Deepa, P (2015) Evaluation of Serum 25 Hydroxy Vitamin D in Type 2 Diabetes Mellitus Patients With and Without Nephropathy. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Diabetes Mellitus (DM) is a metabolic disease of carbohydrate metabolism resulting in hyperglycemia mainly due to absolute or relative deficiency of insulin secretion and or its action. As the global effect of Diabetes constantly intensifies, there is a need for intervention to slow down the progression of disease and to achieve metabolic control. AIM AND OBJECTIVES: 1. To assess the levels of serum 25-hydroxy vitamin D in patients with Type 2 Diabetes Mellitus with and without Diabetic Nephropathy. 2. To correlate the levels of serum 25- hydroxy vitamin D, with urine microalbumin and serum creatinine in patients with Diabetic Nephropathy. 3. To assess the role of vitamin D insufficiency Versus vitamin D deficiency in facilitating the progression of Diabetic Nephropathy. MATERIALS AND METHODS: The present study on the serum 25(OH) D in patients with Type2 DM with and without Nephropathy is a case-control investigation, carried at Diabetology Outpatient clinic in Rajiv Gandhi Government General Hospital, Chennai. This work was conducted after obtaining Institutional Ethical Committee clearance. The Study group included total number of 90 known diabetics of more than 5 years duration, of which the control group were Type 2 DM patients without nephropathy and the case group were patients with Diabetic Nephropathy. The control group were 45, out of which 22 were males and 23 were females, the case group were 45, out of which 24 were males and 21 were females. Inclusion criteria: Diabetics were diagnosed by ADA (American Diabetes Association) criteria. Any one of the following is diagnostic A. Glucose: 1. Fasting Plasma Glucose (FPG) ≥ 126mg/dL (7.0mmol/ L) (or), 2. Hyperglycemia symptoms and Random Plasma glucose levels ≥200mg/dL( 11.1mmol/L) (or), 3. 2 hour Plasma glucose ≥200mg/dL( 11.1mmol/L). B. Hemoglobin A1C (HbA1C): HbA1C ≥6.5% Exclusion criteria: 1. Liver failure patients, 2. vitamin D deficiency patients, 3. Type 1 diabetes mellitus patients with and without nephropathy, 4. Parathyroid disorders, 5. Patients with diabetic nephropathy with other coexisting disease like obstructive uropathy, chronic glomerulonephritis, 6. Patients having malabsorption syndrome, 7. Patients on drugs like barbiturates,phenytoin,Rifampicin,calcium, vitamin D 8. Pregnant and lactating mothers. RESULTS: In the present study, in total number of 90 patients, 45 patients with Type 2 DM patients without nephropathy (controls) and 45 patients with diabetic nephropathy (cases) were investigated. The mean and standard deviation of the age of the cases and controls were 58.82 ±5.11 and 56.71±7.11, respectively. There was no statistical difference in the age between cases and controls (p = 0.110). Thus the study included age matched cases and controls as subjects. CONCLUSION: 1. Serum 25(OH)vitamin D is decreased in diabetic nephropathy(Vitamin D deficiency) and in type 2 Diabetes Mellitus without nephropathy patients(Vitamin D insufficiency). 2. The association between 25(OH)D and UACR is independent of the individuals age, gender and duration of diabetes. 3. When a diabetic patient progresses from Normoalbuminuria to Microalbuminuria, vitamin D levels decrease significantly. 4. Renal impairment in diabetics is associated with significant vitamin D deficiency.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Serum 25 Hydroxy Vitamin D ; Type 2 Diabetes Mellitus Patients ; With and Without Nephropathy. |
| Subjects: | MEDICAL > Biochemistry |
| Depositing User: | Punitha K |
| Date Deposited: | 06 May 2018 15:03 |
| Last Modified: | 06 May 2018 16:41 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7548 |
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