Non-insulin-dependent Diabetes Mellitus Patients Research Articles

EFFECT OF STRICT GLYCEMIC CONTROL ON PERIODONTITIS IN NON INSULIN DEPENDENT PATIENTS: A QUASI EXPERIMENTAL STUDY

Objectives: To evaluate the eff ect of strict glycemic control on pocket depth (PD), bleeding on probing (BOP), fasting blood sugar (FBS), C reactive protein (CRP), and HbA1c.Methods and materials: This quasi-experimental design study was conducted from March to September 2021 taking 32 cases (A) and equal controls (B) with non-insulin uncontrolled diabetes (HbA1c more than 8, whereas the eff ect of strict glycemic control on clinical periodontitis was carried out. Pocket Depth (PD), bleeding on probing (BOP), fasting blood sugar (FBS), C reactive protein (CRP), and HbA1c levels were assessed before and after the intervention.Results: Most of the variables HbA1c (p=0.03), CRP (p=0.007), PD (p=0.006), and BOP (p=0.023) showed improvement showing a better glycemic control in the post-intervention stage; particularly for patients recruited in Group A. HbA1c levels at 3 months post-intervention showed significant reduction (p=0.03) to 8.1 ± 1.7 in Group A in comparison to 9.9 ± 2.3 in the pre-intervention stage with a mean difference of -1.8 showing improvement in the glycemic control. PD (mm) for Group A was reduced from 2.4 ± 0.5 mm to 2.2 ± 0.5. Whereas the PD ≥ 4mm (%) also showed a signifi cant reduction from 27.9 ± 28.4 in the pre-intervention to 19.4 ± 27.0 in the post-intervention stage for Group A. Group B also showed reduction but this was more prominent in group A. Bleeding on Probing (%) in group A was also signifi cantly reduced from 29.4 ± 21.4 in pre-intervention stage to 23.1 ± 23.2 in the post-intervention stage.Conclusion: The present study concludes that strict glycemic control (group A) has a role in clinically correcting/improving periodontitis in non-insulin dependent diabetic patients. It can be further concluded that periodontal treatment has a role in the improvement of glycemic control in type 2 diabetic patients at 3 months.

Prevalence and antibiotic sensitivity of uropathogens isolated from type-ii diabetic patients having urinary tract infection (UTI): A retrospective study from a rural tertiary care hospital

Background: Patients with Diabetes Mellitus are more prone to Urinary tract infection (UTI) than non-diabetic patients. Diabetes Mellitus has certain negative effects on the genital system and increases the incidence of urinary tract infection in diabetic patients. Design: Record based retrospective study. Methods: Records of patients with type-II diabetes having symptoms of UTI were reviewed from August 2021 to January 2022. Result: Out of 210 diabetic patients, the UTI rate was higher in females 59% than male 41%. The most common agents for causing UTI were E.coli followed by Pseudomonas aeruginosa, Klebsiella spp., Candida albicans and Candida non-albicans, Enterococcus, S.aureus and other organisms. About 70.68% Gram-negative isolates were resistant against ampicillin, 75.17% resistant against gentamycin, and 48.16% resistant against amoxicillin-clavulanic acid. Gram-positive isolates were 83.33% resistant against penicillin and 83.33% resistant against ciprofloxacin. However, both gram-negative and gram-positive were susceptible to nitrofurantoin. The overall multidrug resistance was observed in 201 out of 210 (95.71%) bacterial and candiduria isolates, while 3.33% of the isolates were resistant to one only antibiotic. Conclusion: Most common etiological agent is E.coli with high drug resistance to ampicillin and susceptible to nitrofurantoin. Therefore, performing urine culture and regular monitoring of UTI is essential.

Assessment of Eye Care Behavior among Non-Insulin Dependent Diabetic Patients

Assessment of Eye Care Behavior among Non-Insulin Dependent Diabetic Patients

Estimation of serum electrolytes in type-II diabetic patients in Durg District Chhattisgarh, India

The study was to figure out to estimation of electrolytes in type 2 diabetics of diverse ages. For blood sugar analysis, sodium fluoride tubes were used, K3 EDTA tubes were used for Glycosylated Haemoglobin analysis, and plain tubes were used for other parameters analysis. Plasma glucose was calculated using GOD-POD, HbA1c was calculated using nephelometric method, and serum sodium, potassium, and chloride were measured using colorimetric method. Out of 1500 people screened, 299 people with Type 2 diabetes were found, with 46 percent of them being women. The average age was 38.36 years old, and the average BMI was 27.24.8 kg/m2. In this study, we divided type 2 diabetic patients into three age groups: G1 (18-27 years old), G2 (28-37 years old), and G3 (38-47 years old). There was a statistically significant difference observed between Age-wise distributions with respect to blood fasting glucose level (p<0.05). There was no statistically significant difference observed between Age-wise distribution with respect to blood HbA1c percentage (p>0.05), Serum electrolyte.

