Uncontrolled HbA1c Levels Research Articles

Hubungan Antara Kadar HbA1c dengan Kadar Trigliserida terhadap Pasien Prolanis Diabetes Melitus Tipe 2 di Laboratorium Klinik Kimia Farma Depok

Diabetes Mellitus (DM) is a group of metabolic disorders characterized by elevated blood glucose levels resulting from abnormalities in insulin secretion, insulin action, or both. Patients with Type 2 DM are at a higher risk of developing cardiovascular diseases, often indicated by dyslipidemia, which is characterized by elevated triglyceride levels, increased Low-Density Lipoprotein (LDL) levels, and decreased High-Density Lipoprotein (HDL) levels. This study employs an analytical observational design. The data obtained shows that controlled and uncontrolled HbA1c levels with normal triglyceride levels were found in 24.7% of the patients, while 75.3% had high triglyceride levels. The data were further analyzed using the Statistical Package for the Social Sciences 25 (SPSS 25) with a non-parametric test, specifically the Chi-Square continuity correction test, with a significance level of p 0.05. The Chi-Square test results indicated that H0 was rejected and Ha was accepted, with a p-value of 0.036 for the relationship between HbA1c and triglycerides. These results suggest a correlation between HbA1c levels and triglyceride levels in Prolanis Type 2 DM patients at Kimia Farma Clinical Laboratory in Depok. These findings can serve as an evaluation material for Prolanis DM Type 2 patients to control their glycemic levels by routinely monitoring their HbA1c and triglyceride levels.

Exploring the association of social connections and food security among adults with uncontrolled type 2 diabetes: a population-based study

BackgroundPrimary health care professionals are held accountable for various quality measures in the treatment of patients with chronic diseases such as diabetes. Uncontrolled type 2 diabetes (T2D) remains a considerable health problem; thus, further studying patients with this condition is important for delivering effective interventions. Social determinants of health (SDoH) have been shown to affect various aspects of diabetes care in different subpopulations. We studied the association of SDoH with uncontrolled T2D in a population of adult primary care patients.MethodsWe retrospectively searched our electronic health record for adult patients (≥18 years) with a diagnosis of T2D and a hemoglobin A1c (HbA1c) level of 8% or higher. Patients were empaneled to 2 primary care clinic sites between January 1, 2021, and January 31, 2022. Patients were grouped by HbA1c level to stratify patients according to the extent of uncontrolled T2D. Patient characteristics were compared among groups. Unadjusted and adjusted multinomial logistic regression analysis was used to estimate the odds of various SDoH factors among patient groups with different levels of uncontrolled T2D.ResultsThe study cohort included 1,596 patients. Most patients were White (79%), and the median age was 58.8 years. The median HbA1c level was 8.9%, and approximately 68% of patients were obese (body mass index [BMI] ≥30). When the study population was grouped by HbA1c level (8% to < 9% [n = 806], ≥9% to < 12% [n = 684], and ≥12% [n = 106]), significant differences among groups were observed in age group (P < .001), marital status (P < .001), race (P < .001), ethnicity (P = .001), and BMI category (P = .01). In groups with higher HbA1c levels, we noticed a higher percentage of patients who were aged 51 to 65 years or single. Among patients with uncontrolled HbA1c levels, more patients were obese than overweight. Patients in the intermediate HbA1c group had increased odds of food insecurity and some decreased social connections, even after adjusting for age, sex, race, ethnicity, and marital status.ConclusionsAmong patients with uncontrolled T2D, higher HbA1c levels were associated with decreased social connections and increased food insecurity. Our findings provide insight into the role of these SDoH in managing T2D and have important implications for primary care practice.

