scholarly journals Evaluation of Oral Hygiene in Type 2 Diabetics with and without Diabetic Retinopathy - A Comparative Study Done at Yenepoya Hospital

2021 ◽  
Vol 10 (31) ◽  
pp. 2490-2493
Author(s):  
Mallika S. Shetty ◽  
Hasan Sarfaraz ◽  
Sanath Kumar Shetty ◽  
Tushar Milind Wankhede

BACKGROUND Diabetic retinopathy (DR) is a major microvascular complication of diabetes. It has a significant impact on the world’s health systems. Due to a rapid increase in disease burden globally, there arises the need for newer methods of early detection of DR to prevent various complications including total blindness. The association between periodontal problems and diabetes has been studied widely and a positive correlation has been found. Literature search revealed that no studies have been done so far comparing the oral hygiene status among type 2 diabetics with and without retinopathy, thus the purpose of the study was to compare oral hygiene status among type 2 diabetics with and without progressing diabetic retinopathy and thus look for any association between existing oral hygiene status and severity of diabetic retinopathy. METHODS Study was conducted on type 2 diabetic patients with and without progressing diabetic retinopathy visiting the Department of Opthalmology at the University Medical College. A thorough evaluation of oral hygiene status of patients participating in the study was done using OHI - S and Gingival Index. RESULTS There was no statistically significant difference between the OHI - S and diabetic retinopathy, P value (0.522). The gingival index showed statistically significant relation with severity of diabetic retinopathy with P - value of 0.027. The intergroup comparison of the association between the mean OHI - S and GI scores and severity of diabetic retinopathy was found to be statistically insignificant P < 0.269 and P < 0.125. CONCLUSIONS There could be a plausible relationship between diabetic retinopathy and oral hygiene condition. Because of the regional variation in the oral hygiene condition further prospective studies on a large population are required to ascertain whether the existing oral hygiene status has a direct impact on the progression and severity of diabetic retinopathy. KEY WORDS Diabetic Retinopathy, Oral Hygiene, Periodontitis, Type 2 Diabetes Mellitus, Oral Hygiene Index Simplified, Gingival Index

2017 ◽  
Vol 9 (02) ◽  
pp. 084-088 ◽  
Author(s):  
Archana Buch ◽  
Supreet Kaur ◽  
Rahul Nair ◽  
Ambuj Jain

Abstract BACKGROUND: Platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) are the indicators of increased platelet activity and can be considered as potential biomarkers for diabetic complications. PURPOSE: To study PVI in Type 2 diabetics with and without complications in comparison to nondiabetic patients MATERIALS AND METHODS: A case–control study was conducted on 300 Type 2 diabetics and 200 nondiabetics. Detailed clinical history regarding duration, hypertension, and complications was taken. PVI was obtained using automated cell counter. Fasting blood glucose, hemoglobin A1c, lipid profile, creatinine were also obtained. Diabetics were further categorized into patients with complications and without complications. Statistical analysis was performed by Statistical Package for the Social Sciences Version 17 (Chicago, IL) Student’s t-test and ANOVA test. RESULTS: Platelet count was significantly decreased in diabetics (P = 0.005). MPV was significantly increased in diabetic patients with complications as compared to diabetics without complications and nondiabetic group (P < 0.0001). PDW showed statistically significant difference between diabetics with and without complications and nondiabetics (P < 0.0001). However, no statistically significant difference was observed in platelet-large cell ratio (P-LCR) among all the three study groups. We found statistically significant correlation of MPV with diabetic retinopathy (P = 0.000), nephropathy (P = 0.005), and diabetic foot (P = 0.048). PDW was significantly increased in diabetic retinopathy (P = 0.035) and nephropathy (P = 0.007). P-LCR had no statistically significant correlation with diabetic complications. CONCLUSIONS: MPV and PDW are predictive biomarkers of diabetic vascular complications. They are more significant in microvascular complications than macrovascular complications.


2022 ◽  
Vol 9 (1) ◽  
pp. 28-32
Author(s):  
Sara Mariyum ◽  
Nazma Saleem ◽  
Amjad Iqbal ◽  
Shama Iqbal ◽  
Munazza Khattak ◽  
...  

