scholarly journals Glycemic Status, Lipid Profile and Proteinuria in Diabetic nephropathy

2010 ◽  
Vol 49 (178) ◽  
Author(s):  
P Jha ◽  
BKL Das ◽  
S Shrestha ◽  
S Majhi ◽  
L Chandra ◽  
...  

INTRODUCTION: Diabetic nephropathy is one of the major complications of Diabetes Mellitus characterized by persistent albuminuria, elevated arterial blood pressure, a relentless decline in glomerular filtration rate (GFR) and a high risk of cardiovascular morbidity and mortality. METHODS: In this study, urinary micro-albumin estimation was done in 177 diabetic patients. This study aims to ascertain association of glycemicstatus, lipid profile and proteinuria in Type 2 Diabetes Mellitus with nephropathy. RESULTS: Among 177 patients, 26 had frank proteinuria, 79 had micro-albuminuria and 72 were without proteinuria. Increased frequency ofproteinuria was seen in male than female. Micro-albuminuria and frank proteinuria was seen more in older age group. The multiple comparisons showed the significantly increased levels of urea, creatinine, fasting blood glucose in micro-albuminuria and overt proteinuria patients in comparison to without proteinuria. Glycated hemoglobin level was increased with the increasing age group particularly in overt proteinuric patients. CONCLUSIONS: The glycemic control, monitoring of lipid profile and early urinary protein estimation with better management may delay diabetic nephropathy or its further complications in diabetes mellitus.  KEYWORDS: diabetes mellitus, diabetic nephropathy, frank proteinuria, glycated hemoglobin, micro-albuminuria.

Author(s):  
Manish K. Verma ◽  
Pradeep Kumar ◽  
Preeti Sharma ◽  
V. K. Singh ◽  
Shashi Prabha Singh

 Background: Diabetic nephropathy (DN) is a common complication of diabetes mellitus that lead to end-stage of kidney disease (ESKD). Detection of early-stage can slow loss of kidney function and improve patient outcomes with use of diagnostic biomarker detection of DN. Aims and objectives of this study is to evaluate the possible association between glycated hemoglobin and urinary microalbumin as a predictor of diabetic nephropathy in type 2 diabetic patients.Methods: Total 162 subjects were included in this study comprises uncontrolled diabetes 54 cases, controlled diabetes 54 cases and healthy controlled 54 controls. Micro albumin was measured by urinary microalbumin (turbidimetric immunoassay), glycated hemoglobin (HbA1c) measured by ion exchange resin method and fasting blood glucose estimated by GOD-POD method. The inclusion of age group was between 35 to 74 years. Statistical analysis was done by using SPSS, version 16.0. p values were calculated by ANOVA unpaired t-test. The p<0.05 was considered a statistically significant.Results: Urinary microalbumin levels were statistically significant increase in type 2 diabetes mellitus with nephropathy in comparison to uncontrolled diabetes mellitus and controlled diabetes mellitus (138.9±13.7 mg/l vs 67.7±14.1 mg/l and p<0.005**).  HbA1c, which acts as a biomarker of diabetes was significant higher diabetic nephropathy, in comparison to uncontrolled diabetes mellitus, controlled diabetes mellitus and healthy control (8.0±1.1% vs 7.1±0.9% and 5.7±0.4%).Conclusions: The present study was demonstrated impaired glycaemic control is associated with elevations in urinary micro albumin levels and it may be considered as risk marker of diabetic nephropathy.


