scholarly journals Association between Diabetes Complications and the Triglyceride-Glucose Index in Hospitalized Patients with Type 2 Diabetes

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ying Pan ◽  
Shao Zhong ◽  
Kaixin Zhou ◽  
Zijian Tian ◽  
Fei Chen ◽  
...  

Background. Triglyceride-glucose (TyG) index is a convenient indicator of insulin resistance. It has been shown to be associated with macrovascular and microvascular complications in nonhospitalized diabetic patients. However, whether TyG index is a risk factor of diabetes vascular complications in hospitalized type 2 diabetic patients is unclear. We sought to explore the association between TyG index and the risk of macrovascular and microvascular complications in a large Chinese cohort of hospitalized patients. Method. A total of 4,721 patients with type 2 diabetes (T2D) who were hospitalized in the Department of Endocrinology, Kunshan Hospital Affiliated to Jiangsu University were enrolled between January 2015 and November 2020. TyG index was calculated as ln fasting   triglycerides   mg / dL × fasting   glucose   mg / dL / 2 . Measures of macrovascular complications included brachial-ankle pulse wave velocity (ba-PWV) and ankle-brachial index (ABI), whilst urine microalbumin (MAU), chronic kidney disease (CKD), and diabetic retinopathy (DR) were evaluated for microvascular complications. Logistic regressions were used to examine the association between TyG index and diabetes complications. Results. In univariate logistic regressions, higher TyG index was significantly ( p < 0.002 ) associated with increased odds of MAU ( OR = 1.39 , 95% CI: [1.22~1.59]) and ABI ( OR = 1.31 , 95% CI: [1.10-1.57]) but not CKD, DR, or ba-PWV. After controlling for confounders such as age, sex, and body mass index (BMI), TyG index remained strongly ( p < 0.002 ) associated with MAU and ABI. These associations were more pronounced ( p < 0.001 ) in patients with poor glycemic control or in the elderly. Conclusion. Hospitalized patients with an elevated TyG index were at a higher risk of lower limb vascular stenosis and nephric microvascular damage. Close monitoring of TyG index in patients with younger age or poor glycemic control could potentially reduce the burden of diabetes complications and prevent readmission.

2021 ◽  
Vol 8 (6) ◽  
pp. 297-303
Author(s):  
V. Aruna

Type 2 Diabetes Mellitus (Non Insulin Dependent Diabetes Mellitus -NIDDM) is a chronic metabolic disorder most prevalent in India with microvascular complications. Several studies were underway to identify biomarkers to detect complications associated with increasing duration of disease. The present study was done to understand the role of Connecting peptide (C-peptide) in pathogenesis of microvascular changes and it’s correlation to dyslipidemia of T2DM. The study was done at Government General Hospital, Guntur. In this study 61 known T2 DM patients and 51 age sex matched controls were selected. Their fasting blood samples were analysed for FBS, HbA1C, Urea, Creatinine, Total Cholesterol, High Density Lipoprotein Cholesterol and C-peptide. Dyslipidemia was not observed in Diabetic patients compared to controls (TC, HDLC & NonHDL p = 0.363, 0.294 & 0.336 respectively). HbA1C and C-peptide showed significant correlation between cases and controls (P = <0.00001). C-peptide showed significant correlation with lipid parameters & lipid ratios in individuals with poor glycemic control identified by HbA1c value of >9%. (ANOVA p = <0.0001) Pearson’s correlation showed negative relation of HbA1c and C-peptide with lipid parameters TC, HDLC & Non HDLC (r = 0.378, 0.732, 0.313 and 0.81, 0.91 & 0.843 consecutively). C-peptide showed significant variation with Non HDL / HDL ratio & Non HDL / TC ratio (p = <0.002 & <0.00007) in diabetic patients with poor glycemic control identified by HbA1c of > 9%. We conclude that C-peptide would be a good marker to assess degree of function of pancreas and predictor of atherogenic complication in longstanding NIDDM. Keywords: Type 2 Diabetes Mellitus, C-peptide, HbA1c, Atherogenesis.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251506
Author(s):  
Shambel Nigussie ◽  
Nigussie Birhan ◽  
Firehiwot Amare ◽  
Getnet Mengistu ◽  
Fuad Adem ◽  
...  

Objective To assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia. Methods A cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control. Result A total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10–4.29). The odds of poor glycemic control in patients who did not understand the pharmacist’s instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10–3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13–2.55). Conclusion The overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist’s advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.


