Disorders In Diabetic Patients Research Articles

Protocolo diagnóstico y terapéutico de la nefropatía diabética

Diabetic nephropathy (DN) is a common disorder in diabetic patients associated with increased cardiovascular risk. The diagnosis is fundamentally clinical, based on a persistent reduction of the estimated glomerular filtration rate (eGFR) (using CKD-EPI equation and/or proteinuria [albumin/creatinine ratio in urine]). Other tests are required in atypical presentation, including kidney biopsy for selected cases. Staging and follow-up is based on albuminuria values and eGFR. Management includes general treatment, glycemic control (glycosylated hemoglobin [HbA1c] levels<7%) and the control of arterial blood pressure (< 130/80mmHg). Nephroprotective drugs like renin-angiotensin-aldosterone blockers (ACEI and ARA II), sodium–glucose co-transporter type 2 (SGLT2) and glucagon-like peptide-1 receptor agonists (GLP1), which improve renal prognosis and preventing cardiovascular events.

Böbrek Fonksiyonları Normal Olan Diyabetes Mellitus Hastalarında Anemi Sıklığı ve Bazı Nedenleri

Introduction: Diabetes Mellitus (DM) is one of the most common chronic diseases worldwide according to World Health Organization reports. Anemia is common in patients with DM and anemia is a common hematological disorder in diabetic patients. In our study, we aimed to determine the anemia prevalence and the causes that affect anemia in patients with DM with normal renal function. Materials and Methods: Patients with DM who applied to Eskişehir Osmangazi University Medical Faculty Hospital (the clinics of Family Medicine and Internal Medicine) was included in our study and 229 patients with DM who were not diagnosed with renal dysfunction were included in our study within the last 6 months examinations. Laboratory results that were reviewed in the last 6 months were retrospectively screened and recorded. The hemoglobin (Hb) limit values were evaluated as 12 grams/deciliter (g/dl) in females and 13 g/dl in males and patients with Hb levels below these values were accepted as anemia. The data obtained at the end of the study were analyzed by using SPSS package program. Results: DM patients with normal renal function were included in the study. %25.8 (n=59) of patients had anemia. While 20.3% of the anemia was microcytic anemia, 79.7% was non-microcytic anemia (macrocytic and normocytic anemia). Iron deficiency was found in 57.1% (n = 32), while B12 deficiency was found in 11.8% (n = 7) and folic acid deficiency was found in 3.3% (n = 2) of patients with anemia. Iron deficiency was found in 9.9% (n = 14) of DM patients without anemia. Conclusion: Iron deficiency is the most diagnosed reason of anemia in DM patients. As the clinicians, we can provide early diagnosis and treatment of anemia in diabetic patients especially iron deficiency and we can improve the quality of life of patients and decrease morbidity and mortality.

Vitamin D3 effect on Albuminuria in Type 2 Diabetes Mellitus patients in Northern Andhra Pradesh, India

Introduction: Vitamin D deficiency is a common disorder in diabetic patients and may be a risk factor for the progression of diabetic nephropathy. The present study aimed to assess the effects of a large dose of parenteral. Vitamin D on 24 hours albuminuria in T2DM patients. Methods: This prospective single-center study included 80 vitamin D deficient [25(OH) D <50 nmol/l] T2DM patients with an adequate glycemic control (HbA1c< 7.0%). Without any changes in anti-hyperglycemic or antihypertensive drugs, these patients were given a single high dose (600000 IU) of parenteral Vitamin D3. Then the changes in Vitamin D levels and 24 hours albuminuria were seen on follow up at 3 months. Results: Vitamin D3 supplementation improved 24 hours albuminuria. In the present study, Twenty-four-hour urinary albumin excretion decreased from 210.4 ± 101.2 to 204.6 ± 104.5. In males, it changed from 221.8 ± 99.7 to 216.1 ± 100.3 and in females, it changed from 192.3 ± 108.5 to 186.7 ± 113.1. There was a negative association of albuminuria with Vit D levels in the present study. Conclusion: Vitamin D3 supplementation significantly reduces 24-hour urinary albumin excretion in T2DM patients with Vitamin D3 deficiency.