Hubungan Kadar HbA1c Dengan Kadar Serum Kreatinin Pada Penderita Diabetes Melitus Tipe 2 Di RSU Sinar Kasih Purwokerto

Diabetes Mellitus is a metabolic disorder caused by a decrease in insulin products in the body. The World Health Organization estimates an increase in the number of diabetes mellitus sufferers from 8.4 million in 2000 to around 21.3 million in 2030. Chronic diabetes mellitus sufferers can cause complications, one of which is kidney complications. Kidney damage can occur due to uncontrolled blood sugar levels. Complications of diabetes mellitus can be detected by examining HbA1c. HbA1c is a non-enzymatic binding of glucose molecules to hemoglobin through a post-translational glycation process. Uncontrolled HbA1c levels can cause various complications in the body.The samples used for this research were 106 samples with normal HbA1C examination results, namely 59 patients and high results, namely 47 patients. Creatinine examination with normal results was 81 patients and high results were 25 patients. The P-value from the calculation results is 0.066 higher than 0.005. Based on the results of the chi square calculation, it can be concluded that there is not a relationship between HbA1C examination and creatinine examination in type 2 diabetes mellitus patients at Sinar Kasih Hospital.

Assessing the Features of Diabetic Foot Ulcers among Individuals with Type 2 Diabetes Mellitus in Thi Qar, Iraq

Background This study aimed to evaluate the characteristics of diabetic foot ulcers in individuals with type 2 diabetes mellitus (T2DM) in Iraq. Methods The study included 881 participants with T2DM and different types of foot ulcers, who attended a specialized diabetes center. Data on demographics, clinical characteristics, biochemical investigations, comorbidities, and treatment regimens were collected and analyzed. Results The majority of the cases (96.8%) were due to T2DM, with an average age of 58 years and a mean BMI of 30 kg/m2. Participants had elevated serum creatinine, blood urea, and glucose levels, with uncontrolled HbA1c levels. Comorbidities included hypertension, ischemic heart disease, diabetic neuropathy, and retinopathy. Most participants were on insulin and statins. Diabetic foot ulcers were mainly on the right foot (48%) and classified as Grade 2 in Wagner's system. Some participants had Charcot deformity or stages of amputation. Conclusions Random plasma glucose levels and diabetic retinopathy were significantly associated with the classification of foot ulcers. Further research is needed to explore additional variables related to T2DM and foot ulcers, emphasizing the importance of glucose control and retinopathy in ulcer classification.

Effects of diabetes mellitus complications on sleep quality among Saudi Arabian patients-A national study.

In diabetes mellitus (DM) patients, obtaining a good night's sleep is crucial for maintaining body caloric intake, controlling insulin levels, and reducing the likelihood of engaging in unhealthy behavior. Patients with poor sleep quality may experience impaired glycemia, playing a significant role in the development of chronic complications. This study aims to explore the effects of DM complications on sleep quality among Saudi Arabian patients. This is a cross-sectional study conducted among patients with diabetes. A self-administered, validated questionnaire translated into Arabic was distributed among diabetic patients using an online survey. The questionnaire includes sociodemographic characteristics (i.e. age, gender, marital status, etc.), the medical history of the patients, and a questionnaire about sleep quality. Out of 4171 patients involved, 52.7% were females and 27.7% were aged between 40 and 60 years old. The prevalence of patients with perceived poor sleep quality was 24.1%. Significant predictors of poor sleep quality were the gender female, having social stressors, comorbid sleep disorders, associated comorbidities, increasing HbA1c levels, being overweight/obese, and diabetes complications. Furthermore, sleep disturbance, taking sleep medications, daytime sleepiness, and having bad dreams during sleep were also identified as prognostic factors for poor sleep quality. The subjective poor sleep quality of patients with diabetes was 24.1%. Poor sleep quality was significantly demonstrated by females who were having social stressors, comorbid sleep disorders, comorbidities, uncontrolled HbA1c levels, elevated BMI levels, and complications of diabetes. However, regular physical activity and adequate sleep were estimated to be the protective factors against poor sleep quality. Further research is needed to establish the effect of sleep quality among patients with DM.

