Assessment of Glycemic Control, Renal Function, and Oxidative Stress Parameters in Type 2 Diabetes MellitusPatients

Abstract

Diabetes mellitus (T2DM) is a multifactorial syndrome that israpidly rising in all the continents ofthe globe, causing elevated blood sugar levels in affected people. A sample of 81 Iraqi T2DM patients was investigated based on several parameters. Glycemic control parameters includedlevels of fasting blood glucose (FBG),
glycated hemoglobin (HbA1C), and insulin, along with insulin resistance (IR) and insulin sensitivity (IS). Renal function tests includedmeasuring the blood levels of urea and creatinine. Oxidative stress parameters included total antioxidant capacity (TAC) and thelevel of reactive oxygen species (ROS). The results of the present
study showed a highly significant (P˂0.01) increase in FBG, HbA1c, insulin and IR levels in T2DM patients as compared to control.Insulin sensitivity showed a highly significant (p˂0.01) decrease in patients compared with control.Urea and creatinine levelsincreased in T2DM patients, but the differences were insignificant. TAC level
significantly (P<0.05) increased in patients compared with control. Also, the levels of ROSrevealed a highly significant (P<0.01) increasein T2DM patients compared with the control. Correlation analysis showedthat FBG has a highly significant (P<0.01) positive correlation with IR, urea, creatinine and ROS, as well as a significant (P<0.05) positive correlation with TAC. However, FBG shows a highlysignificant (P< 0.01) inverse correlation with IS. The levels of HbA1C show a significant (P<0.05) positive correlation with IR, creatinine, and TAC, whereas it
has a highly significant (P<0.01) positive relation with ROS. However, HbA1C level has a highly significant (P<0.01) inverse relation with IS. Insulin has highly significant (P<0.01) positive and negative associations with IR and IS, respectively.IR showshighlya significant (P<0.01) inverse correlation with IS, significant (P<0.05) positive correlation with creatinine, and highly significant (P<0.01) positive correlation with ROS. IS has a significant(P< 0.05) inverse correlation with urea. Urea shows a highly significant (P<0.01) positive correlation with creatinine. TAC has a significant (P<0.05) inverse correlation with ROS. Conclusion: diabetic patients revealed poor glycemic control. Fluctuating blood glucose concentrations may contribute significantly to oxidative stress, probably
even more than chronic hyperglycemia. The observed significant positive correlation between FBG and the other tested parameters revealed that hyperglycemia is an obvious independent risk factor for T2DM progression.