To evaluate the levels of glycated hemoglobin, serum calcium, magnesium, phosphate, uric acid and microalbuminuria in patients with newly diagnosed type 2 diabetes mellitus

Authors

  • Qazi Najeeb Post M.D. Demonstrator, Department of Biochemistry, SKIMS Medical College, Bemina, Srinagar
  • Ruqaya Aziz Associate Professor, Department of Biochemistry, SKIMS Medical College, Bemina, Srinagar
  • Sajad Hamid Lecturer, Department of Anatomy, SKIMS Medical College, Bemina, Srinagar

Keywords:

Glycated Hemoglobin, Calcium, Magnesium, Phosphate, Uric Acid, Microalbuminuria, Type 2 diabetes mellitus

Abstract

Background: Over the past three decades, the number of people with diabetes mellitus has more than doubled globally, making it one of the most important public health challenges to all nations. Therefore, the present study was undertaken to compare the levels of HbA1c, serum calcium, serum magnesium, serum phosphate, serum uric acid and microalbuminuria in patients with newly diagnosed type 2 diabetes mellitus with normal healthy individuals.

Methods: This is a cross sectional study and was undertaken in the Department of Biochemistry, SKIMS-MC&H, Bemina, Srinagar. Total 300 subjects included in this study were divided into 2 groups. Group I: included 150 normal healthy individuals, who were in the age group 30-80 years, of either sex. Group II: included 150 newly diagnosed patients of Type 2 diabetes mellitus in the same age group. Fasting blood samples were drawn and investigated for serum calcium, magnesium, phosphorus, uric acid, blood sugar and HbA1c. 24-hours urine was taken for estimation of microalbuminuria, and these values were compared with those of normal healthy subjects. Means ± standard deviation were calculated and student t-test was applied to find out significance level.

Results: Mean serum levels of FBS, HbA1c, calcium, magnesium, phosphate, uric acid were 89.71 ± 9.22, 4.68 ± 0.47, 9.61± 0.84, 2.23 ± 0.41, 3.45 ± 0.46, 4.21 ± 1.04 in controls (group-I) and 145.57 ± 76.61, 8.94 ± 2.38, 8.09 ± 0.18, 1.92 ± 0.27, 2.82 ± 0.68, 7.01 ± 0.27 in cases (group-II) respectively (<0.001). Microalbuminuria showed significant mean difference between cases and controls 35.01 ± 41.30 and 15.35 ± 2.60 (<0.001).

Conclusion: There is decrease in serum calcium, magnesium and phosphate levels, all these plays an important role in the regulation of glucose level in the blood. Hence oral supplementation of all these ions other than diet is recommended.Increased serum uric acid and microalbuminuria was seen with reduced glucose tolerance hence early estimation of both the parameters should be done while monitoring case of Type-2 diabetes and thus will help to decrease the incidence of renal complications.

 

References

Lei Chen, Dianna J. Magliano, Paul Z. Zimmet. The worldwide epidemiology of type 2 diabetes mellitus-present and future perspectives, Nature Reviews Endocrinology 2012: 8; 228-236.

LGSR Mehta, Kashyap AS, Das S. Diabetes Mellitus in India; The Modern Scourge. MJAFI 2009:65(1); 50-54.

The International Expert committee: International Expert Committee report on the role of A1c assay in the diagnosis of diabetes. Diabetes care 2009, 32: 1327-1334.

H Vorum, J Ditzel. Disturbance of Inorganic Phosphate Metabolism in Diabetes Mellitus: Its Relevance to the Pathogenesis of Diabetic Retinopathy. Journal of Ophthalmology, vol. 2014, Article ID 135287, 8 pages, 2014.

Mathieu C, Badenhoop K. Vitamin D and type 1 diabetes mellitus: state of the art. Trends Endocrinol Metab. 2005; 16:261–266.

Luis A.G.R, Lucia C.S, Choi H.K. Impact of diabetes against the future risk of developing gout. Journal for Health Professionals and Researches In Rheumatic Diseases. 2010; 69(12): 2090-94.

