Comparison of Protein-C levels in diabetes melitus type 2 patients with and without ulcers at Haji Adam Malik Hospital Medan Indonesia May-July 2017

Abstract

Introduction People with diabetes mellitus (DM) have an increased risk for thrombosis compared with non-diabetic patients. Several studies showed contradicting in data on levels of protein C in people with type 2 DM and diabetic ulcers.Methods This is a descriptive and analytical cross-sectional study on protein C concentration of patients with type 2 DM with and without foot ulcers. The control group was the type 2 DM patients without foot ulcers, whereas the case group was the type 2 DM patients with a rigid diabetic foot ulcer based on the Wagner criteria. Blood samples are then taken after 8 to 10 hours of fasting to check for protein C concentration and hemostasis examination including platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), fibrinogen levels, and D-dimers.Results Of a total of 20 samples, there was no statistically significant difference in protein C levels of diabetic foot ulcers with hypercoagulation compared with no diabetic foot ulcers with hypocoagulation and no significant correlation between grade diabetic foot ulcers and protein C concentration.

Autoimmune Hemolytic Anemia (AHA) with hyperglycemia in a 22-year-old woman: a case report

“…2 Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood glucose levels, which over time, causes serious damage to the heart, blood vessels, eyes, kidneys, and nerves. 3 According to the American Diabetes Association Diabetes (ADA), DM can be diagnosed based on blood glucose criteria, either fasting blood glucose (FBG) 126 mg/dL or glucose values blood 2 hours (2hPBG) after the oral glucose tolerance test (OGTT) 75 g 200 mg/dL, or based on the A1C criteria 6.5%. 4 DM can be classified into the following categories: 1) Type 1 DM (due to damage to beta cells) (ß) autoimmune, usually leading to absolute insulin deficiency, including latent autoimmune diabetes in adulthood); 2) Type 2 DM (due to progressive loss of cell insulin secretion with insulin resistance); 3) Type-specific DM due to other causes, e.g., monogenic DM syndrome (such as neonatal diabetes and early-onset diabetes), diseases of the exocrine pancreas (such as cystic fibrosis and pancreatitis), and diabetes caused by drugs or chemicals (such as with the use of glucocorticoids, in the treatment of HIV/ AIDS, or after organ transplantation); and 4) Gestational diabetes (diabetes diagnosed in the second or third trimester of pregnancy, where the history of DM before pregnancy is unknown).…”

“…4 DM can be classified into the following categories: 1) Type 1 DM (due to damage to beta cells) (ß) autoimmune, usually leading to absolute insulin deficiency, including latent autoimmune diabetes in adulthood); 2) Type 2 DM (due to progressive loss of cell insulin secretion with insulin resistance); 3) Type-specific DM due to other causes, e.g., monogenic DM syndrome (such as neonatal diabetes and early-onset diabetes), diseases of the exocrine pancreas (such as cystic fibrosis and pancreatitis), and diabetes caused by drugs or chemicals (such as with the use of glucocorticoids, in the treatment of HIV/ AIDS, or after organ transplantation); and 4) Gestational diabetes (diabetes diagnosed in the second or third trimester of pregnancy, where the history of DM before pregnancy is unknown). 3,4 In this paper, we will discuss a case of DM at a young age with normal to high C-peptide, which indicated a young DM patient with good insulin production in the presence of a rapid erythrocyte turnover condition due to AIHA so that HbA1c level was false low.…”