Endocrinology, Diabetes, and Metabolism Commons^™

Self-Glucose Monitoring And Glycaemic Control At A Tertiary Care University Hospital, Karachi, Pakistan, Khurshid Khowaja, Humaira Waheed

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVE: To explore the association between Self Monitoring of Blood Glucose (SMBG) levels and improved glycemic control (HbA1c level) among type 2 diabetic patients, receiving oral hypoglycaemic agents and insulin, and to ascertain the factors influencing SMBG.

METHOD: Using Comparative cross sectional study design five hundred Type 2 diabetes patients through convenient sampling between 30-70 years were interviewed through a structured questionnaire in year 2006 and 2007 at AKUH Ambulatory setting. These 500 subjects were divided as 250 in case (doing SMBG) and 250 in control (not doing SMBG) groups.

RESULTS: We identified that HbA1c value was maintained at good …

Imminent Epidemic Of Diabetes Mellitus In Pakistan: Issues And Challenges For Health Care Providers, Waris Qidwai, Tabinda Ashfaq

Department of Family Medicine

No abstract provided.

Exercise And Type 2 Diabetes: The American College Of Sports Medicine And The American Diabetes Association: Joint Position Statement, Sheri R. Colberg, Ronald J. Sigal, Bo Fernhall, Judith G. Regensteiner, Bryan J. Blissmer, Richard R. Rubin, Lisa Chasen-Taber, Ann L. Albrigjht, Barry Braun

Human Movement Studies & Special Education Faculty Publications

Although physical activity (PA) is a key element in the prevention and management of type 2 diabetes, many with this chronic disease do not become or remain regularly active. High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently, but it is now well established that participation in regular PA improves blood glucose control and can prevent or delay type 2 diabetes, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Structured interventions combining PA and modest weight loss have been shown to lower type 2 diabetes risk by up …

A Doppler-Based Evaluation Of Peripheral Lower Limb Arterial Insufficiency In Diabetes Mellitus, Riffat Shaheen, Saba Sohail

Department of Radiology

Objective: To determine the frequency, level and flow patterns of lower limb arterial insufficiency in diabetic patients on Doppler ultrasound study.
Study Design: Cross-sectional study.
Place and Duration of Study: Radiology Department, Civil Hospital, Karachi, from February 2007 to September 2008.
Methodology: One hundred adult diabetic patients with suspected peripheral vascular insufficiency irrespective of gender were included. Demographic data, presenting complaints, treatment history, and level of HbA1c were recorded. Doppler evaluated arterial status and ankle brachial index (ABI) were recorded on proforma. Statical analysis were done on SPSS version 12.
Results: The mean HbA1c was 8.4 ± 1.4gm/dl, a majority …

Etiology, Functional Status And Short Term Outcome Of Patients With Pituitary Lesions. An Experience From A Developing Country, Osama Ishtiaq, Mansoor Ul Haq, Azra Rizwan, Mohammad Qamar Masood, Saeed Mehar, Abdul Jabbar

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVE: To describe the etiology, functional status and short term outcome of patients with pituitary lesions (PL).

METHODS: Brain or pituitary MRI reports of 3753 patients were analyzed for PL over the period of 2000 to 2007, done at the Aga Khan University Hospital (AKUH), Karachi, Pakistan. MRIs with reported PL and all those ordered by Endocrinologists with or without pituitary abnormalities, were included in the analysis. This made a total of 338 (9%) MRI reports. PL were defined as pituitary tumors, cysts, haemorrhage, hypoplasia; and empty sella. Patients with these PL, were analyzed for symptoms, hormonal profile and short …

Fight Against Chronic Diseases (High Blood Pressure, Stroke, Diabetes And Cancer) In Pakistan; Cost-Effective Interventions, Mohammad Wasay, Abdul Jabbar

Department of Medicine

No abstract provided.

Vitamin D Deficiency In Ambulatory Patients, Lubna M Zuberi, Aysha Habib, Naeemul Haque, Abdul Jabbar

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVE: To determine the frequency of subclinical vitamin D deficiency in an ambulatory care setting.

