Praveen Kumar, V C (2023) A Clinical Biochemical Profile of Type 2 Diabetes in Women with Special Reference to Vitamin D Status in Obese and Non Obese Person. Masters thesis, Thanjavur Medical College, Thanjavur.
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Abstract
Introduction: Diabetes mellitus type II (DM II) is a condition that affects multiple body systems and has a rapidly rising prevalence. Therefore, it is essential to adequately manage DM II in order to prevent complications such diabetic nephropathy, peripheral neuropathy, and retinal. Among its many advantages, vitamin D helps regulate haemoglobin A1c (HbA1c). It improves insulin sensitivity and secretion. OBJECTIVES: 1. To study the clinical, biochemical profile of type 2 diabetic women. 2. To assess the vitamin D status in type2 diabetic obese and non-obese women. 3. To determine the influence of glycaemic status of a patient in vitamin D level. 4. To determine the correlation of duration of diabetes on vitamin D level. 5. To establish the relationship between anthropometric measurement with vitamin D levels. METHODOLOGY: 100 patients were selected according to inclusion and exclusion criteria and written informed consent was taken for their participation. Patient history in relation to the duration of type 2 diabetes was also taken. Patients were evaluated for anthropometric measures like height, weight, waist/hip ratio, glycaemic value, renal function test, urine routine and vitamin D levels. Vitamin D levels were correlated with the anthropometric measure and glycaemic control. All data were entered I to Microsoft excel analysed using SPSS version 16. RESULTS: The mean Age (years) among the subjects was 49.94 (± 6.69) years ranging from 38 to 64 years. The mean Weight (kg) among the subjects was 72.43 (± 8.06) kg, mean height in cm was 160.04 (± 4.23), mean BMI was 28.4 (± 3.79) kg/m2 Among the subjects, 90 (90%) had > 1 and 10 (10%) had < 1 Waist Hip ratio. The mean Duration of Diabetes (years) among Obese was 10.7 (± 3.99) which is higher by 2.66 and statistically significant compared to 8.04 (± 3.85) in Non-Obese. The mean Fasting Blood Sugar (mg/dl) among Obese was 248.42 (± 29.83) which is higher by 36.68 and statistically significant compared to 211.74 (± 19.77) in Non-Obese. The mean Post prandial blood sugar (mg/dl) among Obese was 296.42 (± 41.52) which is higher by 48.28 and statistically significant compared to 248.14 (± 21.36) in Non-Obese. The mean Total Cholesterol (mg/dl) among Obese was 233.52 (± 16) which is higher by 14.86 and statistically significant compared to 218.66 (± 12.84) in Non-Obese. The mean Blood Urea (mg/dl) among Obese was 43 (± 5.86) which is higher by 3.7 and statistically significant compared to 39.3 (± 6.73) in Non-Obese. The mean Serum Vitamin D (ng/ml) among Obese was 24.21 (± 3.83) which is lower by 7.17 and statistically significant compared to 31.38 (± 2.53) in Non-Obese. Comparing the Vitamin D level with Obesity distribution, Obese group had higher proportion of Inadequate Vitamin D level with 78% followed by Deficient Vitamin D level with 22% and least in Adequate Vitamin D level with 0% compared to Non-Obese group which had higher proportion of Adequate Vitamin D level with 72% followed by Inadequate Vitamin D level with 28% and least in Deficient Vitamin D level with 0%. The difference in Vitamin D level distribution between Obese and Non-Obese was statistically significant (p < 0.05). The mean Duration of Diabetes (years) among Deficient Vitamin D level was 13.64 which is higher than mean among Inadequate Vitamin D level which was 10.45 followed by Adequate Vitamin D level with a mean of 6.47 and the difference was statistically significant (p < 0.05). The mean Fasting Blood Sugar (mg/dl) among Deficient Vitamin D level was 287.64 which is higher than mean among Inadequate Vitamin D level which was 232.36 followed by Adequate Vitamin D level with a mean of 209.14 and the difference was statistically significant (p < 0.05). The mean Post prandial blood sugar (mg/dl) among Deficient Vitamin D level was 344.55 which is higher than mean among Inadequate Vitamin D level which was 276.25 followed by Adequate Vitamin D level with a mean of 244.36 and the difference was statistically significant (p < 0.05). The mean Total Cholesterol (mg/dl) among Deficient Vitamin D level was 250.55 which is higher than mean among Inadequate Vitamin D level which was 227.75 followed by Adequate Vitamin D level with a mean of 216.17 and the difference was statistically significant (p < 0.05). The mean Blood Urea (mg/dl) among Deficient Vitamin D level was 46.27 which is higher than mean among Inadequate Vitamin D level which was 42.32 followed by Adequate Vitamin D level with a mean of 37.86 and the difference was statistically significant (p < 0.05). The model with these predictors explains 78.53% variability (predictability) of Serum Vitamin D (ng/ml). Serum Vitamin D (ng/ml) decreases -0.03 times for each unit increase in Post prandial blood sugar (mg/dl) and is statistically significant. Serum Vitamin D (ng/ml) decreases -0.04 times for each unit increase in Total Cholesterol (mg/dl) and is statistically significant. Serum Vitamin D (ng/ml) decreases -0.09 times for each unit increase in Blood Urea (mg/dl) and is statistically significant. Serum Vitamin D (ng/ml) decreases -0.3 times for each unit increase in Duration of Diabetes (years) and is statistically significant. Serum Vitamin D (ng/ml) decreases -0.46 times for each unit increase in BMI (kg/m2) and is statistically significant. CONCLUSION: There is a high prevalence of hypo-vitaminosis D among patients with type-2 diabetes, particularly among patients with poor glycaemic control and in those with longer diabetes durations. Therefore, every diabetes patient needs lifestyle changes, prompt glycaemic management, and early vitamin D treatment.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.200120102511 |
| Uncontrolled Keywords: | Type II Diabetes Mellitus, Vitamin D, Obese. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 15 May 2021 13:07 |
| Last Modified: | 24 Mar 2024 02:48 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/16775 |
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