Latent tuberculosis in children and youth with type 1 diabetes mellitus in Dar es Salaam, Tanzania: a cross section survey

BackgroundData for latent tuberculosis in patients with type 1 Diabetes in Africa is limited. We assessed the prevalence of latent tuberculosis in youth and children with type 1 Diabetes in Dar es Salaam –Tanzania.MethodsOur cross-sectional study recruited children and youth with T1DM by stage of puberty, glycaemic control, and age at diagnosis from January to December 2021 in Dar es Salaam. Participants were screened for the presence of latent Tuberculosis using the QuantiFERON test. A positive test was considered to have latent TB.ResultsOf the 281 participants, the mean age was 19 (± 6) years, 51.2% were female, and 80.8% had either a primary or secondary level of education at baseline. The prevalence of latent TB was 14.9% and was slightly higher in females (52.4%) than in males. This difference, however, was insignificant (p > 0.05). On the other hand, the proportion of latent TB was significantly higher in uncontrolled HbA1c levels (76.2%) than in those with controlled HbA1c (23.8%) [p = 0.046]. Duration of diabetes and age at diagnosis did not affect the occurrence of latent Tuberculosis [p > 0.05]. Meanwhile, in the regression model, participants with latent TB were more likely to have uncontrolled HbA1c. [p = 0.045]ConclusionsDespite the methodological limitations, this survey highlights the high prevalence of latent TB among children and youth with diabetes; shouting for better control. These results clearly show the need to screen for Tuberculosis in children and youth with diabetes and start them on prevention as per protocol, especially in tuberculosis-endemic areas like Tanzania.

Metabolic Control and Its Correlates among Diabetic Patients in Aljouf Region, Saudi Arabia: A Cross-Sectional study

Background: Throughout the world, diabetes, and its consequences, constitutes a serious problem for public health. Metabolic control can reduce the risk of diabetes complications. The present study aims to determine diabetic metabolic control among diabetic patients in the Aljouf region, Saudi Arabia, and its association with family function, depression, and other sociodemographic and clinical data. Methods: A cross-sectional study was conducted among 279 diabetic patients attending the diabetic center in a specialized hospital in Aljouf Region, Saudi Arabia. A structured anonymous questionnaire was distributed to the targeted population during a direct interview. Results: The present study showed that HbA1c was 7% among 86% of the participants. Regarding lipid profile, abnormal HDL, LDL, triglycerides, and cholesterol levels were detected among 39.4%, 41.2%, 68.5%, and 50.2% of the participants, respectively. Severe depression and severe family dysfunction were detected among 22% and 6% of the participants, respectively. Increasing age was associated with higher LDL levels and diabetes duration was associated with higher HbA1c levels in patients with diabetes. Conclusion: The study concluded that family function and depression do not directly affect diabetic patients’ diabetes metabolic control and the study showed a high prevalence of uncontrolled HbA1c levels and dyslipidemia among the study participants. Further investigation into the variables underlying the control of diabetes is required to further enhance patient outcomes because many people are still failing to meet the metabolic control objectives. Keywords: Metabolic control; Depression; Family function; Diabetes mellitus; Saudi Arabia

Sleep And Hba1c In Adult Patients With Type 2 Diabetes Mellitus

Sleep is one of the essential factors in life and affects glucose metabolism, so it is crucial for diabetic patients to have good quality sleep to control their diabetes. The study aimed to analyze the relationship between sleep quality and HbA1c levels in adult patients with type 2 diabetes mellitus. This study was conducted with a cross-sectional study approach with a sample of 170 respondents with convenience sampling from a hospital in Banda Aceh. Sleep quality data was measured by the Pittsburgh Sleep Quality Index (PSQI), and HbA1c levels were obtained from the results of respondents' HbA1c examinations in the last three months analyzed through chi-square. The results showed a significant relationship between sleep quality and respondents' HbA1c levels (p = 0.008), where respondents (64.1%) with poor sleep quality had an eight times the risk of having uncontrolled HbA1c levels compared to respondents with good sleep quality. Education on the importance of sleep health in patients regularly should be carried out in groups by health services to motivate T2DM patients to enjoy adequate sleep and improve their glycemic control through learning media that interest patients

Association of Spousal Diabetes Status and Ideal Cardiovascular Health Metrics With Risk of Incident Diabetes Among Chinese Adults

