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  Access statistics : Table of Contents
   2014| February-May  | Volume 5 | Issue 1  
    Online since January 12, 2017

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Plasma TNF-α in obese patients with diabetes and its relation to resting metabolic rate
TH Merghani, AO Alawad, MA Ballal
February-May 2014, 5(1):4-4
Tumour necrosis factor alpha (TNF-α) exerts many biological effects on different tissues resulting in alterations in their rate of metabolism. In addition, it has direct effects on glucose homeostasis and lipid metabolism. Both plasma TNF-α and obesity are associated with insulin resistance and development of type 2 diabetes mellitus. This study was conducted to evaluate plasma TNF-α in obese patients with diabetes and to determine its relation to resting metabolic rate. Random sample of 40 obese patients with diabetes (cases) and 40 obese non-diabetic subjects (controls) were interviewed and examined clinically to exclude presence of symptoms or signs of inflammation. Haemoglobin A1c was measured for each participant using the "NycoCard Haemoglobin A1c test" (Axis -Shield/ Norway). TNF-α was measured using commercially available ELISA kits from ADIPO Bioscience/ USA. The PowerLab 8/35 with a gas analyzer (AD Instruments, Castle Hill Australia) was used for measurement of Oxygen consumption (VO2), Carbon dioxide production (VCO2) and Respiratory exchange ratio (RER). Resting metabolic rate was calculated using Weir's equation. Twenty two (55%) cases had high plasma TNF-α values (≥ 5pg/ml) whereas 31(77%) controls had lower values (p = 0.003). More than half of those with high plasma TNF-α values (18 (58%)) had abnormal haemoglobin A1c (p = 0.037). The relation between plasma TNF-α and resting metabolic rate was statistically insignificant (p = 0.104). This study showed that plasma TNF-α was significantly higher among cases compared to controls. A significant relation was found between high plasma TNF-α and poorly controlled diabetes mellitus whereas its relation to resting energy expenditure was statistically insignificant.
[ABSTRACT]   Full text not available  [PDF]
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A new look at screening and diagnosis of diabetes mellitus in first degree relatives: Role of HbA1c, insulin resistance, metal ions and heat shock proteins
G Raana, R Khurshid
February-May 2014, 5(1):6-6
Family history of diabetes is a major risk factor for the disease. Approximately 35-50% of patients with type 2 diabetes are asymptomatic and unaware of their condition. Present study was conducted to find out the role of metals including calcium, phosphorous and magnesium and heat shock protein (HSP) i.e. HSPs 72 and HSPs 60 in early diagnosis of diabetes in their first degree relatives. Fifty subjects (25 males and 25 female) with the age range of 26-35 years and positive family history of diabetes were enrolled in the study. The present study was performed at the Fatima Jinnah Medical College, Lahore - Pakistan from 2008 to 2009. Twenty age matched subjects with no history of any disease were taken as controls. All participants were interviewed for general demographic characteristics and current use of medications. Levels of HSPs 72 and HSPs 60 were estimated by the technique of SDS electrophoresis. Body mass index (BMI) and insulin resistance were calculated. Plasma glucose, glycated hemoglobin (HbA1c) and serum insulin was estimated by standard methods. Mean age of females and male first degree relatives was 29.67 and 30.44 years respectively. Their BMI was greater than controls (p > 0.05). Level of fasting blood sugar, HbA1c, serum insulin and insulin resistance were increased as compared to their controls but significant difference (p < 0.001) was only observed in male first degree relative (FDR) serum insulin levels. Level of serum calcium and magnesium was decreased in FDR as compared to their controls but significant difference (p < 0.05) was only observed in serum calcium. In female FDR the significant difference (p < 0.05) was observed in both serum calcium and magnesium. Level of serum phosphorus was significantly increased (p < 0.05) in FDR as compared to controls. Raw volume of HSPs 72 and HSPs 60 was significantly increased (p < 0.001, p < 0.05) in FDR as compared to controls. To our knowledge, these are the first estimate of altered mineral elements, impaired fasting blood glucose, HbA1c and serum insulin and their relationship with heat shock protein in FDRs of individuals with type 2 diabetes in Pakistan as an early predictor of diabetes. It is possible that these impairments may contribute to the expression of the disease.
[ABSTRACT]   Full text not available  [PDF]
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Anaphylactic shock following ingestion of aronia juice in a patient with type 2 diabetes
M Mikolajczyk, M Kosmalski, J Drzewoski
February-May 2014, 5(1):1-1
Anaphylaxis is a severe, life-threatening systemic reaction of hypersensitivity occurring unexpectedly in healthy individuals in response to an allergen. Anaphylactic shock combines anaphylaxis with co- existing hypotension. Aronia (Latin - Aronia melanocarpa, common name - black chokeberry) is a bush commonly grown in European countries. Its fruit is used in food industry for production of fruit products, including juices. Due to its antioxidative properties, aronia is recommended as a dietary supplement for people with arterial hypertension, diabetes and lipid metabolism disorders. We present a case of a 54 year old male patient with cardiovascular disease and type 2 diabetes, admitted with signs and symptoms of anaphylactic shock. The symptoms appeared directly after drinking aronia juice. Medical history revealed similar symptoms of alimentary hypersensitivity, requiring hospitalisation and intensive pharmacotherapy, occurred also following ingestion of highbush blueberries and raspberries. The presented case is the first case of anaphylactic shock following ingestion of aronia juice noted in the literature. Additionally, presence of some additional factors that could be responsible for development of hypersensitivity reaction is notable. It is suggested that the patient's age, gender and presence of cardio-metabolic conditions, including type 2 diabetes, could play an important role.
