Blood Sugar Values Research Articles

Estimation of HbA1c Levels in Transfusion-Dependent Thalassemia Patients in Comparison With Normal Healthy Individuals.

Introduction HbA1c values used for diagnosing and treating diabetes can be affected by factors such as red blood cell lifespan, hemolysis, red cell transfusion, and the presence of minor Hb species like HbA2 and HBF inhemoglobinopathies like sickle cell disease, homozygous HbC disease, HbSC disease, and β-thalassemia. This study aims to compare HbA1c levels in transfusion-dependent thalassemia (TDT) patients and healthy individuals. Materials and methods This is a cross-sectional comparative study. This study comprisestwopopulation groups. The first group includes 35 TDTpatients and the second group consists of 35 non-thalassemicindividuals who were matched for age (±1 year), gender, and BMI (±1 kg/m2). The patients were selected from the pediatric outpatient department (OPD), thalassemia ward in the pediatric department, and medicine OPD. Written informed consent/assent was obtained from the participants. A 3 ml fasting venous blood sample for fasting blood sugar(FBS), HbA1c, and complete blood count (CBC) values was obtained in ethylenediaminetetraacetic acid(EDTA) vials on the scheduled blood transfusion day (pretransfusion samples). Samples were then sent to an in-house accredited lab for testing and analysis. HbA1c was performed using the high-performance liquid chromatography (HPLC) technique. Data was compared using a t-test. Qualitative parameters were compared between groups by X2 square analyses. A multivariate linear regression model was used to explore the independent contribution of an individual predictor to HbA1c variability. Results In the study, 85.7% of patients with TDThad HbA1c levels in the diabetic range (>6.4%). In comparison, none of the control group patients had HbA1c values in the diabetic range. The mean HbA1c level was 6.94% in TDT cases and 5.3% in the control group, which was statistically significant (p < 0.001). Elevated FBS levels in the prediabetic range (>100 mg/dl, <126mg/dl) were observed in 25.7% TDT cases. All 35 controls had normal FBS levels(<100 mg/dl). No significant difference was found in FBS levels between cases (92.97 (±9.141) mg/dL) and controls (89.20 (±7.584) mg/dL) (p = 0.065). However moderately positive correlation exists between FBS and HbA1C (r =.470, p = 0.004) and between age and HbA1C (r = 0.335, p = 0.049). Conclusions The use of HbA1c as a screening tool for diabetes mellitus (DM) or assessment of glycemic control is inappropriate in TDT patients. The levels could be falsely elevated, as we found out in our study. In conditions where there is a mismatch between HbA1c and FBS levels, as seen in TDT patients, plasma glucose criteria should be used to diagnose diabetes. It is advised to use alternative indices such as fructosamine levels, glycated albumin, and continuous glucose monitoring.

In Silico Analysis of novel Phytocompounds targetting Dipeptidyl peptidase 4 Enzyme: A New Link between Prediabetes and its cardio-metabolic complications

BackgroundDPP-4 inhibitors, are widely used clinically for treatment of Diabetes. Increase in circulating DPP4 levels have been well demonstrated in patients with Type 2 Diabetes mellitus. The present study assessed the contribution of DPP-4 axis to the pathophysiology of Prediabetes and its cardiometabolic complications. In addition, in silico analysis of phytocompounds that target DPP 4 enzyme was undertaken to identify novel Phytocompounds with therapeutic potential in Prediabetes. MethodologyA novel experimental model of Prediabetes coexisting with hypertension and dyslipidemia was developed in experimental rats to elucidate the pathophysiological role of DPP-4 in Prediabetes and its resultant cardio-metabolic sequale. In the Prediabetic rats, DPP-4 levels, lipid profile, blood pressure readings, fasting blood sugar values, insulin resistance, beta cell function were measured and compared to Normal Control group. In addition, the DPP-4 Inhibitory activity of Phytocompounds (Arjunetin, Guggulsterone) was studied by molecular docking studies including Root Mean Square Deviation (RMSD), Root Mean Square Fluctuation (RMSF), DPP 4 binding affinity and Protein-ligand simulation between the DPP4 and the Phytocompounds was performed. Results were compared to Vildagliptin, the synthetic DPP-4 inhibitor and metformin (Glucophage), the standard antidiabetic drug used in clinical settings. ResultsA statistically significant increase (p < 0.001) in DPP-4 levels along with a decline in bea cell function with increase in Insulin resistance was observed in Prediabetic rats. A positive correlation (p < 0.001) between serum DPP-4 with HbA1c, lipids, and systolic blood pressure was found. The novel model of Prediabetes co-existing with hypertension and dyslipidemia was successfully developed and validated. The silico active site interaction data from simulation studies demonstrated that Arjunetin and Guggulsterone shows effective and stable binding with DPP-4. Arjunetin maintains its contact with Glu205, Glu206, and Asn710 and by interacting with Val207 and His740, it effectively occupies the flanking residues of the active site area. Based on their protein-ligand contact report, Vildagliptin maintains its connection through Tyr547 and during simulation, Guggulsterone interacts with Ser630. ConclusionThe current study offers experimental evidence of DPP-4′s causal role in the development of cardio-metabolic consequences (dyslipidemia and hypertension) of Prediabetes. Arjunetin and Guggulsterone are two Phytocompounds whose potential as promising DPP-4 inhibitors has been further documented using in silico molecular docking studies.