Prognosis of Diabetic Peripheral Neuropathy via Decomposed Digital Volume Pulse from the Fingertip.

Diabetic peripheral neuropathy (DPN) is a very common neurological disorder in diabetic patients. This study presents a new percussion-based index for predicting DPN by decomposing digital volume pulse (DVP) signals from the fingertip. In this study, 130 subjects (50 individuals 44 to 89 years of age without diabetes and 80 patients 37 to 86 years of age with type 2 diabetes) were enrolled. After baseline measurement and blood tests, 25 diabetic patients developed DPN within the following five years. After removing high-frequency noise in the original DVP signals, the decomposed DVP signals were used for percussion entropy index (PEIDVP) computation. Effects of risk factors on the incidence of DPN in diabetic patients within five years of follow-up were tested using binary logistic regression analysis, controlling for age, waist circumference, low-density lipoprotein cholesterol, and the new index. Multivariate analysis showed that patients who did not develop DPN in the five-year period had higher PEIDVP values than those with DPN, as determined by logistic regression model (PEIDVP: odds ratio 0.913, 95% CI 0.850 to 0.980). This study shows that PEIDVP can be a major protective factor in relation to the studied binary outcome (i.e., DPN or not in diabetic patients five years after baseline measurement).

Nano-Level DL-Methionine Biosensing in Blood Serum and Urine Using CuO/AgO Modified Graphite Electrode

DL-methionine (DLM) is a common precursor for some amino acids essential to human physiology, (e.g. homocysteine and cysteine). Its contribution to detoxification and regulation of cell aging as well as fat build-up makes it an essential ingredient in the body fluids. Changes in blood level DL-methionine concentration may not be detrimental to human health, however, its contribution to regulating homocysteine level may contribute to some metabolic disorder in diabetic patients with non-cardiovascular diseases. The current research report features a new approach developed towards fabricating a new CuO/AgO modified graphite pencil electrode for sensing in human blood serum and urine samples at the nanoscale limit of detection. The fabricated sensor was characterized by means of X-ray Photoelectron Spectroscopy, Raman spectroscopy and scanning electron microscopy while being used to detect the DLM analyte. Electrode reactions were monitored using cyclic voltammetric and electrochemical impedance spectroscopic methods. The Ag-induced catalytic activity between pH 7-10 was observed following oxidation of the analyte at the electrode surface in the presence of hydroxide ions. DLM detection was ascribed to the unique electroactive Ag and Cu sites on the sensor electrode. The efficiency of this sensor towards analyte sensing within these biological samples in the presence of potential interferences was also investigated. This study features the success in DLM sensing in the presence of multiple amino acid interferences in complex biological samples. With the emergence of complications involving some neuro and cerebrovascular diseases associated with residual methionine, this work presents a biomolecular means of sensing of DLM as a disease biomarker at the nanoscale. The lowest DLM detection limit (DL) in this study was in the nanomolar level; 50 and 60 nM DLM in the serum and urine, respectively.

Medical and socio-demographic determinants of depressive disorders in diabetic patients.

