Abstract
Diabetes mellitus (T2DM) is a multifactorial syndrome that israpidly rising in all the continents ofthe globe, causing elevated blood sugar levels in affected people. A sample of 81 Iraqi T2DM patients was investigated based on several parameters. Glycemic control parameters includedlevels of fasting blood glucose (FBG),glycated hemoglobin (HbA1C), and insulin, along with insulin resistance (IR) and insulin sensitivity (IS). Renal function tests includedmeasuring the blood levels of urea and creatinine. Oxidative stress parameters included total antioxidant capacity (TAC) and thelevel of reactive oxygen species (ROS). The results of the presentstudy showed a highly significant (P˂0.01) increase in FBG, HbA1c, insulin and IR levels in T2DM patients as compared to control.Insulin sensitivity showed a highly significant (p˂0.01) decrease in patients compared with control.Urea and creatinine levelsincreased in T2DM patients, but the differences were insignificant. TAC levelsignificantly (P<0.05) increased in patients compared with control. Also, the levels of ROSrevealed a highly significant (P<0.01) increasein T2DM patients compared with the control. Correlation analysis showedthat FBG has a highly significant (P<0.01) positive correlation with IR, urea, creatinine and ROS, as well as a significant (P<0.05) positive correlation with TAC. However, FBG shows a highlysignificant (P< 0.01) inverse correlation with IS. The levels of HbA1C show a significant (P<0.05) positive correlation with IR, creatinine, and TAC, whereas ithas a highly significant (P<0.01) positive relation with ROS. However, HbA1C level has a highly significant (P<0.01) inverse relation with IS. Insulin has highly significant (P<0.01) positive and negative associations with IR and IS, respectively.IR showshighlya significant (P<0.01) inverse correlation with IS, significant (P<0.05) positive correlation with creatinine, and highly significant (P<0.01) positive correlation with ROS. IS has a significant(P< 0.05) inverse correlation with urea. Urea shows a highly significant (P<0.01) positive correlation with creatinine. TAC has a significant (P<0.05) inverse correlation with ROS. Conclusion: diabetic patients revealed poor glycemic control. Fluctuating blood glucose concentrations may contribute significantly to oxidative stress, probablyeven more than chronic hyperglycemia. The observed significant positive correlation between FBG and the other tested parameters revealed that hyperglycemia is an obvious independent risk factor for T2DM progression.
Highlights
Y (TAC) and thelevel of reactive oxygen species (ROS)
Diagnosis in patients with risk factors seems to be of utmost importance;routine screening for diabetes is started at the age of 45 years and is repeated at least every three years, while in subjects at risk it is started earlier [3].Type 2 diabetes is typically characterized by certain limits of blood parameters; HbA1c ≥ 6.5%, fasting blood glucose (FBG) ≥ 126 mg/dL, or a 2-hour postprandial glucose of ≥ 200 mg/dL after 75 g oral glucose intake [1]
Glycemic control parameters which involved FBG, HbA1C, insulin, insulin resistance (IR), and ISare shown in patients (204.88±50.03mg/dl) than in control (82.55 ± 11.84mg/dl)
Summary
Glycemic control parameters which involved FBG, HbA1C, insulin, IR, and ISare shown in. The present study agrees with the results reported by an earlier work [23], which detected a boost in insulin levels in T2DM patients that was attributed to the IR status. The current study agrees with Mohsen [16], who recorded a spike in the insulin, IR, and FBG in comparison with controls subjects. This state of insulin resistance manifests as mild postprandial hyperglycemia [13]. Werevealed that IS was significantly decreased in T2DM patients compared to controls The reasons for this finding may be the hyperglycemia and hyper-insulinemia, which may result in impairment of IS [7]. The impaired IS in T2DM patients recorded in the present study was reported in several studies, including the study of Mohsen [16]
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