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Chaudhry M, Kumar M, Singhal V, Srinivasan B. Metabolic health tracking using Ultrahuman M1 continuous glucose monitoring platform in non- and pre-diabetic Indians: a multi-armed observational study. Sci Rep 2024; 14:6490. [PMID: 38499685 PMCID: PMC10948749 DOI: 10.1038/s41598-024-56933-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/12/2024] [Indexed: 03/20/2024] Open
Abstract
Continuous glucose monitoring (CGM) device adoption in non- and pre-diabetics for preventive healthcare has uncovered a paucity of benchmarking data on glycemic control and insulin resistance for the high-risk Indian/South Asian demographic. Furthermore, the correlational efficacy between digital applications-derived health scores and glycemic indices lacks clear supportive evidence. In this study, we acquired glycemic variability (GV) using the Ultrahuman (UH) M1 CGM, and activity metrics via the Fitbit wearable for Indians/South Asians with normal glucose control (non-diabetics) and those with pre-diabetes (N = 53 non-diabetics, 52 pre-diabetics) for 14 days. We examined whether CGM metrics could differentiate between the two groups, assessed the relationship of the UH metabolic score (MetSc) with clinical biomarkers of dysglycemia (OGTT, HbA1c) and insulin resistance (HOMA-IR); and tested which GV metrics maximally correlated with inflammation (Hs-CRP), stress (cortisol), sleep, step count and heart rate. We found significant inter-group differences for mean glucose levels, restricted time in range (70-110 mg/dL), and GV-by-SD, all of which improved across days. Inflammation was strongly linked with specific GV metrics in pre-diabetics, while sleep and activity correlated modestly in non-diabetics. Finally, MetSc displayed strong inverse relationships with insulin resistance and dysglycemia markers. These findings present initial guidance GV data of non- and pre-diabetic Indians and indicate that digitally-derived metabolic scores can positively influence glucose management.
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Affiliation(s)
- Monik Chaudhry
- Ultrahuman Healthcare Private Limited, No. 799, V K Paradise Sector2, HSR Layout Bengaluru, Bangalore, Karnataka, 560102, India
| | - Mohit Kumar
- Ultrahuman Healthcare Private Limited, No. 799, V K Paradise Sector2, HSR Layout Bengaluru, Bangalore, Karnataka, 560102, India
| | - Vatsal Singhal
- Ultrahuman Healthcare Private Limited, No. 799, V K Paradise Sector2, HSR Layout Bengaluru, Bangalore, Karnataka, 560102, India
| | - Bhuvan Srinivasan
- Ultrahuman Healthcare Private Limited, No. 799, V K Paradise Sector2, HSR Layout Bengaluru, Bangalore, Karnataka, 560102, India.
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Chai C, Chen K, Li S, Cheng G, Wang W, Wang H, Wei D, Peng C, Sun Q, Tang Z. Effect of elevated fasting blood glucose level on the one-year mortality and sequelae in hospitalized COVID-19 patients: a bidirectional cohort study. J Med Virol 2022; 94:3240-3250. [PMID: 35357022 PMCID: PMC9088618 DOI: 10.1002/jmv.27737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/04/2022] [Accepted: 03/22/2022] [Indexed: 12/15/2022]
Abstract
To observe the predictive effect of fasting blood glucose (FBG) level on the prognosis, clinical sequelae, and pulmonary absorption in hospitalized coronavirus disease 2019 (COVID‐19) patients with and without a history of diabetes, respectively, and to evaluate the correlation between the dynamic changes of FBG and poor prognosis. In this bidirectional cohort study, we enrolled 2545 hospitalized COVID‐19 patients (439 diabetics and 2106 without a diabetic history) and followed up for 1 year. The patients were divided according to the level of admission FBG. The dynamic changes of FBG were compared between the survival and the death cases. The prediction effect of FBG on 1‐year mortality and sequelae was analyzed. The 1‐year all cause mortality rate and in‐hospital mortality rate of COVID‐19 patients were J‐curve correlated with FBG (p < 0.001 for both in the nondiabetic history group, p = 0.004 and p = 0.01 in the diabetic history group). FBG ≥ 7.0 mmol/L had a higher risk of developing sequelae (p = 0.025) and have slower recovery of abnormal lung scans (p < 0.001) in patients who denied a history of diabetes. Multivariable Cox regression analysis showed that FBG ≥ 7.0 mmol/L was an independent risk factor for the mortality of COVID‐19 regardless of the presence or deny a history of diabetes (hazard atio [HR] = 10.63, 95% confidence interval [CI]: 7.15−15.83, p < 0.001; HR = 3.9, 95% CI: 1.56−9.77, p = 0.004, respectively). Our study shows that FBG ≥ 7.0 mmol/L can be a predictive factor of 1‐year all‐cause mortality in COVID‐19 patients, independent of diabetes history. FBG ≥ 7.0 mmol/L has an advantage in predicting the severity, clinical sequelae, and pulmonary absorption in COVID‐19 patients without a history of diabetes. Early detection, timely treatment, and strict control of blood glucose when finding hyperglycemia in COVID‐19 patients (with or without diabetes) are critical for their prognosis.
