The relative contribution of postprandial glucose to excess hyperglycaemia decreases as glycaemic control deteriorates, being dominant with HbA(1c)= 7.3%, irrespective of the timing of the meal during the day. However, the absolute contribution of postprandial glucose to excess HbA(1c) does not differ significantly ( approximately 1.5%) with varying glycaemic control.
There appears to be a shift in diurnal variation in glucose homeostasis and pancreatic B-cell function. Subjects had decreased glucose tolerance in response to the first and third meal of the day irrespective of glycaemic control. The variability in glucose tolerance was reflected by both quantitative and qualitative dysfunction of the pancreatic B-cell.
Introduction: Lipid and thyroid function abnormalities are common in IDDM and NIDDM. Very few studies have addressed this issue in Bangladesh though Bangladeshi population is very much susceptible to patient with diabetes. Aims: To study on lipid profile and thyroid function in IDDM and NIDDM and the effect of glycemic control on it. Patients and Methods: This was a retrospective study carried out in the Dept. of Endocrinology, BIRDEM, Dhaka, Bangladesh during the period of January, 2012 to May, 2012. In this study, population consisted of 120 subjects (Age between 40-72 years; and Sex matched) divided into two groups: patient with diabetes 60 subjects (male-30, female-30) and patient without diabetes 60 subjects (male-30, female-30). Plasma glucose, HbA1c and serum lipids were measured by enzymatic method. Thyroid hormones were measured by a Chemiluminescent Micro particle Immunoassay (CMIA). Results: The statistical significance was evaluated by Student's t-test, Correlation-Coefficient test. All Values are given as mean ± SD. The level of serum TSH in patient with diabetes (3.43 ± 2.71) was significantly (p < 0.05) increased compared to patient without diabetes subjects (1.98 ± 1.72). TSH levels were positively correlated with fasting plasma glucose (r = 0.240, p < 0.05), serum cholesterol (r = 0.290, p < 0.020) and triglyceride concentration (r = 0.246, p < 0.05). On the other hand, free T 4 levels were inversely correlated with postprandial blood glucose (r = −0.256, p < 0.046). Conclusions: It may be concluded that the lipid and thyroid function abnormalities with others socio-demographic and biophysical risk factors were more common in patient with diabetes cases rather than patient without diabetes cases. Therefore, further prospective studies with larger number of patients are required to strengthen the observations of the present study.
BackgroundHere, we report the phase distribution of chronic myeloid leukemia (CML), defined based on the World Health Organization criteria, among 63 patients in Bangladesh. All patients were diagnosed based on complete blood count, bone marrow examination including bone marrow aspiration and reverse-transcriptase polymerase chain reaction (RT-PCR). Out of 63 patients, 42 were male and 21 were female. The mean age of the subjects was 37.4 years, with an age range of 17-60 years. The majority of patients (86%) were classified in the chronic phase (CP), 7 (11%) in the accelerated phase (AP) and two (3%) in blast crisis (BC). The most frequent patient age ranges were 21-30 years for CP, 41-50 years for AP and 41-50 years for BC.ResultsThe Philadelphia chromosome was detected in 48 patients by RT-PCR. The mean total leukocyte counts, platelet counts, hemoglobin levels and marrow blast frequencies were 101 × 109/L, 409 × 109/L, 12.2 g/dl and 2.8% for CP; 121 × 109/L, 418 × 109/L, 8.7 g/dl and 15% for AP and 311 × 109/L, 396 × 109/L, 9.2 g/dl and 26% for BC, respectively.ConclusionThis study concluded that most CML patients in Bangladesh are from a younger age group (31-40 years). In addition, males were more commonly affected, although females were afflicted with this disease at a younger age.
BackgroundAegle marmelos is a popular fruit plant in the Indian subcontinent, various parts of which are traditionally used against various illnesses including diabetes mellitus (DM). However, the underlying mechanisms of the antidiabetic effects of the plant are not clear, especially in type 2 DM. The present study was undertaken to investigate the effect of aqueous extracts of A. marmelos fruits (AMFE) and leaves (AMLE) on glycemic, lipidemic, insulinemic, insulin resistance and β-cell functional status of type 2 diabetic model rats. Methods An interventional study was designed using 20 type 2 diabetic rats. Type 2 DM was induced in Long Evans rats by a single intra-peritoneal injection of streptozotocin (90 mg/kg body weight) to 48 h old pups. Three months after induction of diabetes, the rats were divided into three independent groups: water-treated control group (n=6), AMLE-treated group (n=7) and AMFE-treated group (n=7). The rats were fed with extracts or water for 21 consecutive days and blood samples were collected at days 0 and 21 after an overnight fast. Data were expressed as mean±SD and analyzed by paired t-test or ANOVA as appropriate. Results There were significantly lower blood glucose values in AMLE and AMFE groups at Endpoint compared to Baseline (mmol/l, mean±SD, Baseline vs. Endpoint, 7.04±1.0 vs. 6.06±0.92; p=0.032 and 7.04±0.97 vs. 5.87±0.93; p=0.047). There were also significantly lower serum insulin levels in AMLE and AMFE groups at Endpoint compared to Baseline (µIU/mL, mean±SD, Baseline vs. Endpoint, 14.02±5.48 vs. 7.57±2.90; p=0.026 and 11.54±4.83 vs. 6.58±4.36; p=0.008). Insulin resistance (HOMA-IR) was significantly improved both in AMLE and AMFE groups at Endpoint compared to Baseline (mean±SD, Baseline vs. Endpoint, 4.22±1.68 vs. 2.05±0.90; p=0.021 and 3.69±1.79 vs. 1.69±1.61; p=0.013). However, β-cell function or lipid profile did not show any significant alteration at Endpoint compared to Baseline in AMLE and AMFE groups. Conclusions Aqueous extracts of A. marmelos leaf and fruit have hypoglycemic property which seem to be mediated by lowering of insulin resistance. These findings highlight the therapeutic potential of the extracts of A. marmelos in human type 2 DM and provides strong impetus for further studies.
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