ImportanceSpouses share common socioeconomic, environmental, and lifestyle factors, and multiple studies have found that spousal diabetes status was associated with diabetes prevalence. But the association of spousal diabetes status and ideal cardiovascular health metrics (ICVHMs) assessed by the American Heart Association’s Life’s Essential 8 measures with incident diabetes has not been comprehensively characterized, especially in large-scale cohort studies.ObjectiveTo explore the association of spousal diabetes status and cardiovascular health metrics with risk of incident diabetes in Chinese adults.Design, Setting, and ParticipantsThis cohort study included individuals in the China Cardiovascular Disease and Cancer Cohort without diabetes who underwent baseline and follow-up glucose measurements and had spouses with baseline glucose measurements. The data were collected in January 2011 to December 2012 and March 2014 to December 2016. The spousal study had a mean (SD) follow-up of 3.6 (0.9) years (median [IQR], 3.2 [2.9-4.5] years). Statistical analysis was performed from July to November 2022.ExposureSpousal diabetes status was diagnosed according to the 2010 American Diabetes Association (ADA) criteria. All participants provided detailed clinical, sociodemographic, and lifestyle information included in cardiovascular health metrics.Main Outcomes and MeasuresIncident diabetes, diagnosed according to 2010 ADA criteria.ResultsOverall, 34 821 individuals were included, with a mean (SD) age of 56.4 (8.3) years and 16 699 (48.0%) male participants. Spousal diabetes diagnosis was associated with an increased risk of incident diabetes (hazard ratio [HR], 1.15; 95% CI, 1.03-1.30). Furthermore, participants whose spouses had uncontrolled glycated hemoglobin (HbA1c) had a higher risk of diabetes (HR, 1.20; 95% CI, 1.04-1.39) but the risk of diabetes in participants whose spouses had controlled HbA1c did not increase significantly (HR, 1.10; 95% CI, 0.92-1.30). Moreover, this association varied with composite cardiovascular health status. Diabetes risk in individuals who had poor cardiovascular health status (&amp;amp;lt;4 ICVHMs) was associated with spousal diabetes status (3 ICVHMs: HR, 1.50; 95% CI, 1.15-1.97), while diabetes risk in individuals who had intermediate to ideal cardiovascular health status (≥4 ICVHMs) was not associated with it (4 ICVHMs: HR, 1.01; 95% CI, 0.69-1.50).Conclusions and RelevanceIn this study, spousal diabetes diagnosis with uncontrolled HbA1c level was associated with increased risk of incident diabetes, but strict management of spousal HbA1c level and improving ICVHM profiles may attenuate the association of spousal diabetes status with diabetes risk. These findings suggest the potential benefit of couple-based lifestyle or pharmaceutical interventions for diabetes.

1087-P: Managing Diabetes in the Delta—Effect of Access to Endocrinology Services in an Underserved Area

Background: The Mississippi Delta has one of the highest rates of diabetes in the nation, but patients in these rural, minority-majority counties have lower access to specialty care. At the start of a hybrid diabetes management program at two rural health clinics in the Delta, 53.1% of patients with diabetes had uncontrolled HbA1c levels. We analyze the specific effect of integrating endocrinology specialists into this intervention. Patients could access this care via telemedicine or in-person. Methods: We conducted a quasi-experimental study with clinical data from electronic health records for patients diagnosed with diabetes or prediabetes (aged ≥ 18). We followed two cohorts of the same patients over time for the first 18 months of the program, each matched on elevated HbA1c levels (≥8% at baseline). The treatment group comprised program participants; the control group comprised general clinic patients at-risk of diabetes. We also followed patients in the treatment group who received endocrine services in addition to other program benefits. Results: Among the control group, HbA1c increased an average of 0.04 points; the treatment group saw an average decrease of 0.42 points. The treatment group's endocrinology subset saw an even greater decrease of 0.85 points. The average HbA1c score for this group went down three points in a two-year period (7/20-7/22). Conclusions: The study results indicate that receiving coordinated endocrinology services has been especially effective in reducing HbA1c levels among program participants. As care continuity is associated with better glycemic control for diabetic patients, sustained program participation will likely help the patient population best manage their diabetes and avoid further adverse health outcomes. Additionally, as this diabetes program takes place in a rural, low-income minority area with low access to specialty care, the results demonstrate promising practices for strengthening the rural health care system. Disclosure C.Brindley: None. W.James: None. J.R.Bennett: None. K.F.Matthews: None. Funding Health Resources and Services Administration, Federal Office of Rural Health Policy (HRSA-20-025, D06RH37500)

