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Article
Seasonal variation of glycated hemoglobin A1c% among diabetic patients in Mosul

Authors: Omar A. Jarjees عمر اكرم جرجيس --- Nabeel N. Fadhil نبيل نجيب فاضل
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2009 Volume: 35 Issue: 1 Pages: 42-49
Publisher: Mosul University جامعة الموصل

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Abstract

Objective: To determine the seasonal variation of glycemic level among diabetic patients in Mosul, and to define the seasons where blood glucose may surge or decline. Patients and methods: An observational retrospective case series study of seven hundred HbA1c% results pertaining to 653 randomly enrolled type 2 (96%), and type 1 (4%) diabetic patients which were collected over 28 consecutive months. The HbA1c% mean of each month separately, and the HbA1c% means of the months whose HbA1c reflects the glycemic control of the preceding season were estimated, plotted, and statistically compared.Results: The monthly HbA1c% means throughout the study period comprised a sinusoidal curve with higher values between early spring (March) to early summer (June) and lower values between early autumn (September) to early winter (January) of each year. Throughout the study period, the mean HbA1c% of all early springs (8.87% ± 1.57% SD) was the maximal, while the mean HbA1c% of all early autumns (7.81% ± 0.94% SD) was the minimal. Conclusion: Glycemic levels among diabetic patients in Mosul, as reflected by early spring's peak, and early autumn's trough of HbA1c%, are highest during winter and lowest during summer.

الخلاصةهــدف البحث: يهدف هذا البحث إلى بيان تأثير الفصول على مستوى كلوكوز الدم لدى السكريين في الموصل وتعيين الفصول التي قد يرتفع فيها مستوى كلوكوز الدم أو ينخفض. طريقة البحث: اشتملت هذه الدراسة على 700 فحص مختبري لنسبة خضاب الدم الكلوكوزي تعود لـ 653 مريض سكري عشوائي الاختيار من النمط 2 و1 خلال 28 شهراً متتابعاً. ولقد تم حساب معدل نسبة خضاب الدم الكلوكوزي لكل شهر من أشهر فترة البحث على حده، وللأشهر التي يمثل معدل خضاب الدم الكلوكوزي فيها مستوى سكر الدم خلال الفصول السابقة لها. كما تمت جدولة النتائج ومقارنتها إحصائيا.النتائــــج: شكلت المعدلات الشهرية لنسبة خضاب الدم الكلوكوزي منحنىً جيبياً يرتفع ما بين بداية الربيع (آذار) وبداية الصيف (تموز)، وينخفض ما بين بداية الخريف (آب) وبداية الشتاء (كانون ثاني) من كل عام. وكان معدل نسبة خضاب الدم الكلوكوزي لبدايات الربيع كلها (8,87% ± 1,57) هو الأعلى خلال فترة البحث، فيما كان معدل نسبة خضاب الدم الكلوكوزي لبدايات الخريف كلها (7,81% ±0,94) هو الأوطأ. الاستنتاج: إن مستوى سكر الدم لدى السكريين في الموصل، كما يعكسه ارتفاع نسبة معدلات خضاب الدم الكلوكوزي في بدايات الربيع وانخفاضه في بدايات الخريف، يبلغ مستواه الأعلى في فصل الشتاء والأوطأ في فصل الصيف.


Article
HbA1c in Patients with Diabetic Foot: A Prognostic Index

Author: Hasanain Hashim Al-Yasiri
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 2 Pages: 204-208
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Diabetes mellitus (DM) is a common worldwide disease; which if poorly controlled, would be associated with high risk of complications, and diabetic foot is one of them.Glycated hemoglobin A1c (HbA1c) is an important control index of DM, and nowadays it is used as a diagnostic test.OBJECTIVE:To assess the benefit of HbA1c as a prognostic index in patients presented with diabetic foot.PATIENTS AND METHODS:This study included 176 patients presented to Al-Hilla Teaching Hospital with diabetic foot during a period of 38 months from 1st March 2007 to 1st May 2010.HbA1c was measured for all patients at time of enrollment which is mostly day of presentation. Level of 8 was considered a separation control point between good and bad control, and patients were classified into two groups; good control group (GCG) where HbA1c levels < 8, and bad control group (BCG) where levels ≥ 8.The end points for the study were determined as death, amputation, surgical wound excision without amputation, improvement on medical treatment only. Death and amputation were considered bad prognosis group (BPG), while others were considered good prognosis group (GPG).Statistical analysis was done using means, independent t-test and F-test.RESULTS:One hundred seventy six patients were studied with age range of 35-76 years, 60.15% (107/176) of them were males.At the end of follow up; 47.7% (84/176) of patients were found in BPG and 52.3% (92/176) in GPG as the following: death (11 patients), amputation (73 patients), wound excision without amputation (52 patients) and medical treatment only (40 patients); while 64.2% (113/176) of patients were found in BCG (HbA1c ≥ 8) and 35.8% (63/176) in GCG (HbA1c ˂ 8).61.1% (69/113) of BCG patients had bad prognosis; whereas only 23.8% (15/63) of GCG patients had bad prognosis, a statistically significant difference (P-value 0.001);Higher HbA1c levels were seen in patients with bad prognosis as mean HbA1c was 8.97 in BPG and 7.79 in GPG; a difference that is statistically significant (P-value ˂ 0.001)CONCLUSION:HbA1c is a significant prognostic index in patients presented with diabetic foot. Levels greater than 8 were associated with poor prognosis and longer hospitalization. So; diabetic control is a very important factor in preventing and alleviating diabetic complication