Diabetes is a civilisation disease creating a serious challenge for public health. In Poland, approximately 2 million people suffer from diabetes, of which about 25% are unaware of their illness. A considerable part of persons with diabetes experience complications related with the disease. The aim of the study was to determine the relationship between elements of the state of health and socio-demographic characteristics of diabetic patients treated in the Diabetes Clinic at the Institute of Rural Health (IMW) in Lublin, eastern Poland, and the occurrence of depressive symptoms in these patients. The study was conducted in 2017-2018 among patients treated in the Diabetes Clinic at the Institute of Rural Health in Lublin, by the method of a diagnostic survey using the Beck's Depression Inventory and an author-constructed questionnaire, as well as data from the patients' medical records. The study included 314 patients from the Diabetes Clinic who expressed their informed consent to participate in the research. The study showed that diabetes is a disease which predisposes for the occurrence of depression. The occurrence of depressive symptoms of various degrees of intensity was confirmed in more than a half of the examined patients. Among the factors which exerted a significant effect on the occurrence of depressive symptoms were: diabetic neuropathy, type 2 diabetes, high BMI value, lack of occupational activity, poor material standard, and the need to obtain assistance in daily functioning due to the fact of being ill with diabetes. It is necessary to implement routinely performed examinations into the diagnostic-therapeutic process to assess the state of psychological health of diabetic patients, which would allow sufficiently early application of appropriate psychological or psychiatric intervention.

Prevalence of depression and its associated factors among patients with diabetes mellitus at Tirunesh-Beijing general hospital, Addis Ababa, Ethiopia

BackgroundDepression is one of the common and overwhelming mental disorder in diabetic patients. A little is known about the prevalence and associated factors of depression among diabetic patients at general hospitals. Therefore, this study aimed to assess the prevalence and associated factors of depression among patients with diabetes mellitus at Tirunesh-Beijing General Hospital, Addis Ababa, Ethiopia.MethodsAn institution-based cross-sectional study was conducted from February 8 to April 8, 2019. A systematic random sampling technique was used to select 403 participants. Depression was assessed by using patient health questionnaire-9 (PHQ-9). Oslo 3 social support scale was used to assess social support. The data were entered into Epidata version 3.1 and analyzed by the statistical package for social science version 23 software. We computed bivariate and multivariate binary logistic regressions to assess factors associated with depression. Statistical significance was declared at P-value < 0.05.ResultsA total of 403 study participants were interviewed with a response rate of 99%. The prevalence of depression among diabetic patients was 21.3%. In the final multivariate analysis, diagnosed with type II diabetes mellitus, being physically disabled and having poor social support were independent predictors of depression.ConclusionsType II diabetes mellitus, poor social support and physical disability were factors associated with depression. An early depression-focused regular screening for diabetic patient should be carried out by trained health professionals. Linkage with mental health service providers also needs to be considered. Clinicians needs to give emphasis to diabetic patients with physically disable and poor social support.

An Electrical Stimulator to Suppress the Nervous Pain in Diabetic Neuropathic Patients

Peripheral neuropathy is an acute disorder in diabetic patients who are suffering a very agonized pain in their peripheral nerves. Symptomatic relief can be achieved by some analgesic pain killers. One of the best approaches is using an electrical stimulation method where the sensory nerve fibers get excited by the application of pulsed currents at the site of pain. This could block the pain signals from reaching the brain, followed either by the pain gate theory or opioid mechanism. This study primarily focuses the feedback principle where the stimulus is given with respective to the patient’s skin intensity to avoid skin burning in therapy. The opioid mechanism has been proved scientifically that it provides long-lasting pain relief even after the stimulation. This paper documents the design and operation of feedback system which provide a constant output by varying the width of pulses. Thereby, the patient’s pain as well as the sufferings of skin reactions upon stimulus is reduced. As this electrical nerve stimulation strategy is a simple, safe, non-pharmacological, cost-effective it proves to be a better alternative for pain relief

