European Journal of Molecular & Clinical Medicine

Diabetes mellitus is a disease that occurs due to the partial or complete dysfunctioning of the pancreas, thereby reducing the amount of insulin secretion in the body. Type II diabetes mellitus is commonly seen in the middle age group individuals, and can lead to a variety of systemic consequences involving multiple systems. One of the known complications of diabetes mellitus is hearing loss and tinnitus. The degenerative process, owing to type II diabetes mellitus affects the microvasculature of the hearing apparatus, the cochlea and the cochlear nerve

Background: Magnesium deficiency at cellular level alters the membrane-bound Na+ K+ AT Pase activity, which is essential for maintenance of sodium and potassium gradients in the transport of glucose. Hypomagnesemia has been linked with defective activity of tyrosine kinase which leads to impaired sensitivity of insulin receptors and exacerbates the insulin resistance among type 2 diabetics. This study was conducted to study serum magnesium levels and HbA1C levels in Type 2 DM patients and to study correlation between serum magnesium levels and HbA1C levels in Type 2 DM patients.
Methodology: This study was conducted as cross sectional study on diabetic patient reporting to medicine department during the study period of 18 months. Detailed history was obtained and clinical examination was done. CBC, FBS, PPBS and serum magnesium assessment was done in each patient.
Results: The present study was conducted on a total of 125 cases of type 2 diabetes mellitus with mean age of 57.82±10.14 years. Mean HbA1c in diabetic patients was 8.2±1.5% and majority of cases had serum magnesium levels above 1.6 mg/dl. Hypomagnesemia was significantly associated with increase fasting as well as post prandial blood glucose level (p<0.05). We observed a statistically significant very strong negative correlation of serum magnesium levels with serum HbA1c (r=-0.808, p<0.05) i.e. as the HbA1c increased, serum magnesium levels decreased significantly (p<0.05).
Conclusions: Hypomagnesemia is one of the common findings in patients with type 2 diabetes mellitus. Poor glycemic control as evidenced from increased FBS, PPBS and HbA1c have been associated with lower serum magnesium levels. As hypomagnesemia is linked with poor glycemic status, it may predict the complications among diabetic patients. It is recommended that serum magnesium levels must be monitored routinely in patients with diabetes as magnesium supplement may help in providing better glycemic control and preventing or delaying the progression of complications

Background:  A persistent metabolic syndrome is diabetes mellitus marked mostly by chronic hyperglycemia. Recently,it is considered as state of prothrombosis,characterized by abnormalities in platelet function which has been recognized as a component of the metabolic syndrome. Aims are made to discover and demonstrate the utility of various blood tests, including platelet indices for the early diagnosis of diabetic problems.  Increased platelet activity  has a role in development of diabetic complications, thus platelet volume indices are considered as potential biomarkers in diabetics who have vascular issues.
Methods :  356 people with diabetes and 201 non-diabetics participated in the study. To perform a complete hemogram, a Sysmex KX-21 automatic blood counter and a Benesphera H51 coulter were used. From the records of the Central Clinical Laboratory, the HbA1c level was assessed using the immunoturbidometric inhibition technique. The statistical analysis was carried out using SPSS version 17 (Statistical Package for the Social Sciences) (Chicago, IL). Student's t-test was used to determine if there was a significant difference in HbA1c, PC, MPV and  PDW. Statistics were judged significant at P 0.05.
Results :  In our study, MPV and PDW was statistically significant in diabetic patients with complications (P<0.0001 and P=0.0001respectively). A positive correlation was seen between MPV and HbA1c. While  MPV was statistically significant in diabetic retinopathy, nephropathy, and diabetic foot, PDW was statistically significant in diabetic retinopathy and nephropathy.
Conclusion : An effective predictor of diabetic cardiovascular issues would be MPV. Additionally, we found a direct correlation between an increase in MPV and a rise in HbA1c levels. Therefore, we propose that MPV can be used as a simple and low-cost method to monitor the onset and control of Diabetes Mellitus and its cardio-vascular effects.

Background: The Iron deficiency anemia is the most common form of anemia in India. Hemoglobin A1c (HbA1c) is used in diabetic patients as an index of glycemic control reflecting glucose levels of the previous 3 months. Like blood sugar levels, HbA1c levels are also affected by the presence of variant hemoglobins, hemolytic anemias, nutritional anemias, uremia, pregnancy, and acute blood loss. We conducted a study to find out the influence of iron deficiency anaemia over HbAc levels.
Materials and Methods: A prospective observational study on 50 iron deficiency anaemia patient cases and 50 healthy control. Exclusion and inclusion criteria were used to recruit cases from the wards and OPDs of the hospital IN IGIMS Patna. HbA1c levels were measured at baseline and 3 months after treatment, and these values were compared with those in the control population.

