Vaibhav S. Bellary, S. Shetty, Srinivas Bellary, N. Rao
Background: The prevalence of diabetes mellitus (DM) is increasing significantly throughout the world. While the vascular complications of diabetes are well recognized and account for the principle mortality and morbidity from the condition, the musculoskeletal manifestations of diabetes are common and not life-threatening, which are an important cause for morbidity, pain, and disability. The most common reported forms of various musculoskeletal manifestations of DM include adhesive capsulitis, hand syndromes such as limited joint mobility syndrome (LJMS), Dupuytren’s contracture (DC), and carpal tunnel syndrome (CTS), flexor tenosynovitis, reflex sympathetic dystrophy, diffuse idiopathic skeletal hyperostosis (DISH), Charcot’s joints, diabetic amyotrophy (DA), and osteoarthritis. Materials and Methods: The study was conducted on a total of 150 patients with type 2 DM for a duration of at least 5 years in Bangalore during the study period from January 2020 to June 2021. The patients fulfilling the inclusion criteria were enrolled for the study after obtaining informed consent. Detailed history was taken and general physical examination was done to determine the musculoskeletal manifestations of DM. The Disability of Arm Shoulder and Hand (DASH) questionnaire was also completed as per the patient’s responses. Laboratory reports were collected, data compiled, and the data were analyzed. Results: Of the 150 cases enrolled, the maximum number of cases belonged to the age group of 36–50 years. About 64% of the diabetic cases were suffering from musculoskeletal disorders (MSDs) (LMJS, CTS, shoulder capsulitis, DC, trigger finger, DISH, DA). Among the MSDs, the highest prevalence was by LJMS (28%). There was a positive correlation among the duration of diabetes, HbA1C, and the DASH score among patients with MSDs in this study and this is statistically significant (P < 0.05). We also see that MSDs are present in 72.7% of the females and 57.1% of the males in the study and this was statistically significant (P = 0.048). Conclusion: MSDs have a high prevalence in diabetic patients. With advancing age and uncontrolled HbA1C levels, the number of MSDs was more as well as the severity as indicated by the DASH score. Early and better glycemic control in diabetic patients can reduce the morbidity associated with MSDs as evidenced by the reduced intensity of DASH score in well-controlled patients.
{"title":"A study of musculoskeletal manifestations of diabetes mellitus and their association with HbA1C among diabetic patients","authors":"Vaibhav S. Bellary, S. Shetty, Srinivas Bellary, N. Rao","doi":"10.4103/jod.jod_91_22","DOIUrl":"https://doi.org/10.4103/jod.jod_91_22","url":null,"abstract":"Background: The prevalence of diabetes mellitus (DM) is increasing significantly throughout the world. While the vascular complications of diabetes are well recognized and account for the principle mortality and morbidity from the condition, the musculoskeletal manifestations of diabetes are common and not life-threatening, which are an important cause for morbidity, pain, and disability. The most common reported forms of various musculoskeletal manifestations of DM include adhesive capsulitis, hand syndromes such as limited joint mobility syndrome (LJMS), Dupuytren’s contracture (DC), and carpal tunnel syndrome (CTS), flexor tenosynovitis, reflex sympathetic dystrophy, diffuse idiopathic skeletal hyperostosis (DISH), Charcot’s joints, diabetic amyotrophy (DA), and osteoarthritis. Materials and Methods: The study was conducted on a total of 150 patients with type 2 DM for a duration of at least 5 years in Bangalore during the study period from January 2020 to June 2021. The patients fulfilling the inclusion criteria were enrolled for the study after obtaining informed consent. Detailed history was taken and general physical examination was done to determine the musculoskeletal manifestations of DM. The Disability of Arm Shoulder and Hand (DASH) questionnaire was also completed as per the patient’s responses. Laboratory reports were collected, data compiled, and the data were analyzed. Results: Of the 150 cases enrolled, the maximum number of cases belonged to the age group of 36–50 years. About 64% of the diabetic cases were suffering from musculoskeletal disorders (MSDs) (LMJS, CTS, shoulder capsulitis, DC, trigger finger, DISH, DA). Among the MSDs, the highest prevalence was by LJMS (28%). There was a positive correlation among the duration of diabetes, HbA1C, and the DASH score among patients with MSDs in this study and this is statistically significant (P < 0.05). We also see that MSDs are present in 72.7% of the females and 57.1% of the males in the study and this was statistically significant (P = 0.048). Conclusion: MSDs have a high prevalence in diabetic patients. With advancing age and uncontrolled HbA1C levels, the number of MSDs was more as well as the severity as indicated by the DASH score. Early and better glycemic control in diabetic patients can reduce the morbidity associated with MSDs as evidenced by the reduced intensity of DASH score in well-controlled patients.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"93 1","pages":"353 - 362"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79436492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Hiccups are a normal physiological response, but sometimes they become a cause of social embarrassment. Materials and Methods: A 72-year-old male who is a known case of type II diabetes mellitus for the last 6 years came to our outdoor department with complaints of hiccups. Currently, he was on Glimipride 2 mg daily for the last 6 years and on Sitagliptin 100 mg daily for the last 6 months. Results: On stopping Sitagliptin himself, his hiccups stopped. Conclusion: Hiccups are regarded as a normal behavior and time-limited symptom but if prolonged or intractable, a thorough history and investigation must be done to find out the cause which might lead to serious consequences. Most probably, this is the first case report showing that Sitagliptin is the cause of hiccups.