Pattern of Musculoskeletal Disorders in Adult Diabetics patient

Diabetes mellitus is associated with several musculoskeletal (MSK) disorders. Due to increased incidence and life expectancy causes increased prevalence and clinical importance of MSK alterations in diabetic subjects. It is difficult to find out the direct relation with metabolic control. This study was conducted to explore the pattern of musculoskeletal disorders in the diabetic patients. A cross-sectional study was conducted from January' 2016 to June' 2016 at Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka with 190 cases divided in two groups. Patients aged 40-70 years with musculoskeletal disorder with diabetes mellitus (type 2) for five years attending in the department of Physical Medicine and Rehabilitation were included in group A. Patients with MSK disorder without diabetes aged 40- 70 years were included in group B. Main outcome measures were done by Chi square test and unpaired t test were calculated by using SPSS-20. Out of 190 patients, more than half (53.68%) patients were belonged to age 51- 60 years in group A and 49(51.58%) in group B. Majority (56.84%) patients were female in group A and 43(45.26%) in group B. Twenty three (24.21%) patients were house wives in group A and 25(26.32%) in group B. Fifty two (54.73%) patients had osteoarthritis of knee in group A and 26(27.36%) in group B. Twenty one (22.11%) patients had frozen shoulder in group A and 9(9.47%) in group B. Sixteen (16.84%) patients had Flexor tenosynovitis in group A and 04(4.21%) in group B. Fifteen (15.78%) patients had Fibromyalgia in group A and 05(5.26%) in group B. Twelve (12.63%) patients had Planter fascities in group A and 03(3.16%) in group B. Which were statistically significant (p&lt;0.05) but other musculoskeletal disorders were not statistically significant (p&gt;0.05) between two groups. More than half patients were belonged to age 51-60 years and female were predominate in both groups. Common musculoskeletal disorders in diabetic patients were osteoarthritis of knee, frozen shoulder, Flexor tenosynovitis, Fibromyalgia, Planter fascities, Rheumatoid arthritis, Carpel tunnel syndrome, Lumbar spondylosis, Cervicalspondylosis and DISH. This study will also be helpful for different organizations working in this area including physiatrist in their program for delivering a comprehensive treatment service. As a result patients were more benefited.&#x0D; Bangladesh Med J. 2019 Jan; 48 (1): 5-12

Fluoxetine Attenuated Anxiety-Like Behaviors in Streptozotocin-Induced Diabetic Mice by Mitigating the Inflammation.

Patients with diabetes mellitus (DM) showed an increased risk of anxiety. High anxiety levels are also shown to increase stress of diabetic patients, which may contribute to poor clinical outcomes. The mechanisms underlying the development of anxiety disorders in diabetic patients remain unknown. As a result, there are no available treatments yet. Here, we tested the hypothesis that glial cells in the hippocampal area of DM mice might be responsible for their anxiety-like behaviors. Furthermore, we postulated that treatment with antidepressant, fluoxetine, could reduce anxiety behaviors and prevent the dysregulation of glial cells (oligodendrocyte and astrocyte) in DM mice. Diabetic mice were administered a single injection of streptozotocin (STZ), followed by treatment with fluoxetine. Mice were then tested on Y maze, open field, dark and light transition, and elevated plus maze tests to measure the status of anxiety and cognition. After completing these behavioral tests, mice were sacrificed and western blot was used to detect the oligodendrocyte and astrocyte maker proteins in hippocampal tissues. Emphasis was directed towards adult oligodendrocyte precursor cells (OPCs) and their marker protein to measure their proliferation and differentiation. We found that fluoxetine could effectively mitigate the level of anxiety and attenuate the cognitive dysfunction in diabetic mice. Meanwhile, fluoxetine inhibited astrocyte activation in mice exposed to STZ, prevented the loss of myelin basic protein (MBP), and affected the function of OPCs in these diabetic mice. The results suggested that the changes of these glial cells in the brains of diabetic mice might be related to the high anxiety levels and cognitive deficit in DM mice. Fluoxetine could ameliorate the high anxiety level and prevent cognitive deficit via inhibiting astrocyte activation and repairing the oligodendrocyte damage.