Diabetes mellitus is characterized by chronic hyperglycaemia with disturbances in carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or both. Dyslipidaemia in diabetes commonly manifests as raised low-density lipoprotein cholesterol (LDL-C), decreased high-density lipoprotein cholesterol (HDL-C) levels or elevated triglyceride (TG) levels. Many studies have proposed HbA1c to be used as a biomarker of both glycaemic control and dyslipidaemia in type 2 diabetes mellitus. Study aimed to observe the lipid profile in type 2 diabetes mellitus patients and to find out the correlation between glycated haemoglobin (HbA1c), FBS and lipid profile in type 2 diabetes mellitus patients.

Red cell distribution width (RDW) have been found to be altered in uncontrolled diabetic patients because of consistent increase in HbA1c values that are known to induce functional and structural changes in Hb and an alteration in its cytoplasmic environment. Alteration in RDW may have a role in the diagnosis and monitoring of glycemic status along with its complications.
Objective: Present study aims towards analysis of correlation of red cell distribution width with HbA1c in T2DM patients.
Methodology: Present study was a case control study in which total 50 cases and 50 controls were recruited. Controls were the healthy non-diabetic patients and cases involved patients with diabetes. Patients were categorized as diabetic and non-diabetic as per American Diabetes Association Diagnostic Criteria. 3ml blood sample was obtained to analyze the RDW and HbA1c.
Results: The mean age of patients was 59.54±10.78 in the cases and was 55.40±15.63 in control group. The mean HbA1c was 10.79±2.45 was significantly high in cases compared to 5.59±0.31 in controls. The mean RDW was 13.69±1.31 in cases and 13.40±1.17 in controls which do not differ significantly. In diabetes patients, a non-significant positive correlation was observed between the HbA1c and RDW with the correlation coeffect of 0.027.
Conclusion: In present study, a non- significant correlation was observed between the RDW and HbA1c in diabetes patients. A multicentric study with a large sample size is required to establish diagnostic significance of RDW in diabetes patients.

Background: Several studies undertaken in different parts of the world have shown that hypomagnesemia occur at an increased frequency among patients with type 2 diabetes compared with their counterparts without diabetes. As current data suggest adverse outcomes in association with hypomagnesemia, it is prudent to monitor magnesium routinely in this patient population and treat the condition whenever possible. Therefore, this study was undertaken to determine the serum magnesium levels in type 2 diabetes in this part of our country. Aim & Objective: 1. Serum magnesium level in type 2 Diabetes mellitus and its relationship with glycemic control and diabetic complications.2. To study Clinical profile of type 2 DM. 3. Correlation of Serum magnesium level in type 2 DM with glycemic control and complications. Method: Study design:  Case control study. Study setting:  Department of Medicine at tertiary care centre. Study duration: January 2021 to December 2021. Study population: The study population included 50 diabetics without complications (group I), 50 diabetics with complications (group II) and 100 normal healthy controls (group III). Sample size: 100. Results: Serum magnesium levels were found low in study group as compared to control group. A significant correlation between HbA1C and magnesium levels was seen. The patients with diabetic complications have significantly higher values of serum cholesterol and triglycerides. Conclusions: Hypomagnesemia in type 2 diabetes was associated with poor glycemic control and with increased frequency of long-term complications.

Diabetes mellitus has been described as the most common endocrine disorder that impairs glucose homeostasis resulting in severe complications. Chronic hyperglycemia in diabetic patients is associated with long term damage, dysfunction and eventually the failure of organs, especially the eyes, kidneys, nerves, heart and blood vessels.
Currently, there is a renewed interest in the plant based medicines. One such herbal drug, Aloe Vera used for different clinical purposes claimed for its effect on blood glucose levels.
Total of 240 type 2 diabetes mellitus patients were enrolled and allocated to four groups viz. A, B, C and D. Group A and C will be given conventional anti-diabetic agents, however Group B and D in addition to anti-diabetic agent, Aloe Vera will be given as add on therapy.
While assessing the results and comparing the overall degree of glycaemia control between group A & B, a significant (p<0.004) difference with mean fasting and mean PP blood glucose (p<0.001) were observed. Similarly comparing the overall degree of glycaemia control between group C & D, a significant (p<0.004) difference with mean fasting and mean PP blood glucose (p<0.000) were observed. A significant difference between mean HbA1c recorded before and after the treatment in the groups were treated with Aloe Vera as add on therapy with conventional antidiabetic drugs.
The study concluded that the subjects who were treated with Aloe Vera as an add on therapy with conventional antidiabetic drugs has comparatively produced better clinical outcome in terms of glycaemia control and lower incidence of complications.

