Correlates Of Glycemic Control Research Articles

Correlation of glycemic control with salivary oxidative markers in subjects with prediabetes and diabetes: A cross-sectional study.

Rising levels of oxidative stress play an important role in the pathogenesis of type 2 diabetes mellitus. This study aimed to some assess salivary antioxidants in patients with type 2 diabetes, prediabetes, and healthy control. We also assessed the potential clinical relevance of salivary antioxidants with glycemic control. This cross-sectional study included 30 prediabetes, 31 type 2 diabetes, and 39 sex-matched normoglycemic individuals. To assess the salivary oxidative status, we measured the levels of malondialdehyde (MDA), superoxide dismutase (SOD), the total antioxidant capacity (TAC), and uric acid (UA) by spectrophotometry. Salivary MDA levels were significantly higher in individuals with diabetes compared to prediabetes, and control groups (p = 0.001). MDA and SOD were significantly correlated with fasting blood sugar (FBS) and HbA1C (p < 0.001, r = 0.43, p < 0.001, r = 0.34, and p = 0.003, r = 0.29 p = 0.01, r = 0.23 respectively). Salivary TAC was also significantly correlated with FBS (p = 0.02, r = 0.23). Furthermore, salivary MDA was an independent determinant of type 2 diabetic patients compared to healthy subjects (p = 0.04). According to the cutoff point in the ROC curve, the MDA index was below 2.8 in 82.1% of the controls (specificity), and it was above 2.8 in 64.2% of the Individuals with diabetes (sensitivity). The simultaneous assessment of salivary oxidative and antioxidant factors, revealed weak but a significant positive association between MDA and glycemic status in diabetes. However, further investigations are required to confirm our results.

Correlates of Glycemic Control Among Patients With Type 2 Diabetes in Eastern Ethiopia: A Hospital-Based Cross-Sectional Study

IntroductionEven though optimal blood glucose control reduces the risk of diabetes-related complications, many patients with type 2 diabetes (T2D) fail to achieve it for a variety of reasons. In the study area, there was a paucity of evidence regarding correlates of glycemic control. Therefore, this study aimed to find out the correlates of glycemic control among patients with T2D in Eastern Ethiopia.MethodsA cross-sectional study was conducted among 879 adult patients with T2D on follow-up at two public hospitals in Harar. Data were collected through interviews, physical measurements, and record reviews. The level of glycemic control was determined from three consecutive fasting plasma glucose (FPG) measurements. A mean value of FPG measurements falling in the normal range (80–130 mg/dl) was considered as optimal glycemic control; otherwise, a mean FPG level that is below or above the normal range (<80 mg/dl or >130 mg/dl) was defined as suboptimal glycemic control. Descriptive statistics were used to summarize the data, while a linear regression model was used to find out the correlates of glycemic control. A beta coefficient and a 95% CI reported associations. The statistical significance was declared at a p-value ≤0.05.ResultsThe mean age of the patients with T2D was 52.7 ( ± 13.3) years. The mean FPG level was 172 ± 56 mg/dl. Suboptimal glycemic control was found in 76% (95% CI: 73.41, 79.04) of patients with T2D. In a multivariable linear regression, khat chewing (β = 6.12; 95% CI: 1.55, 8.69), triglycerides (β = 0.56; 95% CI: 0.41.48, 0.65), comorbidity (β = 5.29; 95% CI: 1.39, 9.13), and poor level of self-care practices (β = 5.43; 95% CI: 1.41, 6.46) showed a significant correlation with glycemic control.ConclusionsThis study found that about three-fourths of patients with T2D had suboptimal glycemic control. Khat chewing, comorbidity, and poor level of self-care practices were independently correlated with glycemic control. Thus, suppressing glycemic levels through appropriate treatment and strict diabetes self-care practices including avoidance of Khat chewing is a useful approach to attaining glycemic target that subsequently reduces cardiovascular risks.

Association of microalbuminuria and glycosylated hemoglobin in type 2 diabetes mellitus

