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"Serum tumor markers expression (CA19-9, CA242, and CEA) and its clinical implications in type 2 diabetes mellitus" authored by Meng and Shi presents an observational case-control study investigating the correlation between tumor markers and type 2 diabetes mellitus (T2DM). The study explores the diagnostic accuracy of tumor markers, particularly cancer antigen 19-9 (CA19-9), CA242, and carcinoembryonic antigen, in poorly controlled T2DM patients with hemoglobin A1c levels exceeding 9%, employing receiver operating characteristic curve analysis. Though study offers valuable insights into the potential utility of tumor markers in clinical practice, caution is advised regarding routine tumor marker testing due to challenges such as limited availability and cost. Additionally, the study overlooks potential confounding factors like smoking and alcohol consumption. Variations in CA19-9 and CA242 expression underscore the complex interplay between tumor markers and systemic diseases, warranting further investigation into their diagnostic and prognostic implications. While Meng and Shi represent a significant contribution to the field, more extensive research is needed to fully elucidate the role of tumor markers in diabetes management and beyond.
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The study by Feng et al, explores treatment approaches for these coexisting conditions. It emphasizes the potential advantages of selenium and vitamin D supplementation but also raises methodological and patient selection concerns. Findings indicate a complex interplay between interventions and disease markers, prompting the need for further research. Despite limitations, the study offers valuable insights into managing the intricate relationship between type 2 diabetes mellitus and Hashimoto's thyroiditis. The authors' contributions shed light on potential treatment avenues, although careful consideration of study design and patient characteristics is warranted for future investigations in this domain.
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This published Meta-Analysis by Lin et al is an indirect comparison between two drugs Chiglitazar and Thiazolidinedione which are commonly used for glycemic control in type-II diabetes mellitus. In terms of safety and efficacy, this Meta-Analysis is inconclusive.
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Background: Epilepsy is one of the most prevalent neurological conditions among the elderly. Age-related epileptogenic disorders as well as the ageing itself pose a risk for seizures in the elderly. The lack of witnesses, non-specific symptoms, and transient symptoms make the diagnosis challenging in the elderly. Aim: This study aimed to assess the various presentation and aetiology for the seizure disorder in the elderly population. Materials and Methods: A total of 125 elderly patients ≥60 years with new onset seizure were included in the study. Demographic data, co-morbidities, and clinical presentation of seizure were elicited. Hemogram, liver and renal function tests, random blood sugar, electrolytes, and serum calcium were analysed. Computed tomography (CT), magnetic resonance imaging (MRI) brain, and electroencephalogram (EEG) were performed. Results: Seizure was seen predominantly in the males with age group of 60-70 years. Generalized tonic-clonic seizure was the commonest presentation, followed by focal seizures. The leading causes of seizures were cerebral vascular accidents, metabolic conditions, and alcohol. CT brain was abnormal in 49%, and 73% of the patients showed abnormality in MRI brain. EEG was abnormal in 17.3% of patients. Temporal lobe infarction was the commonest, trailed by parieto-temporal and frontal lobe involvement. Conclusion: Seizures in the elderly have varied clinical signs and aetiology. An awareness about these atypical presentation and aetiology is essential for the early diagnosis and management to prevent morbidity.
