TYPE 2 DIABETES MELLITUS

HOMOCYSTEINE, TOTAL ANTI-OXIDANT LEVELS AND VITAMINS IN PATIENTS OF DIFFERENT DURATION

Abstract

Objectives: 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.