Levels In Diabetic Patients Research Articles

Relationship between mental symptoms, dietary compliance and glucose levels of diabetic patients in isolation during COVID-19 pandemic

Aim: Coronavirus disease 2019 (COVID-19, 2019-nCoV) which first appeared in Wuhan, China in December 2019 is a disease causing acute respiratory failure. Home isolation methods are used to control the disease all around the world and also in our country. In this study we planned to explain the relationship between some mental symptoms, diet compliance, frequency of blood glucose measurement and blood glucose levels in diabetic patients during home isolation. 
 Material and Method: In this study some questions about the frequency of blood glucose measurement, blood glucose levels, dietary compliance and mental states of the patients were asked on the phone and the patients were asked to give a score to the symptom severity. The notes were retrospectively screened.
 Results: It is known that social isolation triggers the anxiety and depression. Anxiety and depression can increase the secretion of some hormones which leads high blood glucose levels (respectively 54.4% of those with 200-300 mg/dl, 91.7% of those with >300 mg/dl don't follow their diets) in diabetic patients. These symptoms can reduce dietary compliance and frequency of the blood sugar measurement, therefore can make metabolic control of the diabetes difficult.
 Conclusion: In this study, we found that blood glucose levels were very high and the frequency of blood glucose measurements were very low in the patients who had some mood changes and we saw that the patients did not follow on their diets. It is important to support patients mentally during this process. Training and following up should be used with some various methods.

Investigation of serum level relationship anti-glutamic acid decarboxylase antibody and inflammatory cytokines (IL1-β, IL-6) with vitamins D in type 2 diabetes.

Various factors are involved in the development and progression of diabetes mellitus, from cytokines and autoimmune destruction of pancreatic beta cells to vitamin D.This study aimed to investigate the association of serum levels of anti-glutamic acid decarboxylase (anti-GAD) and inflammatory cytokines with vitamin D in type 2 diabetes (T2D). This case-control study was performed on 30 patients with T2D and 30 healthy individuals in Mashhad hospitals in 2020. Lipid profile, creatinine, uric acid, FBS, HbA1c, and blood pressure were recorded. All study variables were measured, particularly serum vitamin D, anti-GAD, and inflammatory cytokine levels in diabetic patients, and the data were compared to those from healthy subjects by performing an appropriate statistical analysis. Diabetic patients with a mean age of 52.9 ± 10.4years, including 16 women and healthy individuals with a mean age of 48.5 ± 10.4years, including 16 women, were studied. BMI level (P = 0.002), systolic blood pressure (P = 0.034), HbA1c, insulin, IL-6, IL1-β, anti-GAD levels, and insulin resistance in diabetic patients were significantly higher than the control group (P = 0.001). The vitamin D level in the control group was significantly higher than in the case group (P = 0.0001). The results showed a significant direct relationship between IL-6, IL-1β, and anti-GAD with HbA1c, FBS, insulin, and insulin resistance. However, there was a significant inverse relationship between IL-6, IL-1β, and anti-GAD with vitamin D. Inflammatory cytokines and anti-GAD and vitamin D are associated with diabetes, and thus controlling these factors can help improve T2D.

RECENT APPROACHES IN GLUCOSE RESPONSIVE INSULIN DELIVERY SYSTEM

Diabetes mellitus is a chronic medical condition currently affecting 382 million people across the globe, caused due to increased blood glucose levels due to less insulin production or insulin resistance. Subcutaneous insulin administration for diabetes is the only most accepted therapy for maintaining blood glucose levels in diabetic patients. Many patients with advanced type II diabetes mellitus need to regularly monitor their blood glucose level to keep their blood glucose level in the target range. However long-term insulin therapy through an invasive route of administration causes problems with patient compliance and a sudden decrease in blood glucose levels. An artificial closed-loop insulin release system that mimics the glucose-responsive insulin secretion by β-cells of pancreas is one of the ways to overcome the problem faced with the conventional method of insulin administration. Many polymeric formulations showed an improved glucose-responsive release of insulin when incorporated with glucose-responsive catalysts such as glucose oxidase, phenylboronic acid, and glucose binding proteins, the release rate can be controlled by optimizing the concentration of glucose-responsive catalysts. This article is been focused on different mechanisms of glucose-responsive release by incorporation with glucose-responsive catalysts.

