Journal of Diabetes and Endocrinology Association of Nepal

Diabetes distress prevalence, determinants and its association with the treatment regimen -A cross sectional study from north-east India

V Veeraraghavan, D Agrawal, A Singh — Sun, 31 Dec 2023 00:00:00 +0000

Background: Diabetes distress (DD) in India has always been studied along with depression. There are no studies explaining the prevalence, correlation with diabetes management. This is study is first of its kind from northeast India.

Methods: The aim of this study was to estimate the prevalence of DD and determine the socio-demographic variables. Focus was also on the relationship between treatment regimen and diabetes distress. A cross sectional study was conducted in a tertiary care hospital in Guwahati, Assam. DD scale was administered on 226 patients reporting to the medicine outpatient department. Data on treatment regimen for diabetes mellitus was collected and formulated. Sample size calculation was done according to the prevailing prevalence estimates. Statistical tests like ANOVA, independent t-tests and regression analysis were used.

Results: DD was found to have a prevalence of 43% in our study. Duration of diabetes, sedentary lifestyle, and low education were associated with higher distress levels. Patients on insulin were found to have greater distress when compared with patients on oral hypoglycaemic agents.

Conclusion: DD was found to have higher prevalence in our study. This influences the self-care in diabetes. DD specific modalities have to be incorporated in conventional treatment of diabetes mellitus. Early screening should be foci of interest.

The glycemic control and side effects of Empagliflozin on patients with type II diabetes mellitus in tertiary care Hospital

M Man Bahadur, D Malla, P Ghimire, SB Karkee — Sun, 31 Dec 2023 00:00:00 +0000

Background: Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia associated with disturbances of carbohydrate, fat and protein metabolism due to absolute or relative deficiency in insulin secretion and/or action. The burden of it is increased globally especially middle- or low-income countries. Different oral anti-diabetic medicines including older regimen to novel medicine like empagliflozin are used for the treatment of different types of diabetes. This study was aimed to study the effects of empagliflozin on patients with type II diabetes mellitus in tertiary care Hospital, Nepal.

Methods: A hospital based prospective follow up study with purposive sampling was carried out for a period of six months from July to December 2022. A representative sample of more than 110 from prescriptions of T2DM patients aged between 20 to 60 years were observed for demographic details (age, sex, body weight, body height, body mass index (BMI) etc.), Hb1AC level, fasting plasma glucose (FPG), postprandial plasma glucose (after 2 hours) (PPG), blood pressure (SBP and DBP), adverse effects and an interview was conducted with Endocrinologist as well as patients who receive empagliflozin for first time and data were analyzed by using applicable statistical tolls.

Results: A total of 215 patients were prescribed empagliflozin 10mg tablet out of which only 110 patients came for the follow up at 6 months. Hence, 110 respondents completed the study with in the study period (n=110). Out of 110 patients, 56 (50.9%) were male and 54(49.1%) were female. The majority of patients belonged to the age group 51-60 years 55 (50%) with mean age of 48.89±8.81 years. The mean diabetic duration was 7 years. After 6 months of empagliflozin therapy there was significantly reduction in weight, BMI, blood pressure, anthropometric values (HbA1c, FPG, and PPG) with some suspected side effects were also observed.

Conclusion: Thus, the main aim of this research was to study the effects of empagliflozin on patients with type II diabetes mellitus in tertiary care Hospital, Nepal. The outcomes of this research will be used as the reference for the preparation of diabetes treatment guidelines, regimens and related policies in the future.

Kisspeptin levels in polycystic ovary syndrome and its manifestations

S Kharel, H Banu, S Md Morshed, E Chowdhury, MA Hasanat — Sun, 31 Dec 2023 00:00:00 +0000

Background: The altered luteinizing hormone to follicle-stimulating hormone (LH/FSH) ratio- an important component in the pathogenesis of polycystic ovary syndrome (PCOS), is regulated by a brain peptide kisspeptin. This study aimed to explore the association of serum kisspeptin levels with PCOS and its manifestations.

Methods: This cross-sectional study included 80 participants with PCOS on the basis of International evidence-based guidelines, 2018, and 71 healthy matched controls. Along with clinical information, fasting blood was drawn to measure total testosterone, sex hormone binding globulin, thyroid stimulating hormone, prolactin, 17-hydroxyprogesterone, and kisspeptin in all, and glucose, lipids, insulin, LH, FSH in only PCOS participants in the follicular phase of the menstrual cycle. Kisspeptin was measured by sandwiched enzyme-linked immunosorbent assay method with a lower limit detection level of 0.01 pg/mL.

Result: Kisspeptin levels were undetectable in 25 out of 80 and 16 out of 71 controls. Among the participants with detection levels (55 in each group), kisspeptin did not differ between PCOS and control [31.2 (19.2 – 43.1) vs. 40.4 (14.9 – 70.4), pg/mL, p=0.446]. Among participants with PCOS, kisspeptin levels had no significant associations or correlations with any manifestations (ns for all). ROC curve analysis showed kisspeptin as not an acceptable marker for PCOS [AUC (95% CI): 0.57 (0.46 – 0.68), p= 0.221].

Conclusion: Our study failed to show any association of kisspeptin levels with PCOS and its manifestations.

Correlation of Neutrophil Lymphocyte ratio with HbA1c in patients of type 2 Diabetes Mellitus attending Medical Department of a Tertiary Care Centre

R Singh, JK Shrestha, OP Chaudhary, S Singh, MK Agrahari — Sun, 31 Dec 2023 00:00:00 +0000

Background: Type 2 diabetes mellitus is associated with chronic low-grade inflammation. Neutrophil lymphocyte is an indicator of subclinical inflammation. One of the novel inflammatory markers is neutrophil to lymphocyte ratio. We find only less studies that are directly accessing the relation between NLR and HbA1c, in the present study we aim to correlate neutrophil lymphocyte ratio with glycemic control in patients having type 2 diabetes.

Methods: Hospital based observational cross section study was carried out at department of medicine at Bharatpur Period August 2023 to December 2023. 176 patients with type 2 diabetes mellitus as per ADA criteria aged more than 18 years were included in the study. Microsoft excel and SPSS version 20.0 were used for collection and analysis of the data, p<0.05 was considered as significant.

Results: Out of 176 cases having mean age 55.78±9.111, Mean BMI of all participant was 28.37±4.061, mean absolute Neutrophil count was 7.36±7.123 10³/μl and Mean neutrophil lymphocyte ratio count was 4.03±1.545, in which 147 patients (83.5%) had NLR within normal limit, and remaining 29 patients (16.5%) had NLR within more than 3.53. In our study 123 patients (69.9%) had HbA1C more than 9.0. The association of NLR with HbA1c which was significant association (p=0.047) noted between two parameters indicating higher frequency of NLR had a positive correlation with HbA1c and was found to be an independent predictor of poor glycemic control in patients with type 2 diabetes mellitus.

Conclusions: Our study concluded that the association of NLR with HbA1c which was significant association. The Association of HbA1c with absolute neutrophil count was which significant and association of HbA1c with absolute lymphocyte count was which significant. Type 2 DM patients with raised NLR should be evaluated for cardiovascular, renal and ocular complications of diabetes. NLR may be useful as an easily measurable, noninvasive, widely available and cost-effective parameter for the disease monitoring tool during follow up of diabetic patients.

PCOS : We see what we know, we understand what we do

PS Shrestha — Sun, 31 Dec 2023 00:00:00 +0000

No Abstract available.