Article
IL-6 and Type 2 Diabetes

Author: Maha F.Almelan* VM, MSc د. مها فضيل
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 4 Pages: 407-410
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:Background: Interleukin -6 (IL-6) as the key mediator of the acute phase reaction is of interest .elevated protein concentrations of IL-6 in the blood have been shown in patients with type 2 diabetes. This study aimed to investigate the association of IL-6 and type 2 diabetes.Materials and Methods: Blood samples were collected from 40 patients with type 2 diabetes and 40 person apparently healthy control were examined for IL-6 level by Enzyme Linked Immune Sorbent Assay. HbA1c determined by high pressure liquid chromatography .total cholesterol, HDL cholesterol and triglyceride were determined enzymatically. Other risk factors study like age, sex and BMI. Results: results shows that IL-6 was higher in patients than in control (p<0.006) and there is significant increase in triglyceride. HbA1c shows high levels in diabetic patients (mean 6.855±1.57%) than the healthy control (mean 4.650±o.673) and when comparing the three diabetic BMI groups with healthy control a significant higher serum IL-6 level was found p=0.008 in over weight group .Conclusion: there is a significant elevation in serum IL-6 in type 2 diabetics when compared to healthy controls and there is a significant elevation of IL-6 in over weight.Key words: Interleukin -6, Type 2 Diabetes, Hemoglobin A1c, Body Mass Index.


Article
Impact of Sleep Quality on Glycemic Control in Type 2 Diabetes Mellitus

Author: Ameer Kadhim Al‑Humairi, Nawar Kadhim Hassan
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2018 Volume: 15 Issue: 4 Pages: 369-375
Publisher: Babylon University جامعة بابل

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Abstract

Background: Glycemic control is important to reduce the risk of micro ‑ vascular problems among patients with diabetes mellitus. Sleeplimitation leads to increase Hemoglobin A1C (HbA1c) levels; though, slight is known regarding the metabolic impacts of usual sleep limitation.The current study was a hospital‑based cross‑sectional study which performed to evaluate the association between habitual sleep quality withglycemic control and HbA1c fluctuations among contributors in the medical merjan city among Type 2 diabetics. Objectives: The purpose ofcurrent study is to assess sleep quality among Type 2 diabetic patients and to consider the influence of sleep value on glycemic control amongthose patients in Al‑Hilla City. Methods: Our study was “descriptive cross sectional study” to assess the sleep quality using Pittsburgh SleepQuality Index by filling out the questionnaire formats which designed for usage of the study. This study include a “convenient sample” of150 Type 2 diabetic patients who visit the specialist day clinic in diabetic center of merjan medical hospital between the 25th of February tothe end of June, 2018. Verbal approval was attained from each Type 2 diabetic patient, data collection was done through the interviewing ofcontributors by use of structural questionnaire. Results: The mean age of diabetic patients was (53.20 ± 13.53), Male represents (42.7%) andfemale represents (57.3%). Poor sleep quality represent (35.3%). There was a significant increase in level of HbA1c and random blood sugaramong patients with Type 2 diabetics with poor sleep quality and significant decrease of cholesterol and triglycerides levels with increaseduration of diabetes mellitus. Conclusions: Poor sleep was common among diabetic patients. There is close association between sleep qualityand glycemic control, as well as short sleepers have an increased occurrence of diabetes.


Article
Effect of thyroid dysfunction on hemoglobin A1c in polycystic ovary patients during ovulation induction trials
تاثير اضطرابات الغدة الدرقية على هيموغلوبين اي وان سي في مرضى متلازمة تكيس المبايض خلال محاولات تحفيز المبايض.

