European Journal of Cardiovascular Medicine

Background: Diabetes is one of the most common chronic diseases. The development of albuminuria in Type 2 Diabetes (T2DM) increases the risk for renal disease. Methods: The study was retrospective conducted at the Primary Health Care Clinics at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. A total of 1583 Saudi with T2DM were randomly selected. Results: Total of 1583 patients with T2DM included in this study; 636 (40.2%) male and 8947 (59.8%) female with mean age 56.0

Background: Metabolic syndrome (MetS) including dysglycemia, obesity (especially central obesity), high blood pressure, low high-density lipoprotein cholesterol (HDL-C), and elevated triglyceride levels, is a complex of risk factors for type 2 diabetes and cardiovascular disease (CVD). MetS is a disease associated with multiple factors, and the main diagnostic indicators (components) include blood pressure, overweight and obesity, HDL-C, and fasting blood glucose. However, controversy exists about the impact of MetS on the prognosis of patients with CVD. Materials and methods: This are a prospective, cross sectional and observational study was conducted in the Shadan Institute of Medical Sciences Teaching Hospital and Research Center from June 2019 to November 2019 involving 470 students. The study was conducted using the criteria for metabolic syndrome defined by international diabetes federation. Data for height, weight, body mass index, waist circumference, fasting blood glucose, serum cholesterol, serum triglycerides (TG), high density lipoprotein (HDL), and low density lipoprotein were collected

Introduction: Type 2 Diabetes mellitus (Type 2DM) is chronic, lifelong progressive metabolic disease characterized by hyperglycaemia due to absolute or relative insulinopaenia. Monotherapy with Metformin, a biguanide agent acts primarily as an insulin sensitizer. Its primary clinical site of action is in the liver, improving hepatic insulin sensitivity and as a result, decreasing hepatic gluconeogenesis. Sitagliptin is an oral, highly selective dipeptidyl peptidase-4 (DPP-4) inhibitor for the treatment of patients with Type 2 Diabetes Mellitus. Sitagliptin inhibits the enzymatic degradation and inactivation of glucagon-like peptide-1 (GLP-1) and glucose dependent insulinotropic peptide (GIP) by DPP-4 the major incretins involved in glucose homeostasis, thereby increasing insulin release and lowering glucagon secretion in a glucosedependent manner. Material and Methods: This is an Open label, Randomized, Parallel group, Comparative and Prospective clinical study. Study was conducted in Type 2DM patients attending the outpatient department of Medicine in tertiary care center. Inclusion criteria: Patients of either sex having age group between 30 -60 years, Patients willing to participate and willing to give written informed consent prior to any study-related procedures and to comply with the requirements of the study protocol. Patients having newly diagnosed Type II DM with prandial blood glucose levels >180 mg% and <250 mg%. HbAlc in the range of 6.5 to 8.5 % at screening and BMI >27 kg/m2 Results: The mean fasting blood glucose level in Group I at baseline was 150.81±11.61 mg/dl, in Group II was 151.92±10.44 mg/dl and in Group III was 150.53±11.64. The mean fasting blood glucose level in Group I after 3 months was 99.73±9.91 mg/dl, in Group II was 92.72±9.82 mg/dl and in Group III was 85.72±9.82 mg/dl. These was statistically highly significant difference in mean Fasting Blood Glucose level at baseline versus after 3 months in Group I, Group II and Group III (p<0.0001). The mean of HbA1c level was 9.61±1.91% at baseline and 8.99±1.82% after 3rd month. In Group II the mean of HbA1c level was 9.61±1.83% at baseline, 8.65±1.73% after 3rd month. In Group III the mean of HbA1c level was 9.64±1.81% at baseline and 8.44±1.73% after 3rd month. Conclusion: Sitagliptin with Metformin causes efficient glycaemic control with less significant adverse reaction but the gylcaemic control of patients taking Sitagliptin with Metformin was slightly better as compared to patients taking alone. Thus, concluding Sitagliptin with Metformin to be more efficacious than alone

Background: Megaloblastic anaemia during metformin therapy can be treated by administrating vitamin B12. 10-30% of diabetic patients on long term treatment with metformin had vitamin B12 deficiency. Objective: To determine VitaminB12 deficiency in type2 diabetes patients on long term metformin therapy for >2years. Materials & Methods: This prospective study carried out in Department of Medicine in Dr DY Patil Medical College and Hospital, Pune. It was comparison between 50 cases and 50 controls to find Vitamin B12 Deficiency In Type 2 Diabetes Patients On Long Term Metformin Therapy For >2years. Results: Mean age was for cases was 47.12 + 12.54 years and for controls was 41.64 + 9.74 years with majority in the age group of 41 to 60 years among both groups. Among cases males 52% were more than females 48%. Mean weight was for cases was 70.72 + 11.6 kg and controls was 58.02 + 6.80 kg. Mean BMI was for cases was 27.36 + 4.88 and controls was 23.93 + 2.71 and majority were in range of 25 to 30. Common symptoms seen were Polyuria and polydipsia. 50% had HTN. Majority were smokers followed by alcoholic. Mean duration of DM among cases was 6.18 + 2.64years. Mean serum vitamin B12 of cases was 271.75 + 184.21 and controls were 410.45 + 154.34, showed statistical significance. Majority among cases had Vit B12 levels lower than 200 and controls were more than 301. P value was highly significant. Conclusion: Routine supplementation of vitamin B12 given to patients on long-term high dose metformin therapy seems to be clinically more prudent and a cost-effective approach

Background: H. pylori is the most common human bacterial pathogen that colonizes the gastric epithelium especially in those habitual Qat chewers; it influence can absorption of glucose which is also abnormal in DM patients, its common infection in diabetic patients who have inadequate metabolic control, this study was conducted to reveal the prevalence of H. pylori among T2DM and non-DM patients and potential risk factors. Methods: A cross-sectional study was conducted in the department of medicine, a tertiary care hospital in India, and there were 250 patients who included in this study. Data were collected through structural intervals questionnaire and sampling information. Results: The overall prevalence of H. pylori among diabetics was 29.2%. There was no significant association between H. pylori infections and diabetes (P> 0.05), most of the patients were 46-60 year age group, with male predominance (76.7%) H. pylori infections were not significantly associated with the smoking, hypertension, dyslipidemia and obesity. H. pylori infection increased in longer duration of diabetes and the increase in HbA1c level. Conclusion: Positive H. pylori DM patients should update their sugar level values and control the disease. Further research is highly recommended on relationship between H. pylori infections and diabetes

Background: Depression is associated with a 60% increased risk of type 2 diabetes mellitus, and diabetes doubles the likelihood of depression. This study was conducted to estimate the prevalence of depression and assess the association between glycemic control and depression in diabetic patients. Methods: A total of 100 patients with type 2 diabetes mellitus were included in this cross-sectional hospital study.

Introduction: Type 2 Diabetes Mellitus (T2DM) is one of the most common metabolic disorders worldwide and its development is primarily caused by a combination of two main factors

Background: The long-term complications of DM have a variety of severe effects on people's quality of life as well as their prospective life, harming both individuals and civilizations. In order to reduce the microvascular and macrovascular complications, glycated haemoglobin (HbA1c), should be maintained below 7% in DMT2 patients. It is possible to predict complications in type 2 DM using the simple, reliable, and affoGlycosylated Haemoglobin and Microvascular, Type 2 Diabetes Mellitus Patientsrdable tests like Mean Platelet Volume (MPV)

Introduction: In India, diabetes is turning into an epidemic as currently, more than 62 million individuals suffer from the disease. To our knowledge, very few studies have evaluated the correlation between lipid profiles and glycated hemoglobin (HbA1c) in newly diagnosed type II diabetes patients with hypertension. The early detection of lipid abnormalities in these patients will help prevent the cardiovascular outcomes

Diabetes is a public health problem; prevalence of diabetes is progressively on the rise. International diabetes federation estimates a doubling prevalence of diabetes mellitus by 2035 from that of 541 million in 2022. Objectives: To find out the prevalence of peripheral neuropathy among known type 2 diabetics and to correlate peripheral neuropathy with select socio – demographic variables. Materials and Methods: A Descriptive cross -sectional community-based study was done among Known type 2 diabetes mellitus individuals of age group 30 years and above. The study was carried out for a period of 10 months after getting approval from the institutional ethical committee. Peripheral neuropathy was classified using the Toronto clinical scoring system of peripheral neuropathy. Data collected was entered in Microsoft 2010 excel spread sheet, compiled and analyzed using IBM SPSS Version 22 statistical package. Results: The prevalence of peripheral neuropathy was found to be 12.6% among the study subjects. Frequency of Peripheral neuropathy was increasing as the duration of diabetes increases. A significant association was found between duration of diabetes and peripheral neuropathy. A significant association was found between increased RBS value and peripheral neuropathy. Conclusion: Maintaining a proper blood-glucose control is the key to primary prevention of diabetes related complications. Regular monitoring of blood-glucose level must be done for the management of Diabetic peripheral neuropathy.

Prospective observational study, to formulate a risk scoring system that can predict the risk of amputation in a patient with an infected diabetic foot in patients presenting to the OPD and IPD of Katuri medical college &hospital, Chinakondrupadu, Guntur. Atotalof203patients in the duration from December 1st, 2020, to June 1st, 2022 presented with infected diabetic foot ulcerto our hospital, of which150 were enrolled in the study.

Using the specificity and sensitivity of our 11 risk factors, we constructed a ROC curve according to which our new Risk score had a high prognostic accuracy based on the area under the curve of 0.903, which was higher  than  the International Working Group on the Diabetic Foot (IWGDF) system which was 0.67. The Resultant ROC curve yielded a cut off score of 16.5.

Our study found the risk of amputation increases with the severity of the infection reflected in our study, with the highest incidence rate of 44.7%ofamputations belonged to IDSA grade4. An association between HbA1c levels and Lower extremity amputation can be drawn, with the maximum number of amputations identified in patients with HbA1c≥9.5. A strong correlation between the previous history of diabetic Lower extremity amputation and present amputation. 77.8% of patients who had a history of lower extremity amputation due to diabetes underwent amputations. 68.1 % of patients who underwent amputations had sensory neuropathy in ≥3sites.

A total of 9 patients required re amputation and 26 patients who were our previous amputee subjects required re debridement within a period of 18 months. All the patients who underwent re amputation had a score of>16.5.

Thus our score predicted the need for future amputation in those patients who had a Score of > 16.5.

Limitations of our study are:

1. The effect of our risk factors on major and minor amputations separately were not assessed.
2. The history of the previous lower extremity revascularization procedure was not taken into account while calculating the score.
3. The effects of venous insufficiency on diabetic foot ulcers in this study were not accounted for.
4. The motor neuropathy was not segregated into subsequent grades based on the muscle power

The effects of type 1 and type 2 diabetes was not studied independently

Background: The incidence of autonomic dysfunction has increased in the presence of type 2 diabetes mellitus and various tools have been developed for assessing it. Classical autonomic function tests are one among them. Autonomic nervous system (ANS) innervates almost all organ systems and is primarily involved with homeostatic regulatory mechanisms. The important functions of ANS are maintenance of homeostatic conditions of the body; regulation of visceral activities; smoothening body’s responses to environmental changes, stress, and exercise; and assisting endocrine system to regulate various functions.  Materials and methods: This cross-sectional study was conducted in the Department of Physiology, Tertiary Care teaching Hospital over a period of 1 year. Involves participants with T2DM (n = 70) and healthy volunteers (n = 70) with an age range of 30-60 years of both genders. Subjects ranging from 30 to 60 years of both genders who were diagnosed with type 2 diabetes mellitus for 3 years duration were recruited for the study. The controls were normal healthy volunteers in the same age group. The cases were selected from diabetology OPD and endocrinology OPD according to the inclusion criteria. The controls were selected from medical OPD who were non diabetic healthy volunteers. Details of present history, treatment history were obtained. Result: There was no significance in age between cases and controls as the p value was 0.2789. The mean SDNN of cases was 29.88 ± 3.99 and for controls was 37.65 ± 4.69. The difference in SDNN between cases and controls were significant as the p value was < 0.05. The mean RMSSD of cases was 20.61± 16.81 and for controls was 22.65 ± 3.85. The difference in RMSSD between diabetics and non - diabetics were significant as the p value was < 0.05. The mean VLF % of cases was 88.75 ± 12.75 and for controls was 80.35 ± 8.59. The difference in VLF % between cases and controls was significant as the p value was < 0.05. The mean rise in DBP after hand grip in cases was 5.25 ± 0.58 and for controls was 12.18 ± 3.94. Conclusion: Results of this study concluded that cardiac autonomic dysfunction was present in LT2DM patients without CAN (based on conventional autonomic test) characterized by predominant parasympathetic nerve function impairment and sympathetic overactivity.

