BODY MASS INDEX AND IT’S ASSOCIATION WITH DIABETIC RETINOPATHY IN TYPE 2 DM

2021 ◽  
pp. 56-58
Author(s):  
Mukesh kumar samota ◽  
Mamta bijarnia

1.BACKGROUND: Overweight and obesity are global public health problem with increasing prevalence worldwide1-3. It is a risk factor for many metabolic and cardiovascular diseases including type 2 diabetes, hypertension, and dyslipidaemia etc4. Diabetic retinopathy (DR) is the common micro vascular complication of diabetes mellitus (DM) and a leading cause of acquired blindness in adults. The aim of this study is nd relationship between different BMI classes and DR development in type 2 diabetic patients. 2. AIMS AND OBJECTIVES:To determine the association of BMI and diabetic retinopathy and risk factors for DR 3. MATERIALS AND METHODS: A total of 206 type 2 diabetes patients from medicine ward of Swai man singh hospital and college Jaipur [Rajasthan]. The subjects were classied into one of the three categories according to the BMI. (1).Normal BMI 18.5–24.9 kg/m2; (2).Overweight BMI 25–29.9 kg/m2.(3).Obese BMI ≥30 kg/m2. Blood samples were collected after overnight fasting. Glycated haemoglobin value (HbA1c), total cholesterol and triglycerides were measured. Complete eye examination included best corrected visual acuity (BCVA), slit lamp microscopy, and fundus examination with binocular indirect ophthalmoscope and plus 20D lens after mydriasis with topically administrated 1% tropicamide and 5% phenylephrine eye drops was done. According to the DR status, patients were divided into two groups: group 1 (no retinopathy; N= 168), group 2 diabetic retinopathy; N= 38) RESULT: Duration of type 2 diabetes was found longer with group 2 (9.6±4.5 years) as compare with group 1 (16.82±7.21 years). Association of body mass index (BMI) of type 2 diabetic patients (n =206) with diabetic retinopathy, no correlation was found with mean BMI in group 1 (25.48 ± 2.4) and group 2 (27.21± 2.0)( P value <0.1). In our study were found signicant correlation of HbA1c with DR (p value <.01). Mean value of HbA1c was higher in group 2 (8.41±.6) as compare with group 1 (7.01±.8). We found a signicant increase in total cholesterol (P <.01), triglycerides (P< 0.05) with the diabetic retinopathy

2020 ◽  
Vol 11 (5) ◽  
pp. 38-43
Author(s):  
Shrikrishna V Acharya

Background: Microalbuminuria is one of the earliest markers of diabetic nephropathy, and if not recognized and treated early it may lead to diabetic nephropathy resulting in chronic renal failure. Aims and Objective: The aim of the current study was to find out the prevalence of microalbuminuria among newly detected Type 2 diabetic patients and also compare prevalence of microalbuminuria in patients with or without hypertension, dyslipidaemia and obesity. Materials and Methods: In this retrospective study, we analysed 90 patients with new onset type 2 diabetes mellitus. We divided the patients into two groups, group 1 with comorbidities like hypertension, dyslipidaemia and obesity (50 patients) and group 2 without comorbidities (40 patients). We analysed urinary microalbumin level in all patients and compared the prevalence of microalbuminuria between group 1 and group 2. Results: In our cohort of 90 patients, urinary microalbuminuria was found in 30 patients (33.3%). When we divided these nephropathy patients to group1 and group 2, we observed that group 1 with comorbidities had higher percentage of nephropathy patients i.e 24 out of 50(48%). Group 2 with 40 patients had only 6 patients with microalbiminuria ie 6 out of 40(15%). Incidence of microalbiminuria was higher in patients with hypertension, dyslipidaemia and obesity. Conclusions: We conclude that incidence of microalbiminuria is much more common in newly diagnosed type 2 diabetes. We also conclude that hypertension, obesity and hypercholesterolemia are risk factors for nephropathy and urinary microalbuminuria appears to be much more sensitive than serum creatinine as screening tool to detect diabetic nephropathy.


2021 ◽  
Vol 15 (11) ◽  
pp. 3269-3272
Author(s):  
Darikta Dargahi Shaikh ◽  
Tehmina Imdad ◽  
Safdar Ali ◽  
Fayaz Ali Kalhoro ◽  
Sajida Parveen Shaikh ◽  
...  

