglobin A1c and Serum Lipid Profile in Afghani Patients with Type 2 Diabetes: Hemoglobin A1c Prognosticates Dyslipidemia

Mohammed Asif Shaik, Mohammed Abdul Rafi, Ayesha Abdul Raoof, Abdullah Ansari, Dr. Khuteja Samreen

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2399-2405

Background:Patients with type 2 diabetes (T2DM) have an increased prevalence of dyslipidemia, which contributes to their high risk of cardiovascular diseases (CVDs). This study is an attempt to determine the correlation between hemoglobin A1c (HbA1c) and serum lipid profile and to evaluate the importance of HbA1c as an indicator of dyslipidemia with T2DM.
Materials and Methods: This is a prospective and observational study was accomplished at Tertiary care teaching Hospital over a period of 6 months. Patients of either gender with an established diagnosis of T2DM were selected according to the American Diabetes Association criteria (ADA). These criteria set the following as values that are indicative of T2DM: HbA1C ≥6.5%, FPG ≥126 mg/dl, 2-h plasma glucose ≥200 mg/dl during an oral glucose tolerance test (OGTT), or random plasma glucose ≥200 mg/dl.
Results: Blood glucose level was 149.35 ± 13.23 mg/dl and mean HbA1c was 7.96±1.46. Mean total cholesterol was 179.53±16.36, mean total triglyceride was 183.74±17.64, mean LDL was 105.85±8.50, Mean HDL was 36.94±4.28. HbA1c positively and significantly correlated with total cholesterol (r=0.091), LDL (r=0.013), HbA1c negatively and significantly correlated with HDL (r= - 0.126), and did not show any show correlation with VLDL (r=0.024) and total triglycerides (r=0.103).
Conclusion: Our study accomplished that HbA1c has a direct, significant correlation with total cholesterol, triglyceride, VLDL, and LDL among the lipid profile. Significant positive correlation of HbA1c with lipid profiles from our study results implies that HbA1c can also be used as a predictor of dyslipidemia in addition to as a glycemic control parameter for prevention of complication.

Immunological profile of youth onset Diabetes Mellitus patients

Sanjay Nath Jha, Gopi Nath Dubey, Sushil Kumar, Vinya Nand Jha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 677-683

Background & objectives: There has been a rise in the occurrence of diabetes mellitus
in the youth population of India. There is restricted information accessible on the
immunological profile of youth beginning diabetes mellitus (DM) particularly in type 2.
Hence, this study was embraced to assess the clinical and immunological profile of
youth beginning DM in east India.
Methods: Fifty-one successive patients of 7–36-year-old enough with diabetes mellitus
going to the Darbhanga Medical College Hospital, Laheriasarai were remembered for
the review. All subjects were tried for glutamic acid decarboxylase (GAD), an islet cell
antigen ICA512/IA2, and insulin antibodies. Stray and ICA512/IA2 were finished by
ELISA and insulin autoantibodies were tried by radioimmunoassay (RIA) technique.
These patients were likewise evaluated for hepatitis A to E, cytomegalovirus (CMV) and
Epstein-Barr Virus (EBV) as trigger elements for the beginning of type 1 DM.
Results: Of the total 51 patients, 38 were male and 13 were female. The mean age and
BMI of the subjects were 19.7 (±7) years and 21 (± 5) kg/m2, separately. Twenty
patients were beneath the age of 18 years and their stature was more than 75th
percentile of Indian norms. All patients were indicative and 12 of these gave
ketoacidosis. Just 48% (n=24) were positive for GAD, 14% (n=7) for ICA512/IA-2, and
28% (n=14) were positive for insulin neutralizer. Five of these patients had proof of
hepatitis E virus infection. None of the subjects had proof of dynamic CMV or EBV
infection.