Comparison of frequency of depression and sleep quality in patients with Type 2 Diabetes mellitus with controls

Diabetes mellitus with its high prevalence and related hygienic problems is one of the most important worldwide burdens that can also cause mental and psychological side effects. The disease complications, chronic progress, treatment costs and social problems are among the issues that can affect the patients’ cognitive function and cause depression and sleep disorders. Failure to diagnose and treatment of such issues causes a poor prognosis and increases the risk of death. High prevalence of sleep disorders in diabetic adults and its association with depression and glucose metabolism encouraged us to conduct a study to compare the frequency of depression and sleep disorders in type-2 diabetic patients with non-diabetics. Methodology In a prospective case-control study design, considering the inclusion and exclusion criteria, 64 diabetic patients from 22 Bahman Hospital and 86 non-diabetic individuals as the matched group, were enrolled in the study during the years 2013 to 2014. To gather the data, Pittsburg sleep quality index and Hamilton depression rating scale was used. Results Sleep quality disorders and depression are more common in diabetic patients. In diabetic patients, percentage of depression and sleep quality disorders was 78.1, 68, and in non-diabetics, it was 50% and 36%, respectively. This study showed significant relationship between sleep quality disorders and depression between the two groups of participants. No significant relationship was found regarding control blood sugar, type of treatment and the amount of time a person is exposed to the disease and incidence of depression and sleeping problems. Conclusion Regarding the high prevalence of depression and sleep disorders in diabetic patients, it is necessary to diagnose depression and sleep disorders.&#x0D;

292-LB: The Exercise-Like Impacts of Conditioned Media Harvested from Cultured Dental Pulp Stem Cells on Myokine Expressions in Skeletal Muscles

Exercise improves not only glycemic control, but also other metabolic disorders in diabetic patients. Furthermore, exercise also stimulate muscle-derived secreted factors, myokines, via muscle contraction. The receptors of myokines expressed in the whole body and myokines affect autocrine, paracrine, and systemic functions for all people and patients with diabetes. In this study, we have demonstrated that there are exercise-like impacts of conditioned media from cultured dental pulp stem cells (DPSCs) on myokine expressions in skeletal muscles. DPSCs were isolated and cultured from the mandibular incisors of 6-week-old male Sprague-Dawley (SD) rats. Conditioned media from DPSCs (DPSC-CM) was collected after 24-hour culture of DPSCs in the serum-free medium and concentrated by a factor of 10. We firstly investigated the effects of DPSC-CM on exercise-induced myokines, follistatin-like 1 (Fstl1), Fractalkine, and fibroblast growth factor 21 (FGF-21) in C2C12 myotubes. DPSC-CM significantly increased the gene expressions of Fstl1 (209±16%, P&amp;lt;0.01), Fractalkine(182±41%, P&amp;lt;0.05), and FGF-21 (1021±39%, P&amp;lt;0.01) in C2C12 myotubes. To confirm these effects in vivo, we administered DPSC-CM (1.0 ml/rat) into 10 sites of unilateral hindlimb skeletal muscles of male SD rats, and examined the effects on myokine gene and protein expression. DPSC-CM significantly increased Fstl1 gene expression in the gastrocnemius muscles (477±140%, P&amp;lt;0.05). Immunohistochemical staining revealed that the expression of Fstl1 was increased in the DPSC-CM-injected gastrocnemius muscles. These results suggest that there is a novel exercise-like impact of DPSC-CM on skeletal muscles. Disclosure S. Kanada: None. E. Makino: None. N. Nakamura: None. M. Miyabe: None. M. Ito: None. M. Hata: None. T. Saiki: None. T. Minato: None. K. Miyazawa: None. S. Goto: None. T. Matsubara: None. K. Naruse: None.