Co-abuse of amphetamine and alcohol harms kidney and liver.

The prevalence of alcohol use disorder was found 75% higher among amphetamine dependent patients. Alcohol and amphetamine alone have nephrotoxicity and hepatoxicity. But, the degree of risk with coabuse of alcohol and amphetamine is unknown. The objective of this study was to assess toxic effects of amphetamine-alcohol co-abuse on the liver and kidney. he present study was a cross-sectional study conducted et al. Amal Hospital for Mental Health, Qassim region, KSA and include one hundred participants. Seventy-five participants were patients hospitalized for the treatment of abuse, and twenty-five participants, were healthy voluntaries, have no history of abuse. An experienced psychiatrist conducted patient interviews and assessed the patients using the DSM-5 criteria. The data from healthy participants were considered as a control. The abuse group was paired with the control group by age and lifestyle. Participants were split into: Group I: Control group (n = 25); Group II: Amphetamine (AMP) abuser group (n = 25); Group III: Alcohol abuser group (n = 25) and Group IV: Combined drug abuser group (AMP and alcohol) (n = 25). The socio-demographic data was collected. Complete medical examination, Body Mass Index and samples of blood and urine were collected from all participants for analytical tests; determination of alcohol and AMP levels, kidney functions and liver functions. The mean BMI values in groups II, III, and IV showed no significant change from the control group. The serum level of albumin and alkaline phosphatase showed significant decrease in all abuser groups. While, alanine transaminase (ALT), Aspartate transaminase (AST) and osteopontin levels showed significant increase in all abuser groups. Fasting blood sugar values showed significant increase in alcohol abusers. On the other hand, it revealed no significant change in AMP and combined groups. The mean values of urea showed no significant change in AMP and alcohol abusers and significant increase in combined drug abuser group. The serum creatinine and all abuser groups showed significant increase in Cystatin C. The alteration in the most of studied biochemical parameters were more than two folds in combined group compared with that of AMP or alcohol groups. Study reveals synergistic liver and kidney toxicity. Amphetamine-alcohol co-abuse significantly heightens kidney and liver toxicity.

Prevalence of diabetes mellitus, hypertension, and obesity and their correlation with quality of life among elderly people living in old age homes of Kamrup, Assam

Background: The world population is rapidly ageing due to increased longevity and decreased mortality rates. The United Nations has declared 2021-2030 as the decade of healthy ageing. To attain this concept, the ultimate goal is to improve the quality of life (QoL) of elderly people by early detection and prevention of complications of non-communicable diseases. Changes in family structure and psycho-social values in today's era often compel the elderly to shift to old age homes (OAHs). Thus, this study aimed to estimate the prevalence of type 2 diabetes mellitus, hypertension, and obesity in the elderly living in OAHs and their correlation with QoL. Methods: A community-based cross-sectional study was conducted at the OAHs of Kamrup (M), Assam for twelve months. A sample of 300 elderly living in OAHs was selected and data was collected using a pre-designed, pre-tested schedule. All the respondents were screened and evaluated for diabetes mellitus, hypertension and obesity. Their quality of life was assessed using WHOQOL-BREF and correlated with blood pressure, blood sugar values and anthropometric indicators. Results: The prevalence of type 2 diabetes mellitus, hypertension and obesity were found to be 32.33%, 37% and 37.33% respectively. On spearman rank correlation the relation between blood pressure, random blood sugar values and anthropometric indicators with QoL was found to be significant. Conclusions: This high prevalence necessitates the adoption of various strategies to combat the burden, promote healthy lifestyle behaviour and provide proper care with counselling to improve the QoL in elderly.