The Potential Role of Cytokines in Diabetic Intervertebral Disc Degeneration.

Intervertebral disc degeneration (IVDD) is a major cause of low back pain. Diabetes mellitus is a chronic inflammatory disease that may cause or aggravate IVDD; however, the mechanism by which diabetes induce IVDD is currently unclear. Compared to non-diabetic individuals, diabetic patients have higher levels of plasma cytokines, especially TNF-α, IL-1β, IL-5, IL-6, IL-7, IL-10, and IL-18. Due to the crucial role of cytokines in the process of intervertebral disc degeneration, we hypothesized that elevation of these cytokines in plasma of diabetic patients may be involved in the process of diabetes-induced IVDD. In this review, changes in plasma cytokine levels in diabetic patients were summarized and the potential role of elevated cytokines in diabetes-induced IVDD was discussed. Results showed that some cytokines such as TNF-α and IL-1β may accelerate the development of IVDD, while others such as IL-10 is supposed to prevent its development. Apoptosis, senescence, and extracellular matrix metabolism were found to be regulated by these cytokines in IVDD. Further studies are required to validate the cytokines targeted strategy for diabetic IVDD therapy.

Smart erythrocyte-hitchhiking insulin delivery system for prolonged automatic blood glucose control

Long and automatic control of blood glucose levels in diabetic patients could solve the problems caused by frequent insulin injections. Herein, we exploited the protection potential of erythrocytes by a "hitchhiking" strategy to significantly prolong the blood circulation time of a specifically-designed smart hitchhiking insulin delivery system (SHIDS). In the SHIDS, insulin, glucose oxidase, and catalase were co-loaded into nanoparticles formed by modified chitosan. The free glucosamines in chitosan anchor glucose transporters on the surface of erythrocytes, allowing erythrocyte-hitchhiking in the blood flow. A high glucose level triggers quick insulin release from the SHIDS to reduce the glucose level, which then slows the insulin release. This closed-loop glucose regulation by the SHIDS effectively controlled blood glucose within the normal range for at least 24 h and under 250 mg dL-1 for ∼48 h with one injection. This injectable erythrocyte-hitchhiking nanoplatform, which achieves long-term and automatic blood glucose control, thus has potential for further development. As the carrier could be used for delivering other drugs/agents or interacting with other substances, the hitchhiking strategy is versatile and may be applied in other medical applications too.

Host factors and risk of pin site infection in external fixation: A systematic review examining age, body mass index, smoking, and comorbidities including diabetes

Introduction: Host factors affecting pin site infections were selected by The Pin site Consensus Group, using a modified Delphi approach, to be one of the top 10 priorities to investigate how to reduce rates of pin site infections, improve clinical management, and inform research. The aim of this study was to perform a systematic literature review of the association between host factors and pin site infection, focused on age, smoking, body mass index, and comorbidities, in particular diabetes. Materials and Methods: The literature search strategy was developed as advised in the Cochrane Handbook for Systematic Reviews of Interventions following the PRISMA guidelines with the help from a scientific librarian. The protocol was registered in the International Register of Systematic Reviews, PROSPERO (ID: CRD42021273305). The literature search was executed in three electronic bibliographic databases, including Embase MEDLINE (1111 hits) and CINAHL (2066 hits) through Ovid and Cochrane Library CENTRAL (387 hits). Results: A total of 3564 titles were found. 3162 records were excluded by title and abstract screening. 140 studies were assessed for full-text eligibility. All excluded studies were not reporting specific numbers of patients with pin site infection and the associations of interest. 11 studies were included for data extraction. The included studies were all designed retrospective, and the risk of bias assessment was done using Joanna Briggs Institute risk appraisal tool. The extracted data are presented as results in tabular summaries. This review reveals an increased risk of pin site infection associated with increased HbA1C level in diabetic patients and congestive heart failure in diabetic patients. An increased risk of pin site infection was associated with a lower ASA score. None of the included studies found any association between pin site infection and smoking, age, or body mass index. Conclusion: This systematic literature search identified a surprisingly low number of studies examining the association between pin site infection and the specific host factors. Thus, this review most of all serves to demonstrate a gap of evidence about the correlation between host factors and risk of pin site infection, and further studies are warranted.

