"Cross sectional study of HbA1c levels in patients with cardio and Renal complication and their association with demographic parameters".

Thesis protocol

Cross sectional study on association of HbA1c with Cardiovascular disease (Macro vascular),Cronic Kidney Disease (Micro vascular complications).

 Study Team :

Research Scholar         : S.Jayanthi, Sr.Lab Supervisor, MMM Hospital

Guide                          : Dr.P.Amudha , Assistant Professor,

Department of Biochemistry, Vels University

Clinical Guide             :

Dr,Mullasari Ajit - Director -  ICVD

Dr.V.Chitra Sree - HOD & Senior Consultant

Department of Biochemistry  & Haematology

Dr.Manoj Kumar Shah – Consultant – Diabetologist

 Introduction:

Diabetes Mellitus has been identified as a contributing factor in a number of conditions, most notably cardiovascular disease, retinal disease, and renal disease. With the constant development of living standards, the increasing incidence of chronic diseases has gradually become important. Diabetes as one of the most important chronic diseases is the most common endocrine system disease.

Its complications are numerous, and the proportion of diabetes patients with hypertension and cardiovascular and cerebrovascular diseases is increasing, which seriously threatens human health and causes severe social and economic burden. Therefore diabetes has attracted more and more attention.

A large number of epidemiologic studies suggested that patients with diabetes had several times higher risks of cardiovascular disease and diabetes was a continuous risk factor of cardiovascular disease.

A distinct manifestation of diabetic renal disease is diabetic nephropathy (DN),which is seen in patients with both type 1 and type 2 diabetes mellitus. DN, commonly a manifestation of uncontrolled DM, is a chronic disease state with glomerular hypertrophy, transient glomerular hyperfiltration, renal fibrosis, proteinuria, and a progressive decrease in glomerular filtration rate (GFR). Anemia is an important component of diabetic nephropathy.

Thyroid hormones are involved in cell metabolism, blood sugar regulation, and insulin resistance. The prevalence of an abnormal thyroid function is higher in patients with diabetes (approximately 2.2–17% increase) than in healthy individuals. Hypothyroidism is the commonest abnormal thyroid function in Diabetic patients. In addition, thyroid hormones interact with the kidneys. Thyroid hormones contribute to the growth and development of the kidneys, maintain water and electrolyte balance, and participate in the renal transport system. Thyroid dysfunction affects the function of the glomerulus and renal tubules, and indirectly affects the renin–angiotensin system and renal blood flow. Changes in hemodynamics and the cardiovascular system have an effect on renal function.

Dyslipidemia is a well-recognized risk factor for diabetic kidney disease (DKD) in patients with type 2 diabetes (T2D).Dyslipidemia in patients with T2D is typically characterized with high levels of triglyceride (TG) and low density lipoprotein cholesterol (LDL-C), and low level of high density lipoprotein cholesterol (HDL-C)

People with diabetes can have an eye disease called. Diabetic Retinopathy High blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak. Or they can close, stopping blood from passing through. Sometimes abnormal, new blood vessels grow on the retina. The condition can develop in anyone who has type 1 or type 2 diabetes.

Aim:

1.      To study and correlate on association of HbA1C levels in Macro vascular and Micro, and thyroid dysfunction among people visiting a tertiary care hospital.

 2.      To identify the severity of the diseases based on the HbA1C levels and duration of diabetes.

 3.      To compare on the high risk of the studied health condition for diabetic patients.

  Objectives:

1.      To investigate the extent to which the HbA1c levels correlate with the severity of Macro vascular and Micro vascular complication.

2.      To assess the prevalence of Thyroid dysfunction among diabetic patients.

3.      To assess the prevalence of dyslipidemia in diabetic patients.

4.      To explore the potential interactions between HbA1c levels and other demographic or clinical variables such as age, gender, BMI, co-morbidities in relation to the mentioned health conditions.