Glycosylated haemoglobin and serum proteins in diabetics

The glycosylated haemoglobin was measured in two different categories of diabetic subjects. In poorly controlled subjects of group II, a significant alteration in serum proteins was observed. Total protein along with albumin concentrations were decreased and α₂ globulin fraction was increased. Insulin therapy resulted in normalisation of blood glucose and gradual decrease in glycosylated haemoglobin in the therapy period of eight weeks. This also resulted in a rise of total protein and albumin concentrations with a decrease in α₂ fraction. The present study indicates that prolonged therapy of insulin is needed to correct the serum protein abnormalities in diabetics.     

Glycosylated hemoglobin A1 in a random group of adult onset diabetics of indian subpopulation

Glycosylated Hemoglobin (GHb) was estimated using cation exchange resin binding method in 50 non diabetic healthy controls and 500 maturity onset diabetics. Percentage of glycosylated hemoglobin levels in controls was 7.27±0.456 (range 6.0–8.04) and 9.47±0.98 (range 8.2–13.63) in diabetic group. Glycosylated hemoglobin levels remain unaffected inspite of transient rise of serum glucose levels during an oral glucose tolerance test. Significantly elevated GHb A₁. Furthermore significant elevation of GHb A₁ was noticed in diabetics with all secondary complications suggesting poor glycemic control in these patients. The diabetics having retinopathy, nephropathy or diabetic foot had relatively higher GHb levels compared to patients having coronary artery disease or hypertension.     

δ-ALA levels in serum and urine—A diagnostic tool for possible lead poisoning

We present 2 cases of lead poisoning, the first of a child playing with painted toys and the second of an adult on local medicine. The former presented with acute abdomen and the latter with peripheral muscle weakness. We propose that raised serum δ-amino leavulinic acid (δ-ALA) levels strongly point towards the possibility of lead poisoning.     

糖尿病患者的饮食治疗法

目的:浅谈糖尿病病人饮食护理。方法:对临床32例糖尿病患者的实际观察与护理。结果:全部病例血糖控制良好,好转出院。结论:饮食疗法是糖尿病治疗的基础措施,需长期严格执行。     

Glycosylated proteins and serum lipid profile in complicated and uncomplicated NIDDM patients

In the present study, 58 diabetic patients (type II) comprising uncomplicated (27) and complicated (31) cases along with 38 healthy matched controls were investigated for glycosylated hemoglobin (HbA₁), glycosylated serum proteins (GSP) and serum lipid profile viz. triacylglycerol, total cholesterol, HDL-cholesterol (HDL-C), VLDL-C, LDL-C and their ratios. HbA₁ and GSP were significantly elevated in diabetic group as a whole when compared with controls (p<0.01), but comparison of mean values of complicated and uncomplicated group revealed (though higher in complicated) that the difference between two groups was not statistically significant (p>0.05). Follow-up studies showed that while GSP levels reflect variations in blood glucose over a shorter period of 15 days, those of HbA₁ do so for about 3 months. HbA₁ correlated with fasting blood glucose (p<0.01), whereas GSP showed correlation with both fasting (p<0.01) and postprandial (p<0.05) blood glucose. Hypercholesterolemia and hypertriacylglycerolemia were observed (p<0.01) in both the groups. However no significant change was seen in HDL-C (p>0.05) even after accounting for sex in both the groups. Interestingly TC:HDL-C was elevated significantly (p<0.01) in the above groups. These findings seem to suggest that at the levels of hyperglycemia, hypercholesterolemia and hypertriacylglycerolemia observed, some patients are prone to develop complications earlier.     

Serum lipid profile in diabetics with and without retinopathy

Diabetics showed significantly raised levels of total and LDL cholesterol, (257.0±68.88 mg% 173.5±67.7mg% respectively) compared to controls matched with age, sex and socioeconomic status. No significant difference was observed in these parameters in diabetics with and without retinopathy.     