Therapeutic Interventions of Novel SGLT2 Inhibitors Against Metabolic Disorders: Transforming the Association into Perspectives.

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are an emerging group of therapeutic agents that show their tremendous glucose lowering activity without producing hypoglycemia, which is one of the major drawbacks of existing antidiabetic therapy. Comprehensive literature was searched in English using electronic databases including PubMed, ScienceDirect, Medline, Scopus and Embase. SGLT2 inhibitors reduce blood glucose levels by producing glucosuria via insulin-independent pathway. The major mechanism by which SGLT2 inhibitors are involved in glucose homeostasis is to prevent the reabsorption of glucose in the proximal convoluted tubule and increase glucose excretion in the urine. Deterioration of β-cells, impairment of functions and development of insulin resistance do not affect the efficacy of SGLT2 inhibitors. SGLT2 inhibitors significantly reduce HbA1c, ameliorate glycemic control and control body weight. SGLT2 inhibitors can block Na+/H+ exchanger (NHE) 1 and play a significant role in treatment of heart failure especially in diabetic patients. They have also positive effects on different metabolic syndromes which cumulatively ameliorate the risk factors for cardiovascular diseases in diabetic patients. SGLT2 inhibitors can improve kidney function by reducing inflammation and improving renal microvasculature up to its original state. The increase in triglyceride level has a strong relationship with coronary artery disease in diabetic patients when combined with other indicators of metabolic disorders while SGLT2 inhibitors cause a significant reduction in plasma triglyceride level in diabetic patients. We have comprehensively summarized the features, mechanism of action of SGLT2 inhibitors and their impact on various metabolic syndrome traits, including diabetic condition, renal dysfunctioning, arterial stiffness, hypertension, lipid profile and cardiovascular diseases. The aim of this review to examine the safety, efficacy and therapeutic properties of SGLT2 inhibitors in renal and diabetic patients.

Anti-Diabetic Activity of Polypeptide-K Isolated from Momordica Charantia: A Retrospective Study of 142 Cases

Diabetes Mellitus occurs when the pancreas fails to produce sufficient insulin, or the body is unable to use the insulin produced effectively. In order to regulate the blood glucose of diabetic patients, Diabegard®, a herbal antidiabetic medicine and daily supplement, contains polypeptide-k which exists in the seed of Momordica Charantia (bitter gourd) was prescribed. Purpose: A retrospective study is therefore done with the aim to examine the effectiveness of Diabegard®, polypeptide-k in regulating the blood glucose and cholesterol level of diabetic patients who took Diabegard® for four weeks with a dose of 60 mg per day. Methods: A database record of 105 male and 37 female (ages 25-81) treated with Diabegard®, polypeptide-k was assessed. The effectiveness of Diabegard®, polypeptide-k in blood glucose regulation was determined based on four aspects: gender, three different age categories, four different categories of duration of the disease and five different categories of severity of the disease. The Pearson's correlation was used to find the correlation among variables. Paired sample t-test was used to compare the means of pre- and post-treatment of blood glucose level. One-way ANOVA was used to compare the means of different groups for each aspect. Results: Result showed that age and duration of disease (r2=0.469), pre-treatment of blood glucose and post-treatment of blood glucose (r2=0.606) showed positive relationship. Both paired sample T-test of pre-and post-treatment of blood glucose showed significant difference (p<0.05). Categories with very mild (7 mmol/L), severe (13.9-19.4mmol/L) and very severe (>19.4mmol/L) diabetes showed significant difference (p<0.05). Other tests showed no significant difference. Conclusion: In conclusion, this present retrospective study showed that Diabegard®, polypeptide-k was effective in controlling blood glucose level of all diabetic patients especially in patients with mild (26.87% reduction), severe (40.43% reduction) and very severe diabetes (49.27% reduction).