HbA1c is highly prognostic for long term diabetes related complications such as microalbuminuria. Albumin is one of the most commonly assessed clinical parameters in diabetic patients. Present study was aimed a) to estimate microalbuminuria, HbA1c, urinary creatinine and urinary albumin to creatinine ratio (ACR) in patients with type 2 DM and b) to find out the correlation of glycemic control with microalbuminuria and urinary creatinine. This work is extension of our previous work on microalbuminuria in type 2 DM. Patients with type 2 DM were involved in the study. Biochemical investigations like Blood sugar, Glycosylated hemoglobin (HbA1c), Urinary micro albumin and urinary creatinine were analyzed.There was a significant difference in the values of all parameters i) between patients and normal standard values, ii) Among the three groups based on duration of diabetes. Significantly lower values of urinary creatinine (p&amp;#60;0.000) and significantly higher values of microalbumin (p&amp;#60;0.000) and ACR (p&amp;#60;0.000) were found in patients with poor glycemic control than moderate glycemic control in our study. We observed positive correlation between microalbuminuria and glycemic control.Hyperglycemia in type 2 diabetes is leading to lethal effects by damaging the kidney. Early detection and prevention of nephropathy in patients with type 2 DM will be possible by frequent and timely screening the patients for HbA1c, microalbuminuria, urinary creatinine and ACR. This will definitely help to reduce the mortality rate due to diabetic nephropathy and also the economic burden of society.

Association between Glycemic Control and Serum Lipid Profile in type 2 Diabetic Patients: Experience in a Medical College Hospital

Impaired lipid metabolism in diabetic patients can lead to cardiovascular complications. Poor glycaemic control is associated with a significant increase in the risk of both patient’s morbidity and mortality. An early intervention to regulate circulating lipids has been found to lower the risk of cardiovascular problems and death. Glycated hemoglobin (HbA1c) is a reliable indicator of rising blood sugar levels. This hospital based observational study was conducted in the Department of Medicine, Sher-E-Bangla Medical College Hospital, Barisal from October 2014 to March 2015 over a period of 6 month to determine the correlation of glycemic control and lipid profile in patients with type 2 diabetes. A total of 110 type 2 diabe- tes mellitus(DM) patients of both sexes admitted to the Deapartment of Medicine of Sher-E- Bangla Medical College Hospital, Barisal, were recruited for this study. Following standard procedures and protocols, fasting blood sugar (FBS), blood sugar two hours after breakfast, Glycosylated Hemoglobin (HbA1c) and fasting lipid profile were measured. The age of respondents ranged from 34 to 70 years with the mean age of 54.35}8.02 years. Among the patients male were 70 (63.6%) and female were 40 (36.4%). Mean age at diagnosis of DM and duration of DM was 47.07}6.03 years and 7.27}3.41 years, respectively. Mean body mass index (BMI), FBS and HbA1c were 25.02}5.22 kg/m2, 8.06}2.01 mmol/L and 8.34}1.9 % respectively. Significant positive correlation of HbA1c and FBS with BMI, total cholester- ol(TC), triglyceride(TG), low density lipoprotein(LDL-C) and negative correlation with high density lipoprotein (HDL-C) was found. Significantly higher TC, TG and LDL-C and lower HDL-C were found in poor glycemic control (HbA1c ≥ 7) group than good glycemic control (HbA1c &lt; 7 ) group. The results of this study showed that , higher levels of glycemic parame- ters are significantly associated with dyslipidemia. These findings also indicate that HbA1c can be utilized for screening of high risk diabetic patients for early diagnosis of dyslipidemia and timely intervention with lipid lowering drugs. BSMMU J 2021; 14(4): 138-143

Correlation of glycemic control and BMI with pulmonary function test in Type-2 diabetes mellitus – A cross-sectional case–control study

Background: Type-2 diabetes mellitus is related to decreased lung function. Prolonged inadequate control of glucose levels may alter regulation of inflammatory pathways that are implicated in pulmonary function complications. Aim and Objectives: The objjectives of the study were to assess the relationship of pulmonary function test (PFT) with factors influencing glycemic status in type 2 diabetes mellitus. Materials and Methods: A total of 110 diabetic cases with uncontrolled blood sugar levels and similar number age- and gender-matched control subjects above 30 years of age were recruited. Sociodemographic details were collected and participants underwent laboratory ad radiological investigations. PFTs including Forced vital capacity (FVC), peak expiratory flow rate (PEFR), forced expired volume in 1 s (FEV1), forced expiratory flow (FEF 25–75%), and FEV1/FVC ratio were assessed. Results: The comparison of PFTs with levels of HbA1c (&lt;7 and &gt;7) showed that the levels of FVC, PEFR, FEV1, and FEF 25–75% were higher in diabetics with HbA1c &lt;7 and FEV1/FVC ratio was high in diabetic cases with HbA1c &gt;7. The mean difference of PFT with HbA1c and body mass index (BMI) was statistically not significant in diabetics (P &gt; 0.05). The person’s correlation analysis showed a negative correlation between FVC, FEV1 with HbA1c, and BMI in diabetics. Conclusion: Uncontrolled glycemic status and increased BMI were associated with functional impairment of lungs. Organized glycemic control and duly checking the PFTs may reduce the risk of onset of respiratory complications and lung function.