Authors: Abdulaali H. Salman عبد العال حسن --- Hanan L. Sudek حنان لؤي --- Hiba S. Mahdi هبه صباح مهدي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2014 Volume: 56 Issue: 2 Pages: 211-215
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders leading to infertility. Majority of women with PCOS have insulin resistance and elevated hemoglobin A1c.The presence of thyroid dysfunction may affect the levels of HbA1c and the results of ovulation induction programs. Objectives: To evaluate the level of serum hemoglobin A1c according to the type of thyroid dysfunction in polycystic ovary patients during ovarian stimulation trials. Patients and Methods: Eighty three polycystic ovary patients were enrolled in this study, attending the infertility clinic in Al-Yarmouk Teaching Hospital, in the period between November 2012 and May 2013. After thorough history and examination blood samples were withdrawn for the estimation of LH, FSH, testosterone, prolactin, TSH, T3, T4 and A1C in day 2 or 3 of the menstrual cycle, Progesterone was determined in day 21 of the cycle. Ultrasound was done also at cycle day 3 for antral follicles measurements. After diagnosing PCOS the patients were divided into 3 groups, euthyroid group (control), hypothyroid and hyperthyroid groups. Ovulation induction treatment was given and ultrasound was done at the day of hCG injection. Results: There was no significant difference between control and patients groups regarding age (26.31 ± 5.04 Vs 27.17 ± 5.76) and BMI (31.7 ± 5.69Vs 29.25 ± 6.28).HbA1c level was significantly different between the control and patients group with a significant positive correlation between HbA1c and TSH. In clomiphene citrate treated groups, Hb A1c level, the number of antral follicles and the size of follicles at day of hCG injection were not significantly different between the patients and control groups. Conclusions: HbA1c level is significantly affected by thyroid dysfunction in PCOS patients as it is higher in the Hypothyroid group and lower in the Hyperthyroid group. Using Clomiphene citrate in PCOS does not significantly increase the mean size of follicles after ovarian stimulation in patients with thyroid dysfunction from that in Euthyroid ones. Key word: Polycystic ovary syndrome, thyroid dysfunction, hemoglobin A1c, ovulation induction.

خلفية عن البحث:ان متلازمة تكيس المبايض هي من اكثر انواع اعتلال الغدد الصماء شيوعا التي تؤدي الى العقم. ان اغلب النساء المصابات بمتلازمه تكيس المبايض لديهن مقاومه لهرمون الانسولين وارتفاع نسبه هيموغلوبين اي ون سي .ان اضطرابات الغدة الدرقيه تؤثر على نسبه هيمموغلوبين اي ون سي وكذلك على نتيجه تحفيز المبايض الهدف:ان الهدف من هذه الدراسة هو لتقييم مستوى هيموغلوبين اي ون سي بحسب نوع الاضطراب بالغدة الدرقية في مرضى تكيس المبايض خلال محاولات تحفيز المبايض. الطرق والمواد: ثلاثة وثمانون مريضة مصابة بتكيس المبايض كانو قد ارتادوا عيادة العقم في مستشفى اليرموك التعليمي للفترة بين تشرين الاول عام 2012 وايار 2013. بعد اخذ المعلومات الطبية من المريضة والفحص السريري الكامل تسحب عينات دم من المرضى لقياس الهرمون اللوتيني ,الهرمون المحفز للبويضات ,هرمون الحليب ,هرمون التستوستيرون ,تحاليل الغدة وهرمون البروجستيرون في اليوم 21 من الدورة الشهرية.بالاضافة الى التحاليل الرئيسية وهي ال,PCV نسبه هيموغلوبين اي ون سي و نسبة السكر في الدم. ضهتخضع المريضة ايضا الى الفحص بالموجات فوق الصوتية في اليوم الثاني والثالث من الدورة الشهرية لقياس عدد وحجم البويضات.بعد تشخيص تكيس المبايض تقسم المريضات الى ثلاثة اقسام حسب عمل الغدة الدرقية الى مجموعة قياسية ومجموعةالمصابات بارتفاع عمل الغدة الدرقية والمصابات بانخفاض عمل الغدة الدرقيةثم تعطى المجاميع برامج لتحفيز المبايض ويعاد عمل الفحص بالسونار في يوم حقن ال اج سي جي لتحديد حجم البويضة الناضجة. النتائج: لايوجد اختلاف ذو دلالة احصائية بين مجموعة المرضى والمجموعة القياسية بالنسبة للعمر ووزن الجسم.اما هرمون اي ون سي فقد وجد ان له اختلافا ذو دلاله احصائية بين مجموعة المرضى والمجموعة القياسية وله علاقة ايجابية ذات دلالة احصائية مع الهرمون المحفز للغدة الدرقية لكل المرضى . اما بعد تحفيز المبايض بواسطة الكلوميد فلا يوجد اختلاف ذو دلاله احصائية بين المجموعة القياسية ومجموعة المرضى فيما يخص عدد البويضات في اليوم الثاني للدورة و حجم البويضات في يوم الحقن بال اج سي جي.الاستنتاج: ان مستوى هيموغلوبين اي ون سي يتاثر باختلال عمل الغده الدرقيه حيث يكون عاليا بدلاله احصائيه في المريضات المصابات بانخفاض عمل الغده الدرقيه ومنخفضا في المريضات المصابات بارتفاع عمل الغده الدرقيه . ان استعمال الكلوميد لا يؤثر على زيادة حجم البويضات في المريضات المصابات باختلال عمل الغدة الدرقية عن المجموعة القياسية. مفتاح الكلمات:متلازمة تكيس المبايض, اضطراب الغدة الدرقية,هيموغلوبين اي ون سي,تحفيز المبايض

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