{"title":"Sitagliptin-induced hiccups: A rare side effect","authors":"P. Agrawal, A. Gautam, N. Pursnani","doi":"10.4103/jod.jod_69_22","DOIUrl":"https://doi.org/10.4103/jod.jod_69_22","url":null,"abstract":"Background: Hiccups are a normal physiological response, but sometimes they become a cause of social embarrassment. Materials and Methods: A 72-year-old male who is a known case of type II diabetes mellitus for the last 6 years came to our outdoor department with complaints of hiccups. Currently, he was on Glimipride 2 mg daily for the last 6 years and on Sitagliptin 100 mg daily for the last 6 months. Results: On stopping Sitagliptin himself, his hiccups stopped. Conclusion: Hiccups are regarded as a normal behavior and time-limited symptom but if prolonged or intractable, a thorough history and investigation must be done to find out the cause which might lead to serious consequences. Most probably, this is the first case report showing that Sitagliptin is the cause of hiccups.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"112 1","pages":"312 - 313"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75032266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: The aim of this study was to elicit information on the perception of dietitians about gestational diabetes mellitus (GDM) and their dietetic practices. Materials and Methods: A survey was conducted among dietitians working in hospitals, maternity centers, and other clinics using the purposive sampling criterion. A validated questionnaire was used to obtain details about the perception of GDM, guidelines used, dietetic screening, assessment, interventions and follow-up. Descriptive statistics were reported as frequency of total number of responses for each question. Fisher’s exact test on perception of GDM, operating guidelines and topics discussed in diet consultations with respect to the years of clinical experience, age group and educational qualification of the participants were performed. Results: Perception of dietitians on family history of type2 DM as an associated risk factor of GDM had significant association with their clinical experience. Majorly discussed topic in diet consultation was carbohydrate distribution followed by protein requirement, fiber and small frequent meal pattern. On the basis of clinical experience of dietitians, difference was observed in discussed topics such as hypoglycemia, food groups, post-natal diet, and breast feeding. A major inconsistency observed was the nonavailability or lack in the use of pregnancy specific screening tool. Conclusion: Specific screening tools for pregnancy should be brought into practice. There is also the need for sustainable protocols in hospitals for uniformity in management of GDM.