2013 ◽  
Vol 1 (1) ◽  
pp. 18-21 ◽  
Author(s):  
L Shrestha ◽  
B Jha ◽  
B Yadav ◽  
S Sharma

Background: Diabetes mellitus (DM) comprises a group of common metabolic disorders that share phenotype of hyperglycemia. Objectives: This study was conducted to determine the correlation between glucose monitoring by fasting blood glucose or two hours postprandial blood glucose with glycated hemoglobin (HbA1c) in type 2 diabetic patients. Method: A cross sectional study was conducted over a period of six month in the Department of Biochemistry. Institute of Medical, Tribhuvan University Teaching Hospital. Sixty inpatients with Diabetes mellitus type 2 were assessed for daily fasting and postprandial blood sugar for 15 consecutive days. HbA1c was measured on the 15th day. Result: Both postprandial blood glucose and fasting blood glucose significantly correlated with HbA1c. Postprandial blood glucose showed better correlation to HbA1c than fasting blood glucose (r = 0.630, P <0.001 vs. r =0.452, P = 0.05). Conclusion: These results show that postprandial blood glucose correlated better than fasting blood glucose to HbA1c. Thus, postprandial blood glucose predicted overall glycemic control better than fasting blood glucose. This finding has potential implications for treatment and monitoring of metabolic control in type-2 diabetes. DOI: http://dx.doi.org/10.3126/stcj.v1i1.8654 Sunsari Technical College Journal Vol.1(1) 2012 18-21


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S S Hosny ◽  
M M Maher ◽  
M M Bekhet ◽  
A M Bahaaeldin ◽  
H M A Mahmoud ◽  
...  

Abstract Background Type-2 diabetes mellitus (T2DM) is the leading cause of cardiovascular morbidity and mortality worldwide . Poor glucose control, hypertension, and dyslipidemia are the main factors that increase the risk of atherosclerotic disease in T2DM. Aim of the Work To study the relationship between Chitotriosidase level in patients with Type 2 Diabetes Mellitus and the development of atherosclerosis. Patients and Methods This study was conducted on 75 persons. Cases were selected from Internal medicine & endocrinology outpatient clinics at Ain Shams University Hospital. They were divided into Two groups: Group 1 formed of 50 Type 2 Diabetic patients. Group 2 formed of 25 healthy subjects as control Results Serum Chitotriosidae level was higher in type 2 diabetic patients than healthy control.and its level was significantly higher in type 2 diabetic patients with atherosclerosis. There was also positive significant correlation between Chitotriosidase and Fasting blood glucose, 2 h p.p,HBA1C, cholesterol, LDL, Triglycerides, BMI and W/H Conclusion serum chitotriosidase can be used as predictble marker for diabetic vasculopathy.


2015 ◽  
Vol 28 (suppl 1) ◽  
pp. 19-22 ◽  
Author(s):  
José SAMPAIO-NETO ◽  
Luís Sérgio NASSIF ◽  
Alcides José BRANCO-FILHO ◽  
Luciana Alves BOLFARINI ◽  
Luiara Stefanelo LORO ◽  
...  

Background : DiaRem score consists in preoperative model for predicting remission of type 2 diabetes mellitus in obese patients who underwent gastric bypass. Aim : To evaluate the applicability of DiaRem comparing the scores obtained preoperatively with remission of T2DM after surgery. Method : Preoperative parameters such as age, use of insulin, oral hypoglycemic agents and glycated hemoglobin, were retrospectively evaluated in diabetic patients undergoing gastric bypass during the period between July 2012 to July 2013. Through these data the DiaRem score were applied. The results of fasting blood glucose and glycated hemoglobin were requested prospectively. Results : Were selected 70 patients; the remission of T2DM after surgery was found in 42 (60%) and no remission in 28 (40%). Checking the final score, it was observed that: from 0 to 2 points, 94.1% of patients remitted completely; between 3 and 7 had remission in 68.9%, of which 42.8% complete; from 8 to 12, 57.1% achieved complete remission; between 13 to 17, 87.5% did not achieve remission and was not seen this complete remission group; between 18 to 22, 88.9% were not remitted. Conclusion : The DiaRem score showed appropriate tool to assess remission of T2DM in obese patients who will undergo gastric bypass.


