Swati Shah

Pulmonary function tests in type 2 diabetes mellitus and their association with glycemic control and duration of the disease.

Background: Pulmonary complications of diabetes mellitus (DM) have been poorly characterized. Some authors have reported normal pulmonary functions and even concluded that spirometry is not at all necessary in diabetic patients. Some studies have shown abnormal respiratory parameters in patients of DM. Moreover, the duration of DM and glycemic control have varied impact on the pulmonary functions. Aims and Objectives: The study was undertaken to analyze the pulmonary function parameters in diabetic patients and compare them with age and gender matched healthy subjects. We correlated forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in diabetic patients with duration of the disease and glycosylated hemoglobin (HbA1c). Materials and Methods: Pulmonary function tests (PFTs) were recorded in 60 type 2 diabetic male patients and 60 normal healthy male controls aged 40-60 years by using Helios 702 spirometer. The PFTs recorded were - FVC, FEV1, FEV1/FVC, FEF25, FEF50, FEF75, FEF25–75, FEF0.2–1.2, and peak expiratory flow rate (PEFR). HbA1c of all the patients was estimated by ion exchange resin method, which is a very standard method of estimation. PFTs of diabetic patients and controls were compared by applying Student′s unpaired t test. Associations between FVC and FEV1 and HbA1c and duration of illness in diabetic patients were analyzed by applying Pearson′s coefficient. Results: The PFTs were significantly decreased in diabetic patients compared with the healthy controls except FEV1/FVC. There was no correlation found between FVC and FEV1 and duration of illness as well as HbA1c. Conclusion: DM being a systemic disease, which also affects lungs causing restrictive type of ventilatory changes probably because of glycosylation of connective tissues, reduced pulmonary elastic recoil and inflammatory changes in lungs. We found glycemic levels and duration of disease are probably not the major determinants of lung pathology, which requires further research.

Are we ignoring diabetic disability: a cross sectional study of diabetic myopathy.

BACKGROUND The complications associated with type 2 Diabetes Mellitus (DM) may cause functional impairment in older people. Recently it has been proved that motor dysfunction in the form of skeletal muscle dysfunction does occur in type II DM. However very few studies have assessed the upper limb skeletal muscle dysfunction. OBJECTIVES The study was aimed to assess the hand grip strength, endurance in type 2 DM patients and compare the same with age matched healthy controls. We also correlated glycosylated Hb and duration of illness with the hand grip strength and endurance in the patients. MATERIALS AND METHODS Hand grip dynamometer was used to measure the hand grip strength and endurance in sixty diagnosed patients of type II DM. Similar tests were performed in age matched healthy controls. Blood samples were collected for blood glucose fasting, postprandial levels and Hb1AC in both the groups. Comparisons between patients and controls, and correlations were done by applying suitable tests. RESULTS The hand grip muscle strength and endurance in type II DM patients were significantly lower as compared to the normal controls (P < 0.05, P < 0.001). There was no correlation between the hand grip muscle strength and endurance with HbA1c and the duration of the disease in the patients of type II DM (P > 0.05). CONCLUSIONS The present study shows that type II DM patients suffer from skeletal muscle dysfunction in the form of reduced hand grip strength and endurance. Hence the treating Physician should not be ignorant about these disabilities. In addition to the strict measures to control the blood glucose levels, interventions to improve the muscle mass and strength in these patients should be undertaken.

Effect of menopause on lipid profile in relation to body mass index

Background: Menopause is a natural event in the ageing process and signifies the end of reproductive years with cessation of cyclic ovarian function as manifested by cyclic menstruation. Lipid profile is altered in menopause because of various reasons. Objectives: The study was aimed to compare the lipid profile in women with normal body mass index (BMI) = 18.9-24.9 and women with BMI = 25-29.9 in both pre- and post-menopausal group. Materials and Methods: Estimation of total cholesterol (TC) by CHOD-PAP Cholesterol Oxidase - Peroxidase + Aminophenazone + Phenol method, triglyceride (TG) by enzymatic calorimetric method, high density lipoprotein-cholesterol (HDL-C) phosphotungstic acid method, low density lipoprotein-cholesterol (LDL-C) by using Friedewald formula and very low density lipoprotein (VLDL) was done by using the formula -VLDL = TG/5 in 30 women selected in each group. Results: Our study revealed that serum levels of TC, TG and LDL-C were significantly higher in post-menopausal women in comparison to their pre-menopausal counterparts, irrespective of BMI ( P P Conclusions: We found that serum levels of TC, TG and LDL-C were significantly higher in post-menopausal women in comparison to their pre-menopausal counterparts, irrespective of BMI. Similarly, HDL-C levels were significantly lower in post-menopausal women as compared to pre-menopausal women of similar BMI. Since we found similar changes in women of different BMIs, the difference in hormonal status is the probable cause of altered lipid profile. Hence, all post-menopausal women irrespective of body weight and BMI should be strongly counseled to have proper physical exercise and dietary habits to avoid the possible cardiovascular complications.