School Performance Among a Sample of Type1 Diabetic Children and Adolescents in Erbil City

Background: Type 1 diabetes mellitus (T1DM) is the most common endocrine disorder in children. The glycated haemoglobin (HbA1C) level was found to be correlated with the academic skills and classroom attention in children with T1DM. Left untreated both high and low blood sugar levels can affect the child’s ability to concentrate on schoolwork and participate in school activities. Methodology: In Laila Qasim diabetic center from June to August 2022, a questionnaire survey was used for this cross-sectional study. The sample included 120 diabetic children for case group. All primary and secondary school pupils with type 1 diabetes were included in the study population. Result: In the present study, the correlation between diabetes and poor performance is clear in mathematics, english and science. The highest rate of fair followed not pass was found in uncontrolled HbA1c level (greater than 7) in all subjects except kurdish and found that students with type 1 diabetes had significantly lower overall academic grades than their nondiabetic classmates. Conclusion: Diabetes is associated with reduced neuronal function, which ultimately results in cognitive impairment in areas such as intelligence, learning, memory, information processing, attention, executive function, visual motor integration, and academic performances. Keywords: Type 1 diabetes mellitus; Children and adolescents; Academic performance; School

Risk Factors of Chronic Kidney Disease (CKD) in Type 2 Diabetes Mellitus (DM) Patients at Dr. Soetomo General Academic Hospital, Surabaya

Highlights:1. The highest risk was a history of hypertension, followed by a history of low HDL levels.2. Patients with type 2 DM at Dr. Soetomo General Academic Hospital, Surabaya, had a greater risk of developing CKD for patients with a history of hypertension (3.801 times higher) and patients with a history of low HDL (3.356 times higher). AbstractIntroduction: Type 2 diabetes mellitus (DM), categorized as a non-communicable disease, has become a global health concern. This study aimed to identify the risk factors for chronic kidney disease (CKD) in type 2 DM patients at Dr. Soetomo General Academic Hospital, Surabaya.Methods: This was a case-control study. The samples were collected using consecutive sampling methods from the medical records Dr. Soetomo General Academic Hospital, Surabaya. The total samples were 158 patients consisting of 79 cases and 79 controls. Independent variables were a history of uncontrolled HbA1c levels; hypertension; high triglyceride (TG) levels; low high-density lipoprotein (HDL) levels, high low-density lipoprotein (LDL) levels, and being overweight. The dependent variable was CKD. Samples were analyzed using the Chi-Square test and logistic regression.Results: From six independent variables that were analyzed, two variables had significant results based on the Chi-Square test. Logistic regression was performed and showed the significant results between risk factors of CKD and type 2 DM patients at Dr. Soetomo General Academic Hospital, Surabaya, were a history of hypertension (OR = 3.801, 95% CI = 1.875-7.706) and a history of low HDL levels (OR = 3.356, 95% CI = 1.650-6.827). The highest risks were a history of hypertension followed by a history of low HDL levels.Conclusion: Type 2 DM patients at Dr. Soetomo General Academic Hospital, Surabaya, with a history of hypertension and a history of low HDL had a greater risk of developing CKD.

Prevalence of non-adherence to medications in people with type 2 Diabetes mellitus

Diabetes mellitus (DM) is a chronic, non-communicable disease that has an increasing incidence rate over time as well as increasing disease-related deaths. Furthermore, around half of diabetic patients are unaware actually about their disease, and more are not taking their medications. This study aimed to determine the extent of medication adherence and factors contributing to non-adherence among diabetic patients in Majmaah governance, Saudi Arabia. This is an observational cross-sectional study design conducted among patients with type 2 diabetes. A self- administered questionnaire was distributed among diabetic patients .The questionnaire consisted of socio- demographic data, HbA1c level, duration of DM, family history of DM, DM medications and 12-Item Medication Adherence Scale. 180 patients with diabetes type 2 were involved (71.7% females vs. 28.3% males). The prevalence of patients with uncontrolled HbA1c levels was 25%. Family history of DM constitutes 74.4%. The most preferred route for drug administration was oral (50.6%). High non-adherent to medication was found among 57.8%. The independent significant factor associated with high non-adherence to DM medication was uncontrolled HbA1c while being a female was the independent significant factor for low non-adherent to DM medication. The non-adherent of the diabetic patients regarding anti-diabetes medications was widely prevalent. Female patients tend to be more adherent to DM medication than their male counterparts. This study established the fact that uncontrolled glycated hemoglobin was a detrimental factor in adherence to anti-DM medications. More studies are required to raise the awareness of the diabetic population regarding the importance of medication adherence.

