The study was conducted to determine whether the clinical targets for the control of diabetes recommended by American Diabetes Association can be met in the context of routine diabetes practice. This cross-sectional study was undertaken on 211 type 2 diabetic patients at the Outpatients Diabetes Clinic, Hospital Universisti Sains Malaysia (HUSM) Kubang Kerian, Kelantan between the year 2001-2002. Patients' physical examination and their medical history as well as their family history were obtained by administering a structured questionnaire. Samples of patients' venous blood during fasting were taken and analysed for plasma glucose, glycated haemoglobin and lipid profile. Analysis showed that many patients had comorbidities or complications. A large number of them had poor glycaemic control (73%). Systolic and diastolic blood pressures of 75% and 85% subjects were > or = 130 and > or = 80 mmHg, respectively. Body Mass Index (BMI) values of 66% of the patients were outside the clinical target (BMI > or = 25 in male and > or = 24 kg/m2 in female). The lipid profile showed that 96% of the patients had at least one lipid value outside the clinical target level. In this study, 70% of the patients had total cholesterol > or = 5.2 mmol/L, 87% had LDL cholesterol > or = 2.6 mmol/L, 57% had HDL cholesterol less than the normal range, < or = 1.15 mmol/L in men and < or = 1.4 mmol/L in women, while 46% had triglycerides > or = 1.71 mmol/L. Complications of diabetes were observed in 48% of the total number of patients. As for the patients' systolic blood pressure, age and duration of diabetes were found to have significant effects. Older subjects with a longer duration of diabetes were more hypertensive. Variables that had significant effects on BMI were age, duration of diabetes, glycaemic control and gender. Younger females and newly diagnosed subjects with better glycaemic control (A1C < 7%) were found to have higher BMI values. The overall clinical targets were suboptimal. The prevalence of hyperlipidaemia and hypertension was high. It is imperative that better treatment strategies and methods be adopted to enhance diabetes control and reduce long-term complications of the disease.
Study site: Outpatients Diabetes Clinic, Hospital Universisti Sains Malaysia (HUSM)
Two hundred and eleven (211) patients with type 2 diabetes mellitus who were on treatment and monitored for complications at the Outpatient Diabetes Clinic in Hospital Universiti Sains Malaysia, Kubang Kerian between 2001 - 2002 were selected for the study. A structured questionnaire was administered to obtain their medical and family history. Physical examination was performed and fasting venous blood sample was collected for plasma glucose and A1C analysis. Of the total 211 patients, only 4 % were on diet treatment alone, 37 % of them were on mono therapy while 59 % were on combination of therapies. Fasting plasma glucose (FPG) > 7.2 mmol/L and glycated hemoglobin (A1C) levels ≥ 7 % were observed in 60 % and 73 % of type 2 diabetic patients, respectively. Glycated hemoglobin level of 28 % of the subjects were < 7 %; 36 % were between 7 - 9 % and 36 % were more than 9 %. The worst glycaemic control was observed in Malay patients. A1C of Malay and non-Malay subjects were 8.7 ± 2.3 % and 7.7 ± 1.7 %, respectively. Younger patients (age group < 50 years) had significantly higher mean A1C than elderly patients. Duration of diabetes had a clear influence on glycaemic level. Patients with recently diagnosed diabetes (duration of disease < 5 years) had the best glycaemic control. In this study a large proportion of the patients had poor glycaemic control. The variables with significant effects on glycaemic control were ethnicity, age and duration of diabetes mellitus. Better treatment strategies and methods should be used to improve diabetes control and to reduce long-term complications of diabetes.
Study site: Outpatient diabetic clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Bax is essential for apoptosis in normal cells. However, overexpression of Bcl-2 enhances cell survival by suppressing apoptosis in cells subjected to apoptosis-inducing stimuli. The aim of this study was to examine the expression of apoptotic (Bax and Bcl-2) and biochemical markers in type 2 diabetics mellitus.