Study of cardiac co-morbidities in newly diagnosed type 2 diabetes mellitus patients with help of 2D echocardiography

Pratik D Modi, Nanda Jagrit, Usha H Patel, Tejas Shah, Jay Mehta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 833-839

Background: Diabetes mellitus is one of the leading cause of multisystem involvement
resulting in significant comorbidities. Various cardiac disorders such as dilated
cardiomyopathy, left ventricular diastolic dysfunction and myocardial infarction have been
frequently associated with diabetes mellitus. Present study was aimed to study cardiac comorbidities
in newly diagnosed type 2 diabetes mellitus patients with help of 2D
echocardiography.
Material and Methods: A prospective observational study was conducted in patients, 18-70
years, of either gender, newly diagnosed Diabetes mellitus type 2 based on Fasting blood
sugar/ Post prandial blood sugar/HbA1c, willing to participate in the study.
Results: Out of 175 patients, 74 patients belonged to age group 51-60, which is the most
commonly affected age group. Out of 175 patients, 109 (62%) patients were male and 66
(38%) patients were females. Most of the patients had HbA1c` in the range of 7-10%, 139
patients (79%), whereas the least number of patients were in the 6.5-7% group, 5 patients
(3%) Most of the patients had normal cardiac diastolic function, whereas only 15 (8%)
patients restrictive filling (grade 3 diastolic dysfunction). Grade 2 and 3 diastolic dysfunction
was more common in a higher age range i.e. 51-60 and >60 years whereas it was absent in
less than 40 year. Diastolic dysfunction was more common in patients having proteinuria
>200 mg/dl, higher serum cholesterol levels, hba1c levels > 10% and in patents having E/e’
ratio higher than 14. 47 patients were systolic dysfunction <50% with hba1c less than 10%,
whereas only 3 patients had EF <50% with hba1c >10%.
Conclusion: Cardiac diastolic dysfunction is observed in patients of diabetes mellitus 2 more
frequently as compared to systolic dysfunction.

A STUDY TO CORRELATE SERUM PROLACTIN LEVELS IN PATIENTS WITH DIABETIC RETINOPATHY

Chandrashekhar K, Mohammad Nizamuddin H Attar , MD Juned, Sushma S Biradar, Mehak Budhiraja, Rajashekhar Dyaberi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5632-5645

Background: Diabetes mellitus is a major medical problem throughout the world. Diabetes
causes an array of long-term systemic complications that have considerable impact on the patient
as well as society, as the disease typically affects individuals in their most productive years.
Objective: To correlate Serum Prolactin levels in patients with Diabetic retinopathy.
METHODS: A total of 189 patients of diabetic retinopathy were enrolled in the study. Details of
their medical and personal history, viz. age at diagnosis of diabetes, duration of the diabetes,
nature and duration of treatment received, glycaemic control and compliance to the treatment were
obtained. The diabetic retinopathy status was classified according to the ETDRS classification
system. RESULTS: A mean HbA1C levels for each grade of DR: in Mild NPDR the HbA1c was
found to be 8.33%, Moderate NPDR was found to be 8.88%, severe NPDR the HbA1c was 9.92%
and for PDR the HbA1c was 11.01%. A mean Serum Prolactin levels for each grade of DR: in Mild
NPDR the serum prolactin levels was found to be 8.76ng/dl, Moderate NPDR 8.57ng/dl, for Severe
NPDR it was 7.28ng/dl, and it was 5.94ng/dl for PDR. A mean duration
of diabetes for each grade of DR: in mild NPDR the mean duration of diabetes was found to be
8.45yrs and in moderate NPDR it was 9.65yrs, whereas in severe NPDR group it was 11.75yrs
and for PDR group it was 12.58 years.
A significant correlation (p < 0.05) was also found between DR and the duration of diabetes as
increasing severity of NPDR and PDR were seen in patients who were diabetic for more than ten
years and statistically significant correlation was found between increasing severity of diabetic
retinopathy and the decreasing levels of serum prolactin.
CONCLUSION: A statistically significant correlation was found between increasing
severity of diabetic retinopathy and the decreasing levels of serum prolactin.

