BACKGROUND Metabolic syndrome is a group of disorders characterised by hyperglycaemia, central obesity and hypertension and dyslipidaemia. This is a condition which is advocated with increased risk of CVD and diabetes mellitus. It is a major modifiable condition that can be prevented and premature death can be decreased. MATERIALS AND METHODS Present study is designed to study the defect of telmisartan with diet and exercise versus telmisartan and metformin on various metabolic parameters in metabolic syndrome patients with hypertension. All the metabolic parameters fasting plasma glucose, insulin (fasting), total cholesterol, LDL-cholesterol, triglyceride, C-peptide Blood pressure, BMI and HOMA-IR were measured at the start of the study and was followed regularly. Final measurements of all these parameters were done after 6 months. Hexokinase method was used for estimation of plasma glucose. RESULTS Weight of the patient in group A was decreased from 89.52 yrs. to 79.6 yrs. after 6 months, in group B it was decreased from 86.52 kg to 84.56 kg, similarly body mass index (BMI) was reduced in group A from 30.4 kg/m 2 to 27.5 kg/m 2 and in group B it was reduced from 30.1 kg/m 2 to 29.4 kg/m 2. Fasting plasma glucose was 97.79 mg/dL in group A at the start of the study, after 6 months it reduced to 92.76 mg/dL. In group B the fasting plasma glucose was decreased from 96.86 mg/dL to 89.40 mg/dL. Fasting plasma insulin level has been reduced from 12.21 mIU/L to 10.21 mIU/L in group A and from 12.55 to 9.51 mIU/L in group B. HOMA-IR which was 2.96 in group A was reduced to 2.89 and in group B reduced from 3.03 to 2.82. CONCLUSION In our study, we have found that the decrease in weight and body mass index was more in group A than group B percentage change in mean of weight was 12.46% in group A and 4.57% in group B, similarly in BMI was 9.5% and 3.9% respectively. We have found that percentage change in mean of FPG, HbA1C and FPI was more in group B and also the change in HOMA-IR. Before start of the study, basal FPI was more but after six months it decreased, but plasma glucose concentration also decreased that indicates that sensitivity of insulin increased. Diet and exercise has good effect on serum triglyceride and LDL-C, but metformin has good effect on HDL-C and total cholesterol.
BACKGROUNDHeart disease accounts for 50 percentages of all deaths among people with diabetes. Risk factor for people with diabetes is increase in BP, high serum cholesterol and obesity. Adult with diabetes historically have a 2 or 3 times higher rate of cardiovascular diseases than without diabetes. This risk increases continuously with rising fasting plasma glucose higher than optimal blood glucose is a leading cause of cardiovascular mortality in most world region. MATERIALS AND METHODSPresent study is a prospective hospital-based observational study conducted in the Department of General Medicine, Konaseema Institute of Medical Sciences, Amalapuram, between April 2015 to May 2017. A total of 110 patients who has been diagnosed as type-2 diabetes mellitus were selected for this study as per inclusion and exclusion criteria. Electrocardiography of all the patient was done by same machine Philips Page Writer Tc20, 12 leads standard supine ECG was stand recorded. A number of different voltage criteria for LVH has been proposed. We have used Cornell Voltage Criteria for diagnosis of LVH, that is SV3+RAVL >28 mm in males and SV.3+RAVL >20 mm in females, in these patients were divided into two groups. RESULTSThere was statistically significant difference between fasting plasma glucose concentration defence in both groups. Group-1 FPG was 131.1 mg/dL, in group-2, it was 108.4 mg/dL with P value 0.0007. PPPG was also higher in group-1 that is 165.1 mg/dL than group-2 that is 138.45 mg/dL. Glycosylated haemoglobin was higher in group-1 than in group-2 that is 6.86 and 6.20 respectively with a P value 0.327, which is not significant statistically. Duration of diabetes was longer in group-1 than group-2. There is statistically significant difference in SBP and DBP in both group. CONCLUSIONIn our study, we have found that prevalence of left ventricular hypertrophy was high in type-2 diabetes mellitus patients. Prevalence is high in patient with longer duration of diabetes mellitus and with higher fasting and postprandial glucose.HOW TO CITE THIS ARTICLE: Jawaharlal R, Sneha K. A study of prevalence of left ventricular hypertrophy in type-2 diabetes mellitus patients. J. Evid. Based Med.
BACKGROUND As per the fact sheet published by World Health Organisation, South East Asia, nearly one billion people have high blood pressure and are one of the most common causes of premature death worldwide. About one third of the adult population in the South East Asia region is having hypertension. In our country, the number of people with hypertension are undiagnosed and untreated, so early detection and treatment of hypertension will decrease the complication of hypertension and premature death due to it.
BACKGROUND Various oral hypoglycaemic agent has been used for the treatment of diabetes mellitus. Out of that, metformin is a biguanide, which is commonly used for the treatment of diabetes mellitus and sitagliptin is an orally effective inhibitor of dipeptidyl peptidase IV, which indirectly increase the secretion of insulin by preventing degradation of GLP-1. Present study is designed to evaluate the efficacy of addition of sitagliptin with metformin in comparison with metformin alone. MATERIALS AND METHODS Subjects included in this study were randomised into two groups. Group A were given metformin 500 mg once daily and group B was given metformin 500 mg plus sitagliptin 50 mg. Both the group consists of 30 patients each. Before start of the study, various parameter like fasting plasma glucose, postprandial plasma glucose, glycosylated haemoglobin, HDL-C, LDL-C, TG total cholesterol, fasting plasma insulin, glycosylated haemoglobin and HOMA-IR were measured. All the patients were followed regularly and advice regarding diet and regular exercise was given. Fasting plasma glucose was measured every 15 days. All the patients were informed about hypoglycaemia and its presentation. Patients were asked to inform about any adverse experience. All the parameters were measured after 16 weeks of treatment. RESULTS Fasting plasma glucose in group A was reduced to 104.6 mg/dL from its basal value 156.45 mg/dL. In group B, the fasting plasma glucose was reduced to 90.10 mg/dL from its basal value 154.7 mg/dL. Fasting plasma insulin in group A was 12.65 mIU/dL, which has been changed to 11.46 mIU/dL after 16 weeks of treatment with metformin 500 mg once daily. Fasting plasma insulin in group B has been decreased from basal value 13.24 mIU/dL to 12.46 mIU/dL at the end of 16 weeks. Glycosylated haemoglobin in group A was 7.64 at the start of study, which was decreased to 6.0 after 16 weeks treatment with metformin similarly in group B HbA1c was decreased from basal value 7.86 to 5.8 after 16 weeks of treatment. The HOMA-IR value also decreased in both group. In group A, initial value was 4.69, which was reduced to 2.94; and in group B, after 16 weeks, the basal value of 7.86 was reduced to 2.77. CONCLUSION Diabetes mellitus is a chronic progressive disease responsible for damage of major organ system. In present study, we have found that BMI and glycaemic index was improved when sitagliptin was added to metformin. Insulin resistance was better improved in sitagliptin combination group metformin alone. Sitagliptin addition is associated with increase in HDL-C.
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