Background: Patients with diabetes mellitus (DM), have  poor long term glycaemic control,  even when fasting glucose concentrations are normal.^{3, 4}, Glycosylated haemoglobin (HbA1c) is a useful index of glucose intolerance and hyperglycaemia.HbA1cis an established marker of long-term glycaemic control. HbA1c can be assessed in the non-fasted state and has higher reproducibility than fasting glucose
Aim of the study : To study the blood levels of HbA1C in patients of Acute Coronary Syndrome at the time of admission and to find out the correlation with the angiographic pattern.
Materials and methods :Cross sectional study was conducted in the Department of general medicine, at Sundaram Arulrhaj Hospitals Tuticorin, Tamil Nadu in Patients with a confirmed diagnosis of Acute Coronary Syndrome .
Reslts : Among the people with SVD,18 (100%) participants had<6.5% HbA1c, 27 (56.25%) participants had 6.5-8.5 HbA1c and 8 (36.36%) participants had 8.5 – 10.5 HbA1c. Among the people with DVD,16 (33.33%) participants had 6.5-8.5 HbA1c, 10 (45.45%) participants had 8.5 – 10.5 HbA1c and 3 (25%) participants had >10.5 HbA1c. Among the people with TVD,5 (10.41%) participants had 6.5-8.5 HbA1c, 4 (18.18%) participants had been with 8.5 – 10.5 HbA1c and 9 (75%) participants had>10.5 HbA1c
 
Conclusion : Our data suggest that HbA1c level is a significant and independent maker for the severity of angiographic lesion in ACS patients, irrespective of other cardiovascular risk factors, age, and gender, smoking, alcoholism. HbA1c values can be a predictor of the prevalence of complex coronary artery lesions.  It may be used as a cardiac marker in risk stratification of the patients presenting with acute coronary syndrome and indicated for coronary angiography.HbA1c levels are also to be included in investigations apart from routine Blood sugar  levels  in Out Patient Clinics and adoption of lifestyle changes & medications are to be taken to prevent the cardiovascular complications and morbidity from Diabetes mellitus.

Aims and objectives: The present study was conducted to study the prevalence of anemia in mild, moderate and severe degrees of hyperglycemia in type II Diabetes Mellitus, to study the Association of CRP with levels of HbA1c in type II Diabetes Mellitus, to study the Association of CRP with degree of Anemia and to compare the hematological parameters (Hb%, MCV, CRP) among the patients of type 2 diabetes mellitus with HbA1c levels below 6.5% and above 6.5%.
Results: Mild anemia was 57%, moderate anemia was 31% and severe anemia was 12%. Higher infection (>6) CRP has higher HbA1c (15) level and was statistically significant. Comparison of anemia with CRP and HBA1C were showed statistically significant results. Hematological parameters (Hb%, MCV, CRP) were statistically significant among the patients of type 2 diabetes mellitus with HbA1c levels. Lower HbA1c level (<6.5) was showed higher Hematological levels. (Hb%, MCV, CRP)
Conclusion: Prevalence of anemia was found significant with increasing severity of hyperglycemia and higher incidence of anemia is likely to occur in patients with poorly controlled diabetes. Our study indicates lower levels of CRP can be achieved with better glycemic control. Further good glycemic control in diabetes mellitus is associated with better hemoglobin levels and a lesser incidence of anemia

