| dc.description.abstract | Type 2 diabetes mellitus (T2DM) is among the largest global health emergencies of the 21st
century and one of the leading cause of death in the world. The prevalence of diabetes is high and
projected to increase with 10% by 2025. Poor glycemic control continues to be a major concern
with majority of the poor glycemic control cases remaining undiagnosed. Microvascular and
macrovascular complications due to diabetes are the major causes of poor prognosis among
diabetic patients the main ones being hepatic, cardiovascular complications and diabetic
nephropathy. A high percentage of T2DM patients remain undiagnosed during the early onset of
the disease hence making it difficult to establish the level of organ damage. Upon diagnosis in such
cases, hepatic, renal and cardiovascular injury is already evident, and some patients have end-stage
organ damage/ failure. Early determination of organ damage plays a critical role in the
management of the disease thus preventing related complications and mortality. This study aimed
at determining hepatic, renal and cardiovascular decline by evaluating the dynamics and variability
of biomarkers in diabetes patients with poor glycemic control. In the study, 103 consenting
participants were recruited at the Kakamega county general hospital comprising of (Healthy
control, n=27), (T2DM good glycemic control, n=25) and (T2DM poor glycemic control, n=51).
This study was an analytical crossectional study and utilized a random sampling technique in
participant’s recruitment. 6 milliliters of blood sample was collected from the study participants
and processed for biomarkers of hepatic, renal and cardiovascular function using colorimetric,
spectrophotometric, and florescence immunodetection techniques. Data obtained was cleaned,
entered into excel, coded and analyzed using the IBM SPSS 22 software. The normality test was
done using the Kolmogorov Smirnov test. Chi-square test was done on categorical variables while
Kruskal-Wallis test was done on the continuous variables. A Bonferroni Post-hoc test was done to
determine the differences between the groups. The study revealed a significant hepatic biomarker
variability in GGT (P=0.031), Total bilirubin (P<0.0001), Direct bilirubin (P<0.0001), albumin
(P=0.001) and AST/ALT ratio (P<0.0001). Renal biomarkers including Urea (P=0.002), potassium
(P=0.0012), sodium (P<0.0001) and chloride (0.007) showed a significant variability in poor
glycemic control. Additionally, Triglycerides(P<0.0001), total cholesterol(P=0.046) and LDH
(P=0.005) levels were significantly elevated in poor glycemic control. These findings suggest that
poor glycemic control causes a significant variability in biomarkers due to the resultant organ
damage and these biomarkers can be utilized for determination and early diagnosis of poor
glycemic control related organ failure, utilization in disease monitoring and determination of
clinical outcomes in T2DM | en_US |