Serum irisin levels in newly diagnosed type-II diabetic patients: No association with the overall diet quality but strong association with fruit intake.

This study aimed to investigate the serum irisin levels and diet quality of newly-diagnosed type 2 diabetes mellitus (T2DM) patients in comparison with healthy controls and to identify the correlations between serum irisin levels with diet quality, anthropometric measurements and biochemical parameters. This case-control study was conducted with 38 newly-diagnosed T2DM patients and 38 healthy control individuals. Diet quality was calculated from the semi-quantitative food frequency questionnaire by using the Healthy Eating Index (HEI) 2015. The anthropometric measurements were taken and body composition was analyzed with bioelectric impedance analysis (BIA) method. Biochemical parameters and serum irisin levels were analyzed in blood samples which were obtained after overnight fasting. Irisin levels were higher in the T2DM group compared to the healthy control group (2.57±0.44ng/mL and 2.15±0.44ng/mL, respectively; p<0.001). The optimal cut-off value for irisin to predict T2DM was 2.195ng/mL (specificity=71.1%, sensitivity=78.9%). In both groups, irisin levels were not associated with overall HEI 2015; however, they were positively associated with total and whole fruit scores in the T2DM group (p<0.05). After adjustment according to age, sex and BMI, in the T2DM group HDL cholesterol positively affected by irisin levels, while in the control group triglyceride positively affected irisin levels (p<0.05). High levels of irisin in newly diagnosed T2DM patients compared to healthy individuals indicate that irisin may have a role in the monitoring and treatment of T2DM. Though irisin levels were not associated with total diet quality, they were associated with fruit consumption.

The Synergistic effect of Oral Antibiotic Therapy on C- Reactive Protein and Lipid profile in Chronic Periodontitis patients

Oral hygiene plays a critical role in whole-body health. Periodontitis is a chronic inflammatory disease that damages the soft tissue and destroys the bone that supports your teeth. Periodontitis can cause teeth to loosen or lead to tooth loss. Various clinical studies have shown distinct relationships between elevated serum C- reactive protein (CRP), lipid level and chronic periodontitis. Elevated CRP coupled with chronic infections like periodontitis is associated with chronic heart diseases, thus making periodontitis as one of the major risk factors for cardiovascular diseases. Therefore, the study was designed to determine the effect of periodontal treatment on serum lipid and CRP levels in type-II diabetic patients with chronic periodontitis. This prospective observational study was carried out in the dental department of a tertiary care hospital for a period of 6 months. Clinical and biochemistry reports of 90 patients were collected in designed case report forms. All statistical analyses were performed using IBM Statistical Package for Social Sciences (SPSS) 17. Significant reduction in all the clinical and dental parameters was comparatively higher in patients who received azithromycin than in patients who received metronidazole and scaling and root planing (SRP) alone. Hence, treating chronic Periodontitis with antibiotics impediments the complication of developing cardiovascular disease.

Estimation of Serum Sialic Acid in the Patients of Type-2 Diabetes Mellitus

Background: Diabetes Mellitus is one of the leading cause of morbidity &amp; mortality all over the world. The poor glycemic control in the patients of type-II diabetes mellitus can lead the development of complications which cause the morbidity in the life of diabetic population. The aim of this study was to estimate the serum sialic acid in the patients of type- II diabetes for early prediction of diabetic complications. Methodology: This case comparative study was conducted at the Diabetes Clinic of LUMHS Jamshoro with the collaboration of the Department of Biochemistry at LUMHS. A total of 84 diagnosed cases of type-II Diabetes Mellitus were included in this study. In group A, 40 diabetes mellitus cases were diagnosed with a history of diabetes less than five years, while in group B 44 had histories of diabetes over ten years. Spectrophotometers were used to measure serum sialic acid levels using Ehrlich's reagent. SPSS version 22 was used for data analysis with independent student t tests applied. Results: The mean serum sialic acid level of group A was 56.42 ± 5.67 mg/dl, while serum sialic acid level of group B was 69.88 ± 7.34 mg/dl. There was significant (p&lt;0.05) increased level of serum sialic acid in the type-II diabetic patients of group B, which indicate there is more chance to development of micro vascular complications in type-II diabetic patients with prolong duration for their diseases period. Conclusion: Estimation of serum sialic acid in the patients of type-II diabetes mellitus is one of the early predictive marker for the complications of diabetes mellitus. Keywords: Type-II Diabetes Mellitus, Serum Sialic Acid, Estimation, HBA1C