Butler R, Morris AD, Belch JJ, Hill A, Struthers AD. Allopurinol normalizes endothelial dysfunction in type 2 diabetics with mild hypertension. Hypertension Journal of American Heart Association. 2000; 35: 746-51.

Paolisso G, Scheen A, D’ Onfrio F, Lefebvre P. Magnesium and glucose. Diabetologia 1990; 33: 511-514.

Riduara RL, Stamfer MJ, Willet WC, et al. Magnesium intake and risk of type 2 diabetes mellitus in men and women. Diabetes Care 2004; 27:134-140.

Fauci, Braunwald, Kasper, Hauser, Longo and Jameson et. Al. Principles of Internal Medicine, Harrison’s 17th edition. 2008:Mc Graw-Hill.

Robert J. McCarter, James M. Hempe, Ricardo Gomez, Stuart A. chalew. Biological Variation in HbA1c Predicts Risk of Retinopathy and Nephropathy in type 1 Diabetes. Diabetes Care 2004; 27:1259-1264.

Laura S. Greci., Mala Kailasam., Samir Malkani., David L. Katz., Ilja Hulinsky., Ramin Ahmadi and Haq Nawaz., “Utility of HbA1c levels for Diabetes case finding in Hospitalized patients with hyperglycemia; AMJ Diabetic Care, 2003;26:1064-1068.

Lind L, Pollare T, Hvarfner A, Lithell H, Sorensen OH, Ljunghall S. Long-term treatment with active vitamin D (α-calcidol) in middle-aged men with impaired glucose tolerance: effects on insulin secretion and sensitivity, glucose tolerance and blood pressure. Diabetes Res 1989; 11:141–147.

Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004; 27:2813– 2818.

Borissova AM, Tankova T, Kirilov G, Dakovska L, Kovacheva R. The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2 diabetic patients. Int J Clin Pract 2003; 57:258–261.

Schulze MB, Schultz M, Heidemann C, Schienkiewitz A, Hoffmann K, Boeing H. Fiber and magnesium intake and incidence of type 2 diabetes: A prospective study and meta-analysis. Arch Intern Med 2007;167: 956–65.

Paolisso G, Sgambato S, Passariello N, Giugliano D, Scheen A, D’Onofrio F, et al. Insulin induces opposite changes in plasma and erythrocyte magnesium concentrations in normal man. Diabetologia 1986; 29:644–7.

Barbagallo M, Dominguez LJ. Magnesium metabolism in type 2 diabetes mellitus, metabolic syndrome and insulin resistance. Arch Biochem Biophys 2007;458:40–7.

Ditzel J, Lervang HH. Disturbance of inorganic phosphate metabolism in diabetes mellitus: temporary therapeutic intervention trials. Diabetes Metab Syndr Obes 2009; 2: 173–177.

Kramer CK, von Mühlen D, Jassal SK, Barrett-Connor E. Serum uric acid levels improve prediction of incident type 2 diabetes in individuals with impaired fasting glucose: the Rancho Bernardo Study. Diabetes Care 2009 Jul;32(7):1272-3.

Kutzing MK, Firestein BL. Altered uric acid levels and disease states. Pharmacol Exp Ther. 2008 Jan; 324(1):1-7.

Basi S, Fesler P, Mimran A, Lewis JB. Microalbuminuria in type 2 diabetes and hypertension: a marker, treatment target, or innocent bystander? Diabetes Care. 2008 Feb; 31 Suppl 2:S194-201.

Downloads

Published

2017-01-26

How to Cite

Najeeb, Q., Aziz, R., & Hamid, S. (2017). To evaluate the levels of glycated hemoglobin, serum calcium, magnesium, phosphate, uric acid and microalbuminuria in patients with newly diagnosed type 2 diabetes mellitus. International Journal of Research in Medical Sciences, 2(4), 1462–1465. Retrieved from https://www.msjonline.org/index.php/ijrms/article/view/2441

Issue

Section

Original Research Articles