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Register a new userThe effect of diabetes mellitus type II on pulmonary function
دراسة تأثير الداء السكري نمط II على وظائف الرئة
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Tishreen University ورقة بحثية
Publication date
2017
fields
Medicine
and research's language is
العربية
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Shamra Editor
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مقدمة : الداء السكري هو مشكلة صحيّة عامّة كبرى و هنالك ازدياد مستمر في معدل الوقوع و الاختلاطات طويلة الأمد . هذه الاختلاطات هي بشكل رئيسي عقابيل للتخرب الوعائي المجهري في الأعضاء الهدفية . إن حدوث العديد من الأذيات الرئوية في سياق الداء السكري نظراً لوجود دوران مجهري غزير و وفرة في النسج الضامة , يرفع احتمال أن يكون النسيج الرئوي عضواً هدفياً عند مرضى الداء السكري . أهداف البحث : صمم هذا البحث لدراسة تأثير الداء السكري و كل من مدة الإصابة بهذا المرض و ضبط الحالة السكرية على وظائف الرئة . المواد و الطرق : دراسة مقطعية – عرضية , أجريت على 75 من مرضى الداء السكري نمط II من مراجعي مشفى تشرين الجامعي في الفترة الممتدة بين تشرين أول 2015 حتى تشرين أول 2016. و تمت المقارنة مع مجموعة شاهد تألفت من 75 فرداً سليماً غير مصاب بالداء السكري . تم إجراء قياس للخضاب الغلوكوزي , سكر الدم الصيامي و إجراء اختبار وظائف رئة (spirometry) لجميع المشاركين في الدراسة و تم تسجيل القياسات الرئوية التالية : الحجم الزفيري الأقصى في الثانية الأولى (FEV1) , السعة الحيوية القسرية (FVC) , النسبة (FEV1/FVC) . تم تحليل النتائج باستخدام : المتوسط ± الانحراف المعياري , كاي مربع لبيرسون , معامل ارتباط بيرسون , و اختبار ANOVA .
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 .
Artificial intelligence review:
Research summary
تتناول هذه الدراسة تأثير الداء السكري من النمط الثاني على وظائف الرئة. يُعتبر الداء السكري مشكلة صحية عامة كبرى مع تزايد مستمر في معدل الإصابة والاختلاطات طويلة الأمد، والتي تكون بشكل رئيسي نتيجة للتخرب الوعائي المجهري في الأعضاء الهدفية. تهدف الدراسة إلى تقييم تأثير الداء السكري ومدة الإصابة به وضبط الحالة السكرية على وظائف الرئة. أجريت الدراسة على 75 مريضًا بالداء السكري من النمط الثاني و75 شخصًا سليمًا كمجموعة شاهد. تم قياس الخضاب الغلوكوزي وسكر الدم الصيامي وإجراء اختبار وظائف الرئة (spirometry) لجميع المشاركين. أظهرت النتائج أن مرضى الداء السكري لديهم تراجع في وظائف الرئة مقارنةً بالأصحاء، وأن هذا التراجع يزداد مع طول مدة الإصابة وارتفاع مستويات سكر الدم. تقترح الدراسة أن الرئة هي عضو هدفي لإصابة الداء السكري، وأن ضبط سكر الدم يمكن أن يقلل من تأثيرات الداء السكري على وظائف الرئة.
Critical review
دراسة نقدية: تقدم هذه الدراسة مساهمة هامة في فهم تأثير الداء السكري من النمط الثاني على وظائف الرئة. ومع ذلك، يمكن الإشارة إلى بعض النقاط التي قد تعزز من قوة الدراسة. أولاً، كان من الممكن توسيع حجم العينة لزيادة دقة النتائج. ثانيًا، لم يتم تناول تأثير العوامل البيئية مثل التدخين أو التلوث الهوائي بشكل كافٍ، والتي قد تؤثر أيضًا على وظائف الرئة. ثالثًا، قد يكون من المفيد إجراء دراسات مستقبلية تتناول تأثير الداء السكري على وظائف رئوية أخرى مثل التبادل الغازي وسعة انتشار أول أكسيد الكربون (Dlco). وأخيرًا، قد تكون هناك حاجة لمزيد من الدراسات الطولية لتأكيد النتائج على مدى فترة زمنية أطول.
Questions related to the research
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ما هو الهدف الرئيسي من هذه الدراسة؟
الهدف الرئيسي من الدراسة هو تقييم تأثير الداء السكري من النمط الثاني ومدة الإصابة به وضبط الحالة السكرية على وظائف الرئة.
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ما هي الأدوات المستخدمة في قياس وظائف الرئة في هذه الدراسة؟
تم استخدام اختبار وظائف الرئة (spirometry) لقياس الحجم الزفيري الأقصى في الثانية الأولى (FEV1)، والسعة الحيوية القسرية (FVC)، والنسبة (FEV1/FVC).