Comparative Effects of Dried Aloe Vera Gel on Blood Sugar (glucose) in Type-I and Type-II Diabetic Patients

Comparative Effects of Dried Aloe Vera Gel on Blood Sugar (glucose) in Type-I and Type-II Diabetic Patients

P systems with protein rules

Membrane computing or P-systems is a subfield of natural computing, which models living systems with mathematical tools. In classical membrane-computing, cells or organs are surrounded by a simple membrane and computational events take place in either side of the membrane. We have developed a new conceptual tool to better fit P-systems to higher-order organisms, which rely on the actual membrane structure of the cell and on the biochemical reactions (rules), which take place on the membrane of different organs in our body. To demonstrate the power of this new concept, we modeled the process of maintaining normoglycemia in healthy individuals as well as in type-I and type-II diabetes patients. The main challenge was to prioritize the insulin-producing β-cells over other organs, i.e., once glucose has entered the body, it must first enter specifically into pancreatic β-cells in order to release the hormone Insulin. However, using classical membrane computing, we could not implement this hierarchy. Therefore, we chose to utilize the membrane actual physiology and add its properties to the current definitions of membrane computing. In particular, we use enzymes and protein-transporters (as well as channels) to apply algebraic rules. In addition, we show that the defined systems are universal, by simulating register machines. Thus, allowing deterministic manner operations in a non-deterministic system by giving membrane-specific rules. To our gratification, we succeeded to adequately describe the process of glucose homeostasis in health and disease while bringing the science of membrane-computing closer to the natural world.

Comparison of Effect of Sodium-Glucose Co-Transporter-2 (SGLT-2) Inhibitors with Dipeptidyl Peptidase-4 (DPP-4) Inhibitors on HBA1c Level in Type 2 Diabetes in Pakistani Population

Objective: To compare the effect of SGLT-2 inhibitors with DPP-4 inhibitors as the add on therapy to Metformin on HBA1c level in type 2 diabetes patients in Pakistani population.&#x0D; Study Design: Quasi-experimental study.&#x0D; Place and Duration of Study: Combined Military Hospital Sialkot, Pakistan from Nov to Apr 2020.&#x0D; Methodology: The study population comprised of 300 type-II diabetes patients with poorly controlled diabetes on Metformin managed at Combined Military Hospital Sialkot, Pakistan. Patients were divided into two groups via lottery method. GroupA received the SGLT-2 inhibitors at standard dose while group-B received the DPP-4 inhibitors at the usual standard does as recommended by the consultant medical specialist. Values of glycosylated hemoglobin were compared three months after the start of study.&#x0D; Results: Mean age of the patients was 44.31 ± 5.841 years. Mean duration of type 2 diabetes mellitus in the study participants was 4.18 ± 6.369 years. HBA1c after three months of treatment in the SGLT-2 inhibitors-group was 7.01 ± 0.14 mmol/L while in the DPP-4 inhibitors-group was 7.89 ± 0.99 mmol/L. Difference between the two groups was statistically significant (pvalue &lt;0.01). The result showed SGLT-2 inhibitors as the better option for add on therapy to Metformin as compared to DPP-4 inhibitors.&#x0D; Conclusion: SGLT-2 inhibitors emerged as better option to lower the HBA1c level as compared to DPP-4 inhibitors as the add on therapy to Metformin as there was statistically significant difference in HBA1c levels after three months of therapy in both the groups.