Serum Ferritin level, microalbuminuria and non-alcoholic fatty liver disease in type 2 diabetic patients

BackgroundNon-alcoholic fatty liver disease (NAFLD) was considered one of the most common causes of chronic liver disease and is considered the hepatic manifestation of type 2 diabetes mellitus (T2DM). The factors that lead to marked fibrosis and liver cell injury in NAFLD are still remaining undiscovered. Patients and methodsThis study included (40) type 2 diabetic patients with NAFLD and (40) diabetic patients without NAFLD beside 15 healthy persons as a control group. All of them were subjected to full history taking, thorough clinical examination with especial stress on body weight (BW), height, body mass index (BMI), waist-hip ratio, blood pressure. Laboratory tests included serum total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL) and high-density lipoprotein (HDL), fasting blood glucose (FBG) and 2-h postprandial blood glucose (PBG), serum Ferritin and urine microalbuminuria (MAU). ResultsDuration of diabetes, BW, BMI and blood pressure were significantly higher in NAFLD group (P = 0.001). FBG, PBG, TC, TG, LDL, serum Ferritin and MAU were significantly increased in NAFLD group with significant difference between two studied groups as regard HDL. There was a highly significant correlation between serum Ferritin with BW, BMI, duration of diabetes, TC, TG, LDL and MAU. There was a significant correlation between serum Ferritin with age, waist hip ratio, duration of diabetes, SBP, FBG, PBG and HDL. There was a significant correlation between MAU and age, weight, BMI, waist hip ratio, duration of diabetes, DBP, FBG TC, TG, LDL and HDL. ConclusionNAFLD is a common liver disorder in diabetic patients. NAFLD is significantly associated with microalbuminuria and elevated serum Ferritin.

The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies.

Depression is a common co-morbidity in patients with type 2 diabetes mellitus (T2DM). Untreated depression in these patients adversely affects self-care activities and other diabetes complications. The aim of this study is to estimate the prevalence of depression among patients with T2DM by conducting a meta-analysis of observational studies. MEDLINE, Web of Science, Science Direct, and Google Scholar databases were searched for all observational studies that assessed depression in T2DM. Relevant articles were searched using the combination of Medical Subject Heading (MeSH) terms of "depression", "depressive disorder", and "diabetes mellitus" published between January 2007 and July 2018. Random effects model was used to estimate the weighted prevalence rates and 95% CI using "metaprop program in STATA 11". In total, the 248 included studies (with 273 reported prevalence) identified 83,020,812 participants; of them, 23,245,827 (28%; 95% CI 27, 29) suffered from different severity levels of depressive disorders. The prevalence of depression was separately reported in 137,372 males and 134,332 females. Of them, 31,396 males (23%, 95% CI: 20, 26) and 45,673 females (34%, 95% CI: 31, 38) were depressed. Compared with global estimate, depression prevalence was lower in Europe (24%) and Africa (27%), but higher in Australia (29%) and Asia (32%). The prevalence in America was equal to the estimated prevalence in the world (28%). Depression was more common in subjects younger than 65 compared with elderlies (31% vs. 21%). Our findings demonstrated that almost one in four adults with T2DM experienced depression. Given the high prevalence of depressive disorders in diabetic patients, screening these patients for co-morbid depression and its relevant risk factors is highly recommended.

Polydeoxyribonucleotides Improve Diabetic Wound Healing in Mouse Animal Model for Experimental Validation.

BackgroundWound healing mechanisms is believed to have effects similar to wound healing disorders in diabetic patients, including abnormal inflammatory cells, angiogenesis disorders, and reduced collagen synthesis. Therefore, reestablishment of structural and promoted angiogenesis could be beneficial to promote wound healing process.ObjectiveTherefore, we investigated whether the polydeoxyribonucleotide (PDRN) that was self-production in Korea, could be useful as an intradermal injection for promoting wound healing. Also, we validate for wound healing effect of PDRN using healing-impaired (db/db) mice.MethodsIn this study, we confirmed the effects of PDRN by creating wound models in in vitro and in vivo model. Using an in vitro wound healing assay, we observed that PDRN stimulated closure of wounded monolayers of human fibroblast cells. PDRN (8.25 mg/ml) or phosphate-buffered saline (0.9% NaCl) was injected once daily into the dermis adjacent to the wound for 12 days after skin injury.ResultsTime course observations revealed that mice treated with PDRN showed accelerated wound closure and epidermal and dermal regeneration, enhanced angiogenesis. The wound area and depth decreased at 3, 6, 9, and 12 days after skin injury. Histological evaluation showed an increase of vascular endothelial growth factor, CD31, and collagen fibers in the PDRN group compared with the control group, indicating that PDRN was effective in the treatment of delayed wound healing caused by diabetes.ConclusionThis study suggests that our PDRN has a wound healing effect in transgenic animal models with cells and diabetes through angiogenesis.