Introduction: Diabetes mellitus a group of metabolic disorder leading to chronic hyperglycemia. The most common symptoms are polyuria, Polydipsia and polyphagia. There are different classes of antidiabetic drugs that can be prescribed in T2DM. the main aim is to study is to observe the suitable antidiabetic drug for the treatment of T2DM. Aim:  The aim is to study the prescription pattern, comorbidities and complications in type 2 diabetes mellitus in tertiary care hospital. Material and methods: Patients under inclusion criteria was selected for the study. A total of 100 T2DM patients were selected for the study. the patients were divided into two groups, group A – newly diagnosed T2DM and group B – Already diagnosed T2DM. the information was taken from the based on risk factors, ranges of HbA1c, FBS & PPBS, BMI, Duration of diabetes and comorbidities. Results: The study was conducted on 100 T2DM patients. the majority of the patient were male with a age group of 51 – 60 years. In group A patients majority of the patients were prescribe with metformin as monodrug therapy and in group A & B, metformin + glimepride as combination therapy. As per our study most of the patients having hypertension, smokers, and overweight respectively. Conclusion: Metformin and combination of metformin with glimepiride are most commonly prescribed drugs in treatment of type 2 diabetes mellitus

Background: Diabetes mellitus (DM) is a common endocrine disorder with around 415 million affected people worldwide. It is expected that DM will affect more than an estimated 700 million persons, 10.9% of the global adult population, by 2045. Objective: to find the prevalence of LVDD in type 2 diabetics and assess its correlation with HbA1c levels as measure of glycemic control. Methods: The present study was conducted in a tertiary care hospital in Central India from July 2020 to October 2022. Results: In our study majority study subjects were males.  The mean age for this study group was 46.3±8.3 years. Most of the study subjects (48.9%) had HbA1c within intermediate control range (7.1- 9%). 42 (45.6%) subjects were shown to have Left Ventricular Diastolic Dysfunction on 2D ECHO.  The mean HbA1c value for subjects having LVDD is 7.84 ± 1.34 and for those not having LVDD is 7.24 ± 1.35. Therefore, in our study it was concluded that LVDD was significantly associated with higher HbA1c values. Conclusions: The prevalence of left ventricular diastolic dysfunction was more in type 2 diabetic patients with high HbA1c levels

Diabetes Mellitus is a metabolic disorder of multiple aetiology characterized by presence of hyperglycaemia with disturbances of carbohydrate, protein and lipid metabolism due to defects in insulin secretion, action or both. The link of vitamin D with insulin insensitivity or abnormal glucose metabolism gained much more scientific attention in the last 10 years. Various observations or associations were cited. Exploring the possible role for either altered vitamin D status and its metabolites or altered Insulin sensitivity in the pathogenesis of the each disease. In view of increased prevalence of diabetes mellitus, vitamin D deficiency and association of vitamin D with diabetes mellitus the present study is undertaken to evaluate vitamin D levels in type 2 diabetes mellitus and its correlation with HbA1c levels Aim: To study vitamin D levels and its correlation with HbA1c level in type 2 diabetes mellitus. Methods: An observational study was carried out over a span of 1.5 years who were previously diagnosed case of type 2 Diabetes Mellitus attended Medicine department OPD and IPD between age group 30-70 years were included in study Serum vitamin D3, HbA1c, FBS, PPBS and other clinical features were noted based on history and clinical examination of these patients. Results:  25% had HbA1c of less than 7, 39 patients (39%) had HbA1c more than 9. The mean HbA1c level was 8.65 ± 1.93. We observed in 41 patients (41%) the level of Vitamin- D were deficient, in 17 patients (17%) the levels were inadequacy and in remaining 42 patients (42%) the levels were either normal or more than normal. In our study Vitamin D levels were found to be lower in the diabetic cases with >5 years of duration compared to recently diagnosed diabetic cases. The difference is statistically significant (P value 0.001) as compared with recently diagnosed (P value 0.63). It was found that patients with poor glycaemic control had maximum Vitamin D deficiency (12%) which was statistically significant with p value of  0.001 than those with good glycaemic control had sufficient Vitamin D levels (9%) with p value of 0.07. We compared the mean Vitamin D levels with duration of diabetes of mellitus and HbA1c and it was observed that the mean levels of Vitamin D were reduced with increasing duration of diabetes mellitus and increasing HbA1c levels. This difference was statistically significant. (P<0.05). Conclusion: There was an association between Vitamin D levels and HbA1c in patients with type 2 diabetes mellitus. In the present study of 100 patients with type 2 diabetes mellitus we found that lower vitamin D levels were associated with poor glycaemic control

Introduction: Diabetes mellitus (DM) refers to a group of common metabolic disorder that shares phenotype of hyperglycemia. In India, the prevalence rates are estimated to be around 10% in cities, and recent figures showed surprising increasing rates in rural areas. To ascertain the true prevalence in any community, it is essential that there must be standardized methods for the diagnosis with proper acceptable criteria so that the results are comparable.  Aims: To determine the incidence of LV diastolic dysfunction in asymptomatic Type-II  DM patients and to compare it with normal subjects and To quantify the relation of LV diastolic dysfunction with age, duration of DM, HbA1c, obesity indices and other diabetic complications Materials and Methods: The present study was a case-control study. This Study was conducted from April 2021 to November 2022 at Department of Medicine at PMCH, Patna. Result:Transmitral velocity data showed the significant low E/A ratio (E<A), prolonged declaration time (>240ms) and isovolumetric relaxation time (>110ms) in patients with diastolic dysfunction both in study group and control group. Conclusion: The incidence of diastolic dysfunction was found significantly high in newly diagnosed type 2 diabetes mellitus patients as compared with non-diabetic subjects. Prevalence of diastolic diastolic dysfunction in new diabetic population has female preponderance in the ratio of 2:1.

Background: Diabetes is characterized by a chronic hyperglycemic state and the development of alterations in the vascular structure. Nailfold capillaroscopy (NC) is a non-invasive, easy to perform, painless, and sensitive technique for evaluating microvascular involvement. With convenient use of dermatoscopes, we can detect and monitor the changes of the microvascular structure with reliability allowing an evaluation in the progression of the disease.  Materials and Methods: Observational and descriptive study was conducted in out-patient-department of dermatology and endocrinology at tertiary care centre. Total of 100 patients diagnosed with type 2 diabetes mellitus more than 18 years of age, and consenting to the study, were included. The capillary morphology was evaluated as bushy, tortuous, cross-linked, drop out, giant, meandering, micro-hemorrhagic areas, avascular areas, and areas of neo-angiogenesis. Results: Nailfold capillaroscopy was performed on 100 patients who visited the OPD of dermatology and endocrinology. The findings were: bushy (n = 52), tortuous (n = 84), cross-linked (n = 12), drop out (n = 36), giant (n = 52), meandering (n = 52), micro-hemorrhagic areas (n = 24), avascular areas (n = 12), and areas of neo – angiogenesis (n = 20). Morphological changes were more commonly seen in patients with poor glycemic control (HbA1c > 7.0). Thirty patients had HbA1c <7.0 and had changes such as tortuous (73.33%), crosslinked (3.33%), giant (33.33%), meandering (40%), micro – hemorrhages (20%), and neo – angiogenesis (13.33%). Seventy patients had HbA1c >7.0 and had changes such as bushy (34.28%), tortuous (88.57%), cross-linked (15.71%), drop out (51.42%), giant (60%), meandering (57.14%), micro-hemorrhagic areas (25.71%), avascular areas (17.14%), and areas of neo-angiogenesis (22.86%). Conclusion: Nail fold capillaroscopy (NFC) is a noninvasive, easy to perform, in vivo technique aiding detection of changes in the microvascular bed. Significant changes were visualized in patients with T2DM. Our results suggest NFC can be an indispensable tool to predict long term glycemic control and also helps in prognosticating microvascular complications in diabetics. Microvascular changes happening in pivotal organs are also producing significant changes in the capillaries.

Introduction: Diabetes mellitus is a collection of metabolic illnesses that are defined by hyperglycemia brought on by abnormalities in insulin secretion, insulin action, or both, according to the American Diabetes Association. As per recent report of International Diabetes Federation (IDF), diabetes mellitus (DM) affects approximately 415 million people throughout the world today and by 2040 around 642 million people are proposed to be affected by it. 

Introduction: Type 2 diabetes (T2D), a frequent comorbidity in AMI, has been associated to an increased risk of long-term in-hospital mortality and upcoming cardiovascular events. "Inflammation underlies both the complicated diseases diabetes mellitus and atherosclerosis. Acute myocardial infarction is really a risk factor for type 2 diabetes, which is assessed in a state of low-grade inflammation. Aims: To identify the “CRP level at the time of admission as a reliable indicator of hospital mortality and morbidity in both patients with and without diabetes mellitus who experienced an acute myocardial infarction Materials and Methods: The material for the present study was collected from patients who are admitted in Katihar Medical College and Hospital over a period of one and a half year from December 2020 to May 2022.100 Patients were included in this study. Result: This study found that diabetes patients with acute myocardial infarction had statistically significant higher admission CRP levels than non-diabetic patients . Patients with diabetes who had higher CRP levels had a greater incidence of death and morbidity when compared to non-diabetic patients. Conclusion: According to the results of this investigation, CRP is a potent predictor of hospital morbidity and mortality in both diabetes and nondiabetic individuals with acute myocardial infarction.

Background and objectives: The purpose of this study is to determine whether diabetes individuals who have a variation in the MnSOD gene are more likely to experience cardiovascular problems. This is accomplished by determining the prevalence of MnSOD gene polymorphism in type 2 diabetic patients who either have or do not have cardiovascular disease, as well as in healthy control subjects. To determine whether or not this MnSOD polymorphism results in decreased SOD activity. Method: To conduct this case-control investigation, ethical approval was obtained. This investigation was conducted between February 2023 to May 2023 at Government Medical College Sircilla, Telangana, India.  Seventy patients with diabetes that had been ongoing for more than five years were included in the investigation after receiving informed consent. The diagnosis is based on the clinical history, fasting plasma glucose levels, and electrocardiogram (ECG) findings. Result: The genotype and allele frequency of the SOD2 gene are displayed for those with type 2 diabetes, those without the disease, and healthy controls. More people with diabetes and cardiovascular disease (n = 25; 71.42%) have the TT genotype than people with diabetes and no cardiovascular disease (n = 15; 42.85%) or controls (n = 10; 28.5%). There is a significant (P = 0.006) difference in the frequency of the TT genotype among diabetic CVD cases. Genetics and SOD activity interacted. The SOD activity was lower in people with the TT genotype. SOD activity ranges from 86U/L in TT to 187U/L in CC, with CT falling in the middle at 145U/L. It's 0.000. The SOD activity was lower in people with the TT genotype. Conclusion: This study compared diabetics with and without cardiovascular disease for SOD2 gene (T>C) substitution polymorphism. 35 diabetics with and without cardiovascular disease were compared. T2DM patients with cardiovascular disease had a higher SOD2 TT genotype rate than those without CVD and controls. TT genotype differs significantly amongst diabetics with and without cardiovascular disease. Diabetes patients with cardiovascular disease had reduced serum SOD activity, which may contribute to cardiovascular illness. The TT genotype was associated with cardiovascular disease due to its low serum superoxide dismutase (SOD) activity. After controlling for variables, the TT genotype predicts cardiovascular disease complications.