Aim: To study symptomatic and asymptomatic urinary tract infections in patients with diabetes mellitus.
Materials and Methods: The current prospective observational research was carried out on one hundred patients with confirmed diagnoses of diabetes mellitus admitted to the Medicine Dr DY Patil Medical College Hospital and Research Centre in Pimpri, Pune, from October 2020 and September 2023. After receiving approval from the institutional ethics committee, the research was carried out. Every patient had a thorough physical examination and complete history taking in accordance with the proforma. All of the collected information was input into a spreadsheet (Microsoft Excel 2010) and then transferred to the data editor in SPSS 20. (SPSS Inc., Chicago, Illinois, USA).
Results: The prevalence of symptomatic UTI in the study population was 34% and asymptomatic UTI was found prevalent in 66% of the study subjects. The average age of the subjects with symptomatic UTI was 46.32 years and asymptomatic UTI was 52.16 years. Majority of the subjects in both the groups showed HbA1c levels ≥7 (69%) and rest (31%) showed levels below 7. Bacterial culture report showed that E. Coli was found more prevalent in both groups (52%) followed by K. Pneumoniae (14%), Pseudomonas (3%), Coagulase Negative Staphylococcus (2%), Enterococcus Spp. (2%) and P. Rettgeri (1%).
Conclusion: The study indicated that the presence of prior urinary tract infections and inadequate Glycemic control were significant contributors to the high prevalence of urinary tract infections among the study population.

Diabetes mellitus found to be leading cause of mortality and morbidity in worldwide in the future and it is a predisposing factor for cardiovascular disease. End stage renal disease, adult blindness, lower extremity amputation (non-traumatic) are the leading causes in diabetes mellitus. Diabetes mellitus is one of the most common health problems facing mankind and is a major public health problem. Randomly selected 100 patients, both male and female with type 2 diabetes mellitus above age of 40 years including newly diagnosed diabetics attending hospital were included in this study. Among the study group of 100 patients 46% patients had hypertension and 10% had ischemic heart disease. Among the study group of 100 patients 48% had positive family history and 52% had negative family history. Among the study group 100 patients 5% had HbA1C less than 6, 56% had between 6-7.5 and 39% had HbA1C above 7.

Background: Diabetes mellitus is a metabolic disorder distinguished by chronic hyperglycaemia resulting from defects in insulin secretion, insulin action, or both. Cardiovascular diseases (CVDs)-majorly coronary artery disease (CAD), heart failure (HF), and stroke are the major cause of death and disability in patients with type 2 diabetes mellitus (T2DM). The aim of the study was to asses cardiac co-morbidities in newly diagnosed type 2 diabetes mellitus with the help of echocardiography at a tertiary hospital.
Material and Methods: Present study was single-center, cross-sectional, observational study conducted in newly diagnosed patients of type 2 diabetes mellites (diagnosed in last 3 months), clinically asymptomatic, blood pressure <130/80mmHg, with normal ECG, underwent, conventional 2 D echocardiography.
Results: In present study, 60 asymptomatic type 2 diabetes mellitus patients underwent 2-D echocardiography, majority were male (73.33 %) as compared to females (26.67 %). Most common age group was 41-50 years and 51-60 years (26.66 % each), followed by 31-40 years (21.67 %). On 2-D echocardiography, diastolic dysfunction was noted in 10 patients (16.67 %). Grade I, II and III diastolic dysfunction was noted in 10 %, 5 % and 1.67 % patients respectively. Reduced early mitral inflow velocity was noted in 7 cases (11.67 %) and mitral annular early diastolic velocity was noted in 11 cases (18.33 %). As HbA1c increases, severity of left ventricular diastolic dysfunction increases, difference was statistically significant. We noted a statistically significant difference in values of age (years), BMI (kg/m2), FBS (mg/dl), PPBS (mg/dl) and HbA1c (%) between patients with LVDD and patients without LVDD. Conclusion: 2D Echo is recommended for screening for cardiovascular abnormalities in newly diagnosed type 2 diabetes melites patients to prevent further progression to symptomatic cardiovascular abnormalities. 

Introduction: Nonalcoholic fatty liver disease (NAFLD) prevalence is high, especially in patients with obesity and type 2 diabetes, and is expected to rise steeply in the coming decades. Objective:  We estimated NAFLD prevalence in patients with type 2 diabetes and explored associated characteristics and outcomes.
 
Material and Method: This is a prospective and cross-sectional study was conducted in the Department of Medicine at Tertiary care Teaching Hospital over a period of 6 months. The study population comprised of male and female patients who were diagnosed as having type 2 diabetes mellitus based on their fasting and random blood sugar levels. Frequency and percentages were calculated for categorical variables like sex and non-alcoholic fatty liver diagnosed on abdominal ultrasound. Non-alcoholic fatty liver was stratified among the age, sex and duration of type-2 diabetes mellitus to see the effect modifiers.
 