OBJECTIVES: The purpose of this study was to compare the Type 2 diabetes mellitus patients and non-diabetics in terms of Papillary bleeding index (PBI) of periodontal disease. METHODOLOGY: This comparative cross-sectional study was conducted during the period of November 2020 to February 2021 in three (3) tertiary care hospitals of Peshawar. The sampling technique was purposive sampling. The sample comprised 105 individuals, 56 participants in Type–2 diabetes group and 49 in non-diabetes group. Male and females, having age between 40-65 years were recruited. Each diabetic and non-diabetic were clinically examined for periodontitis. Age and sex-matched participants suffering from periodontitis without a history of diabetes as well as with good glycemic control (HbA1c) were considered as controls subjects. Glycated hemoglobulin (HbA1c) was carried out for all the participants free of cost by using Human Gmbh-Max-Planck-Ring 21-65205 Wiesbaden-Germany kit. The study was approved by the ethical committee of the Peshawar Medical College. Data was analyzed using software package SPSS version 20. RESULTS: Out of 56  diabetics, 24 subjects brushed once daily, 15  brushed twice daily, 11 brushed occasionally and 6  didn’t brush  whereas in 49 non diabetics, 20 subjects brushed once daily, 13 brushed twice daily, 11  brushed occasionally and 5 didn’t brush. The clinical parameter mean (PBI) was recorded in our study. Score was 2.09 (±0.82) in diabetics and 1.02 (±0.47) in non-diabetics. P-value measured by the chi square test was significant. Spearman correlation test was performed to explore the association between the type 2 diabetes and Papillary bleeding index (PBI). CONCLUSION: We concluded that a significant difference exists between the mean PBI scores of Type 2 diabetics and non-diabetics.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Seyit Uyar ◽  
Ayşe Balkarlı ◽  
Muhammet Kazım Erol ◽  
Bayram Yeşil ◽  
Abdullah Tokuç ◽  
...  

Background and Objectives. Nailfold capillaroscopy is an easy and noninvasive technique used to investigate dermal microvasculature. Traditional investigations of vascularity do not detect changes until they are well-established in type 2 diabetics. The objective of the current study was to evaluate nailfold capillaries in type 2 diabetes mellitus patients and to determine the association of retinopathy with changes in the nailfold capillaries.Materials and Methods. Capillaroscopic findings by nailfold capillaroscopy and fundoscopic examinations were assessed in 216 patients with type 2 diabetes mellitus and 101 healthy controls included in this prospective study.Results. Retinopathy was detected in 43.05% of diabetic patients (n=93). Capillaroscopic findings including tortuosity (p<0.001), bushy capillary (p<0.001), neoformation (p<0.001), bizarre capillary (p<0.001), microhemorrhage (p=0.001), capillary ectasia (p=0.002), and aneurysm (p=0.004) were significantly higher in diabetic group than control group. In logistic regression analysis, only tortuosity was shown significant (OR, 2.16;p=0.036). There was also a significant relation between diabetes duration and most of the capillaroscopic findings.Conclusion. Capillaroscopic changes were found to be correlated with diabetic retinopathy, in particular with longer disease duration in our study. Capillaroscopic imaging could be a useful new technique for assessment of diabetic microvascular changes.


Author(s):  
Ghazala Usman

Background: Recent evidence states that about a quarter of all diabetic patients will experience an ulcer on foot at some point in their lifetime and 15-25% of these will require foot amputation. In the present study, we aimed to evaluate the incidence of chronic kidney disease (CKD) in Type 2 diabetes mellitus (T2DM) patients presenting with Diabetic foot ulcer. Methods: The present study was carried out at Jinnah Postgraduate Medical Center (JPMC), Sindh from February-August 2017. Over 100 Type 2 - DM patients, aged between 35-60 years who presented with diabetic foot ulcer took part in this study. Data was collected and documented in pre-approved pro-forma, subsequently, entered and analyzed via SPSS version 19. Chi-square was applied to test any significant difference between the categories with a p-value of ≤0.05 considered as significant. Results: The mean serum creatinine (mg/dl) value was reported to be 1.17 ± 0.45. Frequency of CKD in Type 2 - DM patients presenting with diabetic foot ulcer was 31%. Male gender was affected more from CKD. Frequency distribution of chronic kidney disease among duration of DM groups 10-15 years = 35.5% and >15 years = 64.5%. The characteristics of HbA1c (g/dl) of study population was 8.34 ± 0.59. Conclusion: Occurrence of CKD in Type 2 - DM patients presenting with diabetic foot ulcer was much higher as compared to national and international studies. Therefore, special attention should be given on regular screening of diabetic patients with a complaint of a foot ulcer.


