Analysis of Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Case-Control Study

Authors

  • Noor ul Huda Dr. A. Q. Khan Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, Karachi, Pakistan.
  • Aqiba Sarfaraz Department of Diabetes, Endocrinology and Metabolism, Liaquat National Hospital, Karachi, Pakistan
  • Saima Saleem Dr. A. Q. Khan Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, Karachi, Pakistan
  • Abid Azhar Dr. A. Khan Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi

DOI:

https://doi.org/10.46568/bios.v4i2-3.130

Keywords:

Glycemic management, Glycosylated haemoglobin (HbA1c), Hypoglycemic drugs, Obesity, Type 2 DM

Abstract

The incidence of DM (Diabetes mellitus) is rising all over the world. Inadequate glycemic control in patients having type 2 DM presents a higher risk of developing associated complications. This study was conducted to analyse the information on the management of diabetes in standard clinical practice. The study provides description of clinical profile of subjects with DM2 (Type 2 diabetes mellitus) under treatment with insulin and oral hypoglycemic drugs. A total of 500 patients diagnosed with DM2, and equal number of age and gender matched controls participated in the study. Clinical data including previous medical history of diabetes, medication taken for treatment, comorbidities, pre-prandial and post-prandial plasma glucose, and glycosylated haemoglobin (HbA1c) levels were collected. It was observed that among all participants 59.4% were obese and 30.6% were overweight. It was also found that 57.4% patients were suffering from hypertension while 56% were suffering from hyperlipidemia. Patient’s data about family history revealed that 62.2% patients had both or either of the two parents suffering from diabetes. The mean fasting and random plasma glucose levels were found to be 178.6mg/dL and 245.4mg/dL respectively. Moreover, only 8% patients achieved glycemic goals and had HbA1c levels under normal limits. The study reveals that lack of awareness and poor self-care can increase the risk of comorbidities associated with type 2 DM. This study provides a basis for further investigations on quality of life of diabetic patients in various regions of Pakistan.

References

World Health Organization. Diabetes Fact Sheet; 2018. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes

Moucheraud C, Lenz C, Latkovic M, Wirtz VJ. The costs of diabetes treatment in low-and middle-income countries: a systematic review. BMJ global health. 2019 Feb 1;4(1):e001258.

World Health Organization. Diabetes country profiles; Pakistan. 2016. Available from: https://www.who.int/diabetes/country-profiles/pak_en.pdf?ua=1

Pinti MV, Fink GK, Hathaway QA, Durr AJ, Kunovac A, Hollander JM. Mitochondrial dysfunction in type 2 diabetes mellitus: an organ-based analysis. American Journal of Physiology-Endocrinology and Metabolism. 2019 Feb 5; 316(2):E268-E285.

Bonnefond A, Froguel P. Rare and common genetic events in type 2 diabetes: what should biologists know?. Cell metabolism. 2015 Mar 3;21(3):357-68..

Goedeke L, Perry RJ, Shulman GI. Emerging pharmacological targets for the treatment of nonalcoholic fatty liver disease, insulin resistance, and type 2 diabetes. Annual review of pharmacology and toxicology. 2019 Jan 6;59:65-87.

Reaven GM. Banting Lecture 1988. Role of insulin resistance in human disease. 1988. Nutrition (Burbank, Los Angeles County, Calif.). 1997 Jan;13(1):65-6.

Latres E, Finan DA, Greenstein JL, Kowalski A, Kieffer TJ. Navigating two roads to glucose normalization in diabetes: automated insulin delivery devices and cell therapy. Cell metabolism. 2019 Mar 5;29(3):545-63.

Kasuga M. Insulin resistance and pancreatic β cell failure. The Journal of clinical investigation. 2006 Jul 3;116(7):1756-60.

Butler AE, Janson J, Bonner-Weir S, Ritzel R, Rizza RA, Butler PC. β-cell deficit and increased β-cell apoptosis in humans with type 2 diabetes. Diabetes. 2003 Jan 1;52(1):102-10.

Böni-Schnetzler M, Meier DT. Islet inflammation in type 2 diabetes. InSeminars in immunopathology 2019 Jul 1 (Vol. 41, pp. 501-513). Springer Berlin Heidelberg.

Yang Y, Wang M, Tong J, Dong Z, Deng M, Ren X, Li H, Yang J, Meng Z, Sun J, He Q. Impaired glucose-stimulated proinsulin secretion is an early marker of β-cell impairment before prediabetes stage. The Journal of Clinical Endocrinology & Metabolism. 2019 Oct;104(10):4341-6.

Mezza T, Cinti F, Cefalo CM, Pontecorvi A, Kulkarni RN, Giaccari A. β-cell fate in human insulin resistance and type 2 diabetes: a perspective on islet plasticity. Diabetes. 2019 Jun 1;68(6):1121-9.

American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2019. Diabetes care. 2019 Jan 1;42(Supplement_1):S13-28.

Jellinger PS, Handelsman Y, Rosenblit PD, Bloomgarden ZT, Fonseca VA, Garber AJ, Grunberger G, Guerin CK, Bell DS, Mechanick JI, Pessah-Pollack R. American Association of Clinical Endocrinologists and American College of Endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocrine Practice. 2017 Apr 1;23:1-87.

Asian American Diabetes Initiative (download 2019). BMI Cutoff for Asians. Joslin Diabetes Center http://aadi.joslin.org/content/bmi-calculator.

Nolan CJ, Ruderman NB, Kahn SE, Pedersen O, Prentki M. Insulin resistance as a physiological defense against metabolic stress: implications for the management of subsets of type 2 diabetes. Diabetes. 2015 Mar 1;64(3):673-86.

Samuel VT, Shulman GI. The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux. The Journal of clinical investigation. 2016 Jan 4;126(1):12-22.

American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes care. 2013 Jan;36(Suppl 1):S11.

Lowe F, Feng W. Diabetes and Stroke: The Role of Glucose Regulation. The Diabetes Textbook: Clinical Principles, Patient Management and Public Health Issues. 2019:731-46.

Milo RB, Connelly CD. Predictors of glycemic management among patients with type 2 diabetes. Journal of clinical nursing. 2019 May;28(9-10):1737-44.

Schnurr, T.M., Jakupović, H., Carrasquilla, G.D. et al. Obesity, unfavourable lifestyle and genetic risk of type 2 diabetes: a case-cohort study. Diabetologia 63, 1324–1332 (2020).

Jannoo Z, Wah YB, Lazim AM, Hassali MA. Examining diabetes distress, medication adherence, diabetes self-care activities, diabetes-specific quality of life and health-related quality of life among type 2 diabetes mellitus patients. Journal of clinical & translational endocrinology. 2017 Sep 1;9:48-54.

Rangel EB, Rodrigues CO, De Sa JR. Micro-and macrovascular complications in diabetes mellitus: preclinical and clinical studies. Journal of diabetes research. 2019.

Downloads

Published

2023-07-07

How to Cite

Noor ul Huda, Sarfaraz, A. ., Saleem, S. ., & Azhar, A. (2023). Analysis of Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Case-Control Study. BioSight, 4(2-3), 3–13. https://doi.org/10.46568/bios.v4i2-3.130

Issue

Section

Original Article

Similar Articles

1 2 > >> 

You may also start an advanced similarity search for this article.