Results: Out of 320 participants, 200 patients (62.5%) had NAFLD on ultrasound. A total of 320 participants were enrolled for the study, of whom there were 140 (43.75%) males and 180 (56.25%) females. The mean age and mean duration of T2DM are presented. Overall, NAFLD was present in 200 (62.5%) study participants. Moreover, patients having NAFLD were compared with patients having no ultrasonographic evidence of NAFLD. There was no statistically significant difference between the two groups regarding mean age and gender distribution. Though, there was a statistically significant difference amongst the two groups in terms of HbA1c, triglycerides, total cholesterol, LDL and HDL cholesterol and serum uric acid.
 
Conclusion: This study reported an increased frequency of NAFLD in our diabetic population and evaluated in depth the risk factors associated with NAFLD, underpinning the significance of carrying further large-scale studies to assess the effects of lifestyle modification in the form of physical activity and dietary modifications on the status of NAFLD and glycemic control. Taking in to account the results of this study, patients and their treating physicians should emphasize on the modification of the associated factors and it is also advisable to screen diabetic patients for this condition in routine clinical practice. Early detection and timely management will help promote healthy lifestyle and prevent long term complications of the condition

Aim: The purpose of the present research was to assess the prevalence of cardiac risk factors in case of diabetic patients.
Methodology: We conducted a cross-sectional study that included 800 patients with type 2 DM. We classified the participants into three groups according to the hemoglobin A1c (HbA1c) levels. We assessed the prevalence of other cardiovascular risk factors and their association with HbA1c levels through a detailed history, full clinical examination, and laboratory tests.
Results: We found that 75% of the participants were males, 25.5% elderly, 60.25% had hypertension, 60.75% had dyslipidemia, 33.25% were overweight or obese, 19.75% had a family history of coronary artery disease (CAD), 55.75% had established CVD, 42.5% were smokers, and only 12.25% were physically inactive. We found that 84% of the participants had ≥ two cardiovascular risk factors other than DM. HbA1c level was ≥ 7% in 77% of patients. After multivariate regression analysis, we found a significant association of higher systolic blood pressure (BP), more elevated diastolic BP, higher body mass index (BMI), increased waist circumference, old age, long duration of DM, and an increase in the number of clustered CV risk factors with a higher HbA1c level. At the same time, insulin therapy was significantly associated with a lower HbA1c level.
Conclusion: All type 2 diabetic patients in Upper Egypt villages have other associated CV risk factors. The clustering of cardiovascular risk factors showed a significant association with higher HbA1c levels. These findings require the thought of associated CV risk factors in choosing medical treatments to optimize glycemic control and multifactorial intervention to improve CV risk

Introduction: Diabetes Mellitus (DM) is a complex, chronic illness requiring continuous medical care with multi factorial risk reduction strategies beyond glycemic control. Globally, the prevalence is expected to further increase to 9.9% that reflects a population of 628.6 million people by the year 2045. To assess the prevalence of diabetes related distress (DRD) among Type 2 diabetics.
 
Material and Method: This was a prospective, observational and descriptive study conducted in the Department of Medicine at Tertiary Care Teaching Hospital over a period of 1 year among T2DM patients who were seen and followed up. Patients who were at least 18 years old, and had all recent laboratory results were included in the study. Patients with T1DM, and those who had untreated hypothyroidism, gestational diabetes, cancer, mental retardation, and psychiatric illness, were excluded from the study.
 
Results: A total of 100 subjects were screened (69 males and 31 females). Their demographic and clinical data are presented. The subjects were aged 35–85 years with a mean ± SD of 50.5 ±8.0 years. The mean age for subjects with T1DM was 51.25±9.36 years and for those with T2DM 50.41±0.642 years. Average scores for T1DM were DDS-2, 3.9 ± 1.3 and DDS-17, 3.0 ± 1.0 and for T2DM, DDS-2, 2.4 ± 1.1 and DDS-17, 1.8 ± 0.8. Scores for the different parameters of distress were graded in terms of severity. DD (score ≥2 or moderate to severe distress) was present in 70.0% for DDS-2, 49.0% for DDS-17, 56.0% for EB, 13.0% for PRD, 51.0% for RRD, and 41.0% for ID.
Conclusion: Among type 2 diabetes patients, diabetic distress is a serious problem and needs to be addressed for better glycemic outcome. Among type 2 diabetes patients, diabetic distress is a serious problem which affects their living. It is necessary as clinicians to address diabetic distress in the patients for better glycemic outcome.