2011 ◽  
Vol 101 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Aynur Gulcan ◽  
Erim Gulcan ◽  
Sukru Oksuz ◽  
Idris Sahin ◽  
Demet Kaya

Background: We sought to determine the frequency of toenail onychomycosis in diabetic patients, to identify the causative agents, and to evaluate the epidemiologic risk factors. Methods: Data regarding patients’ diabetic characteristics were recorded by the attending internal medicine clinician. Clinical examinations of patients’ toenails were performed by a dermatologist, and specimens were collected from the nails to establish the onycomycotic abnormality. All of the specimens were analyzed by direct microscopy and culture. Results: Of 321 patients with type 2 diabetes mellitus, clinical onychomycosis was diagnosed in 162; 41 of those diagnoses were confirmed mycologically. Of the isolated fungi, 23 were yeasts and 18 were dermatophytes. Significant correlations were found between the frequency of onychomycosis and retinopathy, neuropathy, obesity, family history, and duration of diabetes. However, no correlation was found with sex, age, educational level, occupation, area of residence, levels of hemoglobin A1c and fasting blood glucose, and nephropathy. The most frequently isolated agents from clinical specimens were yeasts. Conclusions: Long-term control of glycemia to prevent chronic complications and obesity and to promote education about the importance of foot and nail care should be essential components in preventing onychomycosis and its potential complications, such as secondary foot lesions, in patients with diabetes mellitus. (J Am Podiatr Med Assoc 101(1): 49–54, 2011)


2016 ◽  
Vol 41 (3) ◽  
pp. 125-130
Author(s):  
Mahbuba Shirin ◽  
Mofazzal Sharif ◽  
Ayeshna Gurung ◽  
Anindita Datta

Diabetes mellitus is one of the systemic diseases affecting the kidneys. Diabetic nephropathy is a serious microvascular complication of diabetes mellitus. It is the most important cause of death in type I diabetic patients, of whom 30%-40% eventually develop end-stage renal failure and 40% of type II diabetics are at risk of developing diabetic nephropathy. So, diagnosis of diabetic nephropathy is paramount for the survivability of the diabetic patients not only because of the consequences of renal progression but also because of the strong association with the risk of developing cardiovascular disease. A total number of 53 subjects were enrolled in this present cross sectional study in the department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration of Nephrology and Medicine of the same institution during two years (2011-13) aim to evaluate the diagnostic usefulness of renal resistive index (RI) by duplex Doppler ultrasonography for detection of renal dysfunction in diabetic patients. Clinically diagnosed diabetic patients having diabetic nephropathy referred to the department of Radiology and Imaging in BSMMU for ultrasonography of Kidneys, Ureters and Bladder (KUB) region or whole abdomen were selected as sample. Biochemical reports (Serum creatinine and Urinary albumin) and the RI value of intrarenal artery were correlated and analyzed. Only those patients biochemically were diagnosed as having diabetic nephropathy was included. Those with incomplete data, hydro nephrosis and renal calculus were excluded. Both the kidneys were visualized by commercially available real time scanner (GE Voluson) equipped with a curvilinear transducer operating at 3.5 MHz First Gray scale ultrasonography was done followed by Color Doppler of intra renal artery and then RI was measured. Majority (45.3%) patients were in 6th decade with the mean age was of 52.66±7.4 years and ranging from 38 to 65 years in patients. Male was found to be 54.7% of diabetic patients with male to female ratio 1.2:1. Resistive index of (? 0.7) was found in 73.6% patients with diabetes with the mean resistive index of 0.71±0.04. Positive correction between resistive index with serum creatinine (r=0.581, p<0.01) and albuminuria (r=0.725, p<0.01) were observed. It can be concluded that Resistive Index measured by duplex Doppler ultrasonography is useful diagnostic modality for detection of renal dysfunction in diabetic nephropathy patients. Resistive Index has value in identifying diabetic patients who are developing nephropathy and can be used as an additional diagnostic tool. Also it is well correlated with Serum Creatinine and Albuminuria which are the biochemical parameters to diagnose diabetic nephropathy.