Background: Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality all over the world. It causes about one-third of all deaths in people older than 35years. We carried out this study because there was no such study carried out in Andaman and Nicobar Island to ascertain the incidence of CAD and the risk factors which lead to CAD in Andaman and Nicobar population. The health sector in Andaman and Nicobar is developing. Due to the increasing load of CAD patients recently the Cath Lab was started as the ANIIMS Port Blair / GB Pant Port Blair is the only tertiary care hospital in the whole of Andaman and Nicobar Islands. To get a better insight into the disease prevalence and how to lower the risk factors. Material and methods: This cross-sectional study was done in a tertiary hospital in Port Blair to find out the prevalence of risk factors among patients with coronary artery disease. A total of 315 patients were screened based on a questionnaire, ECG (Electrocardiography) and laboratory investigations. Data was analysed in SPSS and Microsoft Excel and was presented as tables and graphs. There was significant observation based on age, clinical features, risk factors, ECG patterns and laboratory diagnosis. The result was conclusive of increased prevalence of risk factors among CAD patients which was also reported in various studies conducted in India and across the world.  Results: This study has estimated that the overall prevalence of Hypertension is 86.03%, Type 2 diabetes mellitus is 88.89%, Smoking is 55.87%, Hypercholesterolemia is 71.43%, Hypertriglyceridemia is 68.25%, Obesity is 65.40%, Stress is 61.9%, and Family history is 12.38%.  Conclusion: The present study demonstrates a high prevalence of CAD risk factors in the population of Port Blair, Andaman and Nicobar Islands. The study population reflects the rising trends of CAD in urban India. The incidence of CAD has increased further because of rapid urbanization and its accompanying effects like sedentary lifestyle changes, change in food habits, lack of outdoor activity. There should be an early detection of a risk factor to prevent morbidity and mortality in the community. Therefore, there is an immediate need to raise awareness among the general population regarding these risk factors, signs and symptoms of coronary heart disease promote the correct diet and physical activity, meditation,yoga and others and at the same time develop guidelines for screening and preventive therapeutic programs to identify and manage individuals at high risk for future CAD.  CAD can be prevented by dietary modification, changing lifestyle, decrease tobacco consumption and regular physical exercise. Screening and regular medical check-up of patient helps in early detection of CAD.

Background: Evaluation of retinal nerve fiber layer and ganglion cell complex thickness in diabetes mellitus using SD-OCT Methods: This cross-sectional study was carried out on 183 eyes of 100 patients of type 2 diabetes and 80 age and gender matched healthy control. Diabetic patients were further grouped into Group 1(no diabetic retinopathy) and Group 2 (mild diabetic retinopathy) as per ICDRDSS classification. Patients with evidence of macular oedema were excluded.  Demographic data and relevant medical details were documented and all study subjects underwent a comprehensive ophthalmic evaluation. Peripapillary RNFL thickness and macular GCC thickness were assessed for all study participants by SD-OCT (Carl Zeiss Cirrus HD-OCT) and their mean values were compared between both groups of diabetic patients and healthy controls. Results: Significantly (p<0.0001) reduced RNFL thickness was demonstrated in both diabetic patients’ groups (81.73µm in no DR and 76.99 µm in DR) compared with controls (96.86 µm). For GCC values also, significant (p<0.0001) reduction was observed in no DR (71.99 µm) and DR (71.0 µm) groups compared to controls (84.81 µm).  Conclusion: The statistically significant reduction in RNFL and GCC thickness in diabetic patients (with and without retinopathy) compared to healthy controls indicates that retinal neuronal degeneration occurs in early stages of DR.

Introduction: Hypertension is a condition in which the blood flows through the blood vessels with a force greater than normal. Patient with hypertension have an increased prevalence of type 2 diabetes mellitus (T2DM) and impaired glucose tolerance, and the prevalence of type 2 diabetes is increasing in epidemic proportions worldwide. Several trials involving patients with hypertension or cardiovascular disease have suggested that agents that block or inhibit the renin angiotensin system that is ACE inhibitors and ARBs decrease the incidence of new-onset type 2 diabetes. However, the exact role of these agents in diabetes prevention has not yet been fully elucidated. Blocking angiotensin II decreases proinflammatory mediators and the oxidative stress.  Material and Methods: This is a prospective and observational was conducted in the outpatient Department (OPD) of General Medicine and Department of Pharmacology at Shadan Institute of Medical Sciences, Teaching Hospital & Research Centre -A Post Graduate Institute (SIMS), Hyderabad from April 2018 to March 2019. In 100 prediabetic hypertensive outpatients, 78 prediabetic hypertensive outpatients [45 males, 33 females mean age = 49.85±10.35] continued for a period of 12 months. The patients were recruited with following inclusion and exclusion criteria. Fasting blood sugar test: a blood sugar level from 100 to 125mg/dL (5.6 to 6.9mmol/L) is considered as Pre-diabetes, this is sometime referred to as impaired fasting glucose (IFG). Results: In our study 78 cohorts of hypertensive Prediabetic patients on ACE /ARBs were followed for one year and at the end of the study when all the parameters were compared at first visit /baseline with that of third visit /at the end of 12 months in both of the ARB (Telmisartan) and ACEI (Ramipril) group, it was observed that there is decrease in the mean and standard deviation of the different parameters included in the study i.e., SBP(mm Hg), DBP(mm Hg), FBG(mg/dl), OGGT(mg/dl) and HbA1c(%).In Telmisartan and Ramipril groups on the final visit at the end of 12 months, compared to the first visit or at base line, there is no significant difference in the p values of the different parameters i.e., SBP(mm Hg), DBP(mm Hg), FBG(mg/dl), OGGT(mg/dl) and HbA1c. Conclusion:  In the present study it was observed that in hypertensive pre-diabetes patients, the beneficial effect of RAAS Inhibitors is more marked if the therapy started with initial rise diastolic and systolic blood pressure, especially at a relatively younger age.

Introduction: Diabetes is a chronic disease with life altering consequences. It not only forces one to question and alter one’s life style but also thrusts the added responsibility of self-care upon them. Patients are required to maintain controlled levels of glycalated hemoglobin (HbA1c). But up to 50 percent fail to do so and land up with a wide array of complications. One among these many complications is the psychiatric co-morbidity of depression. Materials and Methods: The present study is a cross sectional study conducted at Department of Psychiatry, Shimoga Institute of Medical Sciences, Shimoga, Karnataka from the period of February 2022 to October 2022. The study population was determined to be 120 in number. Participants who were diagnosed with diabetes mellitus under American Diabetic association criteria were randomly selected from outpatient department of General medicine and referred to  Department of Psychiatry, Shimoga Institute of Medical Sciences, Shimoga. Results: 75% of the study population had history of diabetes mellitus for more than 5 years of duration. More than half of the study population did not have any substance use (56.7%), however use of nicotine (13%) or alcohol (11%) or both (2%) were found in 43.3% of the population in total. Systemic hypertension was found to be the most common medical co-morbidity accounting to 88.3% of the study participants. More than 60% of the study population did not have any family history of depression. 31.7% of the study population expressed worthlessness (21.7%), death wishes and suicidal thoughts (8.3%) or attempts (1.7%). Conclusion: Early screening and appropriate intervention may lead to improvement in both mental and physical wellness along with prevention of suicides in these patients. Prevalence of depressive disorders among diabetes mellitus patients is increasing in number and severity. We would like to stress upon the need for screening depression among all patients who have been diagnosed with diabetes mellitus to ensure early detection, diagnosis, management, and suicide prevention.

Background: The problem of hypoglycemia in individuals with type 2 diabetes poses a significant health risk, potentially leading to adverse outcomes such as confusion, seizures, or unconsciousness. Balancing glucose levels in these patients becomes challenging due to various factors, including medication management, lifestyle choices, and fluctuating insulin sensitivity. Addressing and managing hypoglycemia effectively is crucial for improving the overall well-being and quality of life for those with type 2 diabetes. Aims and Objectives: The present study aimed to study the prevalence and associated factors of hypoglycemia among type 2 diabetics. Materials and Methods: The present study included 200 diabetic patients attending the General Medicine OPD of Osmania General Hospital, Hyderabad. After obtaining consent, all the participants were subjected to a well-structured clinical questionnaire. Data was collected in MS Excel, analyzed and presented as tables and figures. Results: It was found that most of the patients considered for this study (83.5%) had at least 1 episode of Hypoglycemia. Among the symptoms of Hypoglycemia, dizziness was found to be the most observed symptom with 38% patients experiencing it, while 28% of patients displayed sweating. About 16% patients had excessive hunger. Shaking was observed in 14% patients. 19% patients had other symptoms. Conclusion: The high reported incidence of hypoglycemia in individuals with type 2 diabetes underscores the critical need to consistently inquire about and educate diabetic patients regarding hypoglycemic episodes during their routine healthcare visits.

Background: Type 2 Diabetes Mellitus (T2DM) is a global health concern associated with various complications, including peripheral neuropathy. While the prevalence of T2DM continues to rise, particularly in urban areas, there is limited comprehensive research on the prevalence and associated factors of peripheral neuropathy in urban communities. Methods: A cross-sectional study was conducted in a representative urban community to assess the prevalence of peripheral neuropathy among individuals with T2DM. Clinical evaluations, neuropathy assessments, dietary surveys, socioeconomic data collection, and healthcare access inquiries were performed on 500 adult participants. Data were analyzed using descriptive statistics, logistic regression, and prevalence calculations. Results: The study revealed a substantial prevalence of peripheral neuropathy in the urban population, with rates of 38.5% according to the Michigan Neuropathy Screening Instrument (MNSI) and 42.0% based on the Neuropathy Symptom Score (NSS). Participants with neuropathy exhibited poorer glycemic control, higher blood pressure, and higher BMI. Lower education and income levels were associated with neuropathy. Additionally, individuals with neuropathy had slightly reduced access to healthcare services. Conclusion: Peripheral neuropathy is a common complication among T2DM patients in urban communities. Early screening, intervention, and management of glycemic control and blood pressure are essential. Addressing socioeconomic disparities and improving healthcare access and patient education can help reduce the burden of neuropathic complications in urban populations.

Introduction: Diabetes mellitus is one of the common non-communicable diseases in India. Dyslipidemia is also associated with diabetes mellitus. Role of vitamin D is described in diabetes mellitus in multiple studies owing to its facilitation/inhibition of transcription factor and immune-modulator property. Aim: to evaluate association of vitamin D level with parameters of fasting lipid profile. Methods: It was an analytical observational case study. Patients of type 2 diabetes mellitus were included in the study. All routine lab parameters were done. Statistical analysis was done by pearson correlation test, fisher’s exact test and ANOVA. Linear regression analysis was also done. Results: 119 patients were included in the study. Vitamin D deficiency was found in 77 patients (64.71%). Negative correlation was present between vitamin D level and HbA1c. Vitamin D deficiency was found to be significantly associated with high HbA1c (p = 0.024). Furthermore, Negative correlation was found between vitamin D level and total cholesterol (r = -0.0134, p = 0.8987), serum triglyceride (r = -0.0310, p = 0.7690) and serum LDL (r = -0.0149, p = 0.8873). Positive correlation was present between vitamin D level and serum HDL (r = 0.0296, p = 0.7782). On ANOVA test, mean values of serum triglyceride in vitamin D deficient, vitamin D insufficient and vitamin D sufficient groups were 206 ± 147.3 mg/dl, 152.78 ± 64 mg/dl and 147.84 ± 72.6 mg/dl respectively. (p = 0.0510), near significant association was found between vitamin D deficiency and increased serum triglyceride level. Conclusion: Vitamin D deficiency in type 2 diabetes mellitus is associated with poor glycemic control. Vitamin D deficiency in type 2 diabetes mellitus may be a risk factor for dyslipidemia.