In Vitro Evaluation of the Anti-Diabetic Potential of Aqueous Acetone Helichrysum petiolare Extract (AAHPE) with Molecular Docking Relevance in Diabetes Mellitus.

Diabetes mellitus (DM) is a chronic metabolic condition that can lead to significant complications and a high fatality rate worldwide. Efforts are ramping up to find and develop novel α-glucosidase and α-amylase inhibitors that are both effective and potentially safe. Traditional methodologies are being replaced with new techniques that are less complicated and less time demanding; yet, both the experimental and computational strategies are viable and complementary in drug discovery and development. As a result, this study was conducted to investigate the in vitro anti-diabetic potential of aqueous acetone Helichrysum petiolare and B.L Burtt extract (AAHPE) using a 2-NBDG, 2-(N-(7-Nitrobenz-2-oxa-1,3-diazol-4-yl) amino)-2-deoxy-d-glucose uptake assay. In addition, we performed molecular docking of the flavonoid constituents identified and quantified by liquid chromatography-mass spectrometry (LC-MS) from AAHPE with the potential to serve as effective and safe α-amylase and α-glucosidase inhibitors, which are important in drug discovery and development. The results showed that AAHPE is a potential inhibitor of both α-amylase and α-glucosidase, with IC50 values of 46.50 ± 6.17 (µg/mL) and 37.81 ± 5.15 (µg/mL), respectively. This is demonstrated by a significant increase in the glucose uptake activity percentage in a concentration-dependent manner compared to the control, with the highest AAHPE concentration of 75 µg/mL of glucose uptake activity being higher than metformin, a standard anti-diabetic drug, in the insulin-resistant HepG2 cell line. The molecular docking results displayed that the constituents strongly bind α-amylase and α-glucosidase while achieving better binding affinities that ranged from ΔG = −7.2 to −9.6 kcal/mol (compared with acarbose ΔG = −6.1 kcal/mol) for α-amylase, and ΔG = −7.3 to −9.0 kcal/mol (compared with acarbose ΔG = −6.3 kcal/mol) for α-glucosidase. This study revealed the potential use of the H. petiolare plant extract and its phytochemicals, which could be explored to develop potent and safe α-amylase and α-glucosidase inhibitors to treat postprandial glycemic levels in diabetic patients.

A Study of Carotid Doppler and Highly Specific C Reactive Protein in Type II Diabetes Mellitus and Its Correlation with Macrovascular Complications

Background: Diabetes has a multitude of macrovascular complications, one of them being Carotid artery Atherosclerosis leading to stenosis and predisposing patient to Stroke. A hypothesis put forward is the presence of low-grade inflammation in Diabetic patients, which may enhance atherosclerosis. A study was planned to assess Carotid artery stenosis and HsCRP levels in Diabetic patients, so as to identify at risk group and take measures to prevent complications such as stroke and ischemic heart disease.
 Aim: To study the patients by clinical parameters, ultrasound carotid doppler study, and estimation of HsCRP with patients of type II DM.
 Study Design: Cross sectional observational study.
 Place and Duration of Study: Study was conducted at Department of General Medicine, Dr D Y Patil Medical College, Pune from July 2019 – September 2021.
 Methodology: The study included 50 subjects with type 2 DM (as per inclusion and exclusion criterion). All participants were explained the nature of the study and after informed consent all subjects were clinically examined and were subjected to carotid artery doppler and HsCRP levels.
 Results: In our study 16% had carotid stenosis of <50% while 8% had >50%. However, 42% had increased intima-media thickness. On the other hand, 52% subjects had raised HsCRP levels.
 Conclusion: In our study, Carotid Stenosis and impending stenosis was seen in significant number of Diabetic patients of more than 5 years duration, who also had higher HsCRP levels.

