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Register a new userThe Prevalence of Vitamin B12 Deficiency in Patients with Type2 Diabetes Mellitus on Metformin
انتشار عوز Vit B12 عند مرضى الداء السكري نمط 2 المعالجين بالميتفورمين
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شملت الدراسة 184 مريضاً من مرضى الداء السكري نمط 2 المراجعين العيادة الاختصاصية أو المرضى المقبولين في أقسام مشفى الأسد الجامعي بدمشق خلال عامي 2012-2013. تمّ تقسيم المرضى إلى ثلاث مجموعات: المجموعة A: و هي مجموعة المرضى السكريين غير المعالجين بالميتفورمين و عددهم 72 مريضاً (39,1%)، و المجموعة B: و هي مجموعة المرضى السكريين المعالجين بالميتفورمين لمدة تزيد عن 18 شهراً و عددهم 72 مريضاً (39,1%)، و المجموعة C: و هي مجموعة المرضى السكريين المعالجين بالميتفورمين لمدة تقل عن 6 أشهر و عددهم 40 مريضاً (21,8%). و قد بيّنت الدّراسة أن 43,5% من المرضى لديهم عوز Vit B12 إذ تطوّر لدى 32,6% من المرضى السكريين المعالجين بالميتفورمين العوز بالمقارنة مع 10,9 من المرضى غير المعالجين بالميتفورمين. كما تمّ تقسيم المرضى المعالجين بالميتفورمين (112مريضاً) حسب الجرعة المتناولة ثمّ حسب مدّة العلاج إلى مجموعتين لكل فئة و تبيّن وجود علاقة ارتباط عكسيّة بين مدّة العلاج بالميتفورمين و جرعته و مستويات Vit B12. و قد وجدنا أيضاً أنّه على الرّغم من زيادة خطورة حدوث عوز Vit B12 عند المرضى السكريين المعالجين بالميتفورمين فإنّ هذا لم يترافق مع حدوث الأعراض مثل فقر الدم العرطل و الأعراض العصبية.
The study included 184 patients with type 2 diabetes referred to the specialist clinic or admitted in the sections of Al-Assad University Hospital in Damascus during the years 2012-2013. The patients were divided into three groups: Group A: a group of patients with diabetes is not treated with Metformin, 72 patients (39,1%). Group B: a group of patients with diabetes is treated with Metformin for more than 18 months, 72 patients (39,1%). Group C: a group of patients with diabetes is treated with Metformin for less than 6 months, 40 patients (21,8%). This study showed that 43,5% of the patients have Vit B12 deficiency: 32,6% of patients with diabetes treated with Metformin compared with 10,9% non treated with Metformin. The patients who were treated with Metformin (112 patients) were divided by dose intake and then depending on the duration of treatment into two groups for each category and shown an inverse correlation between duration and dose of therapy with metformin and levels of Vit B12. We also found that despite the increased risk of Vit B12 deficiency in patients with diabetes treated with Metformin but this was not associated with the occurrence of symptoms such as megaloplastic anemia and neurological symptoms.
References used
NATHAN, D. M.; BUSE, J. B.; DAVIDSON, M. B.; et al. Management of hyperglycemia in type 2 diabetes :a consensus algorithm for the initiation and adjustment of therapy: update regarding thiazolidinedione :a consensus statement from the American Diabetes Association and The European Association for The Study of Diabetes. Diabetes Care, 2008, 31, 173-175
UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 3u). Lancet, 1998, 352, 854-65
KOOY, A.; DE JAGER, J.; LEHERT, P.; BETS, D.; WULFFELE, M. G.; DONKER, A. J. M.; et al. Long-term effects of metformin on metabolism and microvascular and macrovascular disease in patients with type 2 diabetes mellitus. Arch Intern Med, 2009, 169, 616-25
PYORALA, K.; LAAKSO, M.; UUSITUPA, M. Diabetes and atherosclerosis: an epidemiologic view. Diabetes Metab Rev, 1987, 3, 463-524
LUIZGUILHERME KRAEMER de AGUIAR, M. D.; LUCIANA, R.; BAHIA, M. D.; Nivaldo Villela. Metformin Improves Endothelial Vascular Reactivity in First- Degree Relatives of Type 2 Diabetic Patients With Metabolic Syndrome and Normal Glucose Tolerance. Diabetes Care, 2006, 29, 1083-1089
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Background: Diabetes mellitus type2 (T2DM) and thyroid dysfunction (TD) are the
two most common endocrine disorders in clinical practice. The unrecognized TD may
adversely affect the metabolic control and add more risk to an already predisposing
s
cenario for cardiovascular diseases. The objective of this study was to investigate the
prevalence of TD in patients with type2 diabetes mellitus.