Background: This study was conducted to evaluate the serum vitamin D levels in patients with type 2 diabetes mellitus with and without nephropathy. Methods: This was a hospital-based cross-sectional case control study conducted among 100 patients who attended OPD and IPD at the Department of Medicine, Dr. B.R. Ambedkar Medical College and Hospital, Bangalore, over a period of 18 months from December 2020 to May 2022, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: In comparison between diabetic nephropathy and non-diabetic nephropathy between both groups, a statistically significant difference (p<0.001) was noted between them with regard to serum creatinine, eGFR, UACR and vitamin D levels, suggesting that the diabetic nephropathic group has increased creatinine levels, highly reduced eGFR, highly elevated UACR and significantly decreased vitamin D levels, which are not present in the non-diabetic nephropathy patients. The eGFR and vitamin D levels were compared among the diabetic nephropathic subjects. The eGFR was split into three groups and by the ANOVA test measure, a significant association was obtained between them suggesting decreased eGFR also decreases vitamin D levels. On correlating vitamin D levels with serum creatinine and UACR a statistically significant (p<0.001) strong negative correlation was obtained (0.85 and 0.91) respectively. Conclusion: The study found that individuals with diabetic nephropathy had a higher prevalence of vitamin D insufficiency. However, at more advanced stages of diabetic kidney disease, their severity is more prevalent. Patients with CKD (Chronic Kidney Disease) should get information from health care providers on vitamin D monitoring and its dietary sources.

Background: Diabetes mellitus (DM) is a chronic endocrine metabolic condition that is mainly avoidable and non-communicable, resulting in millions of deaths, crippling complications, and incalculable human anguish each year. It constantly exhibits three key abnormalities: resistance to insulin action in peripheral tissues, particularly muscle and adipose tissue, reduced insulin secretion, and increased glucose synthesis by the liver. Objectives: 1. To estimate the value of serum adenosine deaminase (ADA) in patients with uncomplicated type 2 diabetes mellitus through a Cross sectional study. 2. To determine any correlation exists between serum ADA and blood glucose values. Material & Methods: Study Design:  Hospital-based, cross sectional study. Study area: The study was conducted in the Department of General Medicine, Siddhartha medical college, Vijayawada. Study Period: September 2022 to August 2023. Study population: Individuals with uncomplicated type 2 diabetes mellitus including both male and female, of age group 30-70 years attending to the hospital. Sample size: Study consisted a total of 100 subjects. (50 cases and 50 controls). Study tools and Data collection procedure: A pre-structured and pre-tested proforma was used to collect the data. Informed consent was taken from all cases and control subjects. A detailed clinical history and physical examination was an integral part of the methodology. Relevant investigations (blood urea, serum creatinine, lipid profile, urine protein, ECG, Fundoscopy etc.) were done before selection of subjects for the study. For all the subjects standing height and weight were measured. BMI was calculated as per the formula: Weight (Kg)/Height(meters)2. Results: In the present study the mean ADA in study group is 40.60±8.65 and in the control group is 19.75±2.65. In the present study the mean FBS in study group is 172.24±76.47 and in the control group is 82.34±10.77. Conclusion: Serum levels of ADA were found to be significantly higher in type 2 diabetics when compared to controls. A very large correlation was found to exist between serum ADA and blood glucose values. Statistical association was found between serum ADA and the long term index of glycemic control, HbA1c. Body Mass Index, Age, Sex, duration of diabetes was not found to significantly influence the ADA level.

Background: The relationship between alteration of serum lipids and vascular complications is more significant in diabetic population. Present study was aimed to study lipid pattern (Serum cholesterol, Triglycerides, HDL & LDL) in Type 2 Diabetes Mellitus subjects. Material and Methods: Present study was single-center, cross sectional study, conducted in patients with duration of Diabetes mellitus of at least 6 months {BSL (Random) ≥200 mg/dl OR BSL (Fasting) ≥126 mg/dl OR HbA1c > 7}, underwent lipid profile estimation. Results: In present study, majority cases were 51-60 years (46 %), were male (64 %), were Obese (More than 25) (42 %) & mean age of the patients was 54.32 ± 7.12 years. Mean weight of cases was 67.38 ± 8.99 kg, mean height of cases was 161.34 ± 8.81 cms, mean BMI of cases was 26.08 ± 3.13 and mean WHR of cases was 1.02 ± 0.11. 19 (38.0) cases had History of Hypertension. It was observed that 16 (32.0) cases were having Normal Cardiac Risk and 34 (68.0) cases were having Increased Cardiac Risk. The BMI is significantly correlated with WHR. The BMI is significantly correlated with HbA1c. The BMI is insignificantly correlated with HDL. The BMI is significantly correlated with LDL. The BMI is significantly correlated with Triglycerides. The BMI is significantly correlated with cholesterol. The WHR is significantly correlated with HbA1c. The WHR is insignificantly correlated with HDL. The WHR is significantly correlated with LDL. The WHR is significantly correlated with Triglycerides. The WHR is significantly correlated with cholesterol. Conclusion: There was a significant association between type of Obesity and Waist hip ratio (WHR), HbA1c, HDL, LDL, triglycerides and Cholesterol.

Osteoporosis and Type 2 diabetes mellitus are two common chronic conditions with potentially significant impacts on patients' health. Osteoporosis, characterized by decreased bone density and increased fracture risk, is influenced by various factors, including parathormone (PTH) and vitamin D levels. Aim: To study the association between PTH, vitamin D levels and BMD in Type 2 diabetic patients. Material And Methods:This cross-sectional observational study was conducted in the Department of Medicine. A total of 50 participants were included in the study. A semi-structured questionnaire was administered and relevant clinical data was obtained. Result: The results show a statistically significant association between vitamin D status and BMD (p = 0.008). Patients with normal vitamin D levels were more likely to have normal BMD, with 57.14% falling into this category. In contrast, 92.3% of patients with osteopenia and 75% of those with osteoporosis had low vitamin D levels. Conclusion: Low vitamin D levels were associated with a higher prevalence of osteoporosis and osteopenia, particularly in patients with low PTH levels.

Background: Diabetes mellitus, characterized by elevated blood glucose levels, poses a significant global health challenge. Type 2 diabetes accounts for the majority of cases and is associated with factors such as obesity, physical inactivity, and poor dietary habits. The global burden of diabetes is substantial, contributing to major complications like blindness, kidney failure, heart attacks, stroke, and lower limb amputation.  Methodology: This study investigates cardiovascular complications in 209 adult diabetic cases with a disease duration exceeding 5 years. The research, conducted at a tertiary care teaching hospital, includes a detailed clinical examination, relevant investigations, and categorization based on disease severity, control status, and treatment type. Various parameters, including fasting blood sugar, postprandial blood sugar, urine examinations, serum cholesterol levels, and hypertension classification, were assessed. Results: The study reveals that 112 cases (53.6%) exhibited cardiovascular complications, with ischemic heart disease (IHD) being the most prevalent (39.7%). The majority of patients were in the 51-60 age group, and 75.6% were male. Poor glycemic control was evident in 79.9% of cases, while 23.9% had severe diabetes. Hypertension and retinopathy were present in 30.1% and 35.8% of cases, respectively. IHD was more prevalent in males (56.6%) and the 51-60 age group. Discussion: The study establishes associations between different complications, emphasizing the frequent coexistence of various cardiovascular issues in diabetes. It explores the distribution of IHD among diabetics, with a peak in the 51-60 age group and a higher incidence in males. The severity of diabetes did not significantly influence IHD incidence. Good glycemic control demonstrated a protective effect against complications. Conclusion: This comprehensive study underscores the substantial impact of cardiovascular complications in diabetes mellitus. It highlights the importance of glycemic control, lifestyle modifications, and weight management in reducing the incidence and severity of complications.

Introduction: Body mass index (BMI) is the most widely used statistic to determine the prevalence of obesity. BMI is defined by the World Health Organisation as "a simple index of weight-for-height that is commonly used to classify adults as underweight, overweight, or obese." It is calculated as follows: kg/m2, which is the weight in kilogrammes divided by the height in metres squared. For instance, a 70 kg adult who stands 1.75 metres tall will have a BMI of22.9.Material and method: Type 2 diabetes, hypertension, elevated blood cholesterol, and triglycerides, which can result in atherosclerosis, are all made more likely by obesity. Previously thought to be a reservoir of excess energy, adipose tissue is now understood to be a functional, autonomous endocrine organ. Adipokines, a group of bioactive mediators that are expressed by adipose tissue and other biological systems, facilitate communication between the two.The adipokineadiponectin is only released by adipocytes. It is widely distributed in the bloodstream as a 360 kDa high molecular weight multimer and a 180 kDa low molecular weight hexamer.Results: This table shows age and sex distribution of cases and controls. Both cases and controls were divided into two groups according to age i.e. 20-35 years and 36-45 years. Maximum cases are within the range of 20-35 years. Percentage of male is more in comparison to controls.Conclusion: Adipokines are substances released by adipose tissue that regulate a variety of physiological processes throughout the human body by way of systemic circulation. Numerous organs and systems experience a disturbance in homeostasis as a result of adipokinedys regulation in obesity. These include insulin resistance, oxidative stress, endoplasmic reticulum stress, synaptic dysfunction, and cognitive decline.

The escalating prevalence of Type 2 Diabetes Mellitus (T2DM) globally necessitates a deeper understanding of its complex metabolic interactions, particularly concerning homocysteine, a known cardiovascular risk marker. This study aims to elucidate the role of homocysteine in the management of hyperglycemia in T2DM patients. Conducted as a cross-sectional study at Osmania Hospital, Hyderabad, India, it involved 30 T2DM patients without prior cardiovascular disease (CVD) complications and 30 age and sex-matched controls. Participants were subjected to comprehensive blood analyses to measure homocysteine, HbA1C, fasting, and post-lunch blood sugar levels. The study employed an independent sample t-test to determine significant differences in these biochemical parameters between T2DM patients and controls, with a significance threshold set at <0.05 and <0.001. Additionally, Pearson Correlation tests were applied to assess the relationship between homocysteine levels and the glycemic profile of the participants. The findings of this study are pivotal in understanding the interplay between homocysteine and hyperglycemia in T2DM. They offer insights into the potential role of homocysteine in T2DM management and its implications for cardiovascular risk in these patients. The results are expected to contribute to the evolving landscape of T2DM management, highlighting the importance of considering homocysteine levels in the holistic care and treatment strategies for T2DM patients. This study not only adds to the existing body of knowledge but also opens avenues for future research in this domain, particularly in developing targeted interventions for better management of T2DM and associated risks.

Research and consideration on vitamin D physiology is crucial as approximately half of the people is being detected with this deficiency. Thus, the study was undertaken to estimate serum vitamin D and plasma cytokines in patients of diabetic retinopathy. More than fifty percent of worldwide population at risk because of vitamin D inadequacy has achieved contagion amounts. It also considered as a multifunctional hormone. In comparison to healthy control, pro-inflammatory cytokines were noticed to be elevated in patient with Type 2 Diabetes mellitus. Several studies reported significant elevation of plasma IL6(p less than 0.001), C reactive protein (CRP) (P less than 0.001) and elevated levels of TNFα in patients of diabetes. Materials and methods: A cross sectional hospital-based study was undertaken on 160 patients, who attended the ‘Retina Clinic’ of the Institute of Ophthalmology and the Out Patient Department of Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh. A well informed written consent for blood sampling was taken from all the patients included in the study and ethical approval was obtained from the institutional ethics committee. Demographic data, serum lipid profiles, HbA1c, fasting blood glucose, arterial blood pressure, visual History and treatment history were documented for all participants using pretested Performa. Results: Maximum and minimum value of different variables. In PDR group range of serum vitamin d level were 4.0ng/mL and 36.0ng/mL. While in NPDR group minimum and maximum levels were 3.50ng/mL and 58.50ng/mL. Minimum and maximum plasma TNFα level in PDR group were1.02pg/mL and 232.2pg/mL. Range of plasma IL10 in PDR patients were 4.6pg/mL and 196.74pg/mL. Minimum and maximum plasma IL1beta level in PDR patients were 11pg/mL and 119.16pg/mL. Range of plasma IL6 in patients with PDR were of 0.07pg/mL and 16pg/m. The mean and standard in various groups. In which, mean serum vitamin D in PDR patients was 15.45±6.15ng/mL whereas in the NPDR patients mean serum vitamin D was 18.99±8.25ng/mL. Conclusion: It concluded that patients with PDR, had lower vitamin D levels as compared to No DR. Showing decline trend in all patients with type 2 diabetes mellitus. On cytokine study it was found that plasma levels of TNF alpha, IL10, IL 1 beta and IL6 are elevated in patients with Type 2 diabetes mellitus patients as compared to non-diabetic healthy controls. 

