Mean Postprandial Blood Sugar Research Articles

PREVALENCE OF LATENT TUBERCULOSIS IN DIABETIC AND NON-DIABETIC INDIVIDUALS IN A TERTIARY CARE CENTER: A COMPARATIVE STUDY

Aims and Objectives: The aims of this study were as follows: (1) To study the prevalence of latent tuberculosis (TB) in diabetic and non-diabetic population attending the tertiary care hospital. (2) To investigate the association between diabetes mellitus (DM) and latent TB, evaluating the prevalence of positive tuberculin tests and assessing glycemic parameters in diabetic patients with latent TB. Methods: This was a single-center, hospital-based, observational, and comparative study conducted in the department of general medicine of a tertiary care medical college. One hundred and thirty-six diabetic patients of either gender or 137 healthy individuals acting as control group were included in this study on the basis of a predefined inclusion and exclusion criteria. Patients were evaluated by detailed history and clinical examination. The diagnosis of latent TB was based on a positive tuberculin test without any clinical features of active TB. The prevalence of latent TB infection was compared in both the groups. p<0.05 was taken as statistically significant. Results: Patients in both the groups were found to be comparable in terms of gender distribution and mean age. Predominant patients were found to have type 2 DM. The mean duration of DM was noted to be 91.58±60.68 months. The most common diagnoses of patients in non-diabetes group were COVID-19 (9.49%), neurological diseases (8.76%), infections (7.3%), acute myocardial infarction (6.57%), and iron deficiency anemia (5.84%). About 21.32% of cases in DM group were noted to have latent TB, while the proportion of latent TB was noted to be 7.30% in the non-diabetes group. The mean fasting blood sugar, mean post-prandial blood sugar, as well as mean HbA1c were significantly higher (p<0.05) in the subgroup with latent TB versus the subgroup without latent TB. Conclusion: Individuals with diabetes mellitus were found to have increased risk of latent TB infection. In addition, male gender and elevated glycemic parameters were found to be key factors associated with latent tuberculous infection in diabetes.

Prevalence of Karapada daha-suptata in Madhumeha with reference to diabetic peripheral neuropathy in type 2 diabetes mellitus patients.

Background: Diabetes mellitus is a major health issue in today's world. Main threat is not the disease itself but its complications like nephropathy, retinopathy and neuropathy etc. Diabetic peripheral neurropathy is the leading cause of foot ulcers, their complications like limb amputation and cost associated with it. Madhumeha which has been described as 'Maharogas' i.e. difficult to treat disease has many similarities with Diabetes mellitus can be understood and studied as same disease. Ayurveda has mentioned the causes, pathophysiology and symptoms of Diabetic Peripheral Neuropathy as 'karapada daha -suptata' in purvarupa lakshanas and upadrava lakshanas but inscattered form. It needs depth study to understand the concept of Karapada daha- suptata (DPN).
 Objective: To study prevalence of Karapada daha-suptata (Diabetic peripheral neuropathy) and the relation of Karapada daha- suptata (DPN) with age, gender, duration of disease Madhumeha, blood sugar level, alcohol and smoking habit etc in Madhumeha patients.
 Method :A cross sectional study was carried out in Tribhuvan University Ayurveda Teaching Hospital,. Madhumeha patients (Type 2 diabetes mellitus) patients were recruited for the study. MNSI (Michigan Neuropathy Screening Instrument) was used to diagnose Karapada daha- suptata (Diabetic peripheral neuropathy).
 Result: Among 100 patients 31% patient had Karapada daha- suptata (DPN). Our study showed that the prevalence of Karapada daha-suptata(DPN) increased with increasing age of the study population. Similarly prevalence of Karapada daha -suptata in patients with disease duration of Madhumeha (DM2) for more than 5 years was 61.29% where as patients having Diabetes for less than 5 year was 38.71%. Prevalence of Karapada daha-suptata (DPN) was very high (43.13%) among uncontrolled fasting blood sugar level (>126mg/dl) and (47.5%) among uncontrolled post prandial blood sugar level (>200mg/dl). In this study mean Fasting blood sugar level was 177.0323 mg/dl in the patients with Karapada daha-suptata(DPN) and mean post prandial blood sugar level in patients with diabetic peripheral neuropathy was 239.1613mg/dl.
 Conclusion: Our study showed Karapada daha-suptata/DPN is highly prevalent and increasing as the duration of disease Madhumeha increses but its not uncommon in newly disagnosed disease too. This study showed significant relation of Karapada daha suptata with disease duration of Madhumeha, level of blood sugar, and increasing age of the patients.Study showed no significant differences in the prevalence of Kara pada daha- suptata in male and female patients and with the smoking habit of the patients.