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ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟
توصلت الدراسة إلى أن مرضى الداء السكري من النمط الثاني لديهم تراجع في وظائف الرئة مقارنةً بالأصحاء، وأن هذا التراجع يزداد مع طول مدة الإصابة وارتفاع مستويات سكر الدم.
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ما هي التوصيات التي قدمتها الدراسة بناءً على النتائج؟
أوصت الدراسة بإجراء اختبار وظائف الرئة بشكل روتيني لجميع مرضى الداء السكري من النمط الثاني، وضبط مستويات سكر الدم بشكل جيد، وإجراء المزيد من الدراسات المستقبلية حول تأثير الداء السكري على وظائف رئوية أخرى.
References used
World Health Organization. Report of WHO study group. WHO Technical Report Series1985; No 727
WILD S, ROGLIC G, GREEN A. Global prevalence of diabetes. Diabetes Care 2004;27:1047-1053.2
GUYTON AC, HALL JE. Textbook of Medical physiology. 11thEdition. Elsevier Inc, New Delhi.2006
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The objectives of this study were to assess the changes in pulmonary function after surgical correction of deviated nasal septum for nasal obstruction. Methods: A total of 81 patients with DNS with the complaints of nasal obstruction underwent septop
lasty were involved in this before-after prospective study. Demographic data, clinical and physical examination including anterior and posterior rhinoscopy was performed. Pre- and post-surgery (after 1 and 3 month) spirometry was done on these patients. FVC, FEV1, PEFR, FEF25-75% and the ratio of FEV1 to FVC were the parameters measured. And the results were analyzed using various statistical tools for difference in spirometry findings depending on age group, gender, smoking and duration of disease. Results: Postoperative all PFT values, except for FEV1/FVC% value, were significantly higher than the preoperative values. Postoperative FEV1/FVC% value was significantly lower than preoperative value. The improvement was more in younger age groups, and it was more in nasal obstruction of shorter duration. There was no significant difference in improvement among males and females or among smoker and non-smokers. Conclusion: These findings suggest that septoplasty has a positive effect on pulmonary functions improvement in patients with nasal obstruction due to deviated nasal septum. And this improvement may be affected by age and the duration of obstruction, but not related to gender or smoking.
Blood glucose control reduces the microvascular and macrovascular
complications in patients with diabetes mellitus type II. According to the American Diabetes Association, less than a half of those with diabetes achieve optimal control of blood gluc
ose and target values of HbA1c. Life style modifications is one of the preferences of diabetes management because the potential relationship between diet and diabetic control. So nutrition therapy which given by dietitian and generally lifestyle modifications are considered mainly integrated to traditional medication for disease.
The study included 104 patients with diabetes type II (HbA1c 8% ± 1.07, BMI 26.45 ± 2.69, fasting blood glucose 148.25 ± 33.76) given diabetes self-management education program and divided into two groups. The first group was treated with glibenclamide only and the second was treated with a combination of glibenclamide and metformin. After three months monitoring, 103 patients Completed the study. Therapeutic efficacy was evaluated considering HbA1c ≤ 6.5% as a target value. The necessary statistical study to analyze the data and evaluate the statistical
significance of the results was made.
The results indicate that the treatment supported with life style
modifications was more effective than traditional therapy and patient education at blood glucose control in patients with diabetes mellitus type II and improve their health.
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.
Many T2D use CAO as a laxative. We did not find sufficient research to explain CAO's potential effect on the levels of HbA1c in T2D patients. This study will study this effect. Rats (n=80) were divided into eight groups (n=10). Five groups (n=50) wer
e injected with streptozotocin intravenously to induce T2D. One group was given CAO with empagliflozin, and the second was assigned CAO only daily. The third was assigned CAO every two days, with empagliflozin, which was given daily. A fourth was assigned CAO alone daily. Also, the fifth was given empagliflozin alone. In the healthy groups, one group was given CAO, and the other was given empagliflozin. Also, the last healthy group was not assigned any drug. CAO's result on HbA1c in healthy rats was noted to decrease when delivered alone for eight weeks. HbA1c of the diabetic groups showed no significant difference (P-value<0.05) when comparing the rats given CAO with empagliflozin, and the rats were given CAO only. There was also no noticeable effect among the groups of rats given CAO daily and every two days. This study explains that CAO does not lead to a significant difference in HbA1c levels in diabetic rats, even it did for healthy rats, and if given alone, CAO could affect HbA1c levels if given over a long period. Also, CAO has a noticeable impact on experimental rats that co-administered Empagliflozin on HbA1c levels, and that Empagliflozin effect is not significantly affected if taken with CAO.
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.
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