Medicina ◽  
2020 ◽  
Vol 56 (8) ◽  
pp. 385
Author(s):  
Ying-Chieh Lin ◽  
Yu-Ching Chen ◽  
Jorng-Tzong Horng ◽  
Jui-Ming Chen

Background and Objectives: Fenofibrate, a PPAR-α agonist, has been demonstrated to reduce the progression of diabetic retinopathy (DR) and the need for laser treatment in a FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study. However, in the subgroup of patients without pre-existing DR, there was no significant difference in the progression of DR between the fenofibrate group and the placebo group. In this study, we aim to investigate whether fenofibrate can decrease the risk of incident DR in a population-based cohort study of type 2 diabetic patients in Taiwan. Materials and Methods: A total of 32,253 type 2 diabetic patients without previous retinopathy were retrieved from 892,419 patients in 2001–2002. They were then divided into two groups based on whether they were exposed to fenofibrate or not. The patients were followed until a diagnosis of diabetic retinopathy was made or until the year 2008. Results: With a follow-up period of 6.8 ± 1.5 years and 5.4 ± 2.6 years for 2500 fenofibrate users and 29,753 non-users, respectively, the Cox proportional hazard regression analysis revealed that the hazard ratio (HR) of new onset retinopathy was 0.57 (95% CI 0.57–0.62, p < 0.001). After adjusting for hypertension; the Charlson comorbidity index (CCI); and medications such as angiotensin-converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB), anticoagulants, gemfibrozil, statins, and hypoglycemic agents, the adjusted HR was 0.75 (95% CI 0.68–0.82, p < 0.001). The need for laser treatment has an HR and adjusted HR of 0.59 (95% CI 0.49–0.71, p < 0.001) and 0.67 (95% CI 0.56–0.81, p < 0.001), respectively. Conclusion: Our study showed that the long-term and regular use of fenofibrate may decrease the risk of incident retinopathy and the need for laser treatment in type 2 diabetic patients. Since there are limitations associated with our study, further investigations are necessary to confirm such an association.


2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Shahnaz Tofangchiha ◽  
Atoosa Moetaghedi Larijani ◽  
Iraj Mirzaii-Dizgah ◽  
Mahdi Isazadeh ◽  
Shima Rahimi ◽  
...  

Background: Type 2 diabetes and thyroid disorders cause extensive changes in insulin resistance. An increase in serum resistin level is associated with insulin resistance. Objectives: The current study aimed to investigate the cumulative effect of diabetes and hypothyroidism on the serum resistin levels of type 2 diabetic patients. Methods: Participants were divided into four groups using the convenience sampling method. Each group contained 30 diabetic patients, 32 hypothyroid patients, 30 diabetics + hypothyroid patients, and 29 healthy individuals. Serum samples were taken from participants and their serum resistin levels were measured. Data were collected and analyzed using SPSS version 23. Pearson correlation test, ANOVA statistical analysis, and Tukey post hoc test were used to analyze the data. A P-value of < 0.05 was used as statistically significant. Results: Among patients with hypothyroidism, resistin, and thyroid-stimulating hormone were moderately correlated (P = 0.001, r = 0.580). ANOVA revealed a statistically significant difference between the resistin levels in the studied groups (P = 0.000, F = 6.813). Conclusions: Serum resistin levels are significantly lower in people with diabetes + hypothyroidism than in people with only one of these two conditions. Therefore, the cumulative effect of diabetes and hypothyroidism on resistin levels cannot be deduced from the findings of the present study.


2005 ◽  
Vol 48 (1) ◽  
pp. 35-38 ◽  
Author(s):  
Naciye Kurtul ◽  
Ebubekir Bakan ◽  
Hülya Aksoy ◽  
Orhan Baykal

Increased oxidative stress might play an important role in the initiation and progression of diabetic complications. The present study has been undertaken to investigate whether there is any relationship between retinopathy degree and leukocyte superoxide dismutase (SOD) and catalase (CAT) activities and lipid peroxidation (LPO) in diabetic individuals with type 2 diabetic retinopathy. Patients were groupped with respect to the degree of retinopathy. Leukocyte malondialdehyde (MDA) levels, and SOD and CAT activities were measured in patients with type 2 diabetes mellitus (n=41) and nondiabetic healthy controls (n=23). Leukocyte LPO of the type 2 diabetic patients with retinopathy was significantly increased (p< 0.001), whereas SOD and CAT activities were decreased (p<0.001 and p<0.001, respectively) compared to those of controls. MDA concentrations rose while SOD and CAT activities fell with increasing severity of diabetic retinopathy, altough there was no significant difference in comprasion of the parameters mentioned above between the diabetic patients with and without retinopathy. Our results show that leukocytes in patients with type 2 diabetic retinopathy are affected by oxidative stress which might be contribute to pathogenesis of diabetic retinopathy. Prospective studies are needed to evaulate the relationship between the leukocyte antioxidants status and DR.


