STUDY OF SERUM GGT ACTIVITY LEVEL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH GOOD AND POOR GLYCEMIC CONTROL

Abstract

Background
Diabetes is a chronic condition caused by either an absolute lack of insulin or a relative lack of insulin due to impaired insulin secretion and action. Insulin resistance and glucose intolerance results in chronic hyperglycemia and alterations in lipid and protein metabolism. Serum GGT is cell surfаce protein which has аntioxidаnt property аnd cаtаbolises extrаcellulаr glutathione. Recent prospective studies hаve suggested thаt аn elevated level of GGT enzyme is аssociаted with subsequent development complications of Diabetes.
Material and Methods
This is a Prospective and observational study. Patients with clinical features of diabetes mellitus admitted in medicine department, KIMS will be taken for study. Total 210 patients presenting with history ,characterstic clinical signs and symptoms of diabetes mellitus are taken into study and the following investigation will be done in selected patients. Group I – Control group (n=70) This group consists of age and sex matched healthy subjects. They are taken from general population. Group II – Type 2 DM patients with good glycemic control (n=70) This group consists of patients with type 2 DM with duration less than 8 years, HbA1c level less than 7%. They are on life style modifications and oral hypoglycemic drugs and free from clinical evidence of any complication of diabetes mellitus. Group III – Type 2 DM patients with poor glycaemic control (n=70).This group consists of patients with type 2 DM with duration more than 8 years, HbA1c level more than 7.1%. They are on life style modifications, oral hypoglycemic drugs, insulin or combination of all three and associated with one or more microvascular or macrovascular complication of diabetes mellitus.
Result
There were 41 males and 29 females in Group I, 39 males and 31 females in Group II, and 36 males and 34 females in Group III. There were 2 patients in age group of 21-30 years, 14 patients in age group of 31-40 years, 37 patients in age group of 41-50 years, 86 patients in age group of 51-60, 62 patients in age group of 61-70 years and 9 patients in age group of 71-80 years. There was no statistically significant difference between the Groups and hence they were comparable in demographic parameters. Mean GGT in Group 1 was 20.93 4.39 U/L, in Group 2 was 36.05 6.53 U/L, in Group 3 was 47.06 6.09 U/L.
Conclusion
There was positive correlation between FBS, PPBS, HbA1c and GGT,FBS, PPBS, HbA1c, indicating increasing oxidative stress and inflammation in patients poor glycemic control in Diabetes Mellitus. There was positive correlation between GGT and hsCRP in Diabetes Mellitus indicating linear relation between oxidative stress and inflammation.