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   2016| October-January  | Volume 7 | Issue 3  
    Online since January 16, 2017

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Identifying Insulin Resistance by Fasting Blood Samples in Bangladeshi population with Normal Blood Glucose
B Bhowmik, T Siddiquee, A Mujumder, M.M.R Rajib, CK Das, MI Khan, AKA Khan, A Hussain
October-January 2016, 7(3):4-4
Insulin resistance (IR) is a major determinant for a number of chronic cardio metabolic diseases including type 2 diabetes (T2DM) and cardiovascular diseases (CVD). Therefore, identifying IR cases would help to better prevent the progression of these diseases. To identify simple indirect methods for detection of IR in Bangladeshi adults with normal blood glucose by using fasting blood samples. A total of 2293 randomly selected subjects (aged ≥20 years) in a rural community were investigated in population-based cross- sectional study. IR was assessed in 1915 individuals with normal blood glucose by fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), fasting insulin resistance index (FIRI), quantitative insulin-sensitivity check index (QUICKI) and McAuley Index. The 75th percentile values as the cut-off point to define IR corresponded with a fasting insulin level of 12.0 mU/l, a HOMA-IR of 2.6, a FIRI of 2.3, a 25th percentile for QUICKI of 0.24 and a McAuley Index of 6.0. Significant correlation was observed between calculated indirect indexes of IR and different components of metabolic syndrome. Simple indirect methods by using fasting samples would be useful to identify IR cases in population-based cross sectional survey especially in facility constraints areas like rural Bangladesh.
[ABSTRACT]   Full text not available  [PDF]
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Hospital-based prevalence of chronic kidney disease among the newly registered patients with diabetes
PA Khanam, MA Sayeed, A Islam, T Begum, SH Habib, N Nahar, H Mahtab, A.K.A Khan
October-January 2016, 7(3):2-2
Chronic kidney disease (CKD) is proved to be a major public health issue worldwide and an important contributor to the overall non-communicable disease burden. It increases risk of mortality, end-stage renal disease and accelerated cardiovascular disease (CVD). Diabetes is the biggest contributor to CKD and end stage renal disease (ESRD). In Bangladesh, very few data on CKD is available. This study aimed to estimate the prevalence of CKD among the newly registered diabetic patients at BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders), a referral center for diabetes in Bangladesh. Methods: The study included all diabetic patients aged 18 - 80 years and were registered in the year 2012. Socio-demographic (age, sex, residence, income, literacy), clinical (obesity, blood pressure) and biochemical (blood glucose, lipids, eGFR) information were collected from the BIRDEM registry. CKD was defined according to the K/ DOQI guidelines. Results: A total of 1317 type 2 diabetic patients of age 18 to 80 years were studied. Of them, men and women were 54.7% and 45.3%, respectively. The overall prevalence of CKD (eGFR ≤60 (ml/min/m2)) was 13.9%. The prevalence was significantly higher in women than men (21.3 v. 7.8%, p<0.001). Higher prevalence was also observed in illiterate than literate (19.8 v. 11.8%, p <0.001) group. The patients with systolic hypertension (sHTN) had also significantly higher prevalence (sHTN ≥140 v. <140 mmHg: 19.9 v. 12.6%, p=0.004). The mean (SD) age of the CKD was found significantly higher than the non-CKD [53.1(11.1) vs. 46.0 (11.2)y, p<0.001] group. Logistic regression estimated that the risk for female sex, older age (>50y), higher sBP (≥140mmHg) and taking oral hypoglycemic agent (OHA) were significant. Conclusions: Thus, the study concludes that the prevalence of CKD among the newly registered diabetic patients is quite high in Bangladesh. The female diabetic patients with older age and with higher SBP bear the brunt of CKD. Considering high prevalence of CKD with severe lifelong complications it is of utmost importance for early detection and intervention at the primary health care (PHC) level.
[ABSTRACT]   Full text not available  [PDF]
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Patterns of glucose self-monitoring among internal medicine outpatient patients with type 2 diabetes
F Akbas, HU Atmaca, IN Okten, F.E.N Kantarci, E Piskinpasa, M Boz
October-January 2016, 7(3):1-1
Self-monitoring of blood glucose is vital for people with diabetes (PWD) to maintain acceptable glucose levels. The aim of this study is to demonstrate how effective home glucose monitoring was among PWD. Randomly selected 89 PWD who were admitted to internal medicine outpatient clinic of our teaching hospital in central Istanbul in a week and who had glucometers were included in the study. After informed consent was obtained, demographic features were recorded and a questionnaire was administered. The answers were categorized and the results were evaluated with SPSS statistical analysis method. Ethical committee approval was taken. The study was conducted according to Helsinki declaration. The patients were mostly female, income and education levels were generally low. Although the duration of diabetes of the patients was mostly more than 5 years, only half of them had a glucometer for more than 5 years. Most of them didn't calibrate their devices. Most strikingly, only 25% of the patients in general were given a proper education for the usage of glucometers. Only 40% of the patients monitored their glucose levels regularly, rest of the patients used their glucometers rarely or none. Home monitoring of glucose levels for PWD would approve blood glucose levels by making necessary treatment adjustments available and help to prevent/delay diabetes related complications. Inclusion of the patients to the treatment and to monitoring of diabetes seems to be a reasonable starting point to achieve a better outcome of the disease.
[ABSTRACT]   Full text not available  [PDF]
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The effect of restless leg syndrome on diabetes control among type-2 diabetic patients in the Northwest region of Saudi Arabia
HO Mirghani, P Amirthalingam, OS Mohammed
October-January 2016, 7(3):3-3
The restless leg syndrome is a common sleep disorder that may affect diabetes control, data are scarce in Saudi Arabia, in this study we aimed to study the prevalence of the restless syndrome and its effects on diabetes control. A comparative cross-sectional study was conducted at the diabetes center in King Khalid Hospital, Tabuk, Saudi Arabia during the period February 2015 to June 2015. Three hundred consecutive patients with type 2 diabetes attending the diabetes center were interviewed using a structured questionnaire including demographic data, diabetes complications, and the Criteria of the restless syndrome. The restless leg syndrome was found in 42% of patients with type 2 diabetes. Women with the diagnosis of the restless leg syndrome had higher levels of glycated hemoglobin with a high significant statistical difference P-value < 0.001. No significant statistical differences were evident between patients with and without restless leg syndrome regarding, diabetes micro vascular complications, and all the components of the restless leg syndrome P-value > 0.05. The restless leg syndrome can affect diabetes control among females with type 2 diabetes. Screening and treatment of the restless syndrome among females with diabetes may be part of holistic diabetes care to bring the glycated hemoglobin closer to target and hence improving diabetes control.
[ABSTRACT]   Full text not available  [PDF]
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