Objective: To determine the prevalence of dry eye disease in type 2 diabetic patients and its correlation with retinopathy Materials and Methods: A cross-sectional study was conducted in the Department of Ophthalmology, Chandka Medical College & Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from 1st April 2021 to 30th September 2021. Consecutive 100 patients with type 2 diabetes mellitus (DM) who attended outpatient department were included as per inclusion-exclusion criteria. Results: The patients were mostly female (58%) with a female-to-male ratio of 1.38:1. Most patients (43%) were under 50, followed by 51–60. (34 %). The overall mean age was 54.26 10.06. More than half (63%) of patients had diabetes for up to 5 years. The patients had a 42 percent frequency of DES. Mild, moderate, and severe dry eye were diagnosed in 21%, 16%, and 5% of individuals. Longevity and poor diabetes control exacerbated the disease. Conclusions: Type 2 DM patients' age, but not their gender, was found to be a significant predictor of DES. Dry eye was found to be more common among diabetics with poor control of their condition. In patients with type 2 diabetes, the age, but not the gender, was substantially linked to DES. Keywords: Type 2 diabetes, Dry eye disease, Diabetic retinopathy, Meibomian gland dysfunction.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Snježana Kaštelan ◽  
Martina Tomić ◽  
Antonela Gverović Antunica ◽  
Spomenka Ljubić ◽  
Jasminka Salopek Rabatić ◽  
...  

The aim of the study was to investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. The study included 545 patients with type 2 diabetes. According to DR status, they were divided into three groups: group 1 (no retinopathy;n=296), group 2 (mild/moderate nonproliferative DR;n=118), and group 3 (severe/very severe NPDR or proliferative DR;n=131). Patients without DR were younger than those with signs of retinopathy at time of diabetes onset whilst diabetes duration was longer in groups with severe NPDR and PDR. DR progression was correlated with diabetes duration, BMI, HbA1c, hypertension, and cholesterol. Statistical analyses showed that the progression of retinopathy increased significantly with higher BMI (gr. 1: 26.50 ± 2.70, gr. 2: 28.11 ± 3.00, gr. 3: 28.69 ± 2.50;P<0.01). We observed a significant deterioration of HbA1c and a significant increase in cholesterol and hypertension with an increase in BMI. Correlation between BMI and triglycerides was not significant. Thus, BMI in correlation with HbA1c cholesterol and hypertension appears to be associated with the progression of DR in type 2 diabetes and may serve as a predictive factor for the development of this important cause of visual loss in developed countries.


2019 ◽  
pp. 1-8
Author(s):  
Most. Zannatul Ferdous ◽  
M. A. Wahed ◽  
Zebunnesa Zeba

Aims: This study aimed to investigate the relationship between microalbuminuria and hypertension in type 2 diabetic patients. Study Design: It was a descriptive type of cross-sectional study. Place and Duration of Study: The study was conducted in collaboration at a diabetic clinic and Hypertension and Research Centre, Rangpur, Bangladesh from January to March 2018. Methodology: A total of 180 diabetic patients were selected purposively age ranges 30-75 years. Anthropometric as well as biochemical measurement was done. Data was collected by a semi-structured questionnaire through face to face interview and analyzed by SPSS-20. Results: Study subjects were separated into two groups. Group 1, those with normoalbuminuria (n=49) and Group 2, those having microalbuminuria (n=131). The prevalence of microalbuminuria was 72.8%. Group 2 or microalbuminuric patients showed higher blood pressure values (113.50±8.90 mm of Hg) as compared to Group 1 (101.88±9.80 mm of Hg). The results were statistically significant (P≤0.05). Further this study showed fasting blood sugar, duration of diabetes, systolic blood pressure and high level of sCreatinine were independently associated with microalbuminuria in the study subjects. The results were also statistically significant (P≤0.05). Conclusion: Our study revealed high prevalence of microalbuminuria in diabetic patients and has an optimistic association with blood pressure. This study suggests the need to screen for microalbuminuria early and the active management of modifiable risk factors in particular fasting blood sugar, sCreatinine, hypertension for intervention and prevention of further complications like end stage renal disease and cardiovascular diseases.


Author(s):  
Debkumar Ray ◽  
Mrinal Kanti Ray

Background: Type 2 diabetes mellitus patients frequently have various distressing gastrointestinal signs and symptoms and intestinal alkaline phosphatase (IAP) may be linked to it. Even after extensive search, there was dearth of literature related to IAP levels in serum of diabetic enteropathy subjects. So, using a case-control design, levels of IAP in the serum of T2DM subjects were determined.Methods: Serum IAP was measured by ELISA in 73 type 2 diabetic patients with enteropathy (group 1) and 71 type 2 diabetic patients without enteropathy (group 2). Statistical analysis of the data was performed by using Statistical Package for Social Sciences (SPSS version 16) and inferences were drawn.Results: Serum IAP was highly significantly reduced in group 1 (3.9 U/L) compared to group 2 (4.2 U/L).Conclusions: Enteropathy in T2DM may be related to reduction in IAP levels in serum. Estimation of serum IAP may be considered in type 2 diabetic patients with enteropathy, for the elaboration of treatment strategy and monitoring.


