Hypertriglyceridemia and Its Association with HbA1c Test: A Prospective In Vivo Controlled Study

Determination of cumulative glucose levels HbA1C and some biochemical variables in the serum of Diabetic nephropathy patients

The study included measuring the concentrations of each of the cumulative sugar HbA1C Glycosylated hemoglobin, urea, creatinine, uric acid, glucose, glucose uric acid, albumin, total protein and calcium, in addition to identifying the concentrations of some electrolytes (sodium, potassium, chloride, calcium) in (35) blood samples from patients with diabetic nephropathy (14 males, 12 females) aged (16-62) years who came to some laboratories in the city of Mosul and compared them to control samples (26) samples. The results showed a significant increase in cumulative sugar, uric acid, glucose and potassium concentrations in the serum of patients of both sexes. An insignificant increase in urea and creatinine concentrations and a significant decrease in albumin, sodium and chloride concentrations, while calcium and total protein did not show a significant difference compared to control samples. When comparing cases of infection between males and females, the results showed a significant increase in the cumulative sugar level for males and an insignificant increase in glucose concentration. In contrast, creatinine, uric acid, total protein and albumin did not significantly differ for males compared to infected females. Keywords cumulative glucose, biochemical variables, Diabetic

Is 25-Hydroxyvitamin D Associated with Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus in Saudi Arabia? A Population Based Study

BACKGROUND

Saudi Arabia has a high burden of diabetes mellitus and vitamin D deficiency. The objective of this study was to explore the association between glycosylated hemoglobin and 25-hydroxyvitamin D in patients with type 2 diabetes mellitus (T2DM) in Riyadh, Saudi Arabia.

METHODS

An interview based cross-sectional study was conducted on 606 patients with type 2 diabetes, aged 30-75 years, visiting primary health care centers. Blood samples were collected for measuring HbA1c, 25(OH)D and bone and lipid markers. Multivariable linear regression analysis was conducted to explore the association between HbA1c and 25(OH)D.

RESULTS

The mean (±SD) levels for HbA1c and 25(OH) D were 7.69 (±1.77) and 44.28 (±23.06), respectively. Around 55% of patients had uncontrolled HbA1c (>7.0), whereas vitamin D deficiency (<50 nmol/L) was found in 52.3% (=317). Multiple linear regression analysis found that a unit increase in vitamin D levels and parathyroid hormone levels was associated with -0.17 (-0.02, -0.01, p < 0.001) and -0.20 (-2.66, -1.18, p < 0.001) unit decrease in levels of HbA1c, respectively. Similarly, increasing age was associated with -0.15 (-0.01, -0.04, p = 0.002) unit decrease in HbA1c levels, whereas unit increases in serum alkaline phosphatase, calcium and diabetes duration were associated with 0.22 (0.01, 0.02, p < 0.001), 0.14 (1.03, 3.88, p = 0.001) and 0.26 (0.42, 0.78, p < 0.001) unit increase in HbA1c levels, respectively.

CONCLUSION

HbA1c levels are associated with 25-hydroxyvitamin D levels. For better control of HbA1c levels, it is important to maintain 25-hydroxyvitamin D level and bone markers within normal range.

Anti-lipid therapy and risk factor management for triglyceridaemia-induced acute pancreatitis

BACKGROUND

Pancreatitis secondary to hypertriglyceridaemia is rare, accounting for less than 5% of pancreatitis presentations. We reviewed our institutional experience with triglyceridaemia induced acute pancreatitis to report the clinical presentation, patient demographics and clinical management.

METHODS

The Acute Surgical Unit database at a high-volume general surgical referral centre was queried to identify cases of acute pancreatitis secondary to hypertriglyceridaemia between 2016 and 2019. Patient demographics, clinical manifestations, biochemical derangements and treatment regimens were analysed. Current related literature was reviewed.

RESULTS

There were 496 presentations for acute pancreatitis of which 14 presentations (2.8%), amongst 12 patients were due to hypertriglyceridaemia. The mean triglyceride level at presentation was 92.46 (standard deviation 46.9) mmol/L. Ten patients (83%) had poorly controlled type 2 diabetes. All patients were managed using conservative therapy combined with a restricted fat diet and commenced on long-term anti-lipid therapy to manage associated risk factors. In addition, 10 patients received an insulin infusion and one patient received insulin infusion, plasmapheresis and heparin infusion in combination. The median length of hospital stay was 5.5 (range 3-13) days. Two patients (16%) developed a recurrent episode related to non-compliance to medical therapy.

CONCLUSION

Hypertriglyceridaemia is a rare cause of acute pancreatitis. Successful management involves the treatment of acute pancreatitis in conjunction with long-term anti-lipid therapy and optimisation of associated risk factors.