{"title":"Medical nutrition therapy in gestational diabetes mellitus: A survey among dietitians","authors":"S. S, S. Uma Mageshwari","doi":"10.4103/jod.jod_37_22","DOIUrl":"https://doi.org/10.4103/jod.jod_37_22","url":null,"abstract":"Aim: The aim of this study was to elicit information on the perception of dietitians about gestational diabetes mellitus (GDM) and their dietetic practices. Materials and Methods: A survey was conducted among dietitians working in hospitals, maternity centers, and other clinics using the purposive sampling criterion. A validated questionnaire was used to obtain details about the perception of GDM, guidelines used, dietetic screening, assessment, interventions and follow-up. Descriptive statistics were reported as frequency of total number of responses for each question. Fisher’s exact test on perception of GDM, operating guidelines and topics discussed in diet consultations with respect to the years of clinical experience, age group and educational qualification of the participants were performed. Results: Perception of dietitians on family history of type2 DM as an associated risk factor of GDM had significant association with their clinical experience. Majorly discussed topic in diet consultation was carbohydrate distribution followed by protein requirement, fiber and small frequent meal pattern. On the basis of clinical experience of dietitians, difference was observed in discussed topics such as hypoglycemia, food groups, post-natal diet, and breast feeding. A major inconsistency observed was the nonavailability or lack in the use of pregnancy specific screening tool. Conclusion: Specific screening tools for pregnancy should be brought into practice. There is also the need for sustainable protocols in hospitals for uniformity in management of GDM.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"146 1","pages":"270 - 276"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86840787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Agrawal, Akhilesh K Singh, N. Pursnani, Upendra Verma
Diabetic striatopathy is a rare clinico-radiological phenomenon characterized by hemichorea/hemiballismus, hyperglycemia, hyperosmolarity in the absence of ketoacidosis. It is due to lesion in contralateral basal ganglia which is evident as T1 hyperintensity in MRI brain study. Here we are reporting a case of hemichorea /hemiballismus which was associated with hyperglycemia. Our patient improved significantly once blood glucose was controlled adequately. As it carries good prognosis, we are reporting this rare case to illustrate the importance of recognition of this rare syndrome.
{"title":"Diabetic striatopathy: A rare entity","authors":"P. Agrawal, Akhilesh K Singh, N. Pursnani, Upendra Verma","doi":"10.4103/jod.jod_38_22","DOIUrl":"https://doi.org/10.4103/jod.jod_38_22","url":null,"abstract":"Diabetic striatopathy is a rare clinico-radiological phenomenon characterized by hemichorea/hemiballismus, hyperglycemia, hyperosmolarity in the absence of ketoacidosis. It is due to lesion in contralateral basal ganglia which is evident as T1 hyperintensity in MRI brain study. Here we are reporting a case of hemichorea /hemiballismus which was associated with hyperglycemia. Our patient improved significantly once blood glucose was controlled adequately. As it carries good prognosis, we are reporting this rare case to illustrate the importance of recognition of this rare syndrome.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"51 1","pages":"305 - 308"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86407021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Gadve, S. Chavanda, Y. Gogate, Vinayak Harale, A. Dasgupta, M. Patwardhan
Diabetes mellitus is present in more than two-fifths of the patients suffering from heart failure (HF), with the incidence being more than twice that found in the non-diabetic population. It doubles the risk of hospitalization and increases the risk of fatal outcomes, thus negatively affecting the prognosis in HF patients. The available pharmacological treatment options are limited, particularly in HF with preserved ejection fraction (EF). Empagliflozin is a sodium-glucose transporter-2 inhibitor, which has shown a protective effect against cardiomyocyte dysfunction through various mechanisms. The benefits of empagliflozin has been seen in multiple studies: EMPA-REG (April 2015), EMPRISE (June 18, 2019), EMPIRE-HF (2019), EMPA-AHF-RESPONSE (January 7, 2020), The EMPEROR Reduced (May 28, 2020), The RECEDE-CHF (November 3, 2020), SUGAR-DM (February 9, 2021), and EMPEROR-Preserved (April 26, 2021). Empagliflozin reduced the risk of all-cause mortality, HF hospitalizations, and biomarkers in patients with HF both with reduced and preserved EF in prospective and retrospective studies, regardless of the presence of diabetes. Linagliptin is a DPP-4i that has demonstrated renal safety with potential albuminuria benefits as well. Both these agents in combination have shown favorable effects on elevated blood pressure and intima-media thickness. Unlike some other gliptins, linagliptin was not associated with an increased risk of HF, rather a nominal reduction noted in CARMELINA (January 18, 2018). When added to the standard of care, it reduced the dose of insulin in high-risk diabetic patients with HF. The risk of hypoglycemia is significantly less in patients treated with linagliptin compared with sulfonylurea regimen as seen in CAROLINA (August 21, 2018). Thus, considering the plethora of clinical benefits demonstrated, a combination of empagliflozin and linagliptin in patients of diabetes at high risk of HF may be a suitable option for primary and secondary prevention.