2010 ◽  
Vol 7 (4) ◽  
pp. 13-19 ◽  
Author(s):  
T Sh Dzhavakhishvili ◽  
T I Romantsova ◽  
O V Roik

The aim of this study was to determine changes in weight and insulin requirements in insulin-treated type 2 diabetic patients with normal and elevated body mass index (BMI) during the first year after initiating the insulin therapy with insulin analogues or human insulins, respectively. Materials and methods: a total of 157 patients with insulin naive type 2 diabetes were included in the study. The patients were divided in two groups. First group consisted of subjects [mean age 57 (45 to 73), duration of diabetes of 10 years (4 to 16)] prescribed a long-acting basal (glargine, detemir), premixed (biphasic insulin Aspart 30, Humalog Mix 25) or short-acting (aspart, lispro) insulin analogues. Patients from second group [mean age 59 (46 to 75), duration of diabetes for 10 years (5 to 15)] were treated with intermediate- acting basal (Protophane, Humulin NPH), premixed (biphasic human insulin 30, Humulin M3) and regular (Actrapid, Humulin R) human insulins. Each of these two groups was divided into three subgroups depending on the baseline body mass index (BMI) of the patients: 18,5-24,9; 25-29 and ≥30. At the beginning of insulin therapy and 12 months later, we compared HbA1c, BMI, waist circumference and required insulin doses in each group. Results: our study results showed that under comparable metabolic control the risk for weight gain and increase in insulin requirement is similar in insulin-treated type 2 diabetic patients with normal and elevated BMI. Use of insulin analogues for treatment of type 2 diabetes patients with normal and elevated BMI results in better glycaemic control, less weight gain, smaller increase in insulin requirement and waist circumference compared to human insulins during the first year of insulin therapy.


2019 ◽  
Vol 7 (1) ◽  
pp. e000845 ◽  
Author(s):  
Rafael Simó ◽  
Jordi Bañeras ◽  
Cristina Hernández ◽  
José Rodríguez-Palomares ◽  
Filipa Valente ◽  
...  

ObjectiveDetection of subclinical cardiovascular disease (CVD) has significant impact on the management of type 2 diabetes. We examined whether the assessment of diabetic retinopathy (DR) is useful for identifying patients at a higher risk of having silent CVD.Research design and methodsProspective case–control study comprising 200 type 2 diabetic subjects without history of clinical CVD and 60 age-matched non-diabetic subjects. The presence of subclinical CVD was examined using two parameters: (1) calcium coronary score (CACs); (2) composite of CACs >400 UA, carotid plaque ≥3 mm, carotid intima–media thickness ratio >1, or the presence of ECG changes suggestive of previous asymptomatic myocardial infarction. In addition, coronary angio-CT was performed. DR was assessed by slit-lamp biomicroscopy and retinography.ResultsType 2 diabetic subjects presented higher CACs than non-diabetic control subjects (p<0.01). Age, male gender, and the presence of DR were independently related to CACs >400 (area under the receiver operating characteristic curve (AUROC) 0.76). In addition, an inverse relationship was observed between the degree of DR and CACs <10 AU. The variables independently associated with the composite measurement of subclinical CVD were age, diabetes duration, the glomerular filtration rate, microalbuminuria, and the presence of DR (AUROC 0.71). In addition, a relationship (p<0.01) was observed between the presence and degree of DR and coronary stenosis.ConclusionsThe presence and degree of DR is independently associated with subclinical CVD in type 2 diabetic patients. Our results lead us to propose a rationalized screening for coronary artery disease in type 2 diabetes based on prioritizing patients with DR, particularly those with moderate–severe degree.


2020 ◽  
Author(s):  
Xuejiao Li ◽  
Shuo Zhang ◽  
Chang Liu ◽  
Zhuoshi Wang ◽  
Peng Zhang ◽  
...  

