Can we assess Diabetic Complications earlier?

Can we assess Diabetic Complication earlier?

Yes/may be

In 1993, most popular Diabetic Control & Complication Trail study (conducted in USA) showed for the first time that strict control in patients with type-1 diabetes greatly reduced the complication of the disease, and United Kingdom Prospective Diabetes Study proved similar evidence in favour of strict control in patient with type-2 diabetes.

Both the studies stressed on quantifying the complications as earliest possible, because once a macro or micro vascular diabetic complications take place, then quality of life effect different level directly or indirectly, hence diabetic complications are –

First cause of increased expense and pain

Second cause of physical disability

Third cause of death

 Cost of medication raised by 22-25% and risk of hospitalisation raised by 30%.

Decontrol or poor blood sugar control is main reason for all diabetic complications, it causes fix by the Global scientists are – Lack of awareness of diabetes, avoid pathological tests, Self- medication, poor compliance (including diet & exercise), unable to differentiate between control and cure, and finally patient don’t want to involve know the severity, so patient rarely involve when doctor were detailing about complications of diabetes. Result pressure on hospitals is increasing every day, rate of emergencies or mortality are now multi fold as compare to last 10 years.

To avoid these most complicated situation scientists of bio-medical field introduced new generation Non-invasive instruments working on a variable frequency (low to high) with built-in ECG capabilities and computer compatibility. These instruments measure R-R interval, Power-Spectrum, Poincare-plotting Pulse wave velocity, Arterial histogram, Arterial-brachial index, Cardio-techogram, valsalva manoeuvre (in graphical presentation) and Vibro-sensometry (for feet’s).

But output of above these instrumentations was again useful for doctors only, but patients were unable to understand, so they were not involving in his problem. After a long exercise, we select some pathological tests- Haemoglobin, haemtocrit, platelet count, lipids, SGOT,SGPT, ALP, Albumin, S.Urea, Creatinine, Uric, Calcium, Magnesium, Phosphors, Sodium, Potassium, Ghb1c, C-peptide, Insulin assay, and coordinate with above said instrumentations and make very first time a new algorithm, and matched with patient complaints, results were encourgable, and the important point was patient were understand about his health status. We labelled as 1^stDiabetic Complication Assessment unit.

The comprehensive report assess risk of General  health, function of pancreas and risk of eye, cardiovascular , cerbrovasculer, kidney, sexual, neuropathic and foot.

For example- If a 35 yrs old, average wt, non alcoholic, non smoker  have diabetes last 1year with diet control having, Ghb1c-8.5. C-peptide-1.4 and insulin-7.2 then his pancreatic function will be appxcimatly  24.00 %( normal 100%), interpretation diet control and exercise are not sufficient, patient should be consult with diabetologist and switch over to anti-diabetic drug.

It is very much useful to dialectologist, because most of the time diabetic patient are unable to explain their problems or new symptom in early stage, while the doctor are busy in his own schedule, so due to communication gap new symptom gradually strengthen and get into a shape of severer diabetic complication.

A quick review of this report quantifying content tell the complete status of target organ, hint to modifying his treatment and reduced the cost of medication by 22-40%, reduced chance of OHGA failure, hypoglycaemic bout of insulin.

By this approach a group of diabetic patients could understand what is our actual status of health due to diabetes, and start efforts for better control to push back diabetes complications, and successfully improve

Quality of life by 65-75%

Reduced approximate cost of medication 22-40%,

Risk of hospitalisation y 45-50%

Complication by 55-60%

Emergency situation by 60-65%

And emergencies burden on hospitals, financial burden of individual as well as govt.

Dr.M.S.Singhal