超过五分之二的心力衰竭患者患有糖尿病，其发病率是非糖尿病人群的两倍多。它使住院风险增加一倍，并增加致死性结局的风险，从而对心衰患者的预后产生负面影响。可用的药物治疗选择是有限的，特别是在保留射血分数(EF)的心衰。恩格列净是一种钠-葡萄糖转运蛋白-2抑制剂，通过多种机制显示出对心肌细胞功能障碍的保护作用。EMPA-REG(2015年4月)、EMPRISE(2019年6月18日)、EMPIRE-HF(2019年)、EMPA-AHF-RESPONSE(2020年1月7日)、The EMPEROR Reduced(2020年5月28日)、The ede - chf(2020年11月3日)、SUGAR-DM(2021年2月9日)和EMPEROR- preserved(2021年4月26日)等多项研究均证实了empagliflozin的益处。在前瞻性和回顾性研究中，无论是否存在糖尿病，恩帕列净均可降低HF患者的全因死亡率、HF住院率和生物标志物。利格列汀是一种DPP-4i，已被证明具有肾脏安全性和潜在的蛋白尿益处。这两种药物联合使用对血压升高和内膜-中膜厚度有良好的影响。与其他一些格列汀不同，利格列汀与HF风险增加无关，而是CARMELINA(2018年1月18日)中提到的名义上的降低。当加入标准治疗时，它减少了高危糖尿病心衰患者的胰岛素剂量。在CAROLINA(2018年8月21日)，与磺脲类方案相比，利格列汀治疗的患者低血糖的风险显着降低。因此，考虑到已证实的大量临床益处，恩格列净和利格列汀联合治疗HF高危糖尿病患者可能是一级和二级预防的合适选择。
{"title":"Journey from EMPA-REG to CARMELINA to EMPEROR-Preserved: Empagliflozin/linagliptin in heart failure and diabetes","authors":"S. Gadve, S. Chavanda, Y. Gogate, Vinayak Harale, A. Dasgupta, M. Patwardhan","doi":"10.4103/jod.jod_24_22","DOIUrl":"https://doi.org/10.4103/jod.jod_24_22","url":null,"abstract":"Diabetes mellitus is present in more than two-fifths of the patients suffering from heart failure (HF), with the incidence being more than twice that found in the non-diabetic population. It doubles the risk of hospitalization and increases the risk of fatal outcomes, thus negatively affecting the prognosis in HF patients. The available pharmacological treatment options are limited, particularly in HF with preserved ejection fraction (EF). Empagliflozin is a sodium-glucose transporter-2 inhibitor, which has shown a protective effect against cardiomyocyte dysfunction through various mechanisms. The benefits of empagliflozin has been seen in multiple studies: EMPA-REG (April 2015), EMPRISE (June 18, 2019), EMPIRE-HF (2019), EMPA-AHF-RESPONSE (January 7, 2020), The EMPEROR Reduced (May 28, 2020), The RECEDE-CHF (November 3, 2020), SUGAR-DM (February 9, 2021), and EMPEROR-Preserved (April 26, 2021). Empagliflozin reduced the risk of all-cause mortality, HF hospitalizations, and biomarkers in patients with HF both with reduced and preserved EF in prospective and retrospective studies, regardless of the presence of diabetes. Linagliptin is a DPP-4i that has demonstrated renal safety with potential albuminuria benefits as well. Both these agents in combination have shown favorable effects on elevated blood pressure and intima-media thickness. Unlike some other gliptins, linagliptin was not associated with an increased risk of HF, rather a nominal reduction noted in CARMELINA (January 18, 2018). When added to the standard of care, it reduced the dose of insulin in high-risk diabetic patients with HF. The risk of hypoglycemia is significantly less in patients treated with linagliptin compared with sulfonylurea regimen as seen in CAROLINA (August 21, 2018). Thus, considering the plethora of clinical benefits demonstrated, a combination of empagliflozin and linagliptin in patients of diabetes at high risk of HF may be a suitable option for primary and secondary prevention.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"71 1","pages":"189 - 198"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89624258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Lakshmi, R. Anjana, M. Siddiqui, Sait Sonie, E. Pearson, A. Doney, C. Palmer, V. Mohan, R. Pradeepa
Aim: To study the health and socioeconomic impact of the COVID-19 pandemic and to assess the barriers to self-management of diabetes during the lockdown, in rural South India. Materials and Methods: Details of demographic, social, economic, migration and health status were collected using a structured questionnaire from participants aged ≥18 years belonging to the 21 villages of Chengalpattu and Kancheepuram districts of Tamil Nadu state in south India as part of the Telemedicine pRoject for screENing Diabetes and its complications in rural Tamil Nadu (TREND) study. From the 11,249 TREND participants, a random list of 25% (n = 2812) was system-generated using random numbers and 2812 participants were contacted for the study, of whom 2511 individuals participated. Telephonic interviews were conducted during the lockdown from June to August 2020. Further, qualitative interviews(Focus group discussions) were conducted among 27 individuals with diabetes between September and December 2020. Data were analyzed using thematic analysis. Results: The mean age of the study