2008 ◽  
Vol 27 (3) ◽  
pp. 376-382 ◽  
Author(s):  
Tatjana Cvetković ◽  
Predrag Vlahović ◽  
Vidosava đorđević ◽  
Lilika Zvezdanović ◽  
Dušica Pavlović ◽  
...  

The Significance of Urinary Markers in the Evaluation of Diabetic Nephropathy Oxidative stress is considered to be a unifying link between diabetes mellitus (DM) and its complications, including nephropathy (DN). The aim of this study was to determine the parameters of oxidative injury of lipids and proteins as well as the activity of ectoenzymes in the urine of DN patients. The study included 40 individuals: 10 patients with type 2 diabetes mellitus and microalbuminuria (DMT2-MIA), 10 type 2 diabetic patients with macroalbuminuria (DMT2-MAA), 10 patients with type 1 diabetes and microalbuminuria (DMT1-MIA) and 10 age- and sex-matched healthy subjects (control). In the urine we determined TBA reactive substances (TBARS), reactive carbonyl groups (RCG), and the activity of ectoenzymes N-acetyl-β-d-glucosaminidase (NAG), plasma cell differentiation antigen (PC-1), aminopeptidase N (APN) and dipeptidyl peptidase IV (DPP IV). A higher concentration of TBARS in the urine was found in DMT2-MIA and DMT1-MIA, compared to the control group (p<0.001 and P<0.05). The urine concentration of RCD shows similar results with a significant elevation in the groups with DMT2-MAA and DMT1-MIA, compared to the DMT2-MIA (p<0.001) and control group (p<0.001). Activities of NAG, APN and DPPIV were significantly higher in the urine of DMT2-MAA, compared to the control (p<0.01). The activity of PC-1 was slightly increased in that group, but not significantly. In conclusion, the level of oxidative stress markers and activities of brush border ectoenzymes in the urine may be a useful non-invasive and easily repeatable test in DN.


2020 ◽  
Author(s):  
Xiaomeng Sun ◽  
Jia Liu ◽  
Guang Wang

Abstract Background: This study was to research the efficacy of fenofibrate in the treatment of microalbuminuria in the patients with type 2 diabetes mellitus (T2DM) and hypertriglyceridemia. Methods: Type 2 diabetic patients (56) with microalbuminuria and hypertriglyceridemia aged 30 to 75 were randomly divided into the fenofibrate treatment group(n=28) and the control group (n=28) for 180 days. Urinary microalbumin /creatinine ratio (UACR) and other metabolic parameters were compared at baseline, during treatment and after treatment. Results: After 180 days, the reduction of levels of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) in two groups were no differences. In treatment group, uric acid (UA) (296.42 ± 56.41 vs 372.46 ± 72.78), triglyceride (TG) [1.51(1.17, 2.06) vs 3.04(2.21, 3.29)], and UACR [36.45 (15.78,102.41) vs 129.00 (53.00, 226.25)] were significantly decreased compared with the baseline. The high-density lipoprotein cholesterol (HDL-C) levels were significantly increased (1.22 ± 0.26 vs 1.09 ± 0.24) compared with the baseline. The decrease in UACR [-44.05(-179.47, -12.16) vs -8.15(-59.69, 41.94)]in treatment group was significantly higher compared with the control group. The decrease in UACR was positively associated with the decreases in TG ( r = 0.447, P = 0.042) and UA ( r = 0.478, P = 0.024) after fenofibrate treatment. Conclusion: In the patients with hypertriglyceridemia and type 2 diabetes mellitus, fenofibrate can improve microalbuminuria and do not increase the deterioration of glomerular filtration rate