Objective: To determine the prevalence and patterns of thyroid dysfunction in
patients with type2 diabetes mellitus.
Material and methods: Study included total 362 subjects (204 type2 diabetic patients
and 158 healthy non diabetic subjects). Agroup of type2 diabetic patients and control group
were evaluated for thyroid dysfunction by testing TSH and FT4 when TSH was abnormal.
The correlation of prevalence of thyroid disorder with gender distribution, age distribution,
duration of diabetes, BMI, treatment, fasting plasma glucose (FPG), serum triglyceride and
serum cholesterol was then done in diabetic patients. The observations and interpretations
were recorded and results obtained were statistically analyzed.
Results: The prevalence of thyroid dysfunction among type2 diabetic patients was
found to be 13,2%. In the control group, the prevalence of thyroid dysfunction was 6,3%.
There was a significant difference between diabetics and control subjects p= 0,031.The
most frequently TD in type2 diabetic patients was subclinical hypothyroidism (8,3%).
Thyroid dysfunction was significantly correlated with gender (women > man), age < 60
years, FPG > 130mg/dl, TG > 150mg/dl and insulin treatment in type2 diabetic patients.
Conclusion: Screening of thyroid dysfunction shoud be done in all Type2 diabetic
patients.
To study the prevalence of the diabetic hand in a group of type 2 diabetics,
comparing to age- sex matched non-diabetics control group, and to investigate clinical features among
diabetics with or without the diabetic hand.
Background: Diabetes mellitus is a leading public health problem with increasing
incidence and long term complications. These complications are mainly a consequence of
macro-vascular and microvascular damages of the target organs. The incidence of
several
pulmonary abnormalities during the course of Diabetes Mellitus because the presence of
an extensive microvascular circulation and abundant connective tissue in the lungs , raises
the possibility that lung tissue may be a target organ in diabetic patients.
Objectives: This research is designed to study the impact of DM and both the
duration of the disease and the glycemic control on pulmonary function tests.
Methodology: This is a cross-sectional study carried out on 75 patients with type II
diabetes mellitus patients at Tishreen University Hospital in the period between October
2015 and October 2016 .We compared with a control group consisted of 75 non diabetic
healthy persons . Measurement of HbA1C , fasting plasma glucose
(FPG) , and spirometry were made to all subjects and the following pulmonary function
parameters were recorded: Forced Expiratory Volume in the first second (FEV1), Forced
Vital Capacity (FVC), and Forced Expiratory Volume percent (FEV1/ FVC%) . Results
were analyzed by calculating Mean ± SD, using X2 test , Karl Pearson correlation and
ANOVA test.
Results: The mean FEV1, FVC, FEV1/FVC% values were low in diabetics (p value
<0.05) compared to healthy non-diabetics (control group). Also, uncontrolled diabetics
show a greater decrease in these values than controlled diabetics. There was a greater
decrease in these values in patients with long period of disease .
Conclusion: The findings of the present study suggest that, the lung is a target organ
for damage in DM and diabetics show a decrease in PFTs with a restrictive pattern lesion
compared with non-diabetics . And this deterioration is exaggerated in uncontrolled
diabetics and with the long duration of DM .
Type 2 Diabetes mellitus T2DM has been suggested to be the most common
metabolic disorder associated with magnesium deficiency which has many adverse
outcomes. The aim of this study was to evaluate plasma Mg in 126 T2DM patients
recruited from Dia
betes Centre in Lattakia, compare them to 70 healthy individuals, and
assess the correlation between plasma Mg and HbA1c as a glycemic control biomarker.
Magnesium was measured using xylidyl blue colorimetric method. HbA1c was measured
using ion-exchange resin separation. The SPSS 19.0 software was used for statistical
analysis. Mean plasma Mg concentrations of the diabetics was significantly lower than
controls (P=0.0001). Plasma magnesium was negatively correlated with HbA1c (r=-0.5,
P=0.0002). Plasma magnesium was below the normal reference range (1.9-2.5 mg/dL) in
47.6% of diabetics and 28.6% of controls. In conclusion, it is important to monitor Mg
levels in both T2DM patients and non-diabetics and take procedures to correct
hypomagnesaemia states.
This study aims to compare between two globally approved strategies to manage diabetes type II in Syria, by comparing their effectiveness in patients with diabetes type II who are treated in the national program of diabetes Clinics in Damascus and in
vestigate their glucose control. The first strategy includes glibenclamide as a monotherapy and the second includes a combination of glibenclamide and metformin.
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