Diabetic COVID -19 Patients are prone to Respiratory Distress Syndrome as compared to Non-Diabetic COVID -19 Patients.

Background: COVID-19 is the alarming problem for all over the world due to its fast spread infection mode and uncertainty in mortality rate. The diabetic population is prone for comorbidity with COVID-19 due to injurious fashion develops in respiratory system. Aim: To compare the serum Lactate dehydrogenase levels in diabetic patients with COVID-19 & non diabetic patients with COVID-19. Methodology: This comparative study was done at Ali medical center Hala New District Matiari Sindh. 42 diabetic & non diabetic clinically suspected cases COVID -19 with fever, cough, shortness of breath, non-pneumonic opacities on digital X.ray with raised TLC, ESR & CRP. The data analyzed for significance on SPSS 19 by applying student t test. Results: The serum LDH levels was significantly raised (p<0.001) in group A contained COVID-19 patients with diabetes as compared to COVID-19 patients with no diabetes mellitus. Conclusion: COVID -19 diabetic population will be more prone to develop the respiratory complications. Keywords: COVID-19, Serum LDH, Diabetes Mellitus, Respiratory Distress Syndrome.

Factors Affecting Eating Patterns on Blood Sugar Levels in Diabetes Mellitus Patients in UPT Puskesmas Narumonda

The purpose of this research was to identify and evaluate the major dietary components linked with blood sugar levels in diabetic patients at UPT Puskesmas Narumonda in Toba Regency. This sort of study employs a cross-sectional descriptive analytic survey. The population in this research was 118 individuals, whereas the sample size was 54. Univariate, bivariate, and multivariate analyses were used to analyze the data. The chi-square test results indicate that the sugar level of people with diabetes mellitus is related to the number of calories p = 0.000, the type of food p = 0.000, and the eating schedule p = 0.003, indicating that there is a relationship between obesity, the number of calories, the type of food, and the eating schedule and blood sugar levels in people with diabetes mellitus. The findings of multivariate analysis indicate that the most relevant variable in this research, with an OR value of 53, is the quantity of calories. The research concluded that the quantity of calories consumed is the most important factor influencing blood sugar levels in persons with diabetes mellitus at UPT Puskesmas Narumonda, Toba Regency. To help lower the occurrence of diabetes mellitus, it is intended that the Health Service, puskesmas, and health professionals would collaborate to give frequent counseling about diabetes mellitus and a healthy and balanced diet.

AACE2021-A-1050: Relationship of Serum Level of Bone Formation Biomarker Osteocalcin and CIMT and Metabolic Parameters in Post-Menopausal Females and Type 2 Diabetes