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Affiliation(s)
- Chen Chai
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Department of Emergency Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430022, China
| | - Kui Chen
- Department of Emergency Medicine, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, China
| | - Shoupeng Li
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Department of Emergency Medicine, Huanan Hospital, Shenzhen University, Shenzhen, 518111, China
| | - Gang Cheng
- Computer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Wendan Wang
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Hongxiang Wang
- Department of hematology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
| | - Dunshuang Wei
- Department of Emergency Medicine, the Third People's Hospital of Hubei Province, Wuhan, 430030, China
| | - Cao Peng
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Qi Sun
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Zehai Tang
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
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Demirtas AO, Icen YK, Koca H, Sumbul HE, Demirtas D, Koseoglu Z, Koc M. The relationship between blood glucose and nocturnal supraventricular tachycardia attacks in non-diabetic patients. J Interv Card Electrophysiol 2019; 55:115-20. [PMID: 31041584 DOI: 10.1007/s10840-019-00549-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 04/03/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Decrease in the blood glucose level may trigger the tachycardia or bradycardia because it has an arrhythmogenic effect on the heart. Our purpose in this study was to investigate whether the blood glucose level has an effect on patients who attended to the hospital with nocturnal supraventricular tachycardia (SVT). METHODS We included 151 patients in our study who have SVT history. Plasma glucose levels which were taken during night hours, electrolytes, and 12 lead electrocardiography were evaluated. RESULTS There were 105 patients without nocturnal SVT attack and 46 patients with nocturnal SVT attack. Patients with nocturnal SVT attack, blood glucose level, potassium, calcium, and hemoglobin levels were significantly lower, hs-CRP was significantly higher, basal cycle length (BCL) was significantly short, and QT interval was significantly longer. It was found that blood glucose (O.R. = 0.904, 95% GA 0.828-0.986, p = 0.023) and potassium levels (O.R. = 0.128, 95% GA 0.029-0.561, p = 0.006) and basal cycle length (BCL) (O.R. 0.988, 95% GA, 0.980-0.996, p = 0.005) values were in independently correlated with nocturnal SVT attacks. CONCLUSION The decrease in blood glucose level of the patients who are being followed with SVT diagnosis might trigger the nocturnal SVT attacks.
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Kakehi E, Kotani K, Nakamura T, Takeshima T, Kajii E. Non-diabetic Glucose levels and Cancer Mortality: A Literature Review. Curr Diabetes Rev 2018; 14:434-445. [PMID: 28699482 DOI: 10.2174/1573399813666170711142035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/03/2017] [Accepted: 07/05/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although diabetes mellitus is a risk factor for cancer, the relationship of an increased glucose concentration at a non-diabetic glucose level with cancer mortality is yet to be determined. OBJECTIVE The aim was to observe whether an increased glucose concentration and/or glucose intolerance at the non-diabetic glucose level can predict cancer mortality. METHODS Population-based prospective cohort studies evaluating cancer mortality at the non-diabetic level (defined as fasting plasma glucose <7.0 mmol/L and two-hour plasma glucose <11.1mmol/L following an oral glucose tolerance test) were collected via a PubMed search with an additional Google scholar search between 1 January 1966 and 31 July 2016. RESULTS We identified seven studies, which met the defined criteria. Studies examining fasting/casual states indicated an increase in cancer mortality with a slight increase in fasting/casual glucose levels in men in particular. Not all, but some studies using a glucose tolerance test indicated an increase in cancer mortality with impaired glucose tolerance/prediabetes. Concerning cause-cancer mortality, glucose intolerance states appeared to have an increase in mortality, particularly due to the stomach, liver and pancreatic cancers. CONCLUSION In these studies reviewed, cancer mortality increased in individuals with an increased glucose concentration and an increased potential was seen in those patients with glucose intolerance even at non-diabetic glucose levels. The outcome of these findings is promising and forms the basis for further studies to directly address the relevance of increased (non-diabetic) glucose and glucose intolerance as a prognostic indicator of cancer mortality.