Identification of Blood Sugar Based on Non-invasive Measurements UsingPhotoplethysmography Method Signal Decoding in Diabetics in Tasikmalaya

Non-invasive blood sugar testing tools are now in great demand among the public. This research aims to develop a non-invasive blood sugar examination tool with a Photopletysmograph signal decoding system based on data acquisition from a wearable sensor device on the wrist. The tool used for data acquisition uses Near Infra Red Light-emitting Diode NIR LED 880 nm, 660 nm and 537 nm. This acquisition transfers signals from the body via a photodiode to a PC Personal Computer for processing using Matlab. The method used in this research is to look for the height of the systolic and diastolic amplitude of the Photopletysmograph PPG signal and use the peak-to-peak voltage Vpp to implement Beer Lambert's law. This method was tested on 54 people, randomly aged 26-89 years, with normal blood sugar to high blood sugar. The results show an error of 18.37% from the gold standard. In conclusion, the use of the PPG signal decoding method has proven to be significant in producing blood sugar values. Furthermore, this method was developed for real-time remote measurements via wearable sensor devices.

Anemia and its association with glycemia and transaminitis in patients with type 2 diabetes mellitus: A cross-sectional pilot study.

Anemia impairs glucose homeostasis, affects glycemic control, and predisposes to complications in diabetics. It correlates with oxidative stress and increases the risk of developing microvascular and macrovascular complications. However, it is an underrecognized comorbidity in diabetics. This study was conducted to assess the prevalence of anemia in diabetic patients and compare the metabolic profiles of anemic and non-anemic diabetics. This is a cross-sectional study, conducted among type 2 diabetes (T2DM) patients, at the outpatient clinic. Patients with chronic kidney disease (CKD), known hematological disorders, and chronic inflammatory disorders were excluded. Of the 97 patients, 37 (38.14%) were found to be anemic (hemoglobin (Hb): male <13 g/dl, female <12 g/dl). The mean values of fasting blood sugar (FBS) in low and normal mean corpuscular volume (MCV) patients were 265.9 ± 43.7 mg/dl and 157.2 ± 7.2 mg/dl, respectively (P = 0.0026), and those of postprandial blood sugar (PPBS) were 370.3 ± 58.4 mg/dl and 226.3 ± 10.1 mg/dl, respectively (P = 0.0015). It was found that 6 (22.2%) of 27 patients with raised alanine aminotransferase (ALT) had anemia against 27 (45.8%) of 59 patients with normal ALT (P = 0.03). The mean Hb levels in patients with raised and normal ALT were 13.31 ± 2.3 gm% and 12.2 ± 2.0 gm% (P = 0.03), respectively. Blood sugar may have a direct relationship with MCV in T2DM patients. Hb tends to relate to hepatic enzymes likely due to altered dietary patterns in anemics. Further larger studies on the effect of iron supplementation and dietary habits on glycemic control and hepatic steatosis are warranted.

Hypomagnesemia in Patients with Type 2 Diabetes Mellitus.