A Study on Dietary and Life Style Behaviors of Selected Type II Diabetic Subjects of Coimbatore

India comprises of largest population of diabetics. Biomarkers, psychosocial and lifestyle are the risk indicators of type 2 diabetes mellitus. To hold back the onward progression of the disease among type 2 diabetic populations early screening for anthropometric and biochemical profiling and life style modification is the need of the hour. Hence with this, the objective of the paper is to explore the association between life style behaviour and biomarker in selected type II diabetic patients in Coimbatore. Five hundred type-II diabetic patient both male (237) and female (263) between the age group of 35-45 years were purposively selected for the conduct of the study. Using a well structured interview schedule the background information, medical history life style and dietary pattern were elicited. Anthropometric measurements, apart from biochemical analysis (fasting blood glucose, post prandial and lipid profile), assessment of diabetic specific Biomarker for HbA1c was done using standard procedures for all the selected 500 type II diabetic patients. The result shows that more than 50% of both male and female Type II diabetic subjects showed uncontrolled Post Prandial Glucose level (PPBS) and Glycosylated Haemoglobin (HbA1C) level, less than 35% of Type II diabetic subjects showed unsatisfactory Fasting Glucose level (FBS).

Impact of a particular diet on the nutritional status and glycemic response of noninsulin-dependent diabetes mellitus patients – An analytical study

BACKGROUND: Diabetes mellitus is a heterogeneous primary disorder of carbohydrate metabolism with multiple etiological factors that generally involve absolute or relative insulin deficiency or insulin resistance or both. All causes of diabetes ultimately lead to hyperglycemia, which is the hall mark of this disease syndrome. Nutrition and diet play a critical role in the course of disease, in the controlling hyperglycemia in addition to drugs in diabetes mellitus patients.OBJECTIVES: To assess nutritional status of noninsulin-dependent diabetes mellitus (NIDDM) patients and glycemic response to the given type of food as compared to normal individuals.MATERIALS AND METHODS: Out of 40 cases of NIDDM patients, 15 normal subjects belonging to the same age and socioeconomic group were selected for the study on glycemic response to dextrose load and given test food (idly). In another six of NIDDM subjects, glycemic response to test food chapati was studied. In 13 cases of diabetes with hypertension, 12 cases of diabetes without hypertension, and 16 cases of normal subjects, a wide range of biochemical parameters like lipid profile, free fatty acid (FFA) levels, serum, and erythrocyte copper and malondialdehyde levels were estimated among them.DISCUSSION: The results of the study showed that in NIDDM patients, body mass index is significantly lower than the normal, showing that obesity is not a predisposing condition in these subjects. The glycemic response to food (idly) is much higher than the response observed in normal subjects. The extent of suppression and FFA levels in the serum that was brought out by the food for glucose is lower than that observed in normal subjects.CONCLUSION: High lipid profile values and low copper levels can favor the generation of lipid-derived free radicals, which further predispose to the vascular changes and hypertensive states observed in the NIDDM patients.

Relationship of fractal analysis in retinal microvascularity with demographic and diagnostic parameters.

Problems and diseases with eye are common in diabetic patients. Early diagnosis and detection of various diseases like retinopathy, neuropathy and nephropathy is crucial in diabetic patients. Certain demographic and diagnostic parameters play a significant role in predicting diseases related to diabetes. Development of a novel diagnostic method which helps to predict the disease by establishing a significant correlation with the demographic and diagnostic parameters is of prime importance. This study proposes a new methodology in which retinal fractals are obtained for the images and the derived retinal fractals are analysed to aid in disease prediction. This study comprises of images from patients with retinopathy, non retinopathy, neuropathy, nephropathy and hypertension. The proposed research is carried out in two aspects: 1) to correlate the retinal fractals of retinopathy and non retinopathy images with certain demographic and diagnostic parameters and interpret its significance, and 2) to exhibit a relationship between the retinal fractals and various diseases/addictive habit to facilitate the prediction of the disease/addictive habit. Hausdorff fractal dimension (HFD) was applied and higher fractal dimension was obtained for healthy cases. Then using Statistical Package for the Social Sciences (SPSS) various statistical parameters and significance were calculated to analyse the relationship. Analysis results showed that fractal value helped in distinguishing between the retinopathy and non retinopathy conditions. It also helped in diagnosing the presence and absence of hypertension. Correlation analysis between certain demographic parameters and fractal value showed a positive correlation whereas few exhibited negative correlation.

Association between family behaviors and self-care activities among type-II diabetes mellitus patients at a teaching hospital in Kathmandu, Nepal.