A study of prevalence of thyroid disorders in type 2 diabetic patients in tertiary care hospital

Background: Insulin and thyroid being intimately involved in cellular metabolism, excess or deficit of one of these hormones leads to abnormality of the other. Association between type 1diabetes and hypothyroidism may be autoimmune. Association of poorly controlled diabetes and thyroid results in a low T3 state and loss of TSH response to TRH. The objective of the present endeavor is to study the thyroid functions in diabetics and to know the spectrum of thyroid dysfunction in DM.Methods: It is a prospective cross-sectional study of 100 diabetic patients admitted in medical wards in a duration of 6 months from November 2017 to May 2018 of both sexes in between age group of 30-80years. All these patients underwent thyroid profile tests. Detailed history and examination done on these patients.Results: Out of total 100 patients included in the study, thyroid disorder was present in 29%. Hypothyroidism in 1 patient, sub clinical hypothyroidism in 15 patients, hyperthyroidism was present in 13 patients. Females (36%) had high incidence than males (22%). Elderly people had higher incidence of subclinical hypothyroidism (18.2%), clinical features of hyperthyroidism present in 8 patients, Poor hypoglycemic control seen in hyperthyroid individuals (55.5%). Duration of diabetes had no relation with incidence of thyroid disorders.Conclusions: Prevalence of thyroid disorders in diabetic patients was 29%. Elderly population had more incidence. Subclinical hypothyroidism more common than other conditions. It was more common in females than in males. There is no relation in between duration of diabetes and thyroid disorder. Severe complications were noted in patients with sub clinical hypothyroidism.

Musculoskeletal problems in diabetes mellitus.

Diabetic patients may suffer from a wide range of musculoskeletal disorders that can cause pain and some dysfunctions in the patient and affect the treatment negatively or reduce the quality of life by causing problems in the implementation of exercise programs, which are very important in the treatment of patients with Diabetes Mellitus. Although most of these problems are also seen in non-diabetics, they are more frequently observed but are not specific to diabetics. Their physiopathology is not fully understood; there is some evidence suggesting that macro- and microvascular complications of diabetes are responsible. A diagnosis of musculoskeletal dysfunctions in diabetic patients is made by clinical findings, and there is currently no specific treatment. If the treatment of problems requires corticosteroid use, diabetes can be hard to manage. In this review, we summarized the general features, diagnosis, and treatment modalities of frequent and important musculoskeletal disorders in diabetic patients.

Is hearing impairment in diabetic patients correlated to other complications?

Diabetes mellitus (DM) is a heterogeneous group of metabolic disorders characterized by chronic hyperglycemia that results by relative or absolute insulin deficiency. Hearing disorders is common otological disorders in diabetic patients. This study aimed to investigate the frequency of hearing impairment among DM patients and its association with diabetes complications and blood sugar control. This analytical cross-sectional study was conducted from 2016 to 2017 on 81 patients with type 2 diabetes mellitus (T2DM), aged 40-65years who were referred to Yazd diabetic research center. Air conduction pure tone hearing thresholds were obtained for each ear at frequencies of 250, 500, 1000, 2000, 4000 and 8000Hz. We defined hearing impairment as the pure-tone average ≥ 25dB hearing level of pure-tone thresholds at low frequencies (500; 1000; and 2000Hz) and high frequencies (4000 and 8000Hz. The demographic data and diabetes complications frequency were gathered. All statistical analysis was done in SPSS 22. The mean (±SD) age of participants was 56.38 ± 5.68years (range 40-65years), 32(39.5%) were males and 49(60.5%) were females. The prevalence of hearing loss in high frequency in right ear was higher in male (p value = 0.047). The grade of diabetic retinopathy and nephropathy were significantly associated with hearing impairment in high frequency in both ears (p value<0.05). Finally, the results showed that even after adjustment of confounding variables using logistic regression analysis there were no relationship between hearing impairment and variables in both ears. The hearing impairment was associated with diabetes complications as retinopathy and nephropathy. The association was significant in high frequency.