Knowledge and Perception of Bidirectional Relationship Between Periodontal Disease and Type 1 Diabetes Mellitus: A Questionnaire Study.

The bidirectional relationship between type 1 diabetes mellitus (T1DM) and inflammatory periodontal disease (PD) is globally recognized. However, oral health components are often given lower priority, and studies related to knowledge and the bidirectional association are limited. This study assesses the knowledge and perceptions of PD and its associated risk factors among T1DM patients and/or their parents. Patients under 18 with T1DM at Universiti Teknologi MARA and Universiti Malaya were invited to participate. Structured interviews were conducted to assess participants' knowledge and perceptions of T1DM, and statistical analysis was performed to examine their associations using Pearson's chi-squared test and Fisher's exact test. A total of 113 T1DM patients, with a mean age of 11.4 ± 4, completed the interviews. Poor knowledge was observed among parents and T1DM patients (P-value = 0.007) and those who exercised regularly (P-value = 0.047). A significant association with good perception was found among individuals with uncontrolled HbA1c levels (P-value = 0.0018) and those experiencing bleeding symptoms (P-value = 0.021). The study highlights the importance of increasing awareness, a key factor in improving oral health knowledge. Interestingly, despite poor control of clinical parameters, the population displayed good perception, suggesting a potential lack of understanding regarding disease control.

PP78 Effectiveness And Safety Of The FreeStyle Libre® Glucose Monitoring System For T1DM In Childhood And Adolescence

IntroductionFreeStyle Libre System (FSL) is a minimally invasive technology, which provides frequent information about interstitial glucose levels, which allows adjustment of insulin dose and a reduction in the number of fingersticks. This study aims to evaluate the effectiveness and safety of FSL in childhood and adolescence.MethodsProspective case series in 27 Spanish hospitals. Patients aged 4-17 years with type 1 diabetes mellitus (T1DM) were included. Follow-up was done at 3, 6 and 12 months after starting to use the FSL. Outcome measures were HbA1c levels, acute complications of DM (severe hypoglycemia, ketoacidosis), DM knowledge, health-related quality of life, satisfaction and adverse effects. Biochemical glycemic outcomes (e.g., glycemic variability, time in therapeutic range) were available from 3 to 12 months. Mixed regression models with repeated time measurements were implemented.ResultsThe mean age of patients was 12.6 years, with 56.4 percent had HbA1c values above 7.5 percent at baseline. This subgroup significantly improved their HbA1c levels at 3, 6 and 12 months (-0.46%, -0.44% and -0.35%, respectively). Patients with controlled HbA1c levels significantly worsened at 12 months (0.29%). There was a significant reduction in severe hypoglycemic episodes, but only in the multiple imputation analysis. In patients controlled at baseline, there were significant reductions between 3 and 12 months in the percentage of time under 55mg/dl (-0.64%), above 250mg/dl (-1.8%) and glycemic variability (-2.6%). In uncontrolled patients, there was a significant reduction in time above 250mg/dl (-5.8%) between 3 and 12 months follow-up. There was no significant improvement in knowledge about disease, although general self-perceived health worsened and general satisfaction improved. Mild adverse events such as skin reactions (14%) and discomfort or pain (11.3%) with no significant reductions in follow-up were recorded.ConclusionsThe use of FSL in childhood and adolescence with T1DM produces a significant reduction in HbA1c levels in patients with uncontrolled HbA1c levels along with a reduction in severe hypoglycemic episodes (in the multiple imputation analysis). FSL-related adverse effects are considered mild.

