Abstract
Background & Objectives: Adenosine modulates insulin action on various tissues and its concentration in tissues is affected by Adenosine Deaminase (ADA) levels. ADA is an enzyme involved in purine metabolism and is considered to be a marker of T cell activation. Immunological disturbances in type 2 diabetic individuals have an association with cell mediated responses and inappropriate T-lymphocyte function. Hence, the study was undertaken to determine the levels of Serum ADA activity in patients of type 2 DM and its correlation with parameters of glycemic profile such as Fasting blood sugar (FBS) and Glycated Haemoglobin.
 Material and Methods- A total of 100 patients diagnosed for type 2 DM visiting the Outpatient Department of General Medicine and Endocrinology at Mahatma Gandhi Medical College & Hospital, Jaipur were enrolled for the study based on predefined inclusion and exclusion criteria. Blood samples were collected for all enrolled patients and analysed for the investigations like Serum BSF, HbA1c and Serum ADA.
 Results- In the study, BSF, mean HbA1c and serum ADA level was significantly higher in diabetic group in comparison to control group (p=0.000). The diabetic group was subdivided on the basis of HbA1c levels, HbA1c ≤ 8% as good glycemic control and HbA1c > 8% as poor glycemic control. BSF, mean HbA1c and serum ADA levels were observed to be significantly higher in poor glycemic control group as compared to that of good glycemic control. A significant positive correlation between S. ADA and HbA1c activity was also seen (r= 0.388).
 Conclusion- Increased ADA level can be used to determine the glycemic status in the patients of type 2 DM and serve as a marker for insulin resistance. Hence, by analysing ADA levels in diabetes, glycemic control and insulin resistance can be assessed. Raised ADA levels can be an early indicator of progressive diabetic change and help to take preventive measures for the development of diabetic complication and thereby improving the outcome of the disease.
 Keywords- Diabetes Mellitus, Adenosine Deaminase, Glycated haemoglobin
Highlights
The worldwide prevalence of diabetes has continued to increase dramatically.[1]World Health Organization (WHO), shows that lndia is going to face a big challenge posed by the rising prevalence of diabetes and its complications, unless steps are taken to implement the primary and secondary prevention measures in diabetes.[2]According to the WHO in2016, about 422 million people worldwide were living with diabetes[3] and International DiabetesFederation (IDF) estimated that the number of people worldwide affected with diabetes is expected to be around 438 million by 2030 and 642 million by 2040.[4]
Increased Adenosine Deaminase (ADA) level can be used to determine the glycemic status in the patients of type 2 DM and serve as a marker for insulin resistance
Raised ADA levels can be an early indicator of progressive diabetic change and help to take preventive measures for the development of diabetic complication and thereby improving the outcome of the disease
Summary
The worldwide prevalence of diabetes has continued to increase dramatically.[1]World Health Organization (WHO), shows that lndia is going to face a big challenge posed by the rising prevalence of diabetes and its complications, unless steps are taken to implement the primary and secondary prevention measures in diabetes.[2]According to the WHO in2016, about 422 million people worldwide were living with diabetes[3] and International DiabetesFederation (IDF) estimated that the number of people worldwide affected with diabetes is expected to be around 438 million by 2030 and 642 million by 2040.[4]. The study was undertaken to determine the levels of Serum ADA activity in patients of type 2 DM and its correlation with parameters of glycemic profile such as Fasting blood sugar (FBS) and Glycated Haemoglobin. Results: In the study, BSF, mean HbA1c and serum ADA level was significantly higher in diabetic group in comparison to control group (p=0.000). BSF, mean HbA1c and serum ADA levels were observed to be significantly higher in poor glycemic control group as compared to that of good glycemic control. Conclusion: Increased ADA level can be used to determine the glycemic status in the patients of type 2 DM and serve as a marker for insulin resistance. By analysing ADA levels in diabetes, glycemic control and insulin resistance can be assessed.
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