Prevalence of dyslipidemia among the diabetic patients in southern Bangladesh: A cross-sectional study

AimDiabetic dyslipidemia is one of the major risk factors for cardiovascular disease which has a vast mortality rate throughout the world. Early detection and treatment of dyslipidemia can avoid risk for cardiovascular disorder in diabetic patients. This study was conducted to determine the prevalence of and pattern of dyslipidemia in diabetic patients. Materials and methodsThis cross sectional study was performed in several specialized diabetic hospital of Noakhali, a southern district of Bangladesh. All known cases of diabetes mellitus were evaluated for their lipid profile. A total number of 1008 patients were included in the study having 683 (67.8%) female and 325 (32.2%) male subjects. ResultsThe prevalence of dyslipidemia among the male subjects was 73% while among female subjects 71%. Among diabetic males the percentage of high serum Cholesterol, high serum TG (Triglyceride), low HDL (High density cholesterol) and high LDL (Low density cholesterol) was 35.69%, 44.31%, 50.15% and 72.92% respectively, whereas the female had the percentage at 35.29%, 40.85%, 49.49% and 70.57% respectively. ConclusionMajority portion of the study subjects were dyslipidemic. The most prevalent pattern among both male and female was high level of LDL and low level of HDL. The prevalence of dyslipidemia in Bangladesh is significantly high, which indicates the urgency of lifestyle intervention strategies to prevent and manage this important health problem and risk factor.

Influence of sex and estrous cycle on blood glucose levels, body weight gain, and depressive-like behavior in streptozotocin-induced diabetic rats.

Depression is the most common psychiatric disorder in diabetic patients, showing higher rates in women than in men. This comorbidity has been studied in rodents using the streptozotocin (STZ)-induced diabetes (DM) model, consistently reporting a depressive-like profile in males. Few articles have examined these disturbances in females (ovariectomized or combined with male rats) yielding controversial results. This work was aimed to study whether there are sex differences in the depressive-like profile of STZ-treated male and naturally cycling female Wistar rats. We also analyzed the possible influence of the estrous cycle in females. DM was induced by injecting STZ (50 mg/kg, i.p.) in 2 consecutive days. Ten days later, the depressive-like profile was assessed in the Forced-Swim Test (FST). Locomotion and motor coordination were also evaluated. Body weight and blood glucose levels were registered at the beginning and at the end of the experiment; the estrous cycle, food and water intake were daily monitored. All diabetic subjects showed increased blood glucose levels, polyphagia, polydipsia and decreased body weight as compared to controls, but males were more susceptible to STZ-treatment than females pooled in all phases of the estrous cycle. After treatment with STZ, males and females in proestrus/estrus (P/E) exhibited a depressive-like profile in the FST (increased immobility and reduced swimming); females in metestrus/diestrus were unaffected. The only sex difference observed was a more pronounced reduced swimming in STZ-treated P/E females compared with hyperglycemic males. No changes in locomotion or motor coordination were found. This work emphasizes estrous cycle differences in STZ-treated rats, and in the resultant depressive-like profile. It also supports clinical evidences made in women with DM and stresses the importance of studying STZ-treated naturally cycling females and their estrous cycle phases.