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Background: India is facing a galloping diabetes epidemic with an estimated 62 million patients and is projected to explode beyond 85 million by the year 2030. There is platelet dysfunction with platelet hyper-reactivity in diabetes mellitus. Aim: To assess for any correlation between HbA1c levels with various platelet indices like mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR). Material and Methods: Applying inclusion and exclusion criteria, diabetes mellitus patients have undergone detailed history, clinical examination, and laboratory investigations. Data is statistically analyzed for levels of HbA1c and their correlation to platelet indices. Results: 58.7% study population is with HbA1c levels of more than 8%. In patients with normal range HbA1c levels between 4-6%, the MPV, PDW, and P-LCR are found to be 9.9 ± 0.97 fl, 10.84 ± 2.08 fl, and 23.75 ± 7.99%, respectively. In patients with HbA1c levels of 6.1 to 7%, the MPV, PDW, and P-LCR are found to be 10.22 ± 1.04 fl, 11.79 ± 1.8 fl, and 26.36 ± 7.05%, respectively. In patients with HbA1c levels of 7.1 to 8%, the MPV, PDW, and P-LCR values are found to be 10.21 ± 1.06 fl, 12.03 ± 2.52 fl, and 26.65 ± 8.05%, respectively. In patients with poor glycemic control with HbA1c levels more than 8%, the MPV, PDW, and P-LCR are found to be 10.64 ± 1.1 fl, 12.81 ± 2.61 fl, and 30.26 ± 8.24%, respectively. Conclusion: In type 2 diabetes mellitus patients, HbA1c is positively correlated with platelet indices.
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Introduction:Vitamin D safeguards cardiovascular health by reducing inflammation and susceptibility to atheroma. This study aimed to evaluate the association of coronary artery disease (CAD) and its risk factors like body mass index (BMI), glycated hemoglobin (HbA1c), and lipid profile with vitamin D. Methods:Patients of both genders aged over 18 years, who underwent coronary angiogram for cardiac symptoms such as chest pain, breathlessness, palpitation, or syncope, were enrolled in the present study. Demographic and anthropometric data were collected. Glycated hemoglobin, lipid profile and 25-hydroxyvitamin D were measured. The severity of CAD was analyzed along with the SYNTAX scoring. Results:The study population was divided into three groups based on vitamin D levels: Group I (vitamin D level <20 ng/mL), Group II (20-30 ng/mL) and Group III (>30 ng/mL). There was a significantly higher number of patients with diabetes mellitus and triple vessel disease in Group I. On multivariable suplogistic regression, vitamin D had a significant odds ratio (OR) of 1.21 (1.03-1.43) for single vessel disease and 0.92 (1.13-1.43) for triple vessel disease. SYNTAX score had a significant OR of 0.697 (0.557-0.873) for single vessel disease and 1.27 (1.13-1.43) for triple vessel disease. There was a significant negative correlation between HbA1c and vitamin D (r =-0.269, p= 0.008). Vitamin D levels negatively correlated with triple vessel disease (r =-0.252, p= 0.013). Conclusions:Incidence of diabetes mellitus and levels of HbA1c were both higher among patients with vitamin D deficiency. Vitamin D deficiency was a risk factor for single and triple vessel disease.
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INTRODUCTION: In the Intensive care unit (ICU), hyperglycemia is often observed; commonly associated with pre-existing diabetes or pre-diabetes or in nondiabetic patients. This study aimed to assess the role of admission blood sugar levels with outcomes in ICU patients. METHODS: A total of 100 patients above 18 years of age were included in the study. A detailed history regarding the patient's age, sex, and any chronic illness were taken. Heart rate, systolic blood pressure, and Glasgow coma scale (GCS) scores were recorded. Admission blood glucose level, blood urea, total leucocyte count, and serum electrolytes were measured; and the outcome was noted. RESULTS: The number of diabetics was significantly higher (65.5%) in the random blood sugar (RBS) ≥180 group. Hyponatremia was significantly associated with hyperglycemia. Patients with hyperglycemia had serum bicarbonate <18. A significantly greater number of patients with hyperglycemia had GCS scores of <8, and required mechanical ventilation. The duration of ICU stay and non-survivors were significantly higher in the hyperglycemia group. Random blood sugar at admission as a factor to assess outcome showed a sensitivity of 68.4 and specificity of 59.3 with a cut-off value of 197. CONCLUSION: Admission of random blood sugar was significantly associated with poor outcomes. More stringent surveillance as well as routine blood glucose checks at the time of hospital admission should be emphasized.