population was 43 ± 14 years and 50.4% were women. Diabetes was present in 14.7%, hypertension in 31.9%, generalized and abdominal obesity in 33.3% and 46.5% respectively. When the lockdown was implemented in March 2020, 37% had migrated from urban to rural areas. Lack of daily wage jobs (68%), price of essential commodities (41.7%), social distancing/curfew (34.8%), mental fatigue/depression (14.7%), and loss of job (7.1%) were some reasons stated for their adverse social and financial circumstances. People with diabetes stated that they had to avoid or cut down their regular hospital visits due to travel restrictions. Many of the patients took the same medications for almost a year. Conclusion: Unemployment, poor mental health, and reduced household income were the most significant negative impacts faced by rural residents during the lockdown due to COVID-19. People with diabetes experienced disruptions in diabetes management due to the pandemic.
{"title":"A study on the health and socioeconomic impact of COVID-19 pandemic and barriers to self-management of diabetes during the lockdown among rural residents of South India","authors":"N. Lakshmi, R. Anjana, M. Siddiqui, Sait Sonie, E. Pearson, A. Doney, C. Palmer, V. Mohan, R. Pradeepa","doi":"10.4103/jod.jod_68_22","DOIUrl":"https://doi.org/10.4103/jod.jod_68_22","url":null,"abstract":"Aim: To study the health and socioeconomic impact of the COVID-19 pandemic and to assess the barriers to self-management of diabetes during the lockdown, in rural South India. Materials and Methods: Details of demographic, social, economic, migration and health status were collected using a structured questionnaire from participants aged ≥18 years belonging to the 21 villages of Chengalpattu and Kancheepuram districts of Tamil Nadu state in south India as part of the Telemedicine pRoject for screENing Diabetes and its complications in rural Tamil Nadu (TREND) study. From the 11,249 TREND participants, a random list of 25% (n = 2812) was system-generated using random numbers and 2812 participants were contacted for the study, of whom 2511 individuals participated. Telephonic interviews were conducted during the lockdown from June to August 2020. Further, qualitative interviews(Focus group discussions) were conducted among 27 individuals with diabetes between September and December 2020. Data were analyzed using thematic analysis. Results: The mean age of the study population was 43 ± 14 years and 50.4% were women. Diabetes was present in 14.7%, hypertension in 31.9%, generalized and abdominal obesity in 33.3% and 46.5% respectively. When the lockdown was implemented in March 2020, 37% had migrated from urban to rural areas. Lack of daily wage jobs (68%), price of essential commodities (41.7%), social distancing/curfew (34.8%), mental fatigue/depression (14.7%), and loss of job (7.1%) were some reasons stated for their adverse social and financial circumstances. People with diabetes stated that they had to avoid or cut down their regular hospital visits due to travel restrictions. Many of the patients took the same medications for almost a year. Conclusion: Unemployment, poor mental health, and reduced household income were the most significant negative impacts faced by rural residents during the lockdown due to COVID-19. People with diabetes experienced disruptions in diabetes management due to the pandemic.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"2679 1","pages":"255 - 261"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86593455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin M. Easow, M. Mathew, U. Rajagopalan, P. Nagarajan, G. Abraham
Glucagon-like peptide-1 (GLP-1) analog liraglutide is extensively used for type 2 diabetes mellitus, especially in those with overweight and cardiovascular risk factors. The risk benefit ratio favors their use. The life-threatening complications such as cholecystitis and pancreatitis are infrequently reported. Here we report two patients who developed recurrent gallstone diseases with cholestatic jaundice and acute pancreatitis in a male patient and an asymptomatic large gallstone stone in a female kidney transplant patient with no previous evidence of gallstone disease. This highlights the importance of surveillance screening in patients on liraglutide to prevent the development of complications.