A prospective study on effect of controlled hba1c levels and normotension in the development of diabetic retinopathy in type 2 diabetics

Dr. Chaithra CM, Dr. Kshama K

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1410-1416

Aim: To determine the importance of HbA1C levels and normotension in predicting the development of diabetic retinopathy and the relationship between them.
Method: Prospective clinical study comprising of a group of 125 diabetics above 40 years visiting for routine eye checkup and clinically diagnosed diabetic retinopathy including both out-patient and in-patients at Department of Ophthalmology, KIMS, Bangalore. Men and women >40years with type 2 diabetes mellitus with HbA1C levels <7.5% and non-hypertensives (<140mmHg systolic and <90mmHg diastolic pressure) were included. Patient’s HbA1C levels and blood pressure were measured. The diabetic retinopathy status was classified according to the ETDRS system. Statistical analysis was done.
Results: At 3rd month follow up, the mean HbA1C levels was 7.25±0.22.At the end of 12th month, the mean HbA1C was 7.42±0.11At baseline, in group A 8.8% showed mild NPDR and 1.6% moderate NPDR. At the end of the study it was 8.8% mild NPDR, 1.6% moderate NPDR. No further progression was seen in a year span. All values showed statistical significance and absence of hypertension also goes in favour of mild diabetic retinopathy changes.
Conclusion: HbA1C levels and systemic hypertension are the two major modifiable risk factors in the development and progression of diabetic retinopathy

Prevalence of cardiovascular autonomic neuropathy in type-2 diabetes mellitus and role of corrected QT interval for its diagnosis

Dr. Rambabu Singh, Dr. ArvindKankane,Dr. BasavarajShirol

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1182-1188

The prevalence of cardiac autonomic neuropathy (CAN) in type 2 DM patients increases with
the duration and poor glycemic control. Patients with CAN are at increased risk for
autonomic dysfunction like resting tachycardia,abnormal systolic and diastolic function
leading to syncope and dizziness, prolonged QT interval, silent ischemia/infarction, lethal
arrhythmias and sudden death.Usage of 5 simple and cheap bed side tests for autonomic
function and corrected QT interval from ECG are helpful in early diagnosis of CAN. Early
recognition of CAN is helpful in delaying effects of CAN by strict control of blood sugar and
following healthy life style. Our study was conducted on100known and newly diagnosedType
2 Diabetes Mellitus patients<60 years whopresentedto Medicine OPD and admitted in IPD
wardsin Maharani LaxmiBai Medical College.Out of total 100 patients,49% had normal
score(0,1); 25% had borderline score(2,3,4); rest 26% had abnormal score ≥5; the prevalence
of CAN was 51%.Among 100 patients 47% patients were foundwith poor glycemic control
(HbA1C ≥ 8),in these 17% had early and 21% had definite CAN. Out of 100 patients of the
study, 55% patients had QTc>440ms out of which 17% had early and 23% had definite CAN.
The CAN also increased with older age group. So it is important to diagnose CAN early in
asymptomatic diabetics. There is significant correlation between CAN and QT prolongation.
QT interval in ECG can be used to diagnose CAN with reasonable sensitivity and specificity.
Usage of 5 bedside autonomic function tests are very helpful in early diagnosis of CAN.Strict
control of blood sugar can delay the early development of CAN. Intensive control of blood
sugar can delay the early development of CAN.

Correlation between sensorineural hearing loss and HbA1c in diabetes mellitus patients