To determine the association between serum levels of OCN and metabolic parameters and carotid intima media thickness (CIMT) in a group of post-menopausal females with type 2 diabetes (T2DM). This cross-sectional study comprised 75 postmenopausal women with T2DM (group 1; 25 patients with normal bone mineral density (BMD), group 2; 25 patients with osteopenia and group 3; 25 patients with osteoporosis) and 40 age matched non-diabetic postmenopausal females. All subjects included in this study were subjected to the following: thorough clinical evaluation, laboratory investigations including fasting blood glucose (FBG), glycated hemoglobin (HbA1c) and lipid profile. Bone mineral density (BMD) was measured by DEXA scan. CIMT was assessed with B-mode ultrasonography. Serum OCN was measured using ELISA. Person’s correlation analysis was used to evaluate the relation of OCN to different parameters of the studied population. Multivariate logistic regression model was used to quantitatively analyze the interactions. Although there was no significant difference between patients with T2DM and control subjects in BMD, serum OCN was significantly lower in patients with T2DM compared to control (63.73±27.20 vs 136.16±21.96 pg/mL, P<.001). Also, there was significant reduction in OCN level in diabetic patients with osteoporosis as compared to those with osteopenia and normal BMD. In diabetic patients there was significant negative correlation between serum OCN and CIMT (r= -0.332; P=0.003) (fig.1), FBG (r= -0.732; P< 0.001), serum insulin(r= -0.302; P=0.007), HbA1c (r= -0.672; P< 0.001) (fig.2), HOMAIR (r= -0.672; P< 0.001). Multiple linear regression analysis showed that serum insulin (β= -0.183, P=0.033), FBG (β= -0.604, P< 0.001) and LDL (β= -0.195, P= 0.02) were still negatively correlated with the serum OCN. Serum OCN concentration is reduced in postmenopausal women with T2DM and it is lower in patients with osteoporosis than those with normal BMD. Low serum OCN level is a significant and independent factor associated with worse glycemic profile and higher insulin resistance conferring thus a larger risk of developing atherosclerosis in this group of patients.

Evaluation of Resistin Levels in Gingival Crevicular Fluid in Diabetic Patients with And without Chronic Periodontitis

Background: Resisting, a newly identified adipocyte secreted hormone may hold a value as an inflammatory mediator, associated with insulin resistance and periodontitis. The aim of the study was to determine the resistin levels in diabetic patients with and without chronic periodontitis. Materials and Methods: A total of 80 patients (both Male and Female) participated in the study. Subjects were categorized into four groups (20 each); the group I (healthy), group II (generalized chronic periodontitis), group III (generalized chronic periodontitis without diabetes mellitus), and group IV (generalized chronic periodontitis with Diabetes Mellitus). The clinical parameters, which included plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL), random blood sugar level (RBS), glycated haemoglobin (HbA1c) were recorded. All the assessments were performed at baseline. GCF samples were collected. Resistin was examined by utilizing a monetarily accessible ELISA unit. Contrasts among groups were statistically analysed. Results: The expression of resisting was significantly increased between the diseased subjects when compared to healthy subjects and was statistically significant (p&lt; 0.001). When all the samples were analyzed together, a significant positive correlation (p &lt;0.001) was observed between GCF resistin expression, clinical parameters (GI, PI, PPD, CAL) &amp; biochemical parameters (RBS and HbA1c). Conclusion: Resisting levels are increased in CP and T2DM. Hence, GCF resistin levels may be considered as a potential inflammatory marker for periodontitis with T2DM

Abstract 9555: A Mean Hemoglobin A1c Level of 7,5% is a Cliff Value for the Development of Cardiovascular Events in Diabetic Patients