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Affiliation(s)
- Eiichi Kakehi
- Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Takashi Nakamura
- Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Taro Takeshima
- Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Eiji Kajii
- Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
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Kumar Jha P, Ete T, Malviya A, Kumar Das C, Saha SK, Nath D, Kapoor M, Mishra A. Microalbuminuria: Correlation With Prevalence and Severity of Coronary Artery Disease in Non-Diabetics. J Clin Med Res 2017; 9:838-843. [PMID: 28912920 PMCID: PMC5593431 DOI: 10.14740/jocmr2785w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 12/09/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Previous studies have shown that microalbuminuria (MAU) is an independent risk factor for cardiovascular diseases in diabetics, hypertensive patients and in the general population. However, the correlation of MAU with the severity of coronary artery disease (CAD) in non-diabetic patients has not been addressed in detail. This study aimed to investigate the relationship between MAU and severity of angiographically confirmed CAD in non-diabetic patients. METHODS This was a cross-sectional study, which included 90 non-diabetic patients with documented CAD by coronary angiography. The ratio of urine albumin to creatinine was used to define MAU and severity of CAD was estimated using SYNTAX score. Patients were divided into two groups: group I that included patients without MAU and group II that included patients with MAU. RESULTS Out of 90 non-diabetic CAD patients, 62 (68.9%) were in group I (MAU negative) and 28 (31.1%) were in group II (MAU positive). There was statistically significant difference in the median SYNTAX score between the groups (21 vs. 28, P < 0.001). The prevalences of double vessel CAD and triple vessel CAD were significantly higher in MAU positive group. There was a strong relationship between the presence of MAU and the extent and complexity of CAD (r = 0.094; P < 0.001). CONCLUSION Thus, we conclude that patients with MAU have more severe angiographically detected CAD than those without MAU, and MAU exhibits a significant association with the presence and severity of CAD.
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Affiliation(s)
- Pravin Kumar Jha
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, India
| | - Tony Ete
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, India
| | - Amit Malviya
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, India
| | - Chandra Kumar Das
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, India
| | - Swapan Kumar Saha
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, India
| | - Dhanjit Nath
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, India
| | - Manish Kapoor
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, India
| | - Animesh Mishra
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, India
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Shaikh AR, Mirani AH, Memon MS, Fahim MF. Visual outcome after phacoemulsification with lens implant in diabetic and non-diabetic patients; A comparative study. Pak J Med Sci 2017; 33:691-694. [PMID: 28811796 PMCID: PMC5510128 DOI: 10.12669/pjms.333.12589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To compare the visual outcomes of phacoemulsification surgery with intraocular lens (IOL) in persons with and without diabetes at end of follow-up. Methods: This was a comparative, cross sectional, observational study with Non-probability, purposive sampling. After approval from “Research Ethical Committee of Isra Post-graduate Institute of Ophthalmology Karachi, 92 patients with cataract in one eye were selected. Patients were divided into two groups. Group A consisted of 48 diabetics and group B consisted of 44 non- diabetics with or without diabetes in the age group ≥ 30 years were included. Patients with small Pupil, Pseudo exfoliation Syndrome, Diabetic Retinopathy, and positive history of Uveitis, Glaucoma, and Macular Degeneration were excluded. Data analysis was performed by SPSS Version 20.0. Results: Best Corrected Visual Acuity (BCVA) in diabetic patients improved from 0.813 ± 0.181 Log MAR pre operatively to 0.183 ± 0.143 after the period of six months post-operatively. Corresponding results in non-diabetics were 0.66 ± 0.31 and 0.08 ± 0.092 Log Mar (P value = 0.001). If WHO criteria was considered, 87.5% diabetics and 92% non-diabetics achieved normal vision (Log Mar 0 to 0.5; ≥ 6/12,) on the first post-operative day. Remaining 12.5% diabetics and 8% non-diabetics achieved moderate vision (0.6 to 1 Log MAR) on first post-operative day improving to normal vision within a week. Conclusion: Visual outcomes in diabetics after phacoemulsification with intra ocular lens implant is almost as good as that in non-diabetic patient if the diabetics have no retinopathy and have good glycemic control.