ASSOCIATION OF GLYCOSYLLATED HEMOGLOBIN (HbA1C) LEVELS TO THE SEVERITY OF DIABETIC FOOT ULCER IN TYPE 2 DIABETES MELLITUS PATIENTS IN RSUP. H. ADAM MALIK MEDAN

Abstrak&#x0D; Introduction: Diabetic ulcers with neuropathy require amputation or time to fully heal. The worse blood sugar control, it will worsen the condition of complications such as diabetic ulcers, diabetic neuropathy, and other complications. Wound healing in diabetic ulcers is influenced by controlled HbA1c levels.&#x0D; Methods: This study is an observational analytic study with a retrospective design used in this study with secondary data. This study is analytical because it aims to obtain the correlation of HbA1c with the severity of diabetic ulcers in patients with diabetes mellitus at H. Adam Malik Hospital.&#x0D; Results: The average age of the patients was 62 with the majority of respondents being male. The dominance of respondents came with Grade IV as many as 17 people, with uncontrolled HbA1c levels as many as 39 people. Using Spearman Corelation test, the value of r = 0.735, 0.736, and 0.785, respecttively for the corelation between HbA1c, Hb and ESR levels with the severity of diabetic foot ulcers ,with a value (p = 0.0001).&#x0D; Conclusion: We found a strong correlation and a significant relationship between HbA1c, Hb, and ESR levels with the severity of diabetic foot ulcers.

Salivary Gene Expression of RANK, RANKL, and OPG in Type 1 Diabetes Mellitus and Periodontal Disease Patients.

The relationship between type 1 diabetes mellitus (T1DM) and periodontal disease may exhibit by the alteration of bone metabolism. However, evidence for this relationship is scarce and inconclusive. Thus, the aims of the present study were to investigate salivary receptor activator of nuclear factor kappa-β (RANK), receptor activator of nuclear factor kappa-β ligand (RANKL), osteoprotegerin (OPG) gene expression and the RANKL:OPG ratio in T1DM and non-T1DM. Secondary objective was to determine the relationships of RANK, RANKL and OPG gene expression to clinical parameters of T1DM and periodontal disease. Twenty patients with T1DM and twenty age-matched non-T1DM were recruited. Clinical periodontal parameters were measured. Total RNA was isolated from non-stimulated saliva, and the relative gene expressions of RANK, RANKL, OPG and RANKL:OPG ratio were determined by quantitative real-time polymerase chain reaction. The T1DM group had significantly higher mean periodontal parameters than the non-T1DM group, while the mean plaque scores of both groups were not significantly different. There was a trend of higher relative gene expression of RANK, RANKL, and the RANKL:OPG ratio and lower expression of OPG in T1DM group but no statistic significant different when compared to non-T1DM. In the T1DM group, RANKL:OPG correlated with the percentage of bleeding sites, whereas RANK, RANKL, and HbA1c levels correlated with pocket depth. Bone metabolisms demonstrating by decreased OPG gene expression and upregulated of RANK, RANKL, RANKL:OPG with higher pocket depth and bleeding in T1DM may play an important role in periodontal destruction in T1DM.

Pengendalian Gula Darah pada DM Tipe 2 dengan Pemeriksaan HbA1c di Rumah Sakit

This study aims to determine the control of blood sugar levels in type 2 DM patients at Raden Mattaher Hospital Jambi. The design of this study was descriptive analysis using 100 samples of type 2 DM patients who underwent inpatient and outpatient treatment while blood sugar and HbA1c were checked. The results showed 82 patients with uncontrolled HbA1c levels with an average HbA1c level of 10.11% and 78 patients with abnormal blood sugar levels with an average blood sugar level of 326 mg/dL. Most patients with type 2 diabetes are female (61%), early adulthood 18-40 years (61%), obesity BMI (50%), moderate activity (52%) and poor diet (59%). Based on the characteristics of the respondents, it was found that HbA1c levels were not controlled in the groups: middle adults (85.2%), women (80.3%), BMI with obesity (86.0%), light activity (81.8%) and poor diet. (86.4%). In conclusion, most of the samples were included in the criteria for poor DM control based on current blood sugar levels and HbA1c.&#x0D; Keywords: Type 2 DM, Temporary Blood Sugar, HAa1c, Blood Sugar Control

DETERMINANTS OF SIGNIFICANT HEPATIC FIBROSIS IN TYPE 2 DIABETES PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE IN SOUTH INDIA.