{"title":"Serious adverse effects following use of liraglutide in individuals with type 2 diabetes","authors":"Benjamin M. Easow, M. Mathew, U. Rajagopalan, P. Nagarajan, G. Abraham","doi":"10.4103/jod.jod_78_22","DOIUrl":"https://doi.org/10.4103/jod.jod_78_22","url":null,"abstract":"Glucagon-like peptide-1 (GLP-1) analog liraglutide is extensively used for type 2 diabetes mellitus, especially in those with overweight and cardiovascular risk factors. The risk benefit ratio favors their use. The life-threatening complications such as cholecystitis and pancreatitis are infrequently reported. Here we report two patients who developed recurrent gallstone diseases with cholestatic jaundice and acute pancreatitis in a male patient and an asymptomatic large gallstone stone in a female kidney transplant patient with no previous evidence of gallstone disease. This highlights the importance of surveillance screening in patients on liraglutide to prevent the development of complications.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"142 1","pages":"314 - 316"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86470917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Lakhani, Kshitij Kumat, Archie Shah, Sachin Gadiya
Pancreatogenic diabetes (T3cDM) is a secondary form of Diabetes mellitus (DM) where exocrine pancreas is the cause of disease. A case of young male, known diabetic and having alcohol use disorder (AUD),with features suggestive of T3cDM is presented here. He had generalized body ache, abdominal discomfort and loss of weight. On presentation he had diabetic ketoacidosis and severe hyperglycemia. His USG abdomen and CECT abdomen showed multiple small foci of calcifications in pancreas which was suggestive of chronic pancreatitis. His random C-peptide level was low and GAD antibodies were negative. He had hepatitis B antigen positivity. He had malabsorption and malnutrition suggestive of exocrine pancreatic dysfunction. The case is presented here for three reasons,(I)to highlight the possibility of misdiagnosis or under diagnosis,(ii) his presentation was with ketoacidosis which is not very usual and (iii) in view of searching evidence for possible association to hepatitis B antigen positivity.
{"title":"Pancreatogenic diabetes mellitus (type 3cDM): Due to chronic alcoholic pancreatitis having hepatitis B antigen positivity presented with ketoacidosis-A case report","authors":"J. Lakhani, Kshitij Kumat, Archie Shah, Sachin Gadiya","doi":"10.4103/jod.jod_63_22","DOIUrl":"https://doi.org/10.4103/jod.jod_63_22","url":null,"abstract":"Pancreatogenic diabetes (T3cDM) is a secondary form of Diabetes mellitus (DM) where exocrine pancreas is the cause of disease. A case of young male, known diabetic and having alcohol use disorder (AUD),with features suggestive of T3cDM is presented here. He had generalized body ache, abdominal discomfort and loss of weight. On presentation he had diabetic ketoacidosis and severe hyperglycemia. His USG abdomen and CECT abdomen showed multiple small foci of calcifications in pancreas which was suggestive of chronic pancreatitis. His random C-peptide level was low and GAD antibodies were negative. He had hepatitis B antigen positivity. He had malabsorption and malnutrition suggestive of exocrine pancreatic dysfunction. The case is presented here for three reasons,(I)to highlight the possibility of misdiagnosis or under diagnosis,(ii) his presentation was with ketoacidosis which is not very usual and (iii) in view of searching evidence for possible association to hepatitis B antigen positivity.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"121 1","pages":"309 - 311"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75379542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes mellitus is one of the most prevalent metabolic diseases in existence. With more than 536.6 million cases having been diagnosed globally, its prevalence is reported to be 10.5% in 2021. In individuals with diabetes, plasma L-carnitine is low and metabolized abnormally. In this review, we aimed to assess whether L-carnitine supplementation is correlated with a reduction of the risk of cardiovascular diseases in individuals with diabetes by improving the compositions of lipid profiles, indicators of oxidative stress, glycemic control, and anthropometric indices. A literature search in major databases such as Web of Science, PubMed, Google Scholar, Scopus, and Scientific Information Database was conducted until November 2021. This was done in conjunction with a search in Elsevier and SpringerLink databases, resulting in the inclusion of relevant articles in this review. To construct the search strategy, “Carnitine” OR “glycine propionyl carnitine” OR “Acetylcarnitine” in combination with “Diabetes Mellitus” OR “Diabetes Complications” OR “Lipid Profile” and all of its components were used to search for and within the articles and databases. After screening, 10 articles published between 1998 and 2017 were identified. They evaluated the effect of L-carnitine on lipid profile metabolism, glycemic control, anthropometric indices, and oxidative stress markers in individuals with diabetes. In this systematic review, we concluded that L-carnitine had no notable effect on lipid profile as well as glycemic control and anthropometric indices. Therefore, using L-carnitine probably has no notable effect on metabolic status in individuals with diabetes. Meanwhile, some articles suggested that L-carnitine may have positive effects on some oxidative stress indicators.
