Islet autoimmunity status in Asians with young-onset diabetes (12-40 years): Association with clinical characteristics, beta cell function and cardio-metabolic risk factors

10.1016/j.diabres.2007.12.003Diabetes Research and Clinical Practice802224-23

The Effects of Short-term, Rapid Glycemic Control on the Peroneal Nerve Function and Serum VCAM-1 and AGE in Type 2 Diabetic Patients in Malaysia

Background : The role of endothelial injury and circulating adhesion molecule in the development and progression of diabetic peripheral neuropathy in the long-term has been established previously. Aims:0 To study the effects of short-term glycemic control using insulin and oral hypoglycemic agent therapy (OHA) on the peroneal nerve function and vascular cell adhesion molecule-1 (VCAM-1) and advanced glycation endproducts (AGE) levels in type 2 diabetic patients. Settings and Design : A randomized controlled study involving poorly controlled (HbA1c, 7.5%-11%) type 2 diabetic patients attending the endocrinology outpatient center in a tertiary hospital in Kuala Lumpur. Materials and Methods Twenty-nine patients were randomized to receive insulin (n=15) or OHA (n=14) for 8 weeks. The glycemic variables (HbA1c, fasting plasma glucose [FPG], fructosamine), VCAM-1, serum AGE and the peroneal motor conduction velocity (PMCV) were measured at baseline and at 4-week intervals. Statistical Analysis Used : Paired ′t′ test or Kruskal Wallis test; and the unpaired ′t′ test or Mann-Whitney U test were used for within-group and between-group analyses, respectively. Correlation was analyzed using Spearman′s correlation coefficient. Results : Within-group analysis showed significant progressive improvement in HbA1c at weeks 4 and 8 in the insulin group. The PMCV improved significantly in both groups by week 8, and by week 4 (P = 0.01) in the insulin group. PMCV correlated negatively with VCAM-1 (P = 0.031) and AGE (P = 0.009) at week 8. Conclusion : Aggressive glycemic control with insulin improves the peroneal nerve function within 4 weeks. Improvement in the serum VCAM-1 and AGE levels correlated significantly with improvement in peroneal nerve conduction velocity only in the insulin group

Ethnicity and glycaemic control are major determinants of diabetic dyslipidaemia in Malaysia

Aims To define the prevalence of dyslipidaemia in young diabetic patients in Peninsular Malaysia and the contributory factors of dyslipidaemia in these subjects. Methods This is a cross-sectional study involving 848 young diabetic patients from seven different centres, with representation from the three main ethnic groups. Clinical history and physical examination was done and blood taken for HbA(1c), fasting glucose, total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol and triglycerides. Results The overall lipids were suboptimal, worse in Type 2 diabetes mellitus (DM) patients compared with Type 1 DM patients. Of the Type 2 patients, 73.2 had total cholesterol > 5.20 mmol/l, 90.9 had LDL-cholesterol > 2.60 mmol/l, 52.6 had HDL-cholesterol 2.30 mmol/l. There were ethnic differences in the lipid levels with the Malays having the highest total cholesterol (mean 6.19 mmol/l), and the highest LDL-cholesterol (mean 4.16 mmol/l), while the Chinese had the highest HDL-cholesterol (geometric mean 1.24 mmol/l). Ethnicity was an important determinant of total, LDL- and HDL-cholesterol in Type 2 DM, and LDL- and HDL-cholesterol and triglycerides in Type 1 DM. Glycaemic control was an important determinant of total, LDL-cholesterol and triglycerides in both Type 1 and Type 2 DM. Waist-hip ratio (WHR) was an important determinant of HDL-cholesterol and triglycerides in both types of DM. Gender was an important determinant of HDL-cholesterol in Type 2 DM, but not in Type 1 DM. Socioeconomic factors and diabetes care facilities did not have any effect on the dyslipidaemia. Conclusions The prevalence of dyslipidaemia was high especially in Type 2 DM patients. Ethnicity, glycaemic control, WHR, and gender were important determinants of dyslipidaemia in young diabetic patients

Selenium dan fungsi tiroid

Pengukuran selenium dan fungsi tiroid telah dilakukan terhadap 442 orang penduduk di lima buah kampung orang Asli di pedalaman Pahang dan Perak. Pengukuran isipadu kelenjar tiroid ditentukan menggunakan alat ultrasound. Serum diambil bagi pengukuran selenium, TSH dan T4 manakala sampel urin dikumpul bagi pengukuran iodin. Min paras selenium adalah 4.082 ± 1.922 ppm (Julat 0.244 - 9.030 ppm). Kajian menunjukkan terdapat perbezaan yang bererti di antara paras selenium kanak-kanak dan dewasa (p<0.0001) dan di antara remaja dan dewasa (p<0.05). Perbezaan paras selenium adalah bererti (p < 0.0001) di antara lima kampung tersebut iaitu Pos Tual (5.638 + 0.332 ppm), Pos Legap (4.545 + 1.794 ppm), Pos Perwor (4.412 + 1.180 ppm), Pos Sinderut ( 3.910 + 2.082 ppm) dan Pos Bertang (0.890 + 0.331 ppm). Perbezaan yang bererti didapati antara isipadu goiter (p<0.0001) dan T4 (p<0.0001) menurut umur. Korelasi yang bererti juga terdapat di antara selenium dengan isipadu tiroid (Korelasi Pearson, r= ­0.1664, p=0.0051) dan selenium dengan T4 (Korelasi Pearson r=0.1789, p=0.0027). Ini menunjukkan kekurangan selenium berkorelasi dengan peningkatan isipadu kelenjar tiroid dan kekurangan hormon tiroksin

Metabolic, immunological and clinical characteristics in newly diagnosed Asian diabetes patients aged 12-40 years

Diabetic Medicine2191007-1013DIME