Recent research has shown that low serum levels of magnesium are often linked to both microvascular and macrovascular complications in individuals with diabetes mellitus. Hence, monitoring of serum magnesium levels is needed in diabetic patients. Furthermore, the addition of magnesium through supplementation may present a novel therapeutic strategy for mitigating vascular complications in individuals with diabetes. To assess the prevalence of hypomagnesemia in type 2 diabetes mellitus patients and to assess the association between hypomagnesemia and microvascular complications of diabetes mellitus in a tertiary care hospital in North Kerala. An analytical cross-sectional study was conducted at a tertiary care hospital involving 230 diabetic patients receiving outpatient and inpatient care in the Department of Internal Medicine at Government Medical College, Kozhikode, Kerala. The study took place from January 2018 to December 2018, during which serum magnesium levels were assessed and analyzed in relation to the patients' microvascular complications and glycemic control. We observed that 19.13% of the participants had hypomagnesemia. This condition was found to be more common among older individuals with diabetes, as indicated by a p-value of 0.022. However, there were no significant differences in serum magnesium levels based on gender (p-value 0.18), body mass index (BMI) (p-value 0.223), or the duration of diabetes (p-value 0.36). The prevalence of diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy was higher in diabetics with hypomagnesemia than their counterparts with normal magnesium, with a p-value of 0.001, 0.001, and 0.001, respectively. There was a significant negative correlation obtained between serum magnesium and glycated hemoglobin (HbA1C) values (Pearson coefficient = -0.240 and p-value = <0.01) and fasting blood sugar (FBS) values (Pearson coefficient = -0.265 and p-value = <0.01). Hypomagnesemia is negatively correlated with HbA1C and FBS but not related to duration of diabetes and gender. The prevalence of microvascular complications was higher among the diabetics with hypomagnesemia.

Efektivitas Kegiatan Pendampingan Penderita Diabetes Melitus terhadap Peningkatan Kualitas Manajemen Diri

Diabetes mellitus (DM) is a non-communicable disease which is currently causing complex problems both globally and nationally, because apart from the high morbidity and mortality rates. The main problem for DM sufferers is non-compliance in implementing a healthy lifestyle for DM sufferers, which has an impact on their quality of life due to complications. Efforts that can be made are to improve self-management with health education. The aim of this research is to determine the effectiveness of mentoring activities in improving the quality of self-management of DM sufferers. This research uses quantitative methods, with a quasi-experimental design, one group pre-test and post-test approach. The target activity is 64 people suffering from diabetes mellitus in Gunung Talang District, Solok Regency for more than 3 months, namely 27 May - 30 September 2022. The stages of data processing are editing, coding, transfer and tabulation. Data were analyzed bivariately using paired t-test with a confidence level of 95% (α=0.05). Data is presented in the form of tables and narratives. This research found that the average pre-test self-management score was = 45.6 while the post-test score = 50.89. The average pre-test blood sugar value = 226.09mg/dl and post-test value = 220.90 mg/dl. The conclusion is that mentoring activities are effective in changing the quality of self-management, but not blood sugar levels. It is recommended that this assistance activity be continued by the community health center so that the results can be maintained in the long term so that they can improve the quality of life of DM sufferers and have an impact on reducing their blood sugar.

Optimizing Newborn Outcomes in Cesarean Sections: A Comparative Analysis of Stress Indicators under General and Spinal Anesthesia.

The moment of birth represents a complex physiological process that is followed by adaptive changes in the vital systems of the newborn. Such reactions have their positive but also negative effects. The aim of this research was to determine the difference in laboratory values of stress indicators in newborn children delivered by cesarean section (CS) with general and spinal anesthesia. We attempted to make a recommendation about the optimal type of anesthesia based on our results. The study was performed on 150 healthy term newborns delivered by urgent or planned CS. Samples for adrenocorticotropic hormone (ACTH), cortisol, triglycerides, and interleukin-6 (IL-6) were analyzed. Leukocyte numbers, triglycerides, and blood sugar values were normal for the newborns' age, with statistically significantly lower values of blood sugar and triglycerides in newborns delivered by CS in spinal anesthesia (p < 0.005) compared to general anesthesia. There were no significant differences in ACTH, cortisol, and IL-6 levels between those newborns delivered via CS after spinal or general anesthesia. In cases where vaginal delivery is not possible, when CS is indicated, the use of well-controlled spinal anesthesia is followed by lower degrees of metabolic, inflammatory, and stress responses and better vitality of the baby upon birth.

