Rehan Khawaja, Muhammad Sarwar, Muhammad Hussain Bloach, Iftikkhar Ahmad, Tahir Ahmad Munir.
Type 2 diabetes mellitus; homocysteine, total anti-oxidant levels and vitamins in patients of different duration.
Professional Med J Jan ;23(09):1084-91.

To access the Homocystein and Antioxidant Status in Patient with Variation in Duration of Type 2 Diabetes Mellitus. Data source: 90 selected patients suffering from Diabetes Mellitus Type 2 (DMT2) and 30 subjects as control group. Design of study: Case Control Study. Setting: Rawal Institute of Health Sciences, Islamabad. Period: July 2013 – March 2014. Materials & methods: Out of 120 selected subjects, 30 were assigned as control, (group 1) and 90 of DMT2. Based on duration, patients of DMT2 were divided into; group 2 (DMT2 <5 years), 3 (DMT2 = 5-10 years) and group 4 (DMT2 >10 years). Smokers, renal failure, coronary artery disease, thyroid disease and patients on antioxidant treatment were excluded from the study. DMT2 was diagnosed according to American Diabetes Association standards. The fasting plasma glucose levels were measured by glucose oxidase method; HbA1c by automated kit, TAC by calorimetric TAC Assay Kit (BioVision), Vitamin C and E by ELISA Kit (HUMAN) while homocysteine measured by AXSYM HCY assay kit (ABBOTT). Cut off values for HbA1c was taken as ≤6%; FBS ≤110 mg/dl; TAC ≥1.16 mmol/L; Vitamin C ≥2 mg/dl; Vitamin E ≥ 9.5nmol/ml and homocysteine was < 6.3 μmol/L. Results: As the duration of DMT2 increases, levels of vitamin C and TAC fall significantly (p <0.05) in all groups except between groups 1 & 2; however, vitamin E, decreased significantly in all the groups with increased DMT2 duration. A significantly increased level of HbA1c was noticed in groups 2, 3 and 4 compared to group 1 with increased DMT2 duration. The fasting blood sugar increased significantly in all the groups except between group 3 and 4. ANOVA showed significant differences (p <0.05) between each group and within the groups when Hb1Ac, vitamin E, vitamin C, & TAC were compared. A positive significant correlation was observed when HbA1c was correlated with FBS; TAC correlated with vitamin C and E and between vitamin C and vitamin E. Conclusions: The levels of TAC, vitamin C and E gradually decrease with increased DMT2 duration; so should be supplemented in diabetics. TAC status can be taken as early marker to detect complications while homocysteine levels to prevent diabetic complications.

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