Background: We sought to evaluate whether there was a difference in the incidence rate of cardiovascular event (CVD) among different hemoglobin (Hb) A1c levels in diabetic patients without a history of atherosclerotic events. Methods: The Japanese primary prevention of atherosclerosis with aspirin for diabetes (JPAD) trial was a multicenter, prospective, randomized, open label, blinded, end-point study done from 2002 to 2008. After completion of the JPAD trial, we followed up with the patients until 2019. We defined the cardiovascular events as the following: acute myocardial infarction; stable angina; unstable angina; sudden cardiac death; stroke; transient ischemic attack; aortic disease; and peripheral artery disease. Among 2,535 JPAD patients, HbA1c levels of the JPAD patients were recorded on average 8 times. Based on the mean value of HbA1c, we divided the patients into three groups: a High HbA1c Group (n=899, HbA1c ≥7.5%); a Moderate HbA1c Group (n=581, 7.5% &gt;HbA1c ≥7.0 %); or, a Low HbA1c Group (n=1055, 7.0% &gt;HbA1c). We compared the incidence of CVD among the three groups. Results: The mean HbA1c (%) was 8.6 in the High HbA1c Group, 7.4 in the Moderate HbA1c Group, and 6.6 in the Low HbA1c Group on registration. During an 11.56-year follow-up, the incidence of CVD was significantly higher in the High HbA1c Group (P&lt;0.0001, Figure) but was not significantly different between the Moderate HbA1c and the Low HbA1c Groups. Cox proportional hazards model analysis revealed that a High HbA1c level (HR, 1.61: 1.26-2.05, P=0.0001) was an independent factor after adjustment for proteinuria ≥±, age ≥65 years, male, body mass index ≥24 kg/m 2 , duration of diabetes ≥7.0% years, medications, eGFR ≥60 ml/min/1.73m 2 , and systolic blood pressure ≥140 mm Hg (Figure). Conclusions: Our study demonstrated that HbA1c ≥7.5% was independently associated with the incidence of CVD in diabetic patients without a history of atherosclerotic events while 7.5% &gt;HbA1c ≥7.0 % was not.

Low Vitamin D Level was Associated with Non-alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus

Background: Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are major public health concerns. Besides the known risk factors, other risk factors, such as vitamin D deficiency, have been suggested for NAFLD. Objectives: This cross-sectional research aimed to investigate the relationship between serum vitamin D levels and NAFLD in a group of patients with T2DM. Methods: We investigated various clinical and biochemical parameters, including serum vitamin D level, liver function tests, and liver sonography in 1,110 adult patients with T2DM. The mean difference of numerical variables in NAFLD and non-NAFLD groups was analyzed with an independent sample t-test. Chi-square test was used to evaluate the association between two categorical variables. Results: Out of 1,110 patients with T2DM, 837 (75.4%) had NAFLD. The mean vitamin D level in diabetic patients with NAFLD was significantly lower than non-NAFLD group (19.71 ng/mL vs. 27.68 ng/mL, respectively; P &lt; 0.001). Furthermore, 410 (49%) patients with NAFLD were found with vitamin D deficiency, while this value was 85 (31.1%) in non-NAFLD group. According to the results of univariate logistic regression analysis, vitamin D deficiency (OR = 3.87) and insufficient vitamin D (OR = 2.83) were the significant variables for NAFLD. Conclusions: There was a significant association between vitamin D deficiency and NAFLD in patients with T2DM.

Type 1 diabetes and oxidative stress markers

Oxidative stress is associated with numerous chronic inflammatory diseases. In type 1 diabetes (T1D), oxidative stress is involved in various complications and might be among the probable causes. In this study, we assessed some markers of oxidative stress and their relationship with the course of T1D.Materials and Methods: This study was carried out on 76 patients with T1D (men and women) and 10 healthy controls. The patients underwent biochemical (glycemia, HbA1c, total cholesterol, triglycerides, creatinine, urea and arterial pressure), and oxidative stress markers evaluation: superoxyde dismutase (SOD), catalase (CAT), xanthine oxidase (XO), malondialdehyde (MDA) and reduced glutathione (GSH).Results: Results show a highly significant increase (P≤0.001) in blood sugar, HbA1c, and plasma creatinine and urea levels in diabetic patients compared to controls. Cholesterol levels show no significant difference, while triglyceride values are significantly elevated compared to healthy people. Levels of MDA, a lipid peroxidation product, are significantly elevated compared to control values. Regarding the antioxidant defense system, there was a significant increase (p< 0.05) in SOD and CAT activities and a reduction in the level of GSH. XO was particularly higher in men than in women.Conclusion: The oxidant / antioxidant balance is altered during diabetes. The oxidative stress biomarkers such as MDA and XO in T1D may be a useful tool to monitor progressive complications. These results are preliminary and requires further investigations on a large cohort to assess the potential role of oxidative markers in T1D.