Intelligent information retrieval: diagnosing information need. Part II. Uncertainty expansion in a prototype of a diagnostic IR tool

This article is part II of a three part series. In part I we described the theoretical framework for developing an “intelligent information retrieval” tool, based on three principles from medical diagnosis theory. In part II, the present article, we outline a prototype of an “intelligent” IR tool, whose purpose is to facilitate information access for an undergraduate seeking information for a history term paper. Our objective is to create a tool that will (i) draw-out the undergraduate's query to the information system by taking the student through the task of doing the term paper and (ii) diagnose the student's information need by measuring his or her degree of topic integration. The degree of integration indicates a class of information need. The classes of information need are based on Kuhlthau's six stage information search process (ISP) model (each stage is a separate information need, demanding different information to satisfy it). The measurement instrument is based on (i) principles from Shannon's mathematical theory of communication and (ii) principles of uncertainty expansion and reduction from differential diagnosis theory.     

Type-2 diabetes related intermediate phenotypic traits in north Indian diabetics

Asian Indians are known to be at a higher risk of developing T2DM, but the underlying genetic factor in this population is still not well understood. T2DM is a complex genetic trait and assessment of disease related intermediate phenotypic traits is an important initial step towards any systematic genomic study. Therefore, in the present study we have assessed diabetes related intermediate phenotypic traits of insulin secretion and insulin resistance in the patients belonging to this population. The study included 157 T2DM patients of either sex ranging in age from 45–80 years and 84 non-diabetic subjects with no family history of diabetes, ranging in age from 45 to 75 years served as controls. Intermediate phenotypic traits studied were BMI, W: H ratio, fasting free fatty acid level and Insulin resistance and secretion. Diabetics were found to have significantly higher W: H ratio (p<0.001), FFA (p<0.001) and HOMA-R (p<0.001) as compared to non-diabetics. However, there was no significant difference in their BMI and HOMA-β. There was a positive correlation between FFA level and HOMA-R among diabetics, but not among controls. These findings suggest that in abdominal obesity FFA mediated insulin resistance is an important causative factor underlying T2DM in this population. Moreover, comparable HOMA-β in diabetics reflects compensatory insulin hyper secretion in these subjects. There is a need to examine relative contribution and precise nature of genetic factor in their tendency for central obesity, free fatty acidemia and insulin resistance.     

Effect of insulin on serum lipids in relation to nutritional status in diabetics

Serum levels of cholesterol, triglyceride, free fatty acid (FFA) and high density lipoprotein (HDL) cholesterol were studied in 10 undernourished and 10 better nourished diabetic patients at different periods of insulin treatment and in non-diabetic controls. Serum concentrations of cholesterol, triglyceride and FFA were significantly higher in untreated diabetic patients than in control but the elevated lipid levels gradually shifted towards normal on insulin treatment. The HDL cholesterol, on the other hand, was significantly lower in untreated diabetic subjects than those in controls and the HDL cholesterol also gradually modified on insulin therapy. However, the improvement of all the lipid parameters on insulin treatment was somewhat delayed in undernourished compared to those of better nourished diabetics. These results, therefore, suggest that malnutrition interferes with the serum lipid improvement in diabetics on insulin treatment and may make them more prone to develop vascular complications.     

Serum fructosamine in a random group of adult onset diabetics of Indian subpopulation

Serum fructosamine (SFRC) was estimated using single colour reading procedure in 50 normals and 160 adult onset random diabetics. Serum fructosamine levels were observed to be 1.86±0.321 m moles/L (Range 1.0 to 2.4) and 3.44±0.671 (Range 2.0 to 5.7) in normal and diabetic subjects respectively. Serum fructosamine levels as determined by the method adapted, were found to be unaffected by a transient rise in serum glucose levels during an oral glucose tolerance test. Significantly elevated SFRC concentration was also seen in diabetic groups in spite of different combinations of antidiabetic treatment. Attempts to correlate SFRC with duration and secondary complications of diabetes did show significant elevation in all the groups irrespective of duration and complications thus indicating poor glycemic control.     

Glycated nail proteins as a new biomarker in management of the South Kivu Congolese diabetics

Introduction

Diagnosis and monitoring of diabetes mellitus in sub-Saharan Africa, based on blood analyses, are hampered by infrastructural and cultural reasons. The first aim of this study was to evaluate the diagnostic accuracy of glycated nail proteins for diabetes mellitus. The second aim was to compare the course of short- and long-term glycemic biomarkers after 6 months of antidiabetic treatment. These objectives should support our hypothesis that glycated nail proteins could be used as an alternative glycemic biomarker.