METHODS: This was an observational study which measured 25 vitamin D levels in medical clinic patients. Patients with chronic renal failure, known osteomalacia and rickets were excluded. A total of 119 patients were evaluated. They were divided in three diagnostic categories based on their serum 25 vitamin D levels. Those with levels below 8 ng/ml were categorized to have severe deficiency, levels between 8 - 20 ng/ml as moderate deficiency and levels of 21-35 mg/ml as mild deficiency.

RESULTS: Of 119 patients, 92% had vitamin …

Hyponatraemia: Etiology, Management And Outcome, Aasima Yawar, Abdul Jabbar, Naeem Ul Haque, Lubna M Zuberi, Najmul Islam, Jaweed Akhtar

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVE: To determine the etiology of hyponatraemia, the treatment instituted and the outcome of treatment in a tertiary care hospital setting.

STUDY DESIGN: Case series.PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, between January and June 2004.

METHODOLOGY: Case records of 220 patients admitted to the medical service were identified through computerized hospital patients' data. All patients (3) 15 years with a sodium level on admission of (2) 130 mmol/litre were included. The records of those patients were reviewed for relevant demographic, clinical and laboratory data, in addition to the diagnosis, treatment and outcome of hospitalization. The …

Does Choice Of Therapy Save Costs And Improve Outcomes In Hyperthyroid Patients, Lubna M Zuberi, Safia Awan, Najmul Islam, J. Akhter, Abdul Jabbar

Section of Internal Medicine

OBJECTIVE: To compare cost of treating hyperthyroidism with antithyroid medications (ATD) versus radioactive iodine (RAI). As secondary outcome we also analyzed data in terms of remission rates.

METHODS: This was a retrospective comparative analysis of hyperthyroid patients treated with ATD or RAI from January 2000 to December 2005. Cost of ATD, TSH. FT4, doctors visits; thyroid technetium scan and RAI treatment were calculated for the duration of treatment and for one year of follow-up after remission.

RESULTS: A total of 143 patients were included, with an average duration of follow-up of 32 months. Mean age was 41 +/- 15.5 years …

Vitamin B12 Deficiency Common In Primary Hypothyroidism, Abdul Jabbar, Aasma Yawar, Sabiha Waseem, Najmul Islam, Naeem Ul Haque, Lubna Zuberi, Ataullah Khan, J. Akhter

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVE: To assess the prevalence and clinical features of B12 deficiency in hypothyroid patients and to evaluate clinical response in symptoms to B12 replacement therapy.

METHODS: One hundred and sixteen hypothyroid patients from our endocrine clinic were evaluated for signs and symptoms of vitamin B12 deficiency. Laboratory parameters including Haemoglobin (Hb), MCV, Vitamin B12 levels and presence of anti thyroid antibodies were analyzed. Patients with low B12 levels were treated with parenteral intramuscular vitamin B12 monthly, and monitored for improvement of symptoms.

RESULTS: A total of 116 patients (95 females and 21 males) were evaluated. Forty six (39.6%) hypothyroid patients …

An Audit Of The Quality Of Care Indicators For The Management Of Diabetes In Family Practice Clinics In Karachi, Pakistan, Raheem H Dhanani, Mohammad Mustafa Qureshi, Ali Khan Khuwaja, Badar Sabir Ali, Riaz Qureshi

Department of Family Medicine

BACKGROUND: Management of diabetes is a painstaking and careful approach. This study was aimed to evaluate the quality of care for the management of diabetes provided by family practitioners to their patients having diabetes. This is a retrospective audit of medical records conducted in a tertiary care teaching hospital of private sector in Karachi for one month.

METHODS: For this study, 150 medical records of patients with type 2 diabetes that visited family practice clinics for their diabetes care were examined. A total of 88 patient's medical records were selected and analyzed who attended the studied clinics for at least …

Chromosomal Localization Of The Islet Neogenesis Associated Protein (Ingap) Gene In Syrian Hamster By Tyramide Signal Amplification-Fluorescence In Situ Hybridization (Tsa-Fish), Sallie A. Smith

Biological Sciences Theses & Dissertations

Diabetes mellitus is a group of conditions characterized by hyperglycemia due to an inability to produce or properly utilize insulin. The majority of cases fall into two categories, Type I and Type 2. Type I results from the autoimmune destruction of pancreatic β-cells of the islets. The beta cells are the exclusive source of insulin and the patient becomes entirely dependent on exogenous insulin to survive. Patients with Type 2 are distinguished by insulin resistance, a condition that develops due to the inability of the body to effectively use the insulin being produced. The β-cells gradually lose their ability to …