Background: Diabetes mellitus is associated with metabolic, cellular and blood changes.Hematological changes have been reported in diabetes and believed to play a major role in diabetes-associated complications. However, reports are contradicting and data on erythrocyte indices in patients with type 2 diabetic patients in the study area are scarce. In the present study we attempted to determine the relation between Erythrocyte Indices with glycemic status in Type 2 Diabetes Mellitus (T2DM). Materials and methods: In this cross sectional, observational study we studied lab reports of 234 patients who attended the outpatient department and admitted as inpatients in a tertiary care hospital over a period of three months. The study group had 170 patients with, and control group had 64 age and sex matched controls. Random blood glucose, glycated hemoglobin (HbA1c) and Erythrocyte Indices includingHemoglobin (Hb), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin Concentration (MCHC), Mean Corpuscular Hemoglobin (MCH), Packed Cell Volume (PCV), Red Cell Distribution Width (RDW), and Red Blood Cell (RBC) count were measured. Results: Our study revealed no significant differences in majority of erythrocyte indices among T2DM cases and controls. However, there was statistically significant difference in RDW (13.40±7.25 fL vs 23.86±15.53 fL, p =0.0001) between T2DM cases and controls. T2DM, patient with poor glycaemic control (HbA1c ≥ 6.5 gm%) had higher Hb compared to T2DM with good (HbA1 <6.5 gm%) glycaemic control (13.74±2.13 vs 12.79±2.64, p=0.0249). Patient with RBS ≥200 mg/dl had higher Hb compared to patients with RBS <200 mg/dl(14.2±2.3 vs 13.1±2.3, p= 0.0029). Hb and RDW showed significant positive correlation (r=0.1889, p=0.01362) with RBS. Conclusions: The present study shows variations of erythrocyte indices in diabetic patient compared to controls. Hence, haematological changes should be evaluated in all T2DM for effective therapeutic intervention 

Background: The incidence and the life expectancy of the diabetic patients have both increased with resulting in the increased prevalence and clinical importance of musculoskeletal alterations in diabetic. Present study was aimed to study correlation between duration of diabetes mellitus and occurrence of rheumatologic manifestations in patients with type II diabetes mellitus. Material and Methods: Present study was cross sectional study, conducted in above 30 years age, either gender, diagnosed cases of Type 2 diabetes mellitus. The control group comprised of subjects without family history of diabetes mellitus, fasting blood sugar values <126mg/dl and postprandial blood sugar values<200. Results: During study period, 100 patients with type 2 diabetes mellitus and 50 non diabetics were included in the study. Mean age for diabetics was 55.3 ± 10 yrs while for control group mean age was 51.3 ± 10 yrs. Out of 100 diabetic pts included in study 66 % were male and 34 % were female. Out of 50 non diabetic control group 35 were male and 15 were female. Majority of diabetic population had 0 - 5 years of duration of disease (52 %) with average duration of disease is 6.7 years. Rheumatological manifestations seen in 31 % pts with type 2 DM and 16% pts without DM. Prevalence of rheumatological manifestations in diabetic population is more in females (47%) as compared to males and it is statistically significant(p- 0. 0126). Majority of diabetic pts with rheumatological manifestations were noted to have 6 -10 years of duration of Diabetes & relation was not significant statistically (p > 0.05). Conclusion: There is no correlation seen with the duration of diabetes and the prevalence of rheumatological manifestations.

Background: Diabetes mellitus, a prevalent metabolic disease globally, causes various complications, including microvascular issues like Diabetic Retinopathy (DR) and macrovascular complications. DR, characterized by retinal microvascular alterations, is a leading cause of vision loss. Diabetic Foot Ulcer (DFU) is a severe complication, often leading to amputation, with studies suggesting a link between DR and DFU. This study aims to assess the severity of DR concerning different grades of DFU. Objective: To evaluate the association between the severity of Diabetic Retinopathy and various grades of Diabetic Foot Ulcer. Methodology: A cross-sectional study was conducted from February 2021 to August 2022, involving 100 patients clinically diagnosed with type 2 Diabetes Mellitus and DFU. Data on socio-demographics, medical history, and DR severity were collected. Statistical analysis was performed using SPSS, with a significance level of 5%. Result: Participants (n=200) were primarily aged 51-60 (39%), with 62% males. About 42% had diabetes for 1-5 years, and 73% reported DFU duration of <1 month. In DR grading, 26% had Moderate NPDR, 15% had severe NPDR, 4% had very severe NPDR, and 21% had no NPDR. A significant association was found between DR severity and DFU grades (p<0.05). Discussion: Comparisons with existing studies revealed variations in diabetes duration and DR severity. The study confirmed the association between DFU and DR, consistent with previous findings. Conclusion: The study emphasizes the need for enhanced screening protocols to detect and manage DR and DFU promptly. The severity of DR increases with DFU stages, suggesting DFU's potential to predict advanced DR stages. As diabetes prevalence rises, addressing these complications is crucial for the working population's well-being. A systematic healthcare approach is essential for early detection and management.

Aim :To Evaluate the Diagnostic Efficiency of Cystatin C As a marker of Early Renal injury in patients of Type 2 Diabetic in comparison with Creatinine. Materials and Methods : 100 proven cases of type 2 Diabetes categorized into 3 groups. Normoalbuminuria (48), microalbuminuria (32) & macroalbuminuria (20). 50 age and sex matched healthy controls. Fasting plasma glucose(FPG), serum Creatinine, serum Cystatin C, urine dipstick analysis for protein, urine albumin, urine creatinine & calculated UACR were estimated. Glomerular filtration rate was estimated by Cystatin C concentrations according to Chronic Kidney Disease Epidemiology (CKD-EPI) equation and Creatinine eGFR according to Modification of Diet in Renal Disease (MDRD). Results : There was raised levels of FPG , serum Creatinine & serum Cystatin C significantly (p<0.01) with increasing duration of Diabetes. The eGFR of Cystatin C was lower than that of Creatinine eGFR in cases but in controls it was more. The calculated sensitivity of Cystatin C eGFR was 91%,specificity was 94% and overall accuracy(OA) was 92% and these results are better than that of Creatinine eGFR with 84% sensitivity ,88% specificity and 85% OA. The eGFR cystatin c showed higher sensitivity, high specificity & higher accuracy than eGFR creatinine in studied diabetic subjects. Cystatin C showed more significant correlation with Cys C e GFR, (r = −0.99, p<0.001) than serum creatinine e GFR ( r= −0.86,p<0.001) in diabetic patients. Conclusion:The results of present study showed Cystatin C was more sensitive than creatinine thereby making se Cystatin.

Type II diabetes mellitus (T2DM) is a chronic disease that develops due to defective insulin secretion and is frequently associated with insulin resistance. It is also characterized by progressively decreasing beta-cell function over time. As a manifestation of symptoms is not always the case, DM is primarily diagnosed on the basis of some form of measurement of blood glucose. Sodium-glucose cotransporter 2 (SGLT2) inhibitors enhance urinary glucose excretion, which consequently reduces hyperglycemia. They exert favorable effects on various biomarkers, including blood glucose, body weight, blood pressure, albuminuria, and fatty liver. In contrast, dipeptidyl peptidase-4 (DPP-4) inhibitors decrease glycaemic variability by stimulating glucose-dependent insulin secretion. Material and Methods: This is a Prospective, randomized, Open-label was conducted in Type 2 DM patients attending the outpatient department of Medicine in Index Medical College and Hospital over a period of 2 years. All the Type 2 DM patients attending outpatient department (OPD) of Medicine were randomly divided into Dapagliflozin Group and Sitagliptin Group. The treatment drug (dapagliflozin 5.0 mg/day and sitagliptin 50 mg/day) was administered for 12 weeks.  Follow-up visits were scheduled at the end of every month for 12 weeks for assessment, including measurement of weight and general and systemic examination. The following laboratory investigation was performed on sample of Type 2 DM patients before and after Dapagliflozin and Sitagliptin therapy.  Results The changes in glycemic and metabolic parameters from baseline to week 12 in the two study groups. The mean ± SD change in HbA1c from baseline to 12  weeks were 1.95 ± 0.94% and 2.71 ± 0.54 in the dapagliflozin and sitagliptin groups, respectively. The changes in the time courses of Fasting plasma glucose at baseline and at week 12 in the two study groups are shown in Table 3. The mean ± SD change in Fasting plasma glucose from baseline to week 12 were 123.9 ± 3.4 and 45.0 ± 6.4 in the dapagliflozin and sitagliptin groups, respectively. The changes in glycemic and metabolic parameters from baseline to week 12 in the two study groups. The mean ± SD change in Fasting plasma insulin from baseline to 12 weeks were 2.08 ± 0.76 and 2.37 ± 0.44 in the dapagliflozin and sitagliptin groups, respectively. Conclusion Although dapagliflozin and sitagliptin provided similar effects on glycemic control with avoidance of hypoglycemic episodes, adequate loss in body weight occurred significantly more frequently in the dapagliflozin group. Additionally, various cardiometabolic indices improved to a significantly greater extent in the dapagliflozin group than in the sitagliptin group

Background: Diabetes mellitus (DM) is a rapidly rising chronic illness in developing countries. Glycosylated hemoglobin (HbA1c) is a widely used tool for diagnosing, screening, and managing patients with diabetes, hence proper interpretation of the HbA1c is crucial. Objectives: To investigate the risk factors affecting type 2 diabetes mellitus HbA1c and their correlation with glycosylated hemoglobin (HbA1c). Material & Methods: Diagnosed patients with type 2 diabetes mellitus during study period were enrolled in this study. Criteria for diagnosis were: HbA1c ≥ 6.5% (48 mmol /mol), Fasting plasma glucose ≥ 126 mg/dL (7.0mmol/L) 2-Hour postprandial plasma ≥ 200 mg/dL (11.1 mmol/L). Demographic data and risk factors associated with diabetes were analysed. Results: Majority of the patients (37%) were 51-70 years age group, predominantly male (63%). Among risk factors assessment, 66.5% were overweight or obese, 53.3% had positive family history of DM, 55.3% were hypertensives, 43.5% had dyslipidemia, 32.7% had a family history of CAD, 39.3% were smokers and 32% were physically inactive. HbA1c were significantly associated with the all these risk factors. Conclusion: Age, higher BMI, family history of DM, smoking, physical inactivity, hypertension, dyslipidemia and history of CVD are positively correlated with the HbA1c level. 

Background: Type 2 diabetes mellitus (T2DM) is a prevalent and chronic metabolic disorder associated with an elevated risk of cardiovascular complications. This assessment aims to provide a comprehensive overview of the multifaceted factors contributing to cardiovascular risk in individuals with Type 2 diabetes. Aim and Objectives: The aim of this study was to assess cardiovascular risk in type 2 diabetic patients. Method: A prospective cohort study was conducted among known diabetes patients. Information on sociodemographic characteristics was gathered using a pre-tested semi-structured questionnaire, relevant lab investigations were performed, necessary clinical data was collected and the PROCAM score was used to calculate the risk of CVD. Results: 200 participants in the age range of 20-60 years took part in the study in total. Of them, women made up the majority (57%). Most of the participants belonged to the age group 41-60 years. About two-third of the patients (66.5%) had diabetes for a period of more than 5 years. With 17.5% of patients in PROCAM score category 6 and 13.5% of patients in category 7, nearly one-third (31%) of the patients were at high cardiovascular risk. Conclusion: Ultimately, a more nuanced comprehension of the cardiovascular risk factors in Type 2 diabetics can guide the development of targeted interventions and preventive strategies to improve patient outcomes and reduce the burden of cardiovascular morbidity and mortality in this high-risk population.