INVESTIGATION OF FACTORS AFFECTING ADHERENCE TO METFORMIN THERAPY IN TYPE 2 DIABETES

Adherence is the degree to which the patient’s behavior (taking medication, following a diet, and/or changing lifestyle) matches the agreed recommendations of the prescriber. Adherence is influenced by socio-economic factors, factors related to the health system, factors related to the disease, factors related to the patient and factors related to therapy. Many methods have been developed to measure adherence. Methods are divided into direct and indirect. Adherence is usually lower in patients with chronic conditions than in patients with acute conditions. More recent studies show adherence values to oral antidiabetic therapy of 65-85%. Adherence is usually considered optimal when patients take at least 80% of their prescribed medication. The research conducted on the sample made up of middle-aged, non-adherent respondents (35-65), who have been using metformin for a minimum of 6 months in the treatment of type 2 diabetes mellitus showed the influence of different factors on adherence. The factors that showed the greatest influence on the low degree of adherence are: lower education, passive life, low physical activity, smoking, long-term therapy, change of therapy, concomitant therapy, metformin dosing more than 2 times a day, forgetting to take therapy. The average value of blood sugar for all subjects is 10.5 mmol/L, which indicates the ineffectiveness of the prescribed therapy, and which can be directly linked to the determined non-adherence of subjects to metformin therapy.

Evaluation of Ema, Töllner and Rodwell scores in the diagnosis of neonatal sepsis

Introduction: There are no specific signs, symptoms and rapid laboratory tests to definitively diagnose sepsis in the neonatal period. This makes it difficult to diagnose sepsis in newborns in a timely manner and initiate appropriate treatment, or causes babies without sepsis to receive unnecessary antibiotics. Purpose: Therefore, in this study, we planned to investigate the clinical adequacy and reliability of EMA (European Medicines Agency), Töllner and Rodwell hematological scoring in the early diagnosis of neonatal sepsis. Method: EMA, Töllner and Rodwell hematological scoring was performed on each patient. Complete blood count, peripheral smear, C-reactive protein, procalcitonin, blood gas and blood sugar values of newborn babies with suspected sepsis were recorded, blood culture, urine culture and cerebrospinal fluid examination and cultures taken when necessary were evaluated. Using statistical analysis, the 'Positive Expected Value and Negative Expected Values' ratios of the scores were obtained, and the performance results were examined. Results: 95 newborns with a preliminary clinical diagnosis of sepsis were included in the study. These babies were divided into two groups: clinical (n:71) and proven sepsis (n:24) according to blood culture results. Positive and negative predictive values of scoring systems in definitive sepsis diagnosis; for EMA respectively; 21.5%, 56.3% for Töllner; It was determined as 31.3%, 77.8%, and 100%, 77.8% for Rodwell. Conclusion: Our study showed that clinician opinion and standard laboratory tests are limited in the diagnosis of neonatal sepsis, and Rodwell hematological scoring is more prominent in recognizing proven sepsis compared to the other two scores .

Telemedicine for the Underserved Racial and Ethnic Minorities During COVID-19 and Beyond.

Objective: To demonstrate that a culturally and linguistically appropriate telehealth protocol can be implemented to improve the glycemic control of patients as an extension of regular clinical services and provide continuity of care. Methods: A telehealth platform was established during COVID-19 pandemic and from numerous telehealth encounters we sampled 498 patients who received telehealth intervention over a 12-month period for specific services: Rx refill, consultation for laboratory results, wellness evaluation and education, and acute or sick visits with appropriate referrals. This telehealth platform was integrated with a remote patient monitoring system utilizing a Bluetooth-enabled glucometer for patients with diabetes compared to their abnormal baseline hemoglobin A1C (HgA1C). The Blood sugar values were recorded at predefined intervals to monitor controls for diabetes. The ethnic diversity and level of education of patients required addressing the digital divide, language interpretation, and navigation at each monitoring step. Results: This method demonstrated that a culturally and linguistically appropriate telehealth protocol can be implemented to improve the glycemic control of patients in an intervention group compared with a control group. Validation of the glycemic control was based on 70 patients identified as eligible for participation based on the inclusion criteria: a HgA1C level of 7% or higher obtained within the last 10 months. Informed consent was obtained for 42 participants based on patient participation constraints during the COVID-19 pandemic. Conclusions: We conclude that telemedicine procedures utilized for patients with little or no prior knowledge of remote self-monitoring methods can support their treatment of chronic diseases, such as diabetes. The outcomes from the implementation of telemedicine services were observed in a well-defined group of underserved racial and ethnic minority patients at our clinic. We now have a protocol to expand this to other chronic diseases and used as a regular clinical procedure.

Spontaneous Hypoglycaemia due to Insulin Autoimmune Syndrome in Six Cases, Response to Steroid Therapy and Rituximab.

