الفهرس 
Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus is a metabolic disorder which is characterized by chronic hyperglycemia and disturbances of carbohydrate, fat and protein metabolism resulting from defects insulin secretion, insulin action or both. The most common cause of type 2 diabetes is insulin resistance. Long term diabetes increase micro and macro vascular complication es-pecially diabetic nephropathy. Diabetic nephropathy is the major root cause of chronic kidney disease culminating in end stage renal disease (ESRD) or dialysis. Glucometabolic disturbances are frequent pathological findings in patient with end stage renal disease, insulin resistance is increased among patient with CKD, hemodialysis is associated with improve insu-lin sensitivity. Thus elevated fasting concentration and abnormal post-prandial responses of glucoregulatory peptide hormones such as insulin, glucagon and two gut in cretin hormones, glucagon like peptide-1 have been observed. Hemodialysis also improve insulin clearance. The study was conducted in 80subjects, 40 on regular hemodialysis. The study subjects their age ranged from 40-78 and they are 42 male and 38 female. All included patients under went full history taking and thorough clinical examination and laboratory investigations including: random blood glucose, fasting blood glucose, post prandial blood glucose, HbA1c levels, serum creatinine, blood urea, concentration of insulin by using ELISA methods, concentration of c-peptide by using ELISA methods. Summary - 82 - The main finding can be summarized as follows: The patients were classified into 4 groups: group 1: Controlled diabetic nephropathy patient, group 2a: controlled type 2 diabetic patient undergoing hemodialysis, group 2b: uncontrolled type 2 diabetic patient undergoing hemodialysis and group 3: control normal person. According to laboratory parameter in this study which done before hemodialysis only (HBA1C, random blood sugar, fasting blood sugar, post prandial blood sugar, serum creatinine and blood urea) group 2b has higher significant mean value than other groups as the mean value of group 2b as regard HBA1C is (8.10 ± 0.66), as regard random blood sugar is (199.55 ± 23.63), as regard to fasting blood sugar is (181.00 ± 11.85), as regard to post prandial blood sugar is (278.65 ± 19.56), as re-gard serum creatinine is (8.46 ± 2.67) and as regard to blood urea is (149.20 ± 51.88). According to laboratory parameter in this study which done before and after hemodialysis (Insulin and C-peptide) we found that group 2b had higher significant mean value as regard to insulin and c peptide be-fore hemodialysis: as regard to insulin mean value of group 2b is (27.95 ± 12.67) and as regard C-peptide is (13.23 ± 6.63) but after hemodialysis we found that group 2a has higher significant mean value as regard to insulin which is (12.62 ± 7.30) than other groups and as regard to c pep-tide group 2b has higher significant mean value which is (7.99 ± 4.89) than other group. Comparison insulin in group 2a before and after dialysis we found that there is no statistically significant difference between group 2a be-fore and after dialysis as regard to insulin but in group 2b there is statis- Summary - 83 - tically significant difference between group 2b before and after dialysis as regard to insulin as insulin decrease after dialysis than before. Comparison c peptide in group 2a before and after dialysis we found no statistically significant difference between group 2a before and after dialysis but in group 2b there is statistically significant difference between group 2b before and after dialysis as regard to c-peptide as c-peptide decrease after dialysis than before.