Impact of Atorvastatin on C-reactive Protein, Glycaemic Status and Liver Enzymes among Non Diabetic Patients: A Prospective Study

Introduction: Atorvastatin is one of the common drugs used for primary and secondary prevention of atherosclerotic cardiovascular diseases. Various studies have suggested variation in C-reactive Protein (CRP) value, glycaemic status and liver enzymes of patients following statin therapy. However, the adequate and exact data regarding the impact of atorvastatin on the above parameters in the population of Eastern India is still limited. Aim: To estimate the effect of atorvastatin on CRP, glycaemic status and haepatic enzymes of non diabetic patients. Materials and Methods: A prospective longitudinal observational study was conducted in the Outpatient Department (OPD) of Internal Medicine at Midnapore Medical College and Hospital, Paschim Medinipur, West Bengal, India. The duration of the study was one year six months, from June 2020- December 2021. A total of 150 non diabetic patients aged between 30- 75 years receiving atorvastatin were enrolled in the present study. Patients with known Diabetes Mellitus (DM), impaired fasting glucose, impaired glucose tolerance, pregnancy and lactation were excluded. CRP, Fasting Blood Sugar (FBS), Postprandial Blood Sugar (PPBS), haepatic enzymes and lipid profile of participants were monitored at baseline, at the end of one month, six months and 12 months. The data was analysed using Statistical Package for Social Sciences (SPSS) version 22.0, Microsoft Excel and GraphPad Prism. Results: The study population were predominantly males (69.6%), with mean age of 54±8.88 years and mean weight of 60±5.86 kg. Majority of the patients were on atorvastatin 40 mg (60.86%) followed by atorvastatin 20 mg (26.8%) and atorvastatin 10 mg (12.3%). There were statistical significant changes of mean CRP (1.502 mg/L), mean FBS (86.52 mg/dL), mean PPBS (113.57 mg/dL), mean Serum Glutamic-oxaloacetic Transaminase (SGOT) (22.84 IU/L), mean Serum Glutamic Pyruvic Transaminase (SGPT) (25.24 IU/L) and lipid profile levels at the end of one year. None of the patients developed new onset DM at the end of one year. A 5% of patients developed prediabetes at the end of 3rd follow-up. Conclusion: Atorvastatin usage showed that, there was a significant increase in blood glucose and haepatic enzymes level in non diabetic population. Hence, strict monitoring of blood glucose levels along with periodic monitoring of haepatic enzyme levels should be done in regular intervals.

Prevalence of peripheral arterial disease in type 2 diabetes mellitus patients by ankle brachial pressure index

Introduction: Diabetes is growing at an exponential rate all around the world and soon is to be an epidemic in many countries including India. India topped the list of maximum reported cases of diabetes in year 2000 with 31.7 million (reported cases) it was followed by China (20.8 million) and the United States (17.7 million) in second and third place respectively. Material and methods: A Cross Sectional Study was done in the department of General Medicine at Muzaffarnagar Nagar Medical college, Muzaffarnagar, UP from September 2021 to August 2022. All type 2 diabetic patients attending the department were invited to participate in the study those fulfilling the inclusion criteria and giving consent for inclusion in the study during the period of study were enrolled in the study. A total of 200 such patients were recruited in the study. Measurement of ABPI was made in supine position after 10 minutes of rest and in a quiet room. Results: Out of 200 patients of type 2 diabetes mellitus, 72 (36.0%) were suffering from peripheral arterial disease. Prevalence of peripheral arterial disease in patients of type 2 diabetes mellitus in our institution (a teaching hospital) was 36.0%. Mean Fasting blood sugar levels of diabetic patients with PAD (187.90+100.64 mg/dl) was found to be higher than that of without PAD (182.15+74.29 mg/dl). Mean Post-prandial blood sugar (PPBS) levels of diabetic patients with PAD (280.58+121.11 mg/dl) were also found to be higher than that of without PAD (253.22+85.30 mg/dl). Conclusion: The findings of present study thus suggested that diabetic population is at a substantial risk of peripheral arterial disease and was significantly dependent on duration of diabetes, obesity (waist circumference) and presence of other comorbidities and complications likehypertension, retinopathy and neuropathy.