Materials and methods

This case-control study consisted of 163 black diabetics and 67 non-diabetics of the South Kivu (Democratic Republic of Congo). Diagnostic accuracy of glycated nail proteins was evaluated using ROC curve analysis. At the start of the study, glycated nail protein concentrations were compared between diabetics and non-diabetics, using a nitro blue tetrazolium (NBT) colorimetric method. In a subgroup of 30 diabetics, concentrations of glycated nail proteins, fasting glucose (Accu-Chek® Aviva), serum fructosamine (NBT) and HbA1c (DCA-2000+®) were measured at start and after 6 months.

Results

ROC analysis yielded an AUC of 0.71 (95% confidence interval (CI): 0.65-0.76) and a cut-off point of 3.83 μmol/g nail. Concentration of glycated nail proteins was significantly higher (P < 0.001) in diabetics in comparison with non-diabetics. After 6 months of antidiabetic treatment, a significant drop in the fasting glucose concentration (P = 0.017) and concentration of glycated nail proteins (P = 0.008) was observed in contrast to serum fructosamine and HbA1c.

Conclusions

Measurement of glycated nail proteins could be used to diagnose and monitor diabetes mellitus in sub-Saharan Africa.Key words: fasting glucose concentration, fructosamine, hemoglobin A1c protein, nails, sub-Saharan Africa, diabetes mellitus     

Inaccuracy as a privacy-enhancing tool

The accuracy principle is one of the key standards of informational privacy. It epitomises the obligation for those processing personal data to keep their records accurate and up-to-date, with the aim of protecting individuals from unfair decisions. Currently, however, different practices being put in place in order to enhance the protection of individuals appear to deliberately rely on the use of ‘inaccurate’ personal information. This article explores such practices and tries to assess their potential for privacy protection, giving particular attention to their legal implications and to related ethical issues. Ultimately, it suggests that the use of ‘inaccurate’ data can potentially play a useful role to preserve the informational autonomy of the individual, and that any understandings of privacy or personal data protection that would tend to unduly limit such potential should be critically questioned.     

数据挖掘—大数据时代的重要工具

介绍了数据挖掘的定义、过程以及数据挖掘的功能、应用和发展前景。     

缺血性脑卒中(IS)早期生物学诊断标志物研究进展

缺血性脑卒中(即脑梗死)是一种高致残率及高致死率的急症,其发病率随着人口老龄化的到来呈增高趋势,严重威胁老年人的生命健康,同时是目前世界第三大死因,在心血管病造成的死亡中,其位居第二。相比高收入国家,我国等一些中低收入国家缺血性卒中的死亡率尤为严重,为保证做出准确的早期诊断,制定有效治疗方案并改善预后,充分了解其早期生物学检测指标已迫在眉睫。     

Serum Lp(a) in diabetics with and without evidence of clinical nephropathy—A preliminary study

Type 2 diabetes is associated with a marked increase in the risk of coronary artery disease. Dyslipidaemia is believed to be a major cause of this increased risk. Recently, elevated levels of lipoprotein (a), Lp(a), have been reported to be associated with an increased risk. However there is very little data regarding Lp(a) concentrations and type 2 diabetes from India. The objective of the study was to assess serum Lp(a) levels in type 2 diabetics with and with out evidence of clinical nephropathy. We estimated serum Lp(a) levels in 30 control subjects, 30 diabetics without evidence of clinical nephropathy and 30 diabetics with evidence of clinical nephropathy. Statistical analysis showed that Lp(a) levels were increased in diabetic patients with nephropathy (mean 46.3±17.6 mg/dl). The Lp(a) levels however did not differ significantly between control (mean 20.2±15.9 mg/dl) and diabetics without nephropathy (mean 22.6±13.1mg/dl). Thus diabetes per se seems to have little or no influence on serum Lp(a) levels, however elevated levels were seen in patients with nephropathy.