Background: Diabetes mellitus type 2 (DMT2) is one of the most prevalent endocrine
illnesses, affecting about 135 million individuals globally. The disease's genesis is
unknown, but subclinical hemochromatosis has recently been identified as one of the
possible causes of DM. The purpose of this study was to look at the association between
serum ferritin as a measure of iron excess and diabetes and HbA1c.
Methods: This 12-month study was carried out in the Medicine department of Katihar
Medical College Hospital in Bihar, India. 46 patients with T2DM were used as cases in
this case control study. The control group consisted of 46 healthy individuals who were
age, gender, BMI, and haemoglobin percent matched to the case group. Blood samples
were tested for ferritin, haemoglobin, HbA1c, and fasting plasma sugar. Anaemia and
any other ailment or medicine that could alter ferritin levels were exclusion criteria.
Result: The Pearson correlation coefficient test, Student's t-test, Chi-square test, and
Odds ratio were used to assess the results statistically. Diabetics had considerably
higher mean serum ferritin levels than the control group (197.97± 75.99 gm/L vs. 64.24±
27.83 gm/L, p<0.001). In diabetic patients, there was a substantial positive connection
between HbA1c and serum ferritin (p<0.001). In this investigation, an OR of 11.64 was
also discovered.
Conclusion: Serum ferritin levels are associated with T2DM patients. This could be a
significant and independent predictor of the development of diabetes mellitus

Aim: To correlate between the severity of diabetic peripheral polyneuropathy and glycosylated hemoglobin (HbA1C) levels.
Material and method: The present prospective observational study was conducted to evaluate the type 2 DM with peripheral neuropathy patients from December 2020 to August 2022. 100 subjects having age > 18 Years, patients diagnosed for DPN by clinically (DNS >=1)/ by electro diagnostic testing (in selected cases) were included in the study. HbA1c levels were assayed using Biochemical method. Severity of DPN Categorized By Neuropathy Disability Score (NDS).
Results: Hypertension and cardiovascular disease was revealed in 14.17% and 6.67% of the subjects respectively. NDS score viz. mild, moderate and severe deficits was found among 13%, 68% and 19% of the subjects respectively. Mean HbA1c level increases along with increase in NDS score i.e., higher the deficits, more is the HbA1c.
Conclusion: It can be concluded that increased HbA1c level indicative of chronic hyperglycemia, could significantly increase the risk and quantitatively reflect the severity of polyneuropathy in diabetic patients

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.

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

Background:Diabetes Mellitus (DM) is a major concern in India and has been described as a modern-day epidemic. It can affect nearly every organ and cause a slew of complications. Cardiac autonomic neuropathy (CAN) is a serious complication of diabetes. It is also one of the least diagnosed and understood diabetic complications. The purpose of this study was to determine the prevalence of CAN in diabetic patients and to investigate its relationship with the duration of DM and glycemic control.
Materials and Methods: 80 diabetic patients admitted to the Department of Medicine, NRI Medical College, Guntur, met the inclusion and exclusion criteria. Demographic data, history, and clinical examination were documented. All individuals were tested for CAN using 3 tests to assess parasympathetic and 2 tests to assess sympathetic function. Patients were classed as normal, early CAN, definite CAN, or severe CAN using Ewing's criteria. The duration of time for the study was one year and eight months.
Results: The prevalence of CAN in the studied population was 60%. In individuals with CAN, the duration of diabetes was substantially longer, and HbA1c was much greater than in patients with normal cardiac autonomic function. There was a significant connection between CAN and DM duration (r=0.54435) and glycemic control as determined by HbA1c levels (r=0.665925), but not with age. The normal CAN score was 29 (36.25 percent), the early CAN score was 30, the definite CAN score was 9, and the severe CAN score was 12. (15 percent). Background retinopathy (68 percent), proliferative retinopathy (31%), and various retinopathies were identified in CAN patients (19.6 percent) Number 11 maculopathy (19.6 percent) 11. Clinical Presentation Characteristics of Patients Patients with severe CAN and impaired cardiac autonomic function developed diabetic foot 35.55 percent of the time, cataracts 57.14 percent of the time, muscle wasting 14% of the time, and tingling 90% of the time.
Conclusion: CAN is a common and widespread consequence of diabetes that is asymptomatic in the early stages. As a result, it is recommended that every diabetic patient be diagnosed for CAN.

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.

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.

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.

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.

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 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.

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.

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% )

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% )