Dr. Hirata of Japan first described insulin autoimmune syndrome (IAS) in 1970. Seven hundred ninety-five cases of this rare syndrome have been reported from Japan and China and 29 from India. IAS has the following characteristic features 1) severe spontaneous attacks of hyperinsulinemic hypoglycaemia, 2) high total immunoreactive insulin levels, 3) elevated insulin autoantibody (IAA) titres, 4) no prior exposure to exogenous insulin, and 5) no pathological abnormalities of the pancreatic islet cells. We treated six cases of IAS with high doses of prednisolone for 4-6 weeks and then gradually reduced the doses. Diagnosis of IAS was established by documenting Whipple's triad of symptoms and signs of hypoglycaemia, blood sugar <55 mg/dl, improvement of symptoms with dextrose infusion, inappropriately increased insulin levels >3 uU/ml, C-peptide levels >0.6 ng/ml, and increased titres of anti-insulin autoantibodies. Insulinoma and non-pancreatic tumours were ruled out by CECT (contrast-enhanced computerised tomography) or MRI (magnetic resonance imaging) of the abdomen and if necessary endoscopic ultrasonography and gallium 68 Dotanoc PET (positron enhanced tomography). Autoimmune screening and serum electrophoresis were done to rule out multiple myeloma. Monitoring of the patient's blood sugars was done by the laboratory, glucometer readings, and a freestyle libre glucose monitoring system. Remission of hypoglycaemic episodes, hyperglycaemic episodes, and marked reduction of serum insulin and insulin autoantibodies in four out of six patients with diet therapy and steroids. Two patients resistant to steroids were treated with rituximab successfully. Patient 6 developed serious complications of cytomegalovirus and Pneumocystis carnii after rituximab, which were treated successfully. A careful history including recent infections, medications, and vaccinations provides vital clues in the evaluation. An increased awareness of IAS will prevent unnecessary and costly investigations and surgery. Although it is often self-remitting, steroids are contributory in severe cases. Immunosuppressives are used successfully in cases refractory to steroids. Continuous glucose monitoring system (CGMS), by freestyle libre glucose monitoring system, provided real-time blood sugar values, total time in hypoglycaemia, and total time in the range (TIR), which proved very valuable in managing IAS patients. Low CGMS values should be corroborated clinically and with laboratory or glucometer values.

Association of Glycated Hemoglobin With Acute Ischemic Stroke in a Tertiary Care Center in a Tribal Region of Jharkhand.

Increased glycated hemoglobin (HbA1c) levels have shown an association with an increased risk of stroke in patients admitted to a tertiary care center in Jharkhand. To find out and estimate the risk of acute ischemic stroke in patients with increased HbA1c levels compared with controls. This observational case-control study was conducted on patients admitted to the department of general medicine at a tertiary care center in Ranchi from June 2021 to November 2022. The patients included in this study were those aged 18 years or older and who were clinically and radiologically diagnosed with acute ischemic stroke. Only patients with a first episode of stroke were included, and patients with hemorrhagic stroke or transient ischemic attack were excluded from this study. An equal number of control participants were also included. Ion exchange high-performance liquid chromatography was used to perform the HbA1c tests. The same method was used to measure HbA1c levels in the controls. All findings were recorded in aMicrosoft Excel sheet (Microsoft Corporation, Redmond, WA), and the data were analyzed using SPSS version 22.0software (IBM Corp., Armonk, NY). After performing a descriptive statistical analysis, the findings were classified over a range of values and described accordingly. For each variable, an independent t-test was performed to compare the cases with the controls. A multivariable logistic regression analysis was used to choose the appropriate potential factors to determine the association in the multivariable analysis. A total of 185 cases and 185 controls were included. The mean age of the cases with ischemic stroke was 63.77 ± 10.312, and that of the controls was 53.18 ± 11.35 (p < 0.01). The mean HbA1c level in the patients of acute ischemic stroke was 6.97 ± 1.84, and that of the controls was 5.99 ± 1.69 (p < 0.01). The mean random blood sugar (RBS) value in the ischemic stroke cases was 170.21 ± 84.16, and that of the controls was 150.03 ± 82.25 (p = 0.02). To compare the factors that were determined to be statistically significant between ischemic stroke cases and controls, a multivariable logistic regression analysis was performed. The HbA1c p-value was 0.01, the odds ratio (OR) was 1.280, and the 95% CI was 1.11-1.48. The other variables apart from HbA1c that were statistically significant between the ischemic stroke cases and the controls were age (p < 0.01, OR: 1.280, 95% CI: 1.06-1.11), hypertension (p = 0.618, OR: 1.130, 95% CI: 0.70-1.83), and high-density lipoprotein (p = 0.055, OR: 0.975, 95% CI: 0.95-1.00). When other cofounders were considered, it was concluded that with a 1% increase in HbA1c, the risk of stroke increases by 28% (OR: 1.28, 95% CI: 1.11-1.48). To compare the variables that were determined to be statistically significant between the control and ischemic stroke case groups, a multivariable logistic regression was used. The area under the receiver operating characteristic curve for HbA1c was 0.773and RBS was 0.600. This study shows that higher HbA1c levels in patients increase the risk of ischemic stroke. This study brings to light the need to screen the population periodically for diabetes by routinely testing for Hba1c in those who are at high risk of diabetes. Stroke risk can be reduced with early management and intervention. This study also concludes that HbA1c is a better predictor for assessing the risk of ischemic stroke than RBS levels.