BACKGROUND:Self-care activities are associated with prognosis of type-II diabetes mellitus patients and include medication adherence, dietary adherence, physical activity, self-monitoring of blood glucose (SMBG), and appropriate foot care. The behaviors of a patient's family members can influence the patient's self-care activities, but little data exist on this association. The objective of this study was to assess the extent of the association between behaviors of family members of Type-II diabetes patients and the patients' self-care activities.MATERIALS AND METHODS:We conducted a cross-sectional study at a teaching hospital in Kathmandu, Nepal, and interviewed 411 outpatients with Type-2 diabetes mellitus. We used exploratory factor analysis to group family members' behaviors into 3 domains (”authoritarian,” “supportive,” and “planning” behaviors) and graded the level of the behavior into 3 categories (”high” vs. “medium” vs. “low”) according to its ranking distribution in each domain. We assessed the association between domains of family behavior and self-care activities using multivariate logistic regression with Bonferroni correction.RESULTS:High (vs. low) level of supportive behavior was associated with compliance to SMBG (58% vs. 11%; adjusted odds ratio [OR] =7.44; 95% confidence interval [CI] =2.41, 23.01). High (vs. low) level of planning behavior was associated with high level of foot care adherence (64% vs. 21%; adjusted OR = 6.03; 95% CI = 3.01, 12.11).CONCLUSIONS:We found associations between behaviors of diabetes patients' family members and the patients' own self-care behaviors. However, the incongruence between the family behavior measurement questions and the self-care of interest limited the implications of the findings.

In-vitro antidiabetic activity of methanolic extract of leaves and fruits of Pouteria campechiana (Kunth) Baehni

Introduction and Aim: Herbal medicine have been used to treat several ailments since decades. Pouteria campechiana (Kunth) Baehni belongs to the family Sapotaceae which is widely found around the world. In folk medicine, various parts of P. campechiana is used to treat various illness. Inhibition of alpha-amylase and alpha-glucosidase enzymes can be an important strategy in management of postprandial blood glucose level in non-insulin dependent diabetic patient. Hence, present study focused to evaluate the in vitro antidiabetic activity of leaf and fruit methanolic extract of Pouteria campechiana (Kunth) Baehni. Materials and Methods: Methanolic extract of P. campechiana leaf (PCL) and fruit (PCF) was screened by biochemical assay such as ?-amylase inhibition activity by CNPG3 method (2-chloro-p-nitrophenyl-?-D-maltotrioside) and ?- glucosidase inhibition activity and in vitro cellular assay such as glucose uptake assay in 3T3-L1 cell line. Results: Methanolic extract of P. campechiana leaf and fruit showed inhibition of ??Amylase and ??Glucosidase enzymes. The methanolic extract of P. campechiana leaf and fruit at varying concentrations (?g/ml), did not exhibit cytotoxicity against 3T3-L1 cell line after 24 hours of incubation. The test compounds PCL and PCF induced the uptake of 2?(N?(7?Nitrobenz?2?oxa?1,3?diazol?4?yl) Amino) ? 2?Deoxyglucose (2-NBDG) in 3T3L1 cells. PCF and PCL both showed almost similar activity of standard drug, Metformin at higher concentrations. Conclusion: Based on the results, it can be concluded that methanolic leaf and fruit extract of P. campechiana possess antidiabetic activity.

Health Related Quality of Life Measurements for Diabetes: A Systematic Review.