糖尿病是现存最普遍的代谢性疾病之一。全球已确诊病例超过5.366亿例，据报告，到2021年，其患病率为10.5%。糖尿病患者血浆左旋肉碱含量低，代谢异常。在这篇综述中，我们旨在通过改善血脂组成、氧化应激指标、血糖控制和人体测量指标，评估补充左旋肉碱是否与糖尿病患者心血管疾病风险的降低相关。在Web of Science、PubMed、谷歌Scholar、Scopus、Scientific Information Database等主要数据库进行文献检索，检索时间截止到2021年11月。这是与Elsevier和SpringerLink数据库的搜索一起完成的，从而在本综述中纳入了相关文章。为了构建搜索策略，我们使用“肉碱”或“甘氨酸丙酰肉碱”或“乙酰肉碱”结合“糖尿病”或“糖尿病并发症”或“血脂”及其所有成分在文章和数据库中进行搜索。经过筛选，确定了1998年至2017年间发表的10篇文章。他们评估了左旋肉碱对糖尿病患者血脂代谢、血糖控制、人体测量指数和氧化应激标志物的影响。在这篇系统综述中，我们得出结论，左旋肉碱对血脂、血糖控制和人体测量指标没有显著影响。因此，使用左旋肉碱可能对糖尿病患者的代谢状况没有显著影响。同时，一些文章认为左旋肉碱可能对某些氧化应激指标有积极作用。
{"title":"Effect of L-carnitine on the lipid profile, glycemic control, oxidative stress, and anthropometric indices of individuals with type 2 diabetes: A systematic review","authors":"Navideh Khodadadi, B. Abbasi","doi":"10.4103/jod.jod_50_22","DOIUrl":"https://doi.org/10.4103/jod.jod_50_22","url":null,"abstract":"Diabetes mellitus is one of the most prevalent metabolic diseases in existence. With more than 536.6 million cases having been diagnosed globally, its prevalence is reported to be 10.5% in 2021. In individuals with diabetes, plasma L-carnitine is low and metabolized abnormally. In this review, we aimed to assess whether L-carnitine supplementation is correlated with a reduction of the risk of cardiovascular diseases in individuals with diabetes by improving the compositions of lipid profiles, indicators of oxidative stress, glycemic control, and anthropometric indices. A literature search in major databases such as Web of Science, PubMed, Google Scholar, Scopus, and Scientific Information Database was conducted until November 2021. This was done in conjunction with a search in Elsevier and SpringerLink databases, resulting in the inclusion of relevant articles in this review. To construct the search strategy, “Carnitine” OR “glycine propionyl carnitine” OR “Acetylcarnitine” in combination with “Diabetes Mellitus” OR “Diabetes Complications” OR “Lipid Profile” and all of its components were used to search for and within the articles and databases. After screening, 10 articles published between 1998 and 2017 were identified. They evaluated the effect of L-carnitine on lipid profile metabolism, glycemic control, anthropometric indices, and oxidative stress markers in individuals with diabetes. In this systematic review, we concluded that L-carnitine had no notable effect on lipid profile as well as glycemic control and anthropometric indices. Therefore, using L-carnitine probably has no notable effect on metabolic status in individuals with diabetes. Meanwhile, some articles suggested that L-carnitine may have positive effects on some oxidative stress indicators.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"18 1","pages":"199 - 209"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74489824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mobarak Hosen, N. Sultana, M. Hasan, S. Jahan, Mohammad Jahangir-Alam, Shadequl Islam, S. Rahman, N. Tanvi, M. Fariduddin, M. Hasanat
Background: Diabetes mellitus (DM) is one of the growing health problems among the young population. Secretory defect of insulin is an important cause, and it can be assessed by measuring fasting serum C-peptide level. Aim: The aim of this article is to assess fasting serum C-peptide in young-onset DM individuals. Materials and Methods: This case–control study was conducted in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March 2015 to February 2017. For this purpose, 40 individuals with DM (irrespective of DM type; age range: 11–29 years) were enrolled as case and an equal number of young healthy individuals as control. Demographic profiles, clinical profiles, and serum C-peptide were recorded in a standard and pre-tested structured datasheet. C-peptide was measured by the chemiluminescent immunometric assay. Results: Median fasting C-peptide was 2.67 [interquartile range (IQR) 1.06–4.07, range 0.12–20.0] ng/mL