Author(s):  
Jarinabanu Tahashildar ◽  
Ravi Shekhar Singh ◽  
Jameela Tahashildar

Background: To evaluate the comparison of clinical outcomes of sitagliptin +metformin and glimepride in uncomplicated Type-2 diabetics.Methods: This one year (July 2016 to August 2017) prospective, open label, observational clinical cohort study was carried out on type-2 diabetics. In this study 299 Type-2 diabetics patients were enrolled and were randomly allocated to two groups viz Group A and Group B. Group A received sitaglitin+metformin (50+500) mg/day and Group B received glimepride 1mg/day respectively. The follow up started after 10 days of stabilization of the patient and data recorded on 10th day was considered Zero month data and follow up continued up to Six month in each group. Comparison of FPG, PPG and HbA1c was evaluated between zero and six months within group and at six month between groups. Adverse events were recorded and summarized by treatment group.Results: At the end of six months follow up the patients of Group A who received sitaglitin+metformin (50+500) mg/day had greater reduction in FPG, PPG and HbA1c (all P<0.001) was recorded when compared between zero and six month within group. A significant reduction in FPG, PPG and HbA1c (all P<0.01) also recorded in Group B who received glimepride 1mg/day when compared between zero and six months within group. A statically significant difference (all P<0.05) was recorded at six months between group. The adverse events like hypoglycemic episodes, gastrointestinal adverse events etc were greater in Group B than Group A. Changes in weight also noted in both Groups. Weight loss in Group A and weight gain in Group B was recorded.Conclusions: The present study suggests that a significant difference may be existing in the clinical outcome interm of glycemia control and adverse events between sitagliptin+metformin combination and glimepride in type-2 diabetic patients.


Author(s):  
Hessam Golshan ◽  
Mohammadreza Esmaelzadeh Toloee ◽  
Hamid Abbasi ◽  
Nasim Namiranian

Objective: : High intensity interval training (HIITs) can induce weight control, lowering blood pressure and beneficial effects on cardiovascular health in type 2 diabetic patients. The effect of different volumes of these exercises is unclear in type 2 diabetic patients. The aim of this study was to compare the effect of low volume and high volume of short-term intensive training on glycemic indexes of men with type 2 diabetes. Materials and Methods: Thirty type 2 diabetes male patients who were referred to Yazd diabetes research center (30 - 46 years old) were selected and randomly divided into 3 groups of low and high volume HIITs groups and control group. The intensity of the exercises in low volume was up to 110% and in high volume up to 80% of the maximum heart rate. The two training groups performed exercises 3 days of week for 8 weeks. Glycemic factors and lipids profile were measured before and after the last training session. Data were analyzed by covariance and paired T-test. Results: Low volume HIIT exercises significantly decreased the glucose ( P -value: 0.01), HbA1c ( P -value: 0.01), insulin ( P -value: 0.005), insulin resistance ( P -value: 0.001), and triglyceride ( P -value: 0.04). Low volume HIIT in the insulin resistance had a significant difference with the control group ( P -value: 0.04). High density lipoprotein in high volume group had a significant difference with the control group ( P -value: 0.021). Conclusion: Low-volume HIIT exercises can be a nonpharmacological approach to improving glycemic factors in type 2 diabetic patients.


2004 ◽  
Vol 5 (2) ◽  
pp. 124-133 ◽  
Author(s):  
Kamer Gokhan ◽  
Nurullah Keklikoglu ◽  
Mete Buyilertan

Abstract It has been suggested diabetes plays an important role in tooth loss. Studies examining the periodontal structures and the alveolar bone architecture in diabetics have revealed some alterations. However, mechanisms responsible for these alterations have not been elucidated completely. Established relationships between the cementum layer, which is resistant to resorption, and diabetes are few in number. The aim of this study was to compare the thickness of the cementum layer in Type 2 diabetic and non-diabetic subjects in order to improve the understanding of dental mobility in Type 2 diabetes and its effect on tooth loss. A total of 46 male patients with a mean age of 61.72 ± 5.45 yr. were included in this study (Type 2 diabetics, n=23; nondiabetics, n=23); undecayed. Single rooted premolar teeth extracted from 46 male patients were used to assess the alterations in the cementum layer in Type 2 diabetics. Histological preparations from extracted teeth were examined under light microscopy. In each tooth, the thickness of the cementum layer was measured by an oculometer in 4 different sites on the specimen with the largest pulp space including the pulp chamber and root canals. Statistical analyses were performed with student's t test. The average thickness of the cementum layer in the decalcified teeth extracted from non-diabetic patients was compared to the average thickness of the cementum layer in Type 2 diabetic patients. A significant difference was observed in every site of measurement between Type 2 diabetic and non-diabetic patients with regard to the thickness of the cementum layer (p < 0.05). The cementum layer was thicker at the apical part of the root and at the midpoint of the apical half, and thinner at the central part of the root and at the midpoint of the coronal half in Type 2 diabetic patients. Citation Gokhan K, Keklikoglu N, Buyukertan M. Comparison of the Thickness of the Cementum Layer in Type 2 Diabetic and Non-diabetic Patients. J Contemp Dent Pract 2004 May;(5)2:124-133.


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