Introduction: Diabetic cardiomyopathy has been proposed as an independent cardiovascular disease, with causative factors being microvascular disease, autonomic dysfunction, metabolic disorders, interstitial fibrosis, etc. This study will determine any association between diastolic dysfunction and type 2 DM in the asymptomatic subjects and its relation to glucose triad, i.e., HbA1C, fasting blood sugar, and Postprandial blood sugar. Aims and Objectives: To assess the prevalence of diastolic dysfunction in patients with type 2 DM and correlate it with the glucose triad, i.e., HbA1C level, fasting sugar, and Postprandial sugar. Materials and Methods: Inclusion Criteria: 100 Patients between 30- 55 years of age with a history of Type 2 DM for at least 5 years. Exclusion Criteria: Patients with evidence of coronary artery disease, hypertension and valvular disease. The diastolic dysfunction was evaluated using Doppler Echocardiography. Results: In this study, diastolic dysfunction was comparable in patients with fasting blood sugar levels of <100mg/dL (58.33%), 100-125mg/dL (65.31%), and ³ 126mg/dL (51.28%). Diastolic dysfunction was comparable in patients with postprandial blood sugar levels of <140mg/dL (66.67%), 140-199mg/dL (64%), and ³ 200mg/dL (51.22%). A significantly higher number of patients with HbA1C levels between 7-8.49 (84.62%) and HbA1C levels of ³8.5% (66.67%) had diastolic dysfunction. Conclusion: The prevalence of diastolic dysfunction in patients with type 2 DM is 59%. Patients with type 2 DM who have diastolic dysfunction are likely to present with raised FBS levels. Hence, controlling diabetes, viz., glucose triad, i.e., HbA1C, FBS, PPBS, may prevent or postpone diastolic dysfunction in type 2 DM patients.

Introduction: Prevalence of Diabetes Mellitus is rapidly increasing in India. So are its complications, of which nephropathy is very common. Identifying these complications at early stage becomes crucial. One such proposed hypothesis is based on inflammatory markers. Their association with cardiac complications is proven. The current study is planned with this background. Objectives: To assess the serum high sensitivity C reactive protein levels in patients with type 2 diabetes mellitus with diabetic nephropathy and to estimate the levels of serum high sensitivity C reactive protein in different stages of diabetic nephropathy. Methodology: Cross sectional study design was adopted to conduct the study in a government tertiary care setting i.e. K.R. Hospital. Study population included all patients, aged more than 18 years with DM type 2 who visited the study setting (OP /IP). Patients having Congestive cardiac failure, Liver disease, Infections, Autoimmune diseases, organ damage or Cancer or habit-forming drug intake were excluded from the study. Sample size was calculated to be 60. Data was collected using pre-tested, semistructured questionnaire which included detailed history, clinical examination and investigation findings; entered in Excel and analyzed using SPSS. Results: Mean age was 60.23 years. Males constituted 70%. Mean duration of DM was 13.02 years. 40% patients were in DN stage 3. 43% patients had microalbuminuria and 30% had macroalbuminuria. S. Creatinine was elevated in one-third patients. Overall, mean hs-CRP was 9.5 (3.3) mg/L; and mean hs-CRP among patients with DN stage -1, 2, 3 and 4 respectively, were 5.1, 9.0, 12.4 and 13.1 mg/L respectively. The difference between the means was statistically significant. Conclusion: There was a significant correlation between mean Hs CRP levels and clinical stages of the diabetic nephropathy. Also, hs-CRP significantly correlates with elevated PPBS, HbA1C, S. Creatinine, and eGFR levels. Hence hs-CRP may be used as a
marker to assess development and severity of the diabetic complications like diabetic nephropathy.

Conclusion: We have to educate our patients and bring awareness regarding DR. Only if they know more about the disease and its eye complications their attitude will change and they will start good practice

Background: Hypothyroidism and Type 2 Diabetes Mellitus (T2DM) are prevalent endocrine disorders, and their interplay has garnered significant attention due to potential bidirectional relationships. This study investigates the association of hypothyroidism in T2DM patients, focusing on prevalence, clinical correlations, and implications for management. Materials & Methods: A cross-sectional study was conducted at Hind Institute of Medical Sciences, Uttar Pradesh, involving 50 T2DM patients. Clinical assessments, thyroid function tests, and diabetes parameters were collected. Statistical analyses, including descriptive statistics, odds ratios, and correlation coefficients, were employed to explore associations. Results: Among T2DM patients, 20% exhibited hypothyroidism, emphasizing a noteworthy prevalence. Alterations in thyroid function parameters, including elevated TSH and decreased FT4 and FT3, indicated subclinical hypothyroidism. Glycemic control analyses revealed significant differences in FBG and HbA1c levels between euthyroid and hypothyroid individuals. Odds ratios demonstrated associations between hypothyroidism and age, BMI, and T2DM duration. Medication usage patterns highlighted the necessity of thyroid-specific interventions. Conclusion: This study uncovers a substantial prevalence of hypothyroidism in T2DM patients, emphasizing the intricate relationship between these endocrine disorders. Clinical correlations with age, BMI, and T2DM duration suggest the need for tailored therapeutic approaches. Recognizing the impact on glycemic control, screening strategies, and public health measures may enhance patient outcomes in this complex interplay.

Background: Diabetes mellitus is a growing public health problem in many countries. Poor Adherence to drugs, especially among patients with type 2 diabetes mellitus (T2DM) is often a challenging issue Objectives: The aim of the current study was to evaluate the demographic profile and serum insulin level in T2DM and patients taking oral hypoglycemic agents Methods: This comparative cross-sectional study was enrolled 120 patients of newly diagnosed T2DM and patients taking oral hypoglycemic agents. Patients demographic profile (age, gender, body mass index and waist circumference) were recorded. Investigations like; Serum insulin levels, Fasting blood sugar, Post lunch blood sugar and lipid profile were done in all the patients. Results: Most of the patients were 41-60 years age group, mean age was 52.2 + 10.5 years. Majority of the patients were male (70% in Metformin/Glimepiride group & 63% in both). Body mass index (BMI) were significantly higher among patients taking both Metformin and Glimepiride as compared to patients taking Metformin or Glimepiride alone (p<0.05). Serum insulin levels were significantly higher among patients taking oral Antidiabetics as compared to newly diagnosed T2DM patients (p<0.05). Lipid profile also significantly de-arranged among newly diagnosed diabetes mellitus patients (p<0.05). Conclusion: Serum insulin levels were significantly higher in patients taking oral Antidiabetic therapy and also significantly altered metabolic lipid profile among T2DM patients.

This community-based observational study explored the relationship between circulating free triiodothyronine (FT3) levels and the progression of diabetic nephropathy in patients with Type 2 diabetes mellitus over one year. A total of 482 participants from Mayurbhanj, Odisha were stratified into quartiles based on their FT3 levels. The results indicated that those in the lowest FT3 quartile exhibited significantly greater progression of nephropathy, as evidenced by declines in estimated Glomerular Filtration Rate (eGFR) and increases in urine albumin to creatinine ratio (ACR), compared to those in higher quartiles. These findings suggest that FT3 could serve as a valuable prognostic marker for diabetic nephropathy progression, emphasizing the need for further research into thyroid function management as a component of diabetes care

Introduction: According to WHO, in 2019, diabetes was the ninth leading cause of death with an estimated 1.5 million deaths directly caused by diabetes. In 2014, 8.5% of adults aged18 years and older had diabetes. The crude prevalence of diabetes in adults aged 20years or older in India increased by 39·4% . Key for prevention of the complication among the diabetic patients is prompt and aggressive treatment aimed at maintaining normal blood sugar levels. C-peptide is commonly used in preference to insulin measurement when assessing b-cell function in clinical practice. Age is a factor which is a determinant of functionality of the human body. Hence it needed to assess the effect of aging on the c-peptide levels i.e., the insulin production in the body. Early initiation of the insulin treatment for the patients of diabetes is depended on the c-peptide levels. This necessitates the need to understand the c-peptide levels as a proxy of insulin levels amongst the diabetics and the correlation between theage of the diabetes and the c-peptide levels. Objectives: To estimate the level of C-peptide in patients with newly diagnosed type 2 Diabetes Mellitus and to correlate C-peptide levels in different age groups of newly diagnosed type 2 Diabetics Mellitus. Materials And Methods: The present study is a cross-sectional study conducted in KR Hospital, Mysuru.  Patients who were newly diagnosed with Diabetes Mellitus, who satisfy the inclusion criteria and consented to participants in the study was included inthe study. Detailed history, Examination and investigations were done to the selected study   participants. C-peptide levels was estimated in all the patients. Data was analysed using SPSS software. Results: Around 50% of the patients belonged to the age group of 30-40 years. While21.9% belong to 51-60 years. Mean age was 49.45 years. 5.71% of them fall under 71-80 years of age category. 52.38% of the study participants were males while 47.61%were females. Mean Fasting blood sugars and Post Prandial blood sugars of the newly diagnosed diabetes mellitus study participants are 217.85 mg/dl and 342.42 mg/dlrespectively. The mean glycosylated hemoglobin is 10.71% among the patients.68.57% of the newly detected diabetes mellitus in our study had high c-peptide levelswhile 31.42% of them had low c-peptide levels. Mean c-peptide levels among the study participants is 6.51 ng/ml with standard deviation of 1.14 ng/ml.There was a negative correlation between the age and c-peptide. The decrease in the c-peptide levels indicates low insulin production by thebeta cells of pancreases. Conclusion: The present study concludes that there is a strong negativecorrelation between the c-peptide levels and age among the study participants Thisindicates the true deficiency in the insulin production in our participants which bringthe need for the early initiation of the insulin therapy, at the time of diagnosis in a newlydetected type 2 diabetes mellitus. Hence, c-peptide levels measured at diagnosis orearlier after the diagnosis of diabetes mellitus at any age helps in understanding theinsulin reserve of the patients. Thus, better treatment can be given by seeing the c-peptidelevels to have good control of blood sugar levels and in preventing thecomplication of diabetes mellitus.

Introduction: T2DM is associated with cell-mediated immune responses and abnormal T-lymphocyte function, further linked to insulin deficiency. Hence this study aims to determine the activity of serum total ADA and correlate these parameters with glycemic control, and biochemical variables in type 2 diabetic individuals. Aims and Objectives: Aim: To estimate serum adenosine deaminase and its correlation with glycemic status in diabetes mellitus. Objectives: To estimate the serum adenosine deaminase levels in type 2 diabetes mellitus patients. Inclusion Criteria: Individuals with diagnosed T2DM in the age group 35 to 70 years. Exclusion Criteria: Individuals with a history of tuberculosis, rheumatoid arthritis, viral hepatitis, and HIV and Patients on insulin therapy. Results: In this study, 41 cases were males and 59 were females. ADA activity was significantly higher in uncontrolled (Group C) diabetic patients (55.428±3.736U/L) compared to the controlled (Group B) population (42.63±4.59 U/L) and non-diabetics (22.0581±5.1968 U/L) with p value 0.001. Patients who have a longer duration of diabetes history had higher serum ADA levels than newly diagnosed patients with significant differences, p < 0.001. Conclusion: This study's findings clearly show that Adenosine deaminase (ADA) levels are elevated in type 2 diabetics, and the positive correlation of ADA with higher glycemic control suggests that ADA may serve as a prognostic factor in T2DM. ADA had a significant positive correlation with HbA1c, which is regarded as a good marker for long-term glycemic control.

Background: Diabetes and its complications require a multipronged approach for its management. In tertiary care government hospital, diabetic patients who were attending at out-patient department were being treated only with drugs and insulin without proper education on self-care practices because of heavy patient load. But in real scenario, patient has an important role to play in terms of self-care practices, which can be taught to them by educational programs. To develop such an educational program, a baseline assessment of knowledge, attitude and practice regarding self-care among patients, need to be made. Research question: What is the knowledge, attitude and practice regarding self-care among the patients of type 2 Diabetes mellitus attending OPD in our set up? The setting of the study was at OPD of department of General Medicine, Government General Hospital, Kurnool Medical College, Kurnool, Andhra Pradesh. A one-year observational study was conducted during the period from May 2023 to April 2024 on about 215 Type 2 Diabetes patients attending General Medicine OPD, GGH during the above period by studying their socio-demographic profiles, Evaluating Risk factors, comorbidities and assessing their KAP related to self-care towards control & prevention of complications of Diabetes etc. Results: 12% of study participants were aware of examination of feet daily, 43.5% of study participants were practicing foot care examination. 76.3% study participants were having low MMAS score and it reflects poor treatment adherence. Conclusion: Continuous health education and reinforcement by health care providers is essential in order to enhance self-care activity.