Correlation of glycemic control with calcium, inorganic phosphate, and alkaline phosphatase in type 1 diabetes mellitus

Correlation of glycemic control with calcium, inorganic phosphate, and alkaline phosphatase in type 1 diabetes mellitus

Effect of Type 2 Diabetes Mellitus and Diabetic Medication on Pulmonary Function

Background: Type 2 diabetes mellitus (T2DM) is a chronic condition with an impairing effect on multiple organs. Numerous respiratory disorders have been observed in patients with T2DM. However, the effect of T2DM on pulmonary function is inconclusive. Aims: In this study, we investigated the effect of T2DM on respiratory function and the correlation of glycemic control, diabetes duration and insulin intake. Methods: 1500 patients were recruited for this study; 560 having T2DM for at least a year were included in the final data, in addition to 540 healthy volunteers. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% (FEF 25-75%), as well as FEV1/FVC ratio values were measured. Results: A two-sample t-test showed that z-scores produced by Al-Qerem et al.’s equations for FEV1, FVC, and FEF 25-75% were significantly lower for the T2DM group than the control group (p &lt; 0.01). FEV1/FVC ratio in the T2DM group was significantly higher (p &lt; 0.01). Multiple linear regression analysis found that glycemic control represented by HbA1c as well as disease duration were negatively associated with the pulmonary function (p &lt; 0.01). However, insulin intake was found to have no significant correlation with pulmonary function. Conclusion: T2DM was linked to reduced pulmonary function and was consistent with a restrictive ventilation pattern. HbA1c, as well as disease duration, were found to be independent risk factors for reduced pulmonary function.

Correlation of glycemic control in newborn at birth in relation to maternal glycemic control: A prospective clinical study

Aim: Correlation of glycemic control in newborn at birth in relation to maternal glycemic control. Materials and Methods: The present prospective clinical study was conducted in the Department of Pediatrics and Obstetrics and Gynecology, SVS Medical College and Hospital, MBNR. 35 cases were found to be eligible for inclusion in the study. Results: Mean maternal age was 27.14 years. 40.0% patients were primigravida and 60.0% were multigravida. Significant correlation of neonatal hypoglycemia at maternal HbA1c >6.5 was observed. Conclusion: The transmission of mothers glycemic control to newborn, which acts as a screening test and thereby helps in preventing asymptomatic hypoglycemia and long-term neurologic dysfunction.

Diabetes fatalism and its emotional distress subscale are independent predictors of glycemic control among Lebanese patients with type 2 diabetes

ABSTRACTBackground: Achieving and sustaining optimal glycemic control in type 2 diabetes (T2DM) is difficult because of socio-cultural and psychosocial factors including diabetes fatalism. Diabetes fatalism is ‘a complex psychological cycle characterized by perceptions of despair, hopelessness, and powerlessness’.Purpose: The purpose of this paper is to explore whether diabetes fatalism and other psychosocial and socio-cultural variables are correlates of glycemic control in Lebanese population with T2DM.Methods: A convenience sample of 280 adult participants with T2DM were recruited from a major hospital in greater Beirut-Lebanon area and from the community. Diabetes fatalism was assessed using the Arabic version of 12-item Diabetes Fatalism Scale. Multiple linear regression models were used to assess the relationship between HbA1c and psychosocial and socio-cultural characteristics including diabetes fatalism. Four models were run to examine the independent association between HbA1c and diabetes fatalism and to identify which of the 3 subscales (emotional distress, spiritual coping and perceived self-efficacy) were associated with HbA1c.Results: The mean age of the participants was 58.24(SD = 13.48) and the majority were females (53.76%), while 32.73% of the sample had diabetes for more than 10 years. Fully adjusted multiple linear regression models showed that higher scores on diabetes fatalism and the emotional distress subscale (P = 0.018) were significantly associated with higher HbA1c values. In addition, having diabetes for more than 11 years (P = 0.05) and a higher number of diabetes complications (P < 0.001) were associated with higher HbA1c levels. However, advanced age (P = 0.055), female gender (P = 0.003), and diabetes education (P = 0.011) were significantly associated with lower HbA1c levels.Conclusion: This is the first study in the Arab region that identifies diabetes fatalism as an independent predictor of glycemic control among Lebanese. Future studies should further investigate this construct to guide interventions that can address it for better diabetes outcomes.