in diabetes individuals, whereas it was 2.19 (IQR 1.36–2.94, range 0.44–9.85) ng/mL in the control group; the difference was insignificant (P = 0.331). Waist circumference (WC) was significantly higher in the young diabetes group in comparison to that of control subjects and so were the plasma glucose values and diastolic blood pressure (P < 0.05 for all). Diabetic participants with low C-peptide group had significantly lower body mass index (BMI) and WC and higher fasting plasma glucose (FPG) and HbA1c in comparison to others (P < 0.05 for all); whereas the high C-peptide group had opposite body indices (higher BMI and WC) and glycemic parameters (lower FPG and HbA1c) (P < 0.05 for all). The classic hyperglycemic symptoms were more common in the low C-peptide group (P = 0.029). In participants with diabetes, C-peptide positively correlated with BMI and WC, whereas it showed a negative correlation with age (P < 0.05 for all). In the control group, C-peptide positively correlated with WC only (P = 0.018). Conclusion: The level of fasting serum C-peptide in diabetic subjects was similar to healthy controls, and it was higher in those subjects who had higher BMI, WC, and lower age.
{"title":"Fasting serum C-peptide level may not be low in young-onset diabetes","authors":"Mobarak Hosen, N. Sultana, M. Hasan, S. Jahan, Mohammad Jahangir-Alam, Shadequl Islam, S. Rahman, N. Tanvi, M. Fariduddin, M. Hasanat","doi":"10.4103/jod.jod_11_22","DOIUrl":"https://doi.org/10.4103/jod.jod_11_22","url":null,"abstract":"Background: Diabetes mellitus (DM) is one of the growing health problems among the young population. Secretory defect of insulin is an important cause, and it can be assessed by measuring fasting serum C-peptide level. Aim: The aim of this article is to assess fasting serum C-peptide in young-onset DM individuals. Materials and Methods: This case–control study was conducted in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March 2015 to February 2017. For this purpose, 40 individuals with DM (irrespective of DM type; age range: 11–29 years) were enrolled as case and an equal number of young healthy individuals as control. Demographic profiles, clinical profiles, and serum C-peptide were recorded in a standard and pre-tested structured datasheet. C-peptide was measured by the chemiluminescent immunometric assay. Results: Median fasting C-peptide was 2.67 [interquartile range (IQR) 1.06–4.07, range 0.12–20.0] ng/mL in diabetes individuals, whereas it was 2.19 (IQR 1.36–2.94, range 0.44–9.85) ng/mL in the control group; the difference was insignificant (P = 0.331). Waist circumference (WC) was significantly higher in the young diabetes group in comparison to that of control subjects and so were the plasma glucose values and diastolic blood pressure (P < 0.05 for all). Diabetic participants with low C-peptide group had significantly lower body mass index (BMI) and WC and higher fasting plasma glucose (FPG) and HbA1c in comparison to others (P < 0.05 for all); whereas the high C-peptide group had opposite body indices (higher BMI and WC) and glycemic parameters (lower FPG and HbA1c) (P < 0.05 for all). The classic hyperglycemic symptoms were more common in the low C-peptide group (P = 0.029). In participants with diabetes, C-peptide positively correlated with BMI and WC, whereas it showed a negative correlation with age (P < 0.05 for all). In the control group, C-peptide positively correlated with WC only (P = 0.018). Conclusion: The level of fasting serum C-peptide in diabetic subjects was similar to healthy controls, and it was higher in those subjects who had higher BMI, WC, and lower age.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"3 1","pages":"249 - 254"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73134537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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