Background: HbA1c is recommended as the standard laboratory assessment of glycaemic control and efficacy of treatment of patients with type 1 and type 2 diabetes mellitus. However, HbA1c assays give incorrect values in patients with hemoglobinopathies. Hemoglobinopathies interfere with the detection of HbA1c by the HPLC method. HbE disorder is very common in North- Eastern part of India both in tribal and non-tribal populations. Serum fructosamine is estimated to find out the glycaemic status of HbE disease patients instead of HbA1c. Methods: This hospital-based cross-sectional study was conducted in the Department of Medicine, Assam Medical College & Hospital, Dibrugarh for a period of 12 months. A total of 90 diabetic patients were included. Serum Fructosamine and HbA1c were analysed. Results: The results showed that the mean age was 49.83 years with male preponderance (55 %) with male to female ratio of 1.2:1. In our study, in diabetic patients with adult hemoglobin there was a statistically significant correlation between serum fructosamine and HbA1C (r=0.93) and in diabetic patients with HbE trait also, there was a statistically significant strong correlation (r=0.522). Conclusion: It is seen that HbE disorder is prevalent in this part of the country, and the presence of Hemoglobin E causes significant interference in HbA1C measurement. In the presence of HbE disease, serum fructosamine can be used in place of HbA1c to know the glycaemic status of the patient.

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by persistent hyperglycemia resulting from insulin resistance and pancreatic beta-cell dysfunction. With the global rise of obesity and sedentary lifestyles, T2DM has become a major public health concern, requiring a combination of pharmacological and lifestyle interventions for effective management. This systematic review explores the roles of exercise, diet, and weight reduction in improving glycemic control, enhancing insulin sensitivity, and reducing the need for pharmacological interventions. By synthesizing evidence from various clinical trials and cohort studies, this review highlights the critical importance of lifestyle modifications in reducing the burden of T2DM and preventing associated complications. The findings underscore the synergistic benefits of combining exercise, diet, and weight reduction strategies in managing T2DM, offering valuable insights for clinical practice and patient care.

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a spectrum of liver conditions characterized by excess fat accumulation in the liver, occurring in individuals with minimal or no alcohol consumption. It has become a major global health concern due to its increasing prevalence, particularly in conjunction with metabolic disorders like type 2 diabetes mellitus (T2DM). NAFLD encompasses a range of liver pathologies from simple steatosis to non-alcoholic steatohepatitis (NASH), which can progress to fibrosis, cirrhosis, and hepatocellular carcinoma. Aims: To study nonalcoholic fatty liver disease in type 2 diabetes mellitus patients. To study the correlation between glycemic control (FBS) and duration of diabetes with ALT/SGPT levels. Materials & methods: For eighteen months beginning in July 2022 and ending in December 2023, researchers from Katihar Medical College and Hospital in Katihar carried out this cross-sectional study. Study population 100.v Result: Out of the 60 people who tested positive for NAFLD, 30 had cholesterol levels below 150 mg/dl, 17 had levels between 150 and 199 mg/dl, and 13 had values of 200 mg/dl or more. Among the 40 people who tested negative for NAFLD, 33 had levels below 150 mg/dl, 6 had levels between 150 and 199 mg/dl, and 1 had levels of 200 mg/dl or more. A statistically significant link between increased cholesterol levels and the existence of NAFLD was indicated by the Chi- square test, which generated a value of 12.17650 with a P value of 0.002. Conclusion: NAFLD affects 60% of diabetics, with the highest incidence in women aged 41-50. Obesity and elevated Alanine Aminotransferase levels significantly influence NAFLD risk. Regular testing and targeted therapies for weight and metabolism control are recommended to reduce NAFLD severity.

Background In this study, we wanted to assess the diastolic dysfunction in type 2 diabetic patients using Doppler echocardiography. Methods: This was a hospital based cross-sectional study conducted among 100 patients with Type 2 Diabetes Mellitus (DM) who exhibited diastolic dysfunction, admitted to the Department of Medicine, of a tertiary care hospital, over a period of 2 years after obtaining clearance from institutional ethics committee and written informed consent from the study participants.

Results

In associations with Diastolic Dysfunction

Diastolic dysfunction was significantly associated with age (p=0.038). Older age groups (51-60 years and >60 years) had higher proportions of advanced diastolic dysfunction (Grades III and IV). Males were more likely to have milder forms of diastolic dysfunction, while females had     higher proportions in the severe grades (p=0.037). A significant association was observed between rural residency and severe diastolic dysfunction (p=0.034), with rural participants showing higher prevalence of Grade III and IV dysfunction. Higher triglyceride levels were associated with increasing diastolic dysfunction severity (p=0.006). Advanced diastolic dysfunction was significantly associated with microalbuminuria and macroalbuminuria (p=0.004), indicating kidney damage. Higher HbA1c levels were associated with more severe diastolic dysfunction (p=0.000), reflecting poor glycemic control. Longer duration of diabetes was significantly associated with worsening diastolic dysfunction (p=0.049). Overweight and obese individuals were more likely to have advanced diastolic dysfunction (p=0.000). Severe forms of neuropathy, particularly autonomic neuropathy, were associated with higher grades of diastolic dysfunction (p=0.000). Conclusion Age, sex, region, and duration of diabetes all showed a significant relationship with the severity of diastolic dysfunction. Older individuals, females, and urban residents were at higher risk for more advanced stages of diastolic dysfunction. Glycemic control (HbA1c) was a key factor, with poorer control being strongly associated with more severe dysfunction. This highlights the importance of achieving good glycemic control to prevent cardiac complications. Triglyceride levels and BMI were also significantly associated with diastolic dysfunction, pointing to the importance of managing dyslipidemia and obesity in diabetic patients. Diabetic nephropathy, retinopathy and neuropathy were more prevalent in those with advanced diastolic dysfunction, indicating that cardiovascular and renal complications often coexist in diabetic populations.

Background: Diabetes is increasingly prevalent in India, with over 62 million diagnosed cases. Studies suggest a complex interaction between diabetes and thyroid disorders, impacting glucose tolerance and insulin sensitivity. This study aimed to investigate the prevalence and types of thyroid dysfunction among type 2 diabetes mellitus (T2DM) patients in India, given limited data on the subject. Methods: This cross-sectional study was conducted at the Sri Aurobindo Institute of Medical College over 18 months, from September 2022 to February 2024. A sample of 130 patients with T2DM was recruited, excluding individuals with a known history of thyroid dysfunction or those on medications affecting thyroid function. Patients underwent clinical assessments and laboratory investigations for fasting blood sugar, postprandial blood sugar, HbA1c, and thyroid profiles. Thyroid dysfunction was categorized as hypothyroidism, hyperthyroidism, subclinical hypothyroidism, or euthyroid. Results: Among the 130 T2DM patients, 85.4% exhibited normal thyroid function, while 14.6% displayed thyroid abnormalities. Subclinical hypothyroidism was the most common (7.7%), followed by hypothyroidism (5.4%) and hyperthyroidism (1.5%). Thyroid dysfunction was more prevalent among female patients, who constituted 70.8% of the sample. A significant correlation was observed between blood glucose levels (fasting and postprandial), HbA1c, and TSH levels (p<0.05), though perfect correlations indicated potential data inconsistencies. Conclusion: Thyroid disorders, especially subclinical hypothyroidism, are relatively common in individuals with T2DM, particularly among women. The presence of thyroid dysfunction correlates with poor glycemic control, suggesting a need for routine thyroid screening in diabetic patients to enable early intervention and improve metabolic outcomes.

Background: Non-alcoholic fatty liver disease (NAFLD) has emerged as a significant public health concern, associated with conditions such as Type 2 diabetes, obesity, and metabolic syndrome. In India, prevalence estimates vary widely across regions. Objectives: This study aimed to determine the prevalence of NAFLD and its association with demographic, anthropometric, and lifestyle factors among patients attending a tertiary care hospital in Guntur, Andhra Pradesh. Methods: A cross-sectional analytical study was conducted on 457 patients aged 20–40 years undergoing abdominal imaging from October 2021 to November 2022. NAFLD was diagnosed using ultrasonography and graded from 0 to 3. Data on demographics, anthropometrics, and lifestyle were collected and analyzed using SPSS version 19.0. Statistical significance was set at p<0.05. Results: The prevalence of NAFLD was 46%, with grades 1, 2, and 3 observed in 33.9%, 19.8%, and 0.3% of participants, respectively. NAFLD prevalence increased significantly with age (p=0.022) but showed no gender difference (p=0.232). Patients with NAFLD had higher BMI (27.39 ± 5.41 vs. 21.84 ± 3.6), waist circumference (97.56 ± 10.05 cm vs. 79.25 ± 9.61 cm), and waist-to-hip ratio (0.95 ± 0.18 vs. 0.87 ± 0.08; p<0.001). Diabetes was more prevalent in NAFLD patients (24.3% vs. 7.1%; p<0.001), while hypertension showed no significant difference. Sedentary lifestyle (88.1% vs. 67.6%; p<0.001) and non-vegetarian diets (p=0.025) were significantly associated with NAFLD. Conclusion: NAFLD prevalence in Guntur was high (46%) higher than the global average of 25.24%. NAFLD patients had higher BMI, waist and hip circumferences, and were less physically active, with a higher prevalence of diabetes. The findings underscore the importance of weight management, routine screening, and lifestyle changes to mitigate NAFLD risk. These findings emphasize the need for early screening, lifestyle modifications, and targeted interventions to address NAFLD effectively.

Background: The COVID-19 pandemic has posed significant challenges, particularly for individuals with underlying health conditions such as Type 2 Diabetes Mellitus (T2DM). Understanding the interplay between T2DM and COVID-19 severity is crucial, given the contradictory findings regarding diabetes as a comorbidity affecting COVID-19 outcomes. This study aims to investigate the clinical relationship between T2DM and COVID-19 to fill the knowledge gap and inform better treatment strategies. Objective: To compare the clinical outcomes, laboratory parameters, and complications of COVID-19 between patients with and without T2DM.Methods: This retrospective cohort study was conducted at SCB Medical College and Hospital, Cuttack, including 180 COVID-19 patients (90 with T2DM and 90 non- diabetic) admitted between September 2020 and September 2021. Data on demographics, clinical presentations, laboratory findings, and outcomes were collected. Statistical analyses included the Chi-Square Test for categorical data and Spearman’s Correlation Coefficient for continuous data, using SPSS software version 26. Results: The mean age was slightly higher in diabetic patients (52.2 years) compared to non-diabetic patients (49.67 years), with a male predominance in both groups. Diabetic patients exhibited more severe disease (78.9%) compared to non-diabetics (64.4%) with a significant association between diabetes and COVID-19 severity (Χ² = 7.2053, p = 0.0273). Laboratory analysis showed higher Random Blood Sugar (RBS) and C-Reactive Protein (CRP) levels in diabetics. Significant differences were observed in SGPT and inflammatory markers (LDH, D-dimer, ferritin, and procalcitonin), indicating heightened inflammatory response in diabetics. Complications such as acute kidney injury (AKI), sepsis, and multiple organ dysfunction syndrome (MODS) were more prevalent in diabetic patients, with higher mortality rates (OR=2.55, 95% CI=1.27-5.09, p=0.007). Conclusion: T2DM significantly exacerbates the severity and complications of COVID-19, highlighting the need for tailored clinical management for diabetic patients during the pandemic. Further research is required to explore underlying mechanisms and improve therapeutic strategies for this high-risk group.

Obesity is a growing global health crisis that significantly contributes to chronic diseases such as type 2 diabetes, cardiovascular disorders, hypertension, and certain cancers. It is recognized as a multifactorial condition influenced by genetic, environmental, behavioral, and psychological factors. Traditional obesity management approaches, which predominantly focus on dietary modifications and increased physical activity, often fail to produce sustainable long-term results. As a result, there is an increasing emphasis on multidisciplinary approaches that integrate dietary interventions, physical activity, behavioral therapy, pharmacological treatments, and bariatric surgery to address obesity more comprehensively.