Author(s):  
Mr. Kedar Prasad Yadav ◽  
Dr. Ricky Mittal

INTRODUCTION: Diabetes mellitus (DM) is a group of metabolic disorder which is characterized by increase blood glucose level resulting from defects in insulin secretion, insulin action or both and disturbances of carbohydrate, lipid and protein metabolism. Worldwide With an increasing incidence of DM may be a likely leading cause of morbidity and mortality in the future[i]. It is well known that dyslipidemia is a major risk factor for macrovascular complications with type-2 diabetes mellitus (T2DM) which affects 10%-73% of this population. It is well known that dyslipidemia is a major risk factor for macrovascular complications with type-2 diabetes mellitus (T2DM) which affects 10%-73% of this population. Dyslipidemia, hyperglycemia and hyperlipidemia are results of Insulin resistance and obesity combine cause and have additive cardiovascular risk. Therefore identification, critical evaluation and follow-up of serum lipid profile is important in DM continuously.  One of the study showed that prevalence of dyslipidemia in diabetes mellitus is 95%. Major risk factor for Coronary Heart Disease is dyslipidemia. In DM patients cardiovascular disease is a cause of morbidity and mortality because of disturbance in lipoproteins i.e. serum triglycerides (TC) 69%, serum cholesterol 56.6%, Low Density Lipoprotein cholesterol (LDL) 77% and High Density Lipoprotein cholesterol (HDL) 71%. AIM: The main aim of this study is to know the lipid profile in Diabetics mellitus (DM). MATERIAL AND METHODS: Total 100 patients with DM were included in this study during the period of 1 year. During the study period 100 normal healthy people without DM were also included as control study. From all the patients detail histories were taken as well as relevant clinical examination with routine investigations were also done. All the patients were for at least 12-14 hours overnight fasting and 5ml venous blood was collected in a disposable syringe on next morning (before breakfast) for the serum lipid profile and fasting blood sugar. RESULT: In this study out of 100 diabetic patients 48 (48%) were males and 52 (52%) were females. 70% of DM patients showed high serum cholesterol level and all persons had normal serum cholesterol level in control group. 75% of DM patients showed high serum triglyceride level (>150mg/dl).  39% of DM patients showed Serum LDL level was high (>160 mg/dl). 85% of DM patients showed low (<40 mg/dl) serum HDL value. CONCLUSION: In DM patients lipid abnormalities in diabetes are raised serum cholesterol, raised triglycerides, and raised serum LDL and low serum HDL. Therefore there is important impact of dyslipidemia on cardio vascular complications required complete attention throughout the course of disease. Hence early screening of diabetic patients for dyslipidemia and intervention is necessary to minimize the risk of cardiovascular diseases. KEYWORDS: Diabetes mellitus (DM), dyslipidemia, cholesterol, triglyceride   Diabetes: facts and figures [Internet]. International Diabetes Federation. [cited 2016Jul14].


Author(s):  
Anil Shrinivasrao Joshi ◽  
Chandrakant Gunaji Lahane ◽  
Akshay Arvind Kashid

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">To study the prevalence of silent myocardial ischaemia in asymptomatic patients with type 2 DM</span>.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The present study was conducted in the Govt. Medical College and Hospital Aurangabad. During December 2012 to November 2014 with 50 patients. It was two year cross sectional study with the patients of asymptomatic type 2 diabetes mellitus without clinical and electrocardiographic evidence of coronary artery disease. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">12 (24%) out of 50 subjects had positive TMT. It correlated with years of duration of diabetes (9 positive TMT cases with duration of diabetes more than 10 years). 5 (25%) out of 20 had serum cholesterol levels &gt;240, Number of positive TMT were higher in patients with LDL &gt;160 [5 (25%) out of 20]</span>.</p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Diabetic patients are at very high risk for cardiovascular morbidity and mortality. Early detection of IHD is very important so that pharmacological therapy, which may improve outcome, can be established. Tread mill exercise TMT being a non-invasive test with high safety, has an important role in early detection of IHD. It is recommended that TMT should be a part of routine management in asymptomatic patients with type II DM. </span></p>


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