Introduction: Non-alcoholic fatty liver disease is more prevalent among type 2 diabetes(T2D). Apart from liver related morbidity and mortality, fatty liver is associated with increased risk for cardiovascular disease. Severity of hepatic brosis correlates with poor outcome. Early diagnosis and treatment will improve the quality of life. Transient elastography (TE) is a validated tool for assessment of severity of brosis. We estimate the proportion of patients with signicant brosis and its determinants using TE in south india. Methods: Hospital based prospective cross sectional study was conducted among type 2 diabetes patients with ultrasound abdomen reported as fatty liver over the study period of one year. Exclusion criteria was applied to rene the study population to asymptomatic non alcoholic fatty liver disease patients. TE examination was done and signicant hepatic brosis (≥ F2 = 7.1 to 8.7kpa) was correlated with various blood parameters and anthropometrics. Results: 140 patients were selected from 781 type 2 diabetes population. Proportion of signicant brosis (≥ F2) was 47.1 percent. All patients except one were either obese 59(89.4%) or overweight 6(9.1%) in the subgroup of signicant brosis. T2D patients with uncontrolled HbA1c levels had more signicant brosis (p = 0.02) than controlled patients. Liver enzymes (AST/ALT) and lipid prole measurements do not correlate with signicant brosis. Ultrasound abdomen imaging fails to detect signicant brosis in two third of cases (p=0.002). Conclusion: Nearly half of type 2 diabetes with NAFLD in south India had signicant hepatic brosis. Higher BMI (&gt; 30) and poor glycemic control were key determinants of signicant hepatic brosis. This subset of T2D patients warrant TE screening study

A Study of Musculoskeletal Manifestations of Diabetes Mellitus and Their Association with HbA1C Among Diabetic Patients

Background: The prevalence of diabetes mellitus (DM) is increasing significantly throughout the world. While the vascular complications of diabetes are well recognized and account for the principle mortality and morbidity from the condition, the musculoskeletal manifestations of diabetes are common and not life-threatening, which are an important cause for morbidity, pain, and disability. The most common reported forms of various musculoskeletal manifestations of DM include adhesive capsulitis, hand syndromes such as limited joint mobility syndrome (LJMS), Dupuytren’s contracture (DC), and carpal tunnel syndrome (CTS), flexor tenosynovitis, reflex sympathetic dystrophy, diffuse idiopathic skeletal hyperostosis (DISH), Charcot’s joints, diabetic amyotrophy (DA), and osteoarthritis. Materials and Methods: The study was conducted on a total of 150 patients with type 2 DM for a duration of at least 5 years in Bangalore during the study period from January 2020 to June 2021. The patients fulfilling the inclusion criteria were enrolled for the study after obtaining informed consent. Detailed history was taken and general physical examination was done to determine the musculoskeletal manifestations of DM. The Disability of Arm Shoulder and Hand (DASH) questionnaire was also completed as per the patient’s responses. Laboratory reports were collected, data compiled, and the data were analyzed. Results: Of the 150 cases enrolled, the maximum number of cases belonged to the age group of 36–50 years. About 64% of the diabetic cases were suffering from musculoskeletal disorders (MSDs) (LMJS, CTS, shoulder capsulitis, DC, trigger finger, DISH, DA). Among the MSDs, the highest prevalence was by LJMS (28%). There was a positive correlation among the duration of diabetes, HbA1C, and the DASH score among patients with MSDs in this study and this is statistically significant (P &lt; 0.05). We also see that MSDs are present in 72.7% of the females and 57.1% of the males in the study and this was statistically significant (P = 0.048). Conclusion: MSDs have a high prevalence in diabetic patients. With advancing age and uncontrolled HbA1C levels, the number of MSDs was more as well as the severity as indicated by the DASH score. Early and better glycemic control in diabetic patients can reduce the morbidity associated with MSDs as evidenced by the reduced intensity of DASH score in well-controlled patients.