Abstract P515: Vascular Stiffness is Not Changed by Dipeptidyl Peptidase 4 Inhibitor

Introduction: The action of dipeptidyl peptidase-4 (DPP-4) inhibitors on blood pressure (BP) and arterial stiffness is controversial. This study aimed to investigate the effects of DPP-4 inhibitor (vildagliptin) on the BP and arterial stiffness. Methods: Fifty patients over 35 years of age with diabetes and hypertension without cardiovascular disease were randomized to vildagliptin (n=25) or glibenclamide (n=25) in a prospective, open, drug-controlled study. Both groups used metformin and renin angiotensin system blockers. BP was evaluated by digital sphygmomanometer and by 24-hour ambulatory BP monitoring with the Mobil-O-Graph PWA® device, which analyzes parameters of arterial stiffness (central systolic BP, pulse wave velocity (PWV) and augmentation index (AIx75). Laboratory evaluation (glycemia and glycated hemoglobin), and BP and arterial stiffness measurements were performed before and after 12 weeks of treatment. Results: Glycated hemoglobin reduced non-significantly with treatment in both groups. 24-hour systolic BP decreased significantly in the vildagliptin (123.8±12.5 vs 119.1 ± 1.7 mmHg, P=0.03) and glibenclamide group (125.1 ± 12.2 vs 117.3 ± 8.0 mmHg, P=0.002), but without difference between the groups. There were no changes in central systolic BP and PWV in the vildagliptin group before and after treament. However, in the glibenclamide group, central systolic BP decreased (116.4±12.19 vs 109.0±7.5, mmHg P=0.003), as well as PWV (8.5±1.3 vs 8.1±1.1 m/s, P=0.003), but with no difference between groups (P=0.27 and 0.32, respectively). There was also no difference for 24 hour AIx75 for both drugs. Pearson’s correlation did not demonstrate a correlation of glycemic control with PWV and AIx75. However, office systolic BP and central pulse pressure showed correlation with PWV in the vildagliptin group (P=0.008 and 0.002, respectively) and glibenclamide (P&lt;0.001 and 0.001, respectively). Conclusions: Vildagliptin does not alter BP and arterial stiffness in diabetic and hypertensive patients. The observed improvement in 24-hour BP is due the antihypertensive treatment, as it was demonstrated in the 2 groups. Unlike blood glucose, BP correlates to arterial stiffness.

Correlation of glycemic control and arterial stiffness in patients with type 2 diabetes mellitus

Correlation of glycemic control and arterial stiffness in patients with type 2 diabetes mellitus

A Study on Correlation of Glycemic Control with Serum Lipid Profile and Lipid Ratios among Type 2 Diabetes Mellitus Patients

Diabetic dyslipidemia is one of the major risk factors for cardiovascular diseases (CVDs). Dyslipidemia in diabetes is manifested as elevated Triglycerides, LDL Cholesterol and decreased HDL Cholesterol levels.

LDL From Patients With Well-Controlled IDDM Is Not More Susceptible to In Vitro Oxidation

Increased susceptibility of LDL to oxidation has been shown to be associated with the presence of coronary heart disease and may account for the accelerated vascular disease seen in diabetes. The response of LDL to in vitro oxidative stress has been proposed as a measure of the predisposition of LDL to the in vivo subendothelial oxidative stress. Increased susceptibility to oxidation has been demonstrated recently in diabetic patients with poorly controlled IDDM. Thus, we conducted studies to determine whether the increased susceptibility of LDL to oxidation was secondary to diabetes per se or to the level of glycemic control. Fifteen IDDM patients with good glycemic control and with no evidence of macrovascular disease or proteinuria were compared with healthy age-, sex-, race-, and BMI-matched nondiabetic subjects. Fasting blood glucose levels averaged 12.1 +/- 1.1 (mean +/- SE) vs. 4.9 +/- 0.1 mmol/l in the diabetic versus the control groups, respectively. HbA1c levels averaged 7.7 +/- 0.5 vs. 4.4 +/- 0.2%, reflecting well-controlled diabetes (P < 0.0001). Total, LDL, VLDL, and HDL cholesterol, triglyceride, and lipoprotein(a) levels did not differ between the groups. The particle size, lipid composition, fatty acid content, antioxidant content, and glycation were similar for LDL isolated from both groups. A rapid LDL preparation technique was used to compare LDL susceptibility to oxidation under the following conditions: final LDL cholesterol concentration of 100 microg/ml, 5 micromol/l of CuCl2 at 25 degrees C. There was no difference in the susceptibility to in vitro oxidation of LDL isolated from IDDM patients compared with control subjects. There was no correlation of glycemic control with any of the parameters of the in vitro oxidation of LDL. LDL from patients with well-controlled IDDM does not differ in composition or in susceptibility to in vitro oxidative stress compared with LDL from nondiabetic subjects.