2021 ◽  
Vol 6 (2) ◽  
pp. 1444-1448
Author(s):  
Santosh Timalsina ◽  
Shishir Mahato ◽  
Sandesh Nepal

Introduction: Insulin resistance (IR) and glycemic control are two very important aspects to be considered during management of patients with Type 2 Diabetes Mellitus (T2DM). The triglyceride-glucose (TyG) index has been proposed as a simple and inexpensive parameter that correlates well with IR and glycemic control. Objectives: To explore the association of TyG index (and other TyG derived indices) with glycated hemoglobin (HbA1c) and evaluate their predictive ability for glycemic control in patients with T2DM. Methodology: This cross-sectional study comprised of 160 adult patients diagnosed with T2DM visiting the medical outpatient department of Chitwan Medical College, Bharatpur, Chitwan between July–December 2019. Socio-demographic data and anthropometric measurements were collected. Glycemic control was assessed by HbA1c. TyG index was calculated by the formula: ln [fasting TG (mg/dl) x fasting glucose (mg/dl)/2]. Receiver operating characteristic (ROC) curve analysis was performed to analyze the predictive ability of TyG-index for poor glycemic control. Results: One hundred and sixty patients (mean age: 53.6 ± 10.7 years, 55.0% males) were included in the study. Eighty (50.0%) had good glycemic control (HbA1c <7.0%). TyG index, along with TyG-BMI and TyG-WC (other TyG derived indices) were significantly increased in the poor glycemic control group. TyG index had a good predictive ability for poor glycemic control (AUC: 0.803, 95% CI: 0.731 – 0.874). A TyG cutoff ≥ 9.12 was optimal for predicting poor glycemic control, with 86.1% sensitivity and 61.5% specificity. Conclusion: TyG index could be a simple and cost-effective screening tool for assessment of glycemic control in patients with T2DM.


2021 ◽  
Vol 18 (7) ◽  
pp. 1539-1546
Author(s):  
Sultan A.M. Saghir ◽  
Abdullah E.A. Alhariri ◽  
Sameer A. Alkubat ◽  
Amer A. Almiamn ◽  
Saleem H. Aladaileh ◽  
...  

Purpose: To determine the status of glycemic control and its associated factors among adult patients with type 2 diabetes mellitus (T2DM) in Hodeidah City, Yemen. Methods: This cross-sectional study involved T2DM patients attending an outpatient clinic at the Military Hospital in Hodeidah, from January to March 2017. Relevant socio-demographic characteristics, clinical factors and self-management behaviours were recorded in face-to-face interviews. Blood pressure, body weight, and height measurements were also obtained. Glycosylated hemoglobin (HbA1c) and lipid profile were evaluated. Urine samples were also obtained and analysed by albuminuria assay. Results: Of 246 participants, 73.2 % showed poor glycemic control (HbA1c ≥ 7 %). Female patients, those aged ≥ 40 years, the illiterate, and Khat chewers were more likely to have poor glycemic control. Moreover, longer disease duration, insulin administration and albuminuria were significantly associated with poor glycemic control. In contrast, a healthy diet, physical exercise, proper self-monitoring of blood glucose levels and taking medicines as prescribed significantly increased the likelihood of good glycemic control. Conclusion: A majority of the Yemeni diabetic patients have poor glycemic control. To achieve better awareness, diabetes educational programs that highlight the benefits of self-management are recommended.


2021 ◽  
Vol 9 ◽  
pp. 205031212110230
Author(s):  
Tadesse Alemu ◽  
Tirhas Tadesse ◽  
Getasew Amogne

Objective: The objective of the study was to explore the level of glycemic control and its determinants among patients with type 2 diabetes mellitus at Menelik II Referral Hospital, Addis Ababa, Ethiopia. Methods: Cross-sectional study design was employed. The sample size was determined using a single proportion formula and 245 patients with type 2 diabetes mellitus were involved in this study. Systematic sampling method was used to select the study subjects. Standard questionnaire was used to collect patient’s biographic data, economic data, self-care activities, and patient compliance to medications. Summary statistics of a given data were calculated. Logistic regression model was used to measure the relationship between the outcome and predictor variable. Direction and strength of association was expressed using odds ratio and 95% confidence interval. Result: More than three-fourth, 191 (80.3%) of diabetic patients had poor glycemic control. Poor glycemic control was found to be 7.03 times higher among diabetic patients with duration of 5–10 years (adjusted odds ratio = 7.03, 95% confidence interval = 2.7–18.6). Similarly, diabetic patients with a duration of above 10 years were poorly controlled their blood sugar level (adjusted odds ratio = 2.3, 95% confidence interval = 1.028–5.08) in comparison to diabetic patients with a duration of fewer than 5 years. It was also found that compliance with a specific diet was significantly associated with good control of blood sugar level (adjusted odds ratio = 3.7, 95% confidence interval = 1.24–11.13). Conclusion: The magnitude of patients with poor glycemic control was high. Duration of diabetes and non-compliance with diets high in fruits, vegetables, and diets low in fat and sugar were significantly related to uncontrolled blood glucose levels. Therefore, developing strategies targeted toward improving blood glucose control with special attention to diabetes mellitus (DM) patients with a duration of ⩾5 years and those who poorly comply with their diet was strongly recommended.