Correlation between HbA1C and CCT in T2DM

Abstract An observational cohort study of central corneal thickness (CCT) in type 2 diabetes mellitus (T2DM) patients in hyperglycemic and euglycemic states. Context: To assess the significance of glycemic control in CCT measurement. Aims: The main aim was to assess the change in CCT with the change in glycemic state by following them after 3 months. Settings and Design: This study was carried out in the department of ophthalmology, SMVMCH, Pondicherry. Materials and Methods: This is an observational cohort study carried out at Sri Manakula Vinayagar Medical College and Hospital after obtaining ethics committee clearance. Fifty-six T2DM patients with HbA1C &gt;7 were included in this study with informed consent. Clinical history with complete ophthalmic examination done, CCT was measured using ultrasonic pachymetry (UP) along with blood samples to measure their blood sugars and HbA1C values. They were advised to follow up on the treatment given by the medical department. Patients were reviewed after 3 months to measure the CCT and blood sugar values. Statistical Analysis: Done using STATA software 16.0. Continuous data and categorical data were assessed using paired t-test and Chi-square test, respectively. Normality of data using Shapiro–Wilk normality test. Statistical significance was adopted with P &lt; 0.05. Results: In our study, the initial mean HbA1C was 9.4 ± 1.9 and mean CCT was 552.6 ± 40.6 μm, whereas follow-up mean HbA1C was 7.1 ± 1.2 and mean CCT was 548.5 ± 38 μm which shows statistical significance. Conclusion: Diabetics present with thicker corneas and there is a decrease in thickness once glycemic control has been achieved. Keeping this in mind, we suggest assessment of CCT in all diabetic patients during clinical work-up.

Sleep Pattern and Diabetes: Finding from a Cross-Sectional Study in Iraq

Aim: Diabetes is a seriously debilitating disease with deleterious complications associated with physical and psychological aspects of diabetic patients. Sleep quality in diabetics is affected by various factors such as the duration of the disease and its complications. The study aimed to investigate the prevalence of poor sleep quality among type 2 diabetic patients and it is relation to glycemic control. Methods: Comparative cross-sectional study to investigate the prevalence of sleep disturbances among type 2 diabetes mellitus patients was conducted. Face to face interview was used to obtain participant’s information by using a validated questionnaire. The value of fasting blood sugar or random blood sugar and HbA1c were also obtained. Results: Among 380 type 2 diabetes mellitus, 76.8% had poor sleep quality. No significant correlation was found between age, body-mass index, duration of diabetes, and duration of comorbid disease. Sleep showed a significant association with HbA1c, gender, educational level, employment and monthly income. Conclusion: Sleep disorder is a common problem among diabetic patients, in this study about two third of patients with type 2 diabetes mellitus had poor sleep quality. Bad sleep has a negative impaction on glycemic control so it is important to focus on sleep quality and try to improve it to maintain accepted glycemic control and reduce the risk of diabetic complications. Keywords: type 2 diabetes, sleep, glycemic control, sleep quality

Pencegahan Diabetes Mellitus melalui Pemeriksaan Gula Darah Acak dan Promosi Kesehatan di Masyarakat