Rukmini Sharma,Dr. Raghuveer Choudhary, Dr. Rajendra K Teharia

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 958-963

Diabetes mellitus is a non-communicable chronic metabolic disorder. The association
between sensorineural hearing loss and diabetes has become an important subject of research.
Pathophysiology of hearing loss in diabetes is not still well explained. Usually gradual,
bilateral, sensorineural hearing loss at high frequency is seen in diabetes mellitus. Our study
aims to know the prevalence of SNHL in DM and its relation to HbA1c. A total of 300
subjects including 150 healthy individuals age and sex matched as control and 150 patients of
type 2 diabetes between 10-50 years age group including 78 males and 72 females were
included in the study. Fasting blood sugar and HbA1c of all the subjects were taken for the
study and after that pure tone audiometry was performed (PTA). By observing the data
degree, type and correlation with HbA1c of hearing loss was concluded. 28% diabetic
patients suffered with SNHL while 72% were found with normal hearing threshold. Among
42 patients 23 mild, 9 moderate, 9 moderately severe and 1 severe degree hearing loss cases
were found in diabetic group. Hearing loss was found on higher frequencies. Association
between hearing loss and HbA1c was observed and it was highest in the 10-13.9% range but
this correlation was not found significant (p value >0.05) in our study.

Mucormycosis in COVID: A pandemic induced epidemic in World’s diabetic capital

Dr Fayaz A. Wani, Dr Ishan Tikoo, Dr Aashish Mahajan, Dr JB Singh, Dr Deepika Dewan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1051-1058

Background: Mucormycosis is a rare disease of immunocompromised adults largely
restricted to the diabetic community with uncontrolled hyperglycaemia. In the second
wave of Covid, in multiple cities over the Indian Peninsula, this much dreaded “black
fungus” has afflicted many individuals who suffered from covid or were recovering
from it.
Aim: To establish the risk factors, clinical presentation, diagnostic sensitivities,
radiological survey of different types of mucormycosis in SARS Cov 2 patients.
Methods: Seventeen patients with covid infection admitted in tertiary care hospital with
diagnosed mucormycosis between Nov 2020 to June 2021 via histopathological or
culture confirmation. This is a cross-sectional observational study where detailed
assessment of clinical profile, biochemical markers and sensitivities of diagnostic
procedures was done. The data then collected and was made into a master chart and
subjected to statistical analysis. Fischer exact test was used for statistical anaylsis.
Result:In total of 17 patients,mean blood glucose levels were compared at the onset of
symptoms of covid and mucormycosis werestatistically significant with (P=0.001). Out
of 17 patients, 11 were rhino-orbital mucormycosis, four had rhino-orbito-cerebral
mucormycosis and 2 had pulmonary mucormycosis.HbA1c >8 had significant
correlation(P=0.009) with rhino-orbital and rhino-orbito-cerebral mucormycosis
whilehigher total dosage of steroids was associated with pulmonary mucormycosis (P=
0.015. Sensitivity of culture was 64.7% in our study while histopathology was
considered gold standard.
Conclusion: Our study shows strong correlation between the long term as well as short
term glycaemic control with the onset of rhino-orbital mucormycosis while dosage and
duration of steroids with pulmonary mucormycosis.

The Compatibility Of Hba1c And Glycated Albumin Levels As Markers For Blood Glucose Follow-Up In Type 2 Diabetes Mellitus

Edward Kurnia Setiawan Limijadi; Ivan Kurniawan Effendy

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2312-2318

BACKGROUND: Diabetes mellitus (DM) is a group of metabolic diseases, characterized by hyperglycaemia that occurs due to abnormalities in insulin secretion. Uncontrolled diabetes will lead to the development of further complications. HbA1c level measurement is the current gold standard for monitoring glucose levels in DM patients. Glycated albumin (GA) is a fructosamine formed through a non-enzymatic glycation process. There are still few studies on the correlation between HbA1c and GA levels in T2DM patients. Therefore, we decided to investigate the correlation between HbA1c and GA levels in T2DM patients.
OBJECTIVE: To determine the correlation between HbA1c and GA levels in T2DM patients.
METHODS: This study was an observational study with a cross-sectional design conducted on 69 T2DM patients at Diponegoro National Hospital from June to August 2020. We collected data consisting of age, weight, blood pressure, waist circumference, HbA1c and GA levels. We measured HbA1c levels using I-chroma Boditech tool with the enzyme-linked fluorescent assay (ELFA) method, and GA levels using the Architect C8000 tool with an enzymatic method. Finally, we performed statistical analysis using Spearman's correlation test.
RESULTS: The median ± SE values of HbA1c and GA levels were (7.1 ± 0.19%) and (21.2 ± 0.85%), respectively. The Spearman's correlation test results between HbA1c and GA levels were p <0.001; r = 0.775.
DISCUSSION: Maintenance of blood glucose levels in the body is essential for T2DM patients. HbA1c and GA levels can be used for clinical evaluation of T2DM patients.
CONCLUSION: There was a strong significant correlation between HbA1c and GA levels in T2DM patients. HbA1c and GA levels can be used for clinical evaluation of DM patients according to the patient's condition.