Abstract Background: To investigate the effects of interleukin 18 (IL-18) on diabetic retinopathy (DR) of type 2 diabetic patients, the contents of IL-18 were measured in serum of 206 case subjects with type 2 diabetes and 40 case subjects without diabetes as control. Methods: According to the degree of DR, the diabetic patients were further divided into three groups: non-diabetic retinopathy (NDR, n=69), non-proliferative diabetic retinopathy (NPDR, n = 52) and proliferative diabetic retinopathy (PDR, n=85). Results: Unlike previous reports, we didn’t found a significant increase in serum IL-18 level in diabetic patients (mean ± SD are 107.4±36.6 and 112.5±32.0 pg/ml for control and type 2 diabetes patients respectively, p > 0.05). Further analysis also failed to found any significant increase of serum IL-18 in patients with NDR, NPDR or PDR (113.0±32.1, 110.8±31.4 and 114.5±33.4 pg/ml respectively) when compared with control (for all values, p > 0.05). Real-time qPCR suggests that the expression of IL-18 mRNA in type 2 diabetic patients with DR was comparable to that of controls (p>0.05). Interestingly, there was a significant positive correlation between levels of serum IL -18 and the amount of fasting blood glucose (FBG, r=0.15,p=0.03) and that Hemoglobin A1c (HbA1c) was relatively higher in diabetic patients than in control subjects (p<0.05). These results suggest that the levels of serum IL -18 in diabetic patients are within the normal range. Even in patients with diabetic retinopathy, the levels of serum IL -18 were only slightly increased in type 2 diabetic patients and was not statistically different from control subjects.Conclusion: these data suggest that the serum IL -18 levels are not associated with the severity of type 2 diabetic patients.


2020 ◽  
Vol 7 (5) ◽  
pp. 754
Author(s):  
Damanpreet Singh ◽  
Gurinder Mohan ◽  
Arshdeep Bansal

Background: Hypothyroidism is an endocrine disorder resulting from deficiency of thyroid hormones, and Diabetes is a metabolic disorder that share the phenotype of hyperglycaemia. Both the endocrinopathies have been found to be associated with dyslipidaemia and atherosclerosis that result into various complications. Our aim was to assess the difference of dyslipidaemia in patients suffering from hypothyroidism with diabetes as compared to diabetes alone.Methods: Study was conducted in department of medicine in SGRDIMSR, Sri Amritsar. A total of 120 patients were enrolled for the present study, the one who presented to hospital from January 2018 to August 2019 diagnosed with diabetes mellitus type 2. The patients were divided into two groups. 60 patients having type 2 diabetes without hypothyroidism (control group). 60 patients having type 2 diabetes with hypothyroidism (study group). Fasting lipid profile were performed in both the groups and were analysed for the study.Results: Dyslipidaemia was seen more in study group as compared to control group with mean cholesterol of 488.3(±144.43) and mean triglyceride levels of 354.30(±128.57) in study  group as compared to control group with mean cholesterol and triglyceride levels of 179.7(±81.47) and 177.08(±118.18) with p-value of 0.001 and 0.01 respectively which were significant. Also, obesity and diabetic complication were more in patients of dual endocrinopathies as compared to diabetes alone which were also significant statistically.Conclusions: From our study it is concluded that type 2 diabetes with hypothyroidism causes more dyslipidaemia as compare to type 2 diabetes alone. So proper screening of thyroid profile of type 2 diabetic patients and its correction helps in achieving better lipidemic control which further prevent complications.


Author(s):  
Suresh Babu Kondaveeti ◽  
Santosh Jagtap ◽  
Shilpa Kumar ◽  
Ankit Kumar Tiwari ◽  
Dipali Khopade ◽  
...  

Introduction: The main issue with the morbidity and mortality of type 2 diabetes is its associated health complications. In the last decade Glycated Albumin (GA) emerged as an extinguished marker for short-term glycaemic control. Aim: To Quadrate the association of Body Mass Index (BMI) along with HDL-cholesterol to GA in Type 2 diabetic cases. Materials and Methods: Total of 50 diabetic cases (Group 1) and 50 healthy non-diabetic control subjects (Group 2) recruited for the study between November 2017 to December 2018, which includes both males and females. Serum samples of both the groups were analysed to assess the lipid profile to GA levels along with BMI. Variations among groups was compared using student t-test by calculating r-values of the parametres and the pearson coefficient was calculated with significant p value at <0.05. Results: The levels of High-Density Lipoprotein (HDL) cholesterol in group 1 when compared with group 2 were significantly lower. Both BMI and GA showed negative correlation with HDL-C levels in both the groups. (p values 0.051 and 0.331 respectively). To boot, there was a statistically undeviating reciprocity of Low Density Lipoprotein (LDL) cholesterol to GA levels, BMI to LDL-cholesterol and BMI to Triglycerides (TG). There was a statistically significant correlation between GA and BMI (r=0.240, p<0.0001) and there was a statistically significant negative correlation between GA and HDL-cholesterol (r=-0.286, p<0.051) in diabetic patients (group 1). The association between GA and LDL-cholesterol (r=0.271, p<0.0001) was also been found statistically significant in group 1. Conclusion: The present study suggests that GA can be adapted as a reliable prospective biomarker that endures the potentiality in prognostication of serum lipid levels in diabetic patients and also BMI is the key formidable feature of dyslipidemia in type 2 diabetic cases.


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