Health-related quality of life (HRQOL) is an essential measure that is used to assess the effect of chronic disease management on the health status of an individual. Previous studies have identified various instruments used in the measuring of diabetes-specific health-related quality of life (HRQOL). The aim of this paper is to provide a systematic review of the various instruments used for the diabetes-specific measure of HRQOL, and place emphasis on its content and measurement properties. Methods Preferred Reporting Items for Systematic Reviews and Meta analyses (PRISMA) guidelines was used. A systematic search strategy was used to identify publications reporting diabetes HRQOL measures. The search terms used were: “diabetes quality of life”, “measurements”, and “instruments”. The database that was searched includes PubMed, Science Direct, CINAHL, and Medline. Articles written in the English language and published from January 1990 to December 2020 were included. Those articles that did not measure HRQOL for diabetic patients were excluded. Results: A total of seventeen instruments met the inclusion criteria and included in the review. The appraisal of diabetes scale (ADS), Audit of Diabetes-Dependent QOL measure (ADDQOL), Diabetes Health Profile (DHP), and Problem Areas in Diabetes (PAID) are more suitable for single-scale questionnaires when investigating one or more specific aspects of diabetes-specific quality of life (QOL). The ADDQOL, ADS, Diabetes Impact Measurement Scales (DIMS), Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ-R), Malay Version of Diabetes Quality of Life (DQOL), Iranian Diabetes Quality of Life (IRDQOL), Brief Clinical Inventory, and PAID are relevant measures of HRQOL for insulin dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM) patients. The Asian Diabetes Quality of Life AsianDQOL, The Chinese Short Version of DQOL, Elderly Diabetes Burden Scale (EDBS), Malay Version of Diabetes Quality of Life (DQOL), are relevant measures of HRQOL for NIDDM patients. Only two instruments assess for responsiveness, namely PAID and DQLCTQ-R. In PAID, the effect sizes ranged from 0.32 to 0.65 for interventions. The DQLCTQ-R four domains were responsive to clinical change in metabolic control. Based on this review ADDQOL, DSQOLS, and EDBS psychometric properties are sufficient. Conclusion: Most studies did not check for responsiveness, and future studies should prioritize responsiveness to change, which was not included in the psychometric finding of the reviewed instruments.

A Study of Cardiac Autonomic Neuropathy among Type-II Diabetic Patients

Background: Though very common, CAN is a least understood complication of diabetes which is often under diagnosed. In diabetes mellitus patients, CAN leads to silent myocardial infarction and sudden death. So by identifying CAN early, which is asymptomatic will help to delay or arrest its progression.&#x0D; AIM: To find out the prevalence and the associated risk factors of Cardiac autonomic neuropathy (CAN) among type-II Diabetes Mellitus patients in a tertiary care hospital.&#x0D; Materials &amp; Methods: A total of 273 type-II diabetic participants were selected after taking into consideration of inclusion &amp; exclusion criteria. The prevalence of CAN was assessed by ewings and clarkesnon invasive cardiac autonomic neuropathy reflex tests. The association of risk factors with the presence of CAN was analysed by using Pearson’s chi square test. Data were analysed by using SPSS 16. The accepted level of significance was set below 0.05 (P&lt;0.05).&#x0D; Results: The prevalence of CAN among type-II diabetic patients in this study was found to be 34%. Prevalence of CAN increased in the participants with male gender, increased age, and increased BMI, increased duration of diabetes, poor glycaemic control,dyslipidimea, smokers and hypertension and it is statistically significant.&#x0D; Conclusion: In this study it is observed that the prevalence of CAN increased with old age, male gender, poor glycemic control, increased duration of diabetes, Dyslipidemia, higher BMI, Hypertension &amp; smoking. So risk factors associated with the CAN be detected and treated at an early stage to further reduce morbidity and mortality.

Peripheral Neuropathy and Cardiac Autonomic Neuropathy among Type II Diabetic Patients: Prevalence and Risk Factors

Background: The two most common chronic complication softype 2 diabetes mellitus (T2DM) are peripheral neuropathy (PN) and Cardiac autonomic neuropathy (CAN).Diagnosing neuropathies at subclinical stage can prevent the morbidity and mortality.&#x0D; Objectives: To determine the prevalence of peripheral neuropathy and cardiovascular autonomic neuropathy and their risk factors in type-II diabetic patients attending a tertiary care hospital.&#x0D; Methods: An observational cross sectional study was done from December 2019 to November 2020 in the department of General medicine at tertiary care hospital. 273 type II diabetic patients were selected for this study. Toronto clinical scoring system was used for assessing PN and ewings cardiovascular reflex study was used done to assess CAN. To identify the risk factors of PN and CAN, Logistic regression analysis was used.&#x0D; Results: The prevalence of PN and CAN was 45.4% and 34.06% respectively, while29.3% participants had both. Smoking (OR: 12.976; 95% CI: 0.052–0.418, P&lt;0.0001) and poor glycaemic control (OR: 27.231; 95% CI: 5.226–38.201, P&lt;0.0001) were independent risk factors of DPN. poorglycaemic control (OR: 26.970; 95% CI: 3.507–16.055, P &lt;0.0001) and Dyslipidimea (OR: 11.792; 95% CI: 0.096–0.526, P ≤ 0.001) were independent predictors of CAN.&#x0D; Interpretation and Conclusions: PN and CAN are common among diabetic patients, and thus it is recommended to screen Peripheral Neuropathy and CAN in all diabetic patients for the early diagnosis and preventing the debilitating complications