Obesity Management in a Multidisciplinary Approach Multifaceted in nature, the management of obesity requires teamwork that involves different health professionals from diverse fields, such as dietitians, exercise physiologists, psychologists, endocrinologists, and bariatric surgeons. They work best at offering individualized and global approaches to overcome the lifestyle challenges and the psychosocial issues that impact weight loss success. This approach emphasizes behavioural and psychological strategies, including evidence-based methods such as cognitive-behavioural therapy (CBT), mindfulness-based stress reduction for managing stress and other triggers that lead to emotional eating, and achieving sustainable lifestyle changes.

Pharmacological interventions are a critical component in obesity management, especially in those patients who do not respond to lifestyle changes alone. GLP-1 receptor agonists and orlistat are two examples of medications shown to help with weight loss. Bariatric surgery is the most effective intervention for patients with severe obesity, resulting in durable and clinically meaningful weight loss, improved metabolic control, and resolution of obesity-related comorbidities. Nevertheless, surgical solutions demand complete support pre-operatively and post-operatively to be successful in the long run.

This systematic review synthesized evidence from 30 studies to assess the effectiveness of multidisciplinary approaches for managing obesity. The results show that combining different modalities yields superior and longer-lasting weight loss to those delivered by a single modality. Moreover, multidisciplinary care enhances patients' psychological well-being, quality of life, and metabolic health. While the results are encouraging, adherence, access, and long-term feasibility are challenges for widespread implementation.

It also discusses future directions in obesity management, including the potential for mobile health applications, telemedicine, and wearable technology to promote patient engagement and monitoring. Such multidisciplinary approaches can transform obesity care by tackling the underlying causes of the disease and delivering personalized, patient-centred interventions. These results highlight the need for multidisciplinary approaches that focus on preventive care and holistic treatment models as healthcare systems move to help alleviate the global burden of obesity and improve long-term health outcomes.

Background: Type 2 diabetes mellitus (T2DM) is a rapidly growing global health concern, particularly in developing countries like India. This study aims to evaluate the sociodemographic, clinical, and biochemical profiles of newly diagnosed T2DM patients in Burla, Odisha, to inform targeted intervention strategies. Methods: A hospital-based observational study was conducted from September 2022 to February 2023, enrolling 783 newly diagnosed T2DM patients through random sampling. Sociodemographic and clinical data were collected using a semi-structured questionnaire. Anthropometric measurements and laboratory investigations, including glycosylated hemoglobin (HbA1c), lipid profiles, and renal function tests, were performed. Data were analyzed using R software, with significance set at p<0.05. Results: The mean age of participants was 47.70±10.94 years, with 60.3% being male. Most were literate (98.6%), with 68.1% classified as obese (BMI ≥25 kg/m²). Classic diabetic symptoms like weakness (59.3%), nocturia (44.4%), and weight loss (26.7%) were prevalent. Poor glycaemic control (HbA1c >9%) was observed in 41.4% of patients, while only 6.8% achieved good control (HbA1c <7%). Dyslipidaemia (78.2%), hypertension (51.2%), and sedentary lifestyles (84%) were common. Obesity was significantly associated with hypertension (p<0.001), and a positive family history of diabetes was linked to increased risk (p=0.049). Conclusion: The study highlights poor glycaemic control, high prevalence of obesity, and associated risk factors like hypertension and dyslipidaemia among newly diagnosed T2DM patients in Odisha. These findings underscore the urgent need for lifestyle modifications and effective management strategies tailored to the region's socio-cultural context to mitigate the growing diabetes burden.

Type 2 Diabetes Mellitus (T2DM) is a multifactorial metabolic disorder characterized by insulin resistance, impaired glucose regulation, and progressive beta-cell dysfunction. The global prevalence of T2DM has been rising at an alarming rate, influenced by genetic, lifestyle, environmental, and socio-economic factors. This systematic review examines the key risk factors associated with the development of T2DM, including obesity, physical inactivity, unhealthy diet, genetic predisposition, psychosocial stress, environmental toxins, and socioeconomic determinants. The review synthesizes evidence from epidemiological studies, clinical trials, and meta-analyses to provide a comprehensive understanding of the complex interplay of risk factors that contribute to T2DM onset. Identifying and addressing these risk factors through preventive strategies is crucial for reducing the burden of diabetes globally. Moreover, this review highlights the importance of personalized lifestyle interventions and early screening methods to mitigate risk and improve long-term health outcomes. Addressing disparities in healthcare access and developing targeted public health strategies are essential in reducing diabetes prevalence and improving patient quality of life. Future research should focus on innovative prevention programs, technological advancements in monitoring glucose levels, and community-based interventions that promote sustainable lifestyle changes

Background: Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia, which can lead to serious microvascular complications such as diabetic retinopathy (DR). DR is one of the leading causes of vision impairment among individuals with diabetes and is closely linked to poor glycemic control. Studies have shown a strong association between elevated HbA1c levels and the severity of DR, highlighting the importance of maintaining optimal blood sugar levels. However, there is limited data exploring this relationship in specific populations, particularly in Bihar. This study aims to evaluate the association between HbA1c levels and DR severity to enhance early diagnosis and management strategies. Materials and Methods: This prospective observational study was conducted at the Department of Ophthalmology, Government Medical College and Hospital, Bettiah, Bihar, on one hundred patients with type II diabetes mellitus. Patients were selected through randomization, and written informed consent was obtained. A comprehensive ophthalmic evaluation, including best-corrected visual acuity, intraocular pressure measurement, and dilated fundus examination, was performed. Patients with type 2 diabetes who underwent fundus examinations and had HbA1c measurements were analyzed. Data on demographic and clinical parameters, including age, gender, duration of diabetes, glycaemic control, anti-diabetic medications, body mass index (BMI), and diabetes-related complications, were collected. The severity of DR was classified into mild, moderate, and severe non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). Statistical analysis was performed using GraphPad version 8.4.3, which included chi-square tests, independent t-tests, and analysis of variance (ANOVA), with P-values < 0.05 considered significant. Results: The study assessed the relationship between HbA1c levels and diabetic retinopathy severity. The mean age of the study group was 52.23±11.34 years. Poor glycaemic control was common, with 48% having HbA1c between 7–9% and 35% above 9%. Obesity was prevalent (45%), and 48% of the patients used insulin therapy. Among diabetic complications, neuropathy and nephropathy were observed in 12% and 17% of cases, respectively, while 31% had macular edema. Retinopathy severity varied, with 40% having mild NPDR, 26% moderate NPDR, 6% severe NPDR, and 28% PDR. While age, gender, diabetes duration, HbA1c, and BMI were not significantly linked to retinopathy severity, insulin use was associated with higher PDR prevalence (p=0.044). Macular edema showed a strong correlation with retinopathy severity (p=0.002), while there were no significant associations were found between DR severity and neuropathy or nephropathy. Conclusion: Early detection and management of glycaemic control and diabetes duration are crucial in reducing diabetic retinopathy severity. Comprehensive care, including patient education and regular screenings, can help preserve vision. Raising awareness and further research on targeted interventions are essential for improving outcomes

Introduction: Type 2 diabetes mellitus (T2DM) is associated with significant cardiovascular complications, often progressing silently before clinical manifestations appear. Subclinical cardiac dysfunction can be detected early using echocardiographic parameters. This study aimed to evaluate the correlation between metabolic risk factors including BMI, lipid profile, and glycemic control—and subclinical cardiac changes in asymptomatic T2DM patients. Material and Methods: A cross-sectional study was conducted at the Department of Medicine, Mamata Academy of Medical Sciences, Hyderabad, enrolling 300 asymptomatic T2DM patients. Clinical and metabolic parameters, including BMI, HbA1c, fasting blood sugar (FBS), lipid profile, and renal function tests, were recorded. 2D echocardiography was performed to assess left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), E/A ratio, and global longitudinal strain (GLS). Correlations between metabolic risk factors and echocardiographic parameters were analyzed using Pearson’s correlation coefficient and multiple regression models. Results: The mean HbA1c level was 8.2 ± 1.0%, and the mean BMI was 28.5 ± 3.4 kg/m². Significant correlations were observed between HbA1c and E/A ratio (r = -0.88, p < 0.001), indicating that poor glycemic control is associated with diastolic dysfunction. Total cholesterol showed a strong correlation with LVMI (r = 0.60, p < 0.001), suggesting that dyslipidemia contributes to left ventricular remodeling. LVEF was mildly reduced (55.0 ± 4.4%), and GLS values (-17.8 ± 1.9%) confirmed early myocardial strain impairment. Conclusion: Metabolic risk factors, particularly poor glycemic control and dyslipidemia, are significantly associated with subclinical cardiac dysfunction in asymptomatic T2DM patients. The strongest correlation was observed between HbA1c and diastolic dysfunction (E/A ratio), emphasizing the need for strict glycemic control to prevent early cardiac impairment. The study highlights the importance of early cardiovascular screening using echocardiographic markers, even in the absence of symptoms, to mitigate the progression of diabetic cardiomyopathy.

Background: Diabetes mellitus, characterized by chronic hyper glycemia due to defects in insulin secretion or action, is a global health concern with significant systemic and ocular implications. Among its lesser-known yet impactful complications is its association with elevated intraocular pressure (IOP), a key risk factor for glaucoma, a leading cause of irreversible blindness worldwide. Chronic hyper glycemia in diabetes has been linked to increased IOP, highlighting a close relationship between diabetes and glaucoma, which is characterized by optic nerve damage and visual field loss. In India, where diabetes prevalence is rapidly rising, with projections estimating 80 million cases by 2030, the need for early diagnosis and intervention to prevent vision loss is critical. This study aims to compare IOP in diabetic and non-diabetic individuals, exploring the impact of Type 2 Diabetes Mellitus on ocular health to inform better prevention and management strategies for diabetes-related vision complications. Materials and Methods: This hospital-based case-control study included 100 participants, 50 diabetics and 50 non-diabetics, aged 20-80 years. Participants were excluded if they had glaucoma, ocular infections, inflammation, surgery history, or medications affecting intraocular pressure (IOP). Type 2 Diabetes Mellitus was confirmed through blood tests according to the American Diabetes Association guidelines. Ocular examinations, including visual acuity, color vision, slit-lamp assessment, tonometry, and dilated fundus examination, were performed. IOP was measured with a non-contact tonometer. Results: We observed that diabetic patients had a higher mean intraocular pressure (IOP) compared to non-diabetic controls. The mean IOP was 17.57±1.67 mm Hg for diabetics and 14.17±1.40 mm Hg for non-diabetics, with a significant difference (p < 0.0001). Elevated IOP was associated with poor glycaemic control and higher HbA1c levels. The duration of diabetes also influenced IOP, with both early and long-term diabetes showing higher IOP levels. This suggests that diabetes contributes to elevated IOP, increasing the risk of ocular complications like glaucoma. Conclusion: The study concluded that intra-ocular pressure (IOP) was higher in diabetic patients compared to controls, with a significant positive correlation between IOP and HbA1c levels in patients with diabetic retinopathy. It recommends regular screening for both diabetic retinopathy and IOP to detect early signs of ocular hypertension or glaucomatous changes

Background: A major public health concern, non-alcoholic fatty liver disease (NAFLD) is more common in those with type 2 diabetic mellitus (T2DM). Finding out how common NAFLD is in people who have just been diagnosed with type 2 diabetes and what variables put them at risk was the goal of this cross-sectional investigation. Methods: A total of 150 patients newly diagnosed with T2DM, attending the Department of Medicine at katihar medical college and hospital, were enrolled. Diagnosis of NAFLD was confirmed through abdominal ultrasonography, and various demographic, clinical, and biochemical parameters were analyzed. Statistical analyses were performed using SPSS software. Results: The mean age of participants was 47.39 ± 13.25 years, with a slight female predominance (54%). The overall prevalence of NAFLD was observed in 56% of the study population, with 56% classified as grade I, 34.7% as grade II, and 9.3% as grade III. Key risk factors associated with NAFLD included hypertension (43.3%), hyperlipidemia (36.7%), and obesity (23.4%). Metabolic syndrome was present in 58% of the patients, with a notable association between its severity and the grading of NAFLD. Conclusion: The study highlights a significant prevalence of NAFLD among newly diagnosed T2DM patients, indicating the need for enhanced screening and management strategies. Identifying risk factors such as hypertension, hyperlipidemia, and obesity