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By Miss Jitjira Chaiyarit ID: 567110015-4

The association between eGFR and Hyperosmolar Non- Ketotic Hyperglycemia Syndrome in Diabetes type 2. By Miss Jitjira Chaiyarit ID: 567110015-4. Doctoral Seminar 1 / 2013. Outline. Doctoral Seminar 1 / 2013. Introduction Materials and Methods Results Discussion. Introduction.

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By Miss Jitjira Chaiyarit ID: 567110015-4

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  1. The association between eGFR and Hyperosmolar Non-Ketotic Hyperglycemia Syndrome in Diabetes type 2 By Miss JitjiraChaiyarit ID: 567110015-4 Doctoral Seminar 1 / 2013

  2. Outline Doctoral Seminar 1 / 2013 Introduction Materials and Methods Results Discussion

  3. Introduction Doctoral Seminar 1 / 2013 Hyperosmolar Non-Ketotic Hyperglycemia Syndrome (HNHS) is a life-threatening complication of uncontrolled diabetes mellitus and often found in patients with type 2 diabetes, is a serious condition most frequently seen in older persons. Complications associated with HHNS include severe metabolic disturbances, renal impairment etc. The testing of kidney working is an uncommon complication of HNHS but probably subclinical and thus underestimated.

  4. Materials and Methods Doctoral Seminar 1 / 2013 • The design was Cross-sectional analytical. • The information for analysis was part of DM&HT dataset. • The sampling method was stratified cluster sampling with probability proportional to size hospitals • The exclusion criteria were: • under age of 18 • not been examined serum creatinine • were diagnosed with HT or both DM & HT

  5. Materials and Methods (Cont.) Doctoral Seminar 1 / 2013 • The main outcome was HNHS (yes, no) • The factor of interest was eGFR that was recalculated by CKD-EPI formulas • Covariate were gender, age, receiving ACEI or ARB and HbA1C

  6. Materials and Methods (Cont.) Doctoral Seminar 1 / 2013 • Statistical analysis: • The continuous variables were presented as mean and standard deviation. ii) The categorical variables were presented as frequency and percentage. iii) Logistic regression models were used to examine association and OR.

  7. Materials and Methods (Cont.) Doctoral Seminar 1 / 2013 • Ethical Consideration The permission to study was granted by each of sampled hospitals. Obtaining written informed consent of all participating patients was done prior to access to their medical records. Data collection was done by participating hospital’s authorized skilled personnel who had been trained to protect and deliberately engaged in the study.

  8. Materials and Methods (Cont.) • Research frame Doctoral Seminar 1 / 2013

  9. Results Mean(SD) = 84.22 (24.44) (mL/minute/1.73m2) Doctoral Seminar 1 / 2013 Baseline Characteristics • eGFR (n=24,133)

  10. Results (Cont.) • Gender (n= 24,263) • Age (n= 24,245) Mean(SD) = 56.09 (10.90) (year) Doctoral Seminar 1 / 2013 Baseline Characteristics (Cont.)

  11. Results (Cont.) • HbA1C (n= 17,653) • Receiving ACEI or ARB (n= 19,162) Doctoral Seminar 1 / 2013 Baseline Characteristics (Cont.)

  12. Results (Cont.) Doctoral Seminar 1 / 2013 Factors associated with HNHS

  13. Results (Cont.) Doctoral Seminar 1 / 2013 Factors associated with HNHS adjusted for all other factors

  14. Discussion Doctoral Seminar 1 / 2013 • The study found statistically significant association between eGFR and HNHS. • The present result found the patients with low eGFR had risk effect (adj.OR=2.89) for having HNHS. This is consistent with a previous finding that if renal function declined, it was cause of glucosuria that was a risk factor for HNHS.

  15. Discussion (Cont.) Doctoral Seminar 1 / 2013 • From result, age was protective effect (adj.OR=0.80) that contrasts with research in the pastwhich found the average age of patients with HNHS is 60 years.In the other hand, the previous research has demonstrated that HNHS may also occur in younger people.

  16. Discussion (Cont.) Doctoral Seminar 1 / 2013 • The patients who had poor glycemic control (HbA1c ≥ 7%) were at greater risk (adj.OR=2.01). This finding suggests that in those who have not been able to control their diabetes, HNHS will occur. This result supports past studies show that the patients were poor management if blood sugar levels rise and left untreated, this can result in diabetic coma and death.

  17. Thank you for your attention.

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