The role of hyperbaric oxygen to platelet aggregation in noninsulin-dependent diabetes mellitus (NIDDM)

Hyperglycemia in diabetes mellitus (DM) could cause rheological disorder, such as platelet aggregation and blood hyperviscosity. Hyperbaric oxygen (HBO) could decrease collagen as platelet aggregation agonist. This study aimed to explore the effect of HBO treatment to platelet aggregation parameters (latency time(LT), aggregation speed, aggregation index, and aggregation percentage) with the collagen aggregator in the noninsulin dependent diabetes mellitus (NIDDM). The number of subjects in this study were 16 for each group normoxia normobaric (NONB) and HBO. NIDDM patients from DM polyclinic in Rumah Sakit AngkatanLaut (RSAL) Dr Ramelan Surabaya which was fulfilled inclusion criteria would receive HBO Therapy. Control Group/NONB were treated with NONB condition (20% O2 1 ATA) for 90min and treatment group/HBO were treated with hyperoxia hyperbaric condition (100% O2 2.4 ATA) for 3×30min with interval of 2×5min for inhaling fresh air. Subject has been blood taken for platelet aggregation test before and after HBO Therapy. The length of treatment was 5days for both condition (NONB and HBO). The data from both groups, NONB and HBO were tested first by normality test, homogenity test, correlation test, analysis of covariance, and paired t-test. Based on paired t-test, the decrease on platelet aggregation speed, aggregation index, and aggregation percentage after HBO treatment was showed significant difference on the LT and aggregation index while in aggregation speed and aggregation percentage was not significant. NONB group after 5days was showed a significant difference on the aggregation speed and aggregation index while in LT and aggregation percentage was not significant. The utilization of HBO 2.4 ATA 100% O2 3×30min, once a day, for 5days could decrease the platelet aggregation parameters (LT, aggregation speed, aggregation index, and aggregation percentage) in patients with NIDDM.

Postoperative Outcomes in Diabetic Pediatric Orthopaedic Surgery Patients: A National Database Study.

Although the negative effects of diabetes mellitus (DM) on operative outcomes in orthopaedic surgery is a well-studied topic in adults, little is known about the impact of this disease in children undergoing orthopaedic procedures. This study aims to describe the postoperative complications in pediatric orthopaedic surgery patients with DM. Pediatric patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) were retrospectively identified while selecting for elective orthopaedic surgery cases from the American College of Surgeons National Surgical Quality Improvement Program Pediatric (ACS-NSQIP-Pediatric) database from 2012 to 2015. Univariate and multivariate analyses were performed to describe and assess outcomes when compared with nondiabetic patients undergoing similar procedures. Of the 17,647 patients identified, 105 (0.60%) had DM. Of those 105 patients, 68 had IDDM and 37 had NIDDM. The median age of DM patients was 13.8 years (11.9 to 15.5 y) and 37.1% of all DM patients were male. Comparing DM to non-DM patients, no significant differences were noted in the overall complications (1.4% vs. 1.9%, P>0.05) or reoperation rates (1.2% vs. 1.9%, P>0.05); however, DM patients did have a higher occurrence of unplanned readmissions (4.8% vs. 1.7%; P=0.037). Diabetic patients were statistically more likely to have an unplanned readmission with 30 days (adjusted odds ratio=3.34; 95% confidence interval=1.21-9.24, P=0.021). when comparing IDDM to NIDDM, there was no significant difference in outcomes. Comparing NIDDM to non-DM patients, there was an increased incidence of nerve injury (5.6% vs. 0.18%; P=0.023), readmission rate (11.1% vs. 1.8%; P=0.043), and reoperation rate (11.1% vs. 1%; P=0.013) in nonspinal procedures and an increased incidence of pulmonary embolism (10% vs. 0%; P=0.002) in spinal arthrodesis procedures. NIDDM predicted longer hospital stays (adjusted odds ratio=1.49; 95% confidence interval=1.04, 2.14; P=0.028) compared with nondiabetic patients in extremity deformity procedures. The 30-day complication, reoperation, and readmission rates for NIDDM patients were higher than that of non-DM patients. Furthermore, NIDDM is a predictor of longer hospital stays while DM is a predictor of unplanned readmissions. No statistical differences were noted when comparing outcomes of NIDDM to IDDM patients. Level III.