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Affiliation(s)
- Abdul Rashid Shaikh
- Abdul Rashid Shaikh, Department of Ophthalmology, Al Ibrahim Eye Hospital, Isra postgraduate Institute of Ophthalmology, Gaddap Town, Malir, Karachi, Pakistan
| | - Abdul Haleem Mirani
- Abdul Haleem Mirani, Department of Ophthalmology, Al Ibrahim Eye Hospital, Isra postgraduate Institute of Ophthalmology, Gaddap Town, Malir, Karachi, Pakistan
| | - Muhammad Saleh Memon
- Muhammad Saleh Memon, Isra Ophthalmic Research & Development Center, Al Ibrahim Eye Hospital, Isra postgraduate Institute of Ophthalmology, Gaddap Town, Malir, Karachi, Pakistan
| | - Muhammad Faisal Fahim
- Muhammad Faisal Fahim, Isra Ophthalmic Research & Development Center, Al Ibrahim Eye Hospital, Isra postgraduate Institute of Ophthalmology, Gaddap Town, Malir, Karachi, Pakistan
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Kapadia J, Dodamani A, Baviskar P, Karibasappa GN, Pathak P, Bezalwar A. Effect of Sugar-Free and Regular Toothpaste on Salivary Glucose and pH among Type 2 Diabetes- A Randomized Crossover Trial. J Clin Diagn Res 2017; 11:ZC71-ZC75. [PMID: 28893048 PMCID: PMC5583924 DOI: 10.7860/jcdr/2017/25580.10250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/03/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diabetes is one of the most prevalent diseases of mankind having general as well as oral health manifestations. Also, there is an increase of salivary glucose level in diabetic, inducing saccharolytic bacteria in saliva which can have adverse effects on oral tissue. AIM To assess and compare the effect of sugar-free toothpaste on salivary glucose and pH among Type 2 diabetic and non-diabetic individuals. MATERIALS AND METHODS A randomized controlled-crossover study was carried out on 30 Type 2 diabetic (Group A) and 45 non-diabetic (Group B) subjects. In first half of study, subjects in Group A and Group B were intervened with sugar-free and regular toothpaste respectively. Salivary glucose and pH was assessed before and after brushing at interval of one week for a period of four weeks. In second half, toothpastes were switched over between the groups, after sufficient washout period. Salivary glucose and pH were assessed again in the same manner for both the groups. The data was subjected to paired t-test and unpaired t-test for intragroup and intergroup comparison respectively. RESULTS Salivary glucose level was significantly reduced and salivary pH was increased significantly (p<0.001) in both groups with sugar free toothpaste when compared to regular toothpaste. CONCLUSION Sugar free toothpaste showed beneficial effect on salivary glucose level and salivary pH level on diabetes and non-diabetes population.
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Affiliation(s)
- Junaid Kapadia
- Assistant Professor, Department of Public Health Dentisry, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Arun Dodamani
- Professor and Head, Department of Public Health Dentisry, ACPM Dental College and Hospital, Dhule, Maharashtra, India
| | - Priya Baviskar
- Assistant Professor, Department of Public Health Dentisry, SMBT Dental College, Ghoti, Maharashtra, India
| | - GN Karibasappa
- Professor, Department of Oral and Maxillofacial Surgery, Sihagad Dental College, Pune, Maharashtra, India
| | - Parag Pathak
- Assistant Professor, Department of Oral Pathology, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Abhishek Bezalwar
- Assistant Professor, Department of Oral and Maxillofacial Surgery, SMBT Dental College, Ghoti, Maharashtra, India
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Khan I, Siddiqui AH, Singhal S, Aslam M, Perwez A, Faraz A. Glycaemic status in patients of acute myocardial infarction: A detailed analysis. Diabetes Metab Syndr 2016; 10:S140-S143. [PMID: 26701341 DOI: 10.1016/j.dsx.2015.09.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 09/27/2015] [Indexed: 10/22/2022]
Abstract
AIMS Diabetes mellitus (DM) is considered to be one of the important risk factors for cardiac diseases. Frank diabetes is usually preceded by long term abnormality in glucose homeostasis which is called pre-diabetes. The hypothesis that diabetic patients have greater risk and worse prognosis of Acute Myocardial Infarction (AMI) than pre-diabetics is controversial. Considering that India has been declared as a diabetic capital of the world, the study aimed to assess the load of pre diabetics, diabetics and non-diabetics landing in myocardial infarction. MATERIALS AND METHODS The study consisted of through physiological and biochemical evaluation of 200 patients of newly diagnosed AMI and evaluating the load of non-diabetics, pre-diabetics and diabetics among them. RESULT It was found that the total non-diabetic population (normoglycaemic and pre-diabetic) formed the bulk of AMI patient (69%) in our study. The degree of biochemical alterations seen among the three groups suggests that abnormal glucose homeostasis is not the sole determinant of the severity of AMI. The study data also suggests that glycaemic status, which poses a risk for AMI, differs in male and female individuals. Males even with normal glucose level are at increased risk to develop MI. CONCLUSION The study concludes that both males and females with their blood glucose in pre-diabetic range are seen to be vulnerable to develop AMI. Thus all individuals irrespective of their glycaemic status around the age of forty should be screened and individuals with fasting sugar in pre-diabetic range should take extra precaution in terms of healthy diet, life style and regular check up.
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Affiliation(s)
- Imran Khan
- Department of Physiology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University, Aligarh 202002, India.
| | - Anwar H Siddiqui
- Department of Physiology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University, Aligarh 202002, India
| | - Sangeeta Singhal
- Department of Physiology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University, Aligarh 202002, India
| | - Mohd Aslam
- Department of Physiology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University, Aligarh 202002, India
| | - Anjum Perwez
- Department of Medicine, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University, Aligarh 202002, India
| | - Ahmad Faraz
- Department of Physiology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University, Aligarh 202002, India
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