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A mandatory practice in type 2 diabetes mellitus to maintain quality of life

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Original Article

Author Details : Sadikshya Shrestha*, Pradeep Krishna Shrestha, Binod Kumar Yadav

Volume : 10, Issue : 4, Year : 2023

Article Page : 289-296

https://doi.org/10.18231/j.ijcbr.2023.053

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Abstract

Background: Nepalese owing to modern lifestyle and processed food are racially at an elevated risk of acquiring central obesity-related insulin resistance (IR) and thus Type 2 diabetes mellitus (T2DM) and Diabetic Kidney Disease (DKD). Low birth weight in utero and later becoming obese risks the development of T2DM.
Materials and Methods: In a total of eighty-four newly diagnosed treatment-naive Nepalese T2DMs, incidence of IR, percentage beta-cell function (?F) and percentage insulin sensitivity (%IS) were determined using Homeostatic Model Assessment 2 (HOMA2-IR). Association of HOMA2-IR with albuminuria, kidney function, hs-CRP, fatty liver, fatty pancreas, several anthropometric and biochemical parameters were analyzed. Among the eighty-four T2DMs, fifty-four agreeing regular follow-ups were prescribed a low-carbohydrate diet (<130gm> Results: From 84 newly diagnosed T2DMs, 56 (66.7%) were insulin resistant and 28(33.3%) insulin-sensitive on HOMA2-IR. There was a significant association of HOMA2-IR with albuminuria and declining kidney function (p=0.006 and 0.034 respectively) and most of them were at reversible stages. Waist circumference (WC), waist-hip ratio (WHR), lipid profile ratios, fatty liver and fatty pancreas were elucidated as potential markers for IR. The IS group (ISG) had significantly inadequate ?F (p=0.001) but high %IS (p<0 p=0.001) p=0.04) p=0.008> Conclusion: Severe insulin resistance and IR-associated DKD, fatty liver and fatty pancreas are highly prevalent from the time of diagnosis of T2DM in the Nepalese population. Thus inspecting for IR and its consequences mandatorily at diagnosis and applying precision therapies like adjustments in the quality and quantity of staple food carbohydrates significantly improves IR-related parameters and glycemia.
 

Keywords: Insulin resistance (IR), Homeostatic model assessment (HOMA), C- peptide, Type 2 Diabetes mellitus (T2DM), Diabetic nephropathy (DN), Microalbuminuria.

How to cite : Shrestha S, Shrestha P K, Yadav B K, A mandatory practice in type 2 diabetes mellitus to maintain quality of life. Int J Clin Biochem Res 2023;10(4):289-296

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