Introduction: Diabetes Mellitus is a health problem that is increasing in prevalence throughout the world. This is of serious concern because of its far-reaching impact on public health and the health system as a whole. Objective: The purpose of this service was Increase access to public health services, especially in diabetes mellitus examination, in addition to increasing public knowledge about diabetes mellitus management. Method: Activities are carried out in several stages, namely the preparation stage includes taking care of permits, the next stage is the implementation of carrying out random blood sugar checks and health promotion. Result: It was found that respondents who carried out the examination were found to have mostly high random blood sugar values as many as 15 respondents or 62.5%. There was a significant change in knowledge from before and after health promotion Conclusion: The community has a potential risk of undetected diabetes mellitus, therefore the participation of health workers is needed to provide counseling. Through counseling delivered by health workers, the public can be given a better understanding of risk factors, symptoms, and ways to prevent diabetes mellitus

Metabolic parameters in acne vulgaris: a case control study investigating fasting blood glucose and insulin levels in acne vulgaris

Background: Influence of diet and lifestyle on acne among Indian population. Objectives were to identify the clinico-epidemiological profile of patients with Acne vulgaris and to assess the fasting plasma glucose and serum insulin levels in Acne vulgaris patients and the controls and correlate them. Methods: This was a hospital-based case-control study conducted in the Department of Dermatology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Study included 60 cases of acne and 60 controls (age and sex matched), attending the outpatient department. After complete history, general physical, systemic and cutaneous examination, all cases were subjected to following investigation: fasting blood sugar and serum insulin levels. Results: Acne was common in the age group 18-24 yrs (70%). In almost half the patients the age of onset was between 12-18 yrs. Commonly observed site for acne was cheeks (83.3%), forehead (66.7%), nose (55%) and chin (41.7%). The risk of developing acne was 3.5 times more among smokers than non-smokers. The mean fasting blood sugar values of cases and controls when compared showed a statistically significant difference (p&lt;0.05). Our study did not find any statistically significant difference in fasting insulin levels between cases and controls. Conclusions: There was only significant difference in the Mean fasting blood glucose in cases as compared to controls. Mean fasting serum insulin level though found to be raised in cases compared to controls, does not prove statistical significance. Fasting plasma glucose was significantly raised in grade III acne as compared to other grades.

Education and early detection of coronary heart disease in the community

Coronary heart disease (CHD), commonly called coronary artery disease, refers to pathological processes that affect the coronary arteries, usually caused by atherosclerosis. One of the factors that influence the occurrence of atherosclerosis is the influence of people's lifestyles, the level of awareness of early detection of coronary heart disease, and the wrong dietary arrangements that cause a high risk of coronary heart disease in the community. This community service aims to increase public knowledge about managing and preventing coronary heart disease. The method used is education using media and early detection through health checks that can affect the occurrence of coronary heart disease, such as blood pressure, blood sugar values, and cholesterol. Knowledge of the risks of PKJ and early detection is expected to increase public awareness. It can be concluded that the activities of providing public education and early detection with health checks produce output that there is an increase in knowledge. Education related to coronary heart disease and health checks is expected to help conduct routine monitoring by educating families about early signs and prevention of coronary heart disease

Health status of police personnel in a selected subdivision of Bengaluru District, Karnataka, India

Introduction: Police personnel perform untiring duties to maintain law and order. The objectives of this study were to assess the physical and mental health status of police personnel in a selected rural subdivision of Bengaluru District. Methods: A cross-sectional study was conducted among 142 police personnel in 7 police stations of the selected rural subdivision using a universal sampling technique. A structured interview schedule was used, which included socio-demographic details, occupational details, anthropometry, blood pressure and blood sugar measurements, Patient Health Questionnaire-9 (PHQ-9) to screen for depression and Perceived Stress Scale (PSS) to identify stress. Results: The mean age of the police personnel was 40.28±10.97 years. Most of the workforce were males (83%). About 68.3% of the studied group were obese. High random blood sugar and high blood pressure values were observed in 5.6% and 48.6% of the personnel who had no previous history of diabetes mellitus and hypertension. The prevalence of mild to severe depression was found to be 36% and that of high stress was 83.1%. Conclusion: The high prevalence of increased blood pressure, obesity, depression and perceived stress warrants the need for routine screening and application of various levels of prevention. Health promotion and improved working conditions can improve their health status.