Jesmin Akter

Pattern and predictors of dyslipidemia in patients with type 2 diabetes mellitus

Dyslipidemia is a major risk factor for macro-vascular complications in patients with type 2 diabetes mellitus (T2DM). Present study explored pattern and predictors of dyslipidemia in Bangladeshi T2DM patients. The cross-sectional study is conducted among 366 consecutive eligible T2DM patients aged >30 years, BIRDEM diabetic hospital, during July-to-December 2010. Physical examination, diabetic profile, lipid profile and serum createnine was performed. Adjusted odds ratio and confidence limit were generated through binary logistic regression. Most frequent form (59.3%) of dyslipidemia is low HDL. Duration of T2DM is significantly correlated with TC (P<0.05), HDL (P<0.05) and LDL (P<0.05) in both male and female. Glycemic control in terms of HbA1c >7% appeared as predictor of dyslipidemia (P<0.01). Duration T2DM is associated with increased risk of having higher TC (P<0.05), LDL (P<0.05) and lower HDL (P<0.01) and does not seem to affect triglyceride (P>0.05). T2DM with comorbid hypertension seems to predict hyper tri-glyceridemia and lower HDL. Both TC-HDL ratio and LDL-HDL ratio appeared as good predictor of all four parameters of dyslipidemia (P<0.01). The characteristic features of diabetic dyslipidemia are low HDL, high triglyceride and LDL cholesterol level. Low HDL level is the most frequent type of abnormality. Poor glycemic control, prolonged duration, coexisting hypertension predicts dyslipidemia in T2DM.

Determinants of overweight and obesity among Bangladeshi diabetic women of reproductive age

BackgroundSeveral reproductive disorders with overweight and obesity are now known to be associated with insulin resistance. The study was aimed to assess the proportion and determinants of overweight and obesity among diabetic women of reproductive age.MethodsThis cross-sectional analytic study was conducted among 888 diabetic women of reproductive age attending the out-patient department (OPD) of the central hospital of the Diabetic Association. Body Mass Index (BMI) was used to assess the general obesity. Waist Circumference (WC), Waist-Hip Ratio (WHR) and Waist-Height Ratio (WHtR) were used to assess central obesity.ResultsThe overall prevalence of overweight was 22% (95% CI 19-24) and that of obesity was 48% (95% CI 45-51). Prevalence of central obesity by waist circumference was 77%, by waist-hip ratio was 99.9% and by waist-height ratio was 89%. Overweight and obesity were higher in the age group of 45-49 years (49%) and 35-44 years (24%) respectively. On Pearson’s correlation analysis, BMI and WC were significantly correlated with age (r = 0.135, p = 0.001; r = 0.162, p = 0.001) and income (r = 0.151, p = 0.001; r = 0.087, p = 0.009) respectively. WHR was also correlated with income (r = 0.094, p = 0.005). Moreover, WHtR was significantly correlated with age (r =  0.139, p = 0.001), income (r = 0.069, p = 0.04) and duration of diabetes (r = 0.073, p = 0.03).On binary logistic regression analysis, BMI was significantly associated with age, income and management of diabetes by Oral Hypoglycemic Agent (OHA) (p < 0.05). WC was significantly associated with age, income and management of diabetes by OHA and insulin (p < 0.05). Where, WHR was significantly associated only with duration of diabetes (p < 0.05). WHtR was significantly associated with age (p < 0.05), management of diabetes by OHA (p < 0.05) and insulin (p < 0.05) in this analysis.ConclusionsA high prevalence of both overweight and obesity exists in diabetic women of reproductive age in Bangladesh and it seems to be associated with increasing age, income, duration of diabetes, and use of oral hypoglycemic agents.

Prevalence and determinants of metabolic syndrome among newly diagnosed type 2 diabetic subjects according to different criteria.

BACKGROUND AND AIM Metabolic syndrome (MS) is becoming a serious global public health problem. The prevalence of MS differs in different population by using different definitions. Present study aimed to find out the prevalence and determinants of MS among newly diagnosed type 2 diabetes (NDT2D) according to different criteria. SUBJECTS AND METHODS This cross-sectional analytic study was conducted among 281 subjects selected purposively from the OPD of BIRDEM. Information on lifestyle factors and disease history were collected using a semi-structured questionnaire by face to face interview. The three definitions of MS used in this study are from the International Diabetes Federation (IDF), a modified version of the ATP III criteria for Asian populations (modified ATP III) and World Health Organization (WHO) criteria. Adjusted odds ratio and confidence limit were generated through logistic regression. RESULTS The overall prevalence of metabolic syndrome among the study subjects according to modified ATPIII, WHO and IDF criteria were 79% (95% CI: 74.2-83.8), 81% (95% CI: 76.4-85.6) and 68% (95% CI: 62.6-73.5) respectively. The prevalence of metabolic syndrome among female were higher compared to males in all the criterias. Female gender (OR=5.93), family history of diabetes (OR=1.92), overweight (OR=6.2), and obesity (OR=5.13) were found as important confounders associated with metabolic syndrome. CONCLUSION The prevalence of the metabolic syndrome among NDT2D is considerably higher in our population which may indicate considerable risk of cardiovascular diseases in future. Female gender, family history of diabetes, overweight and obesity are important confounders of MS in this population.

Utilization of maternal health services and post-partum contraception among Bangladeshi women attending a district level hospital

Utilization of maternal health services and postpartum contraception help to decrease rates of maternal and infant morbidity and mortality by preventing unintended, high risk pregnancies and also by delaying subsequent pregnancies. A cross-sectional study was conducted to find out the utilization of maternal health services and its association with post-partum contraception among Bangladeshi women in a hospital in Gazipur district. A total of 344 women were randomly selected who had delivered at least one child within last one year and completed 12 months post-partum period. Uni-variate and bi-variate analyses were used as statistical methods. Mean age of the respondent was 21.5 years (Mean ± SD, 21.5 ± 6.634). Nuclear families (61.30%) were predominant in number. Most of them were illiterate (44.8%). Antenatal care was significantly associated with socio-demographic factors like respondents’ and their husbands’ education, husbands’ income and types of family. Only 17% illiterate respondents received antenatal care for four or more times whereas 52.38% who graduated or above received the same. Most of the deliveries occurred at home (54.4%). These deliveries were performed by non-skilled personnel (54.6%) while the rest were performed by skilled personnel. This study also found that postnatal care was significantly associated with respondents’ and their husbands’ education, and husbands’ income. This study is expected to help program planners, policy makers to design interventions for their programs to enhance the use of maternal health services as well as postpartum contraception among Bangladeshi women. Keywords: Maternal health services; contraception; antenatal care; postnatal care; Bangladesh