The Effects Of A 10-Week Exercise Program On Physiological Variables And Quality Of Life In Type 2 Diabetes, David Robb Holton

Human Movement Studies & Special Education Theses & Dissertations

The purpose of this study was to determine the interaction between psychological and physiological parameters before and after a 10-week, aerobic training study of sedentary diabetic individuals and sedentary controls. Tests measuring physiological parameters (interstitial NO, blood flow, lactate threshold, VO₂ peak and glycosylated hemoglobin) and a quality of life survey were completed before and after training. Nine previously sedentary diabetic (DE, diabetic exerciser) and 10 control sedentary subjects (CE, control exerciser) engaged in 10 weeks of supervised aerobic exercise. A non-training diabetic group (DS, diabetic sedentary, n=12) and a non-training control group (CS, control sedentary, n=I0) were also …

Autonomic Nervous System And Cholesterol Transport, Yuan-Line Hung

Loma Linda University Electronic Theses, Dissertations & Projects

The effect of autonomic nervous system on cholesterol transport is of clinical interest because the relationship between lipoprotein metabolism and atherogenesis is expressed in coronary artery disease.

Generally speaking, beta blockers increase serum VLDL level but decrease both HDL and HDL₂ cholesterol levels without affecting the LDL in humans. We are unaware of reports concerning the effects of metoprolol on lipoprotein metabolism nor comparison of the effects of metoprolol and propranolol in the unhandled rat model. In part I we employed the unhandled rats to compared the effects of these 2 drugs administered with the drinking water in order …

Insulin And Glucagon Responses To Dietary Protein In Diabetic And Nondiabetic Men, Monica L. Blomstedt

Loma Linda University Electronic Theses, Dissertations & Projects

Five men with non-insulin-dependent diabetes mellitus and fourteen nondiabetic men, were given test meals with soy protein, casein or additional carbohydrate in place of protein. Blood levels of insulin, glucagon, glucose and lipids were measured at fasting, one-half hour and two hours postprandial. To all meals, the nondiabetic subjects responded with a quick rise of the insulin level which decreased at two hours. In contrast, the diabetics showed a significantly lower insulin response at one-half hour (p < 0.05), but a tendency to higher levels at two hours. The same pattern was observed in the insulin to glucagon ratio. No significant difference between the meals was found in regard to insulin or glucagon responses, suggests that a sustained, although delayed postprandial insulin response, may be a precursor to the higher cholesterol and increased risk for cardiovascular disease among diabetics.

Magnesium, Copper And Zinc Concentrations In Blood From Children With Diabetes Mellitus, Linda Lowers Jenkins

Chemistry & Biochemistry Theses & Dissertations

Trace element levels in blood from diabetic children were investigated and compared to control children. Plasma, erythrocyte, mononuclear and polymorphonuclear cells were analyzed for magnesium, copper, and zinc content. Leukocyte separation was performed by density gradient centrifugation on Ficoll-Hypaque, followed by washing steps to remove platelet contamination and hypotonic lysis to remove red cell contamination. Polarized Zeeman-effect atomic absorption spectroscopy was used for trace metal analysis.

Decreased plasma magnesium levels were observed in the diabetic children. This finding is well documented and probably due to increased urinary magnesium loss from glycosuria. Lymphocyte magnesium levels in the diabetic children were also …

Oral Lichen Planus : A Clinical Study Of The Association With Diabetes Mellitus And Vascular Hypertension, Gordon M. Rick

Loma Linda University Electronic Theses, Dissertations & Projects

This investigation concerns the relationship of diabetes mellitus and vascular hypertension to oral lichen planus. Questionnaires were sent to 470 patients with oral lichen planus: 286 responded. Of these patients 103 were examined clinically, and 74 with current lesions were divided into ''keratotic'' and ''erosive'' categories. These patients underwent three-hour oral glucose tolerance tests; also, their asterial blood pressure was determined. In the survey group, diabetes was reported about three times more frequently by those with "erosive"; oral lichen planus than by those ''keratoic" lesions. The overall prevalence of diabetes was about two and one-half times greater than expected compared …