2020 ◽  
Author(s):  
marjan mohammadi ◽  
Seyyed Abolghasem Djazayeri ◽  
Asal Ataie-Jafari

Abstract Background: Food insecurity can increase risks of health and nutritional problems, leading to difficulties in self-care and poor glycemic control in diabetic patients. Purpose: This study assessed food insecurity and its association with diabetes control and self-care in type 2 diabetes patients.Methods: In this cross sectional study, 148 adults with type 2 diabetes participated. Food insecurity and self-care were determined using the 18-item USDA household food security status questionnaire and self-care (SDSCA) questionnaire. Data were analyzed using logistic and linear regression tests (SPSS 20 software).Results: Thirty-seven percent of the participants were food-insecure and significantly more likely than food-secure participants to have poor glycemic control (OR=3.02; CI: 1.45-2.65). No significant association was found between food-insecurity and overall self-care score.Conclusion: Food-insecurity was directly associated with poor glycemic control in type 2 diabetes patients. Since economic status was significantly better in the food-secure group, it can be postulated that financial problems will eventually lead to poor glycemic control.Policy strategies to increaseaccess to diabetes-appropriate foods mayreduce socioeconomic inequalities in glycemiccontrol.


2019 ◽  
Vol 14 (2) ◽  
pp. 13-17
Author(s):  
Luke Rannelli ◽  
Eric Kaplovitch ◽  
Sonia Anand

Worldwide, in 2010, 202 million people were living with PAD, with a prevalence between 3-12 percent. The prevalence of PAD is three times greater in diabetic patients compared to those with normal glycaemia. PAD of the limbs is associated with increased cardiovascular morbidity and mortality, as well as major adverse limb events including acute limb ischemia and amputation. These risks are particularly high in patients who smoke and/or have type 2 diabetes.  The goal of treatment in diabetic patients with PAD is to prevent cardiovascular events and prevent further peripheral artery stenosis leading to limb ischemia, and amputation. Poor glycemic control contributes to atherosclerotic progression; however, no randomized control trial evidence exists that demonstrates improved glycemic control reduces the risk of PAD. Oral diabetic medications are designed to lower glucose levels, reduce symptoms and the microvascular complications of diabetes without the inconvenience of daily injections. However, the data supporting benefit of these medications in diabetic populations with concurrent PAD are limited. We review the evidence for oral hypoglycemic agents in the treatment of patients with concurrent PAD and diabetes.


2017 ◽  
Vol 03 ◽  
pp. 42
Author(s):  
Ni Putu Tesi Maratni ◽  
Dwijo Anargha Sindhughosa ◽  
I Gusti Ayu Mardewi ◽  
Ida Bagus Amertha Putra Manuaba ◽  
Made Ratna Saraswati ◽  
...  

The amount of glycosylated hemoglobin (HbA1c) reflects the long-term glycemic control of patients with diabetes. HbA1c also predicts the risk for the development of diabetic complications such as cardiovascular disease (CVD). Patients with type-2 diabetes and the characteristic of dyslipidemia are frequently found. Also, dyslipidemia plays as an independent risk factor for CVD. This study was aimed to evaluate the relationship between glycemic control status with serum individual lipid profiles and lipid ratios in patients with type-2 diabetes. This cross-sectional study consisted of 80 patients. Depending on the HbA1c level, the patients were divided into two groups, good glycemic control group (HbA1c < 7.0%, n = 15) and poor glycemic control group (HbA1c ≥ 7.0%, n = 65). The association of HbA1c with individual lipids (TC, TG, HDL-C, LDL-C, Non- HDL-C) and lipid ratios (TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, monocyte/HDL-C) were analyzed. The value of individual lipids and lipid ratios did not correlate with HbA1c level (p-value ≥ 0.05). Parameters of individual lipids and lipid ratios were not independently associated with poor glycemic control, which was analyzed by logistic regression. ROC analysis found both LDL-C and LDL-C/HDL-C were not accurate to be used as a prognostic indicator of poor glycemic control in patients with type-2 diabetes (p = 0.155, p = 0.297, respectively). The present study found that there was no association between individual lipids and lipid ratios with glycemic control status.


2020 ◽  
Vol 7 (7) ◽  
pp. 1083
Author(s):  
Rajdeepak V. S. ◽  
Rekha G. ◽  
Jayashree S. C.

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization and increased glucose production. The vascular complications of DM are subdivided into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular complications (coronary artery disease, peripheral vascular disease, cerebrovascular disease). There is an observed disparity between various vascular complications of diabetes and the atherogenic factors.Methods: The patients with type 2 diabetes mellitus attending outpatient and inpatient departments in Dr. B. R. Ambedkar Medical College and hospital, from September 2014 to September 2016 were selected for this study. All patients were subjected to detailed history, physical examination and laboratory investigations with respect to complications of diabetes mellitus.Results: In this study, 76% of the patients had poor glycemic control with elevated HbA1c >7%. 38% of patients had normal BMI. 36% of patients were overweight and 26% were obese. 62% of patients were either overweight or obese. Hypercholesterolemia was seen in 26% of patients with poor glycemic control. Hyperhomocysteinemia was present in 38% of patients with microvascular complications and 33% of patients with macrovascular complications.Conclusions: Type 2 diabetes mellitus showed a strong correlation between glycemic status and incidence of diabetes complications. Hypercholesterolemia and hyperhomocysteinemia have added to the increased incidence of complications as additional factors in metabolic derangements as a consequence of poor glycemic control.


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