Effectiveness of Non-Surgical and Surgical Periodontal Therapy in Lowering HbA1c in Diabetic Patients

Diabetes is global pandemic disease, a metabolic disorder of multiple etiology that is characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Periodontitis is a chronic inflammatory disease that is initiated by the accumulation of dental plaque biofilm, within which microbial dysbiosis leads to a chronic, non-resolving and destructive inflammatory response. In the last decades, many studies investigated the impact of periodontal treatment on glycemic control in people with diabetes. The aim of this dissertation is to conduct a review of the published literature to understand the association between periodontal therapy and glycated hemoglobin (HbA1c) values. A search was conducted in PUBMED and of the 277 articles found, only 21 were considered for being more relevant. As has been recognized for some time, the results show a correlation between the two diseases and their link lies in the inflammatory process. In the diabetic patient, this results in higher HbA1c values and a situation that is difficult to control. Being able to control the inflammatory state of the periodontium through oral hygiene protocols and periodontal therapy has several benefits in a complicated clinical picture in situations of poor glycemic control. Non-surgical periodontal therapy proves effective in significantly lowering HbA1c levels in diabetic patients.

Anthropometric measurements and serum TNF-α, IL-6 and adiponectin in type 2 diabetes.

To investigate the effect of anthropometric measurements on serum adiponectin and inflammatory markers in Type 2 diabetes mellitus (T2DM). This study was conducted with 46 subjects newly diagnosed with T2DM and 30 healthy volunteers free from pre-existing inflammatory disease, cancer, Type 1 diabetes and using any medications. Demographic, clinical and anthropometric data were collected. The anthropometric measurements and insulin resistance components (fasting plasma glucose (FPG), HbA1c, fasting insulin, HOMA-IR) were analyzed. HOMA-β values were calculated to measure pancreatic beta cell functions. Serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels were measured to determine the presence of inflammation and serum adiponectin levels were assessed. Individuals with T2DM showed higher body mass index (BMI), body fat percentage, waist circumference (WC), waist-to-hip ratio and waist-to-height ratio values. Serum cytokine levels were higher but adiponectin levels were lower in diabetic patients. Serum concentrations of CRP were found to be significantly correlated with WC and body fat mass (kg and %); TNF-α was significantly associated with WC and waist-to-hip ratio in individuals with T2DM. Adiponectin was negatively correlated with WC and waist-to-hip ratio in healthy subjects. Prevention of obesity and central adiposity is an important factor to prevent elevations in inflammatory cytokine levels in diabetic patients.

Study of serum uric acid levels in type 2 diabetes mellitus in tertiary care hospital in south Gujarat

Background: The need for early indicators of diabetic complications is essential to prevent late complications and their deleterious effects. There is a need for sensitive serum markers that are associated with diabetes and its complications. Estimation of these parameters helps in early intervention, thereby delaying the chronic complications of diabetes in the early stages. Hyperuricemia has been shown to be linked to a number of diseases and conditions including gout, hypertension, cardiovascular disease, myocardial infarction, stroke and renal disease. Uric acid has long been associated with delayed complications of diabetes mellitus. This study was conducted on 357 patients of diabetes mellitus to investigate the significance of serum uric acid levels and its correlation with it.Methods: This is an observational cross-sectional study carried out amongst 357 patients with T2DM attending out-patient department as well as indoor patients under medicine department at Surat Municipal Institute of Medical Education and Research (SMIMER) Hospital, of south Gujarat.Results: There is highly significant association seen between HbA1c (glycated hemoglobin) and uric acid levels in present study (p&lt;0.001). There is significant association seen between fasting blood sugar (FBS) levels and uric acid levels in the study (p=0.0253).Conclusions: There is increase in uric acid levels in diabetic patients with increased levels of HbA1c. Thus, serum uric acid may serve as a potential biomarker of the deterioration of glucose metabolism.