Effect of Diabetes Mellitus Patient Adherence in Following Prolanis Activities on HbA1C Profile at UPTD Puskesmas Nursing Ngletih Kediri

FidiSetyawan .; Hanik Mariana Dewi; Sri Rahayu D.P; ArifWijayanto .; Nur Wijayanti; Hanie Kusuma Wardani

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 5, Pages 935-941

Diabetes Mellitus (DM) is a chronic disease that has become a major health problem in Indonesia. The Chronic Disease Management Program (Prolanis) developed by BPJS Kesehatan in collaboration with First Level Health Facilities (FKTP) seeks to promote and prevent DM disease control. Efforts made include controlling the glycemic index to prevent microvascular and macrovascular complications that may occur with activities including medical consultation, counseling, home visits, club activities, and monitoring of health status. Aim : The purpose of this study was to analyze the effect of DM patient adherence in participating in Prolanis activities on the patient's HBA1C profile. Method:This study is an analytical study using a retrospective cohort design. The research data is secondary data obtained from the Medical Records of DM patients from January-April 2019. The research subjects were 42 DM patients who were registered as active Prolanis participants who had HBA1C data at the April 2019 examination. Result: The results of this study showed that the mean HBA1C value in 22 patients who routinely followed prolanis activities (7.2 ± 1.48)% was more controlled than the mean HBA1C in 20 patients who did not routinely participate in prolanic activities (9.27 ± 2.06)% . Conclusion: From this study it can be concluded that there is a significant difference between DM patients who adhere to the schedule of prolanis activities and patients who do not comply with the schedule of prolanist activities at the UPTD Puskesmas Nursing Ngletih Kediri City with a value of p = 0.001 (p <0.05; CI = 95% )

Effect Of Diabetes Mellitus Patient Adherence In Following Prolanis Activities On Hba1c Profile At UPTD Puskesmas Nursing Ngletih Kediri

Fidi Setyawan; Hanik Mariana Dewi; Sri Rahayu D.P; Arif Wijayanto; Nur Wijayanti; Hanie Kusuma Wardani

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 4624-4639

Diabetes Mellitus (DM) is a chronic disease that has become a major health problem in Indonesia. The Chronic Disease Management Program (Prolanis) developed by BPJS Kesehatan in collaboration with First Level Health Facilities (FKTP) seeks to promote and prevent DM disease control. Efforts made include controlling the glycemic index to prevent microvascular and macrovascular complications that may occur with activities including medical consultation, counseling, home visits, club activities, and monitoring of health status.
Aim : The purpose of this study was to analyze the effect of DM patient adherence in participating in Prolanis activities on the patient's HBA1C profile.
Method:This study is an analytical study using a retrospective cohort design. The research data is secondary data obtained from the Medical Records of DM patients from January-April 2019. The research subjects were 42 DM patients who were registered as active Prolanis participants who had HBA1C data at the April 2019 examination.
Result: The results of this study showed that the mean HBA1C value in 22 patients who routinely followed prolanis activities (7.2 ± 1.48)% was more controlled than the mean HBA1C in 20 patients who did not routinely participate in prolanic activities (9.27 ± 2.06)% .
Conclusion: From this study it can be concluded that there is a significant difference between DM patients who adhere to the schedule of prolanis activities and patients who do not comply with the schedule of prolanist activities at the UPTD Puskesmas Nursing Ngletih Kediri City with a value of p = 0.001 (p <0.05; CI = 95% )