ROLE OF ANTIDEPRESSANT ON THE GLYCAEMIC CONTROL OF UNCONTROLLED TYPE 2 DIABETES MELLITUS PATIENTS

Background: Depression incidence is higher in diabetic patients when compared to the non-diabetic individuals and there exist a two-directional relationship between depression and the development of type 2 diabetes mellitus.
 Objectives: This study aimed to estimate the frequency of depression and the effect of antidepressant on glycemic control in type 2 diabetes mellitus patients.
 Methods: This prospective interventional study was conducted in type 2 diabetes mellitus patients with a sample size of 100. These patients were diagnosed with depression using WHO-ICD10 criteria. All study patients had uncontrolled blood glucose levels and were on an optimized maximal dose of combination oral hypoglycemic agents with stable glycoregulation (HbA1c 8.4 ±0.5) were taken up for the intervention with antidepressant. These patients were started on with antidepressant after enrollment and followed up for fasting blood sugar (FBS), post-prandial blood sugar (PPBS), and HbA1c at the end of 3 months and 6 months. And also Hamilton depression rating scale scores were estimated at the beginning of the study and at the end of 6 months.
 Results: The frequency of depression among the type 2 diabetes mellitus patients was found to be 42%. There were reduction of mean FBS levels from baseline value of 177 mg/dl to follow-up value of 160 mg/dl (p<0.001), mean PPBS levels from 251.16 mg/dl to 217.84 mg/dl (p<0.001), and mean HbA1c dropped from 8.41 to 7.57 (p<0.001) after the treatment with antidepressant.
 Conclusion: Our study concluded that patient started on antidepressant showed a reduction in the blood sugar levels and HbA1c levels from their baseline values, which was clinically and statistically significant.

METABOLIC EFFECT OF RISPERIDONE IN PSYCHIATRIC PATIENTS

Aim & Objective: This study was designed to evaluate the metabolic effects of risperidone in patients with psychiatric illness treated with risperidone. Method: Thirty non-diabetic patients with Psychiatric illness (e.g. schizophrenia, manic phase of bipolor disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) inducted in this study. These Patients did not receive any drug that would alter the blood sugar levels and also risperidone for at least four weeks prior to the initiation of the study. All the patients who were inducted in this study receive the mean dose of 4mg/day (range 2-8 mg) of risperidone for eight weeks, depending upon the clinical condition. The patients fasting, post prandial blood sugar and weight gain were evaluated at the baseline and then at four weeks and at eight weeks. Results: Thirty patients completed the study. The mean fasting blood sugar level was increased from 87.5mg/dL (baseline) to 101.7 mg/dL at week 8 (P<0.001).The mean post prandial blood sugar was increased from111.68 mg/dl to147.88 mg/dl at week 8 (p<0.001).There was also statistically significant weight gain with a increase in mean weight of59.16 kg to59.96 kg (p=0.001). The 8-week study showed that fasting blood sugar and postprandial blood sugar levels may increase in psychiatric patients receiving risperidone .There was also definite weight gain. No serious adverse events were reported. Conclusion: Measuring and monitoring fasting & postprandial blood sugar before the initiation and during the treatment with risperidone is suggested. Key Words: Metabolic effect, Risperidone , Blood glucose, psychiatric illness.

Nephropathy in noninsulin-dependent diabetes mellitus: Comparative study with normoproteinuric and microproteinuric subjects

The role of specific risk factors in the development of diabetic nephropathy was examined among noninsulin-dependent diabetic subjects attending the Diabetes clinic of Christian Medical College Hospital, Vellore during 1986–1987. Seventy-three subjects with normal protein excretion ( <150 mg 24 hr ) were compared with 66 microproteinuric ( 150–500 mg 24 hr ) and 61 macroproteinuric subjects ( 500 mg 24 hr ). The risk factors included family history of diabetes, tobacco use, dietary habits and metabolic control; the latter was assessed from an average of 5 clinic blood sugar determinations done annually per patient. Patients who had developed proteinuria were characterized as mostly men, with increased tobacco consumption and early onset of proteinuria in relation to duration of diabetes. The mean blood sugar value was significantly high in both the proteinuric groups compared to the group with no proteinuria ( p < 0.01). There was a striking increase in the prevalence of ischemic heart disease, hypertension and retinopathy in the macroproteinuric group compared to the other two groups ( p < 0.01). It is concluded that the risk of developing nephropathy was significantly higher in men, in smokers and in those with poor metabolic control (mean postprandial blood sugar more than 200 mg/dL). Furthermore, it was clearly evident from our study that the diabetic subjects with nephropathy had a higher incidence of hypertension, retinopathy, hyperlipidemia and ischemic heart diseases.