[ABSTRACT]   Full text not available  [PDF]
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Effects of diabetes complications and glycaemic control on some mineral elements in Nigerians patients with diabetes
EI Ugwuja, AN Nwibo, US Ezenkwa, AN Oshim, RC Nnabu, ED Ogiji, M Ogbanshi
February-May 2014, 5(1):2-2
To investigate the effects of diabetes complications and glycaemic control on some mineral elements in Nigerian patients with diabetes, seventy patients with diabetes (37 males and 33 females) aged 29 to 72 years and 30 patients without diabetes matched for age, sex and socio-demographic data were enrolled. Medical history including duration of disease and complications were obtained from the patients' folders while fasting blood samples were collected for glucose, mineral element and other biochemical analysis using standard laboratory methods and techniques. Glycated haemoglobin was used to assess glycaemic control, with values ≤ 7.0% as good and > 7.0% as poor control. Mean duration of diabetes was 4.83 ΁ 4.09 years (range 1-28 years). There was no significant difference in the plasma levels of iron, magnesium and zinc between patients with and without diabetes. Patients with diabetes with poor glycaemic control had lower plasma magnesium and zinc (p > 0.05) but higher plasma iron (p > 0.05) in comparison to their counterparts with good glycaemic control. The most prevalent single complications observed in patients with diabetes were hypertension > renal disease > foot ulcer, with about 10% having both hypertension and renal disease, while about 27% had no complication at all, although no significant difference in the incidence of chronic complications between patients with diabetes with good glycaemic control and those without was observed (X2 = 0.169; p = 0.212). Again, none of the elements correlated with glycated haemoglobin or fasting plasma glucose, although patients with diabetes with complications had lower plasma iron (p > 0.05) but higher zinc and magnesium than patients with diabetes without complications. However, patients with diabetes with complications had significantly higher plasma urea (p < 0.05) in comparison to their counterparts without complications (6.30 ΁ 22.60 vs. 5.07 ΁ 2.39 mmol/l, p = 0.053). It may be concluded that diabetes complications and glycaemic control have no significant effect on plasma iron, magnesium and zinc levels in Nigerian patients with diabetes with short duration of the disease. Further studies on the long term effects of diabetes complications and glycaemic control on mineral element status are desired, food diversification among patients with diabetes is highly advocated.
[ABSTRACT]   Full text not available  [PDF]
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Adherence to insulin therapy at a tertiary care diabetes center in South India
MS Raut, J Balasubramanian, RM Anjana, R Unnikrishnan, V Mohan
February-May 2014, 5(1):5-5
To assess patient adherence to insulin therapy and factors contributing to non-adherence at a tertiary care diabetes center in South India. Adherence to insulin therapy was assessed in 500 consecutive patients with type 2 diabetes on insulin for at least 3 months, using a 30 point questionnaire - Questionnaire for the Use of Insulin in Diabetes (QUID). Non-adherence was defined as deliberate omission of insulin by the patients at least once a week. Severity of hypoglycemia and reasons for non - adherence and patient attitudes towards insulin therapy were also assessed. Only 28(5.6%) out of 500 patients did not adhere to insulin therapy. Of the 472 patients who adhered to insulin, 416 (88.1%) patients were regular insulin users. The cost of insulin was reported as a major issue by 411 (87%) out of the 472 patients who were adherent to insulin, 61 (12.9%) felt uncomfortable with the injections, 50 (10.6%) felt that it affected their routine activities and 16 (3.4%) reported that it worsened their quality of life (QOL). Hypoglycemia was experienced by 264 (55.9%) patients, and severe hypoglycemia by 21 (4.4%) patients. However, 429 (90.9%) patients reported improved QOL after taking insulin and 434 (91.9%) stated that they would recommend insulin to other patients. Adherence rates to insulin are high in this tertiary diabetes care center in South India. Cost of insulin and hypoglycemia could be the primary factors contributing to insulin non-adherence in our setting.
[ABSTRACT]   Full text not available  [PDF]
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Temporal changes in the prevalence of depression in subjects with and without diabetes in a rural area of Bangladesh
K Natasha, B Bhowmik, A Hussain, AK Azad
February-May 2014, 5(1):3-3
Data regarding depression among rural subjects with diabetes in Bangladesh is scarce. Researchers involved with Diabetic Association of Bangladesh have been working in this field for the last two decades. In reference to a previous study in that paticular area, whether the situation has changed, a study was designed to investigate the prevalence of depression in individuals with and without diabetes. In 2004; 952 and in 2009; 2293 subjects, aged ≥ 20 years were recruited from 10 villages after obtaining informed consent. Blood sugar was tested for diabetes. Simplified Montgomery and Asberg Depression Rating Scale was followed to detect depression. Overall the prevalence of depression in the year 2004 and 2009 were 29% and 4.67% respectively. Symptoms of depression in subjects with and without diabetes were observed in 29.7% and 14.1% in the year 2004 and 1.44% and 3.23% in 2009. Trend of diabetes without depression was upwards (2.8% in 2004 and 6.45% in 2009). In the study period of five years the overall prevalence of depression decreased especially in females. Our study results in 2009 are similar to studies in Bangladesh (4.6%) and other neighboring countries. It could be predicted that income and socio-economic facilities may be the prime factors for depression. As our study area had expansion and improvement in these sectors within the study period, the prevalence of depression decreased. We can conclude that diabetes may increase but depression decreases in better infrastructure and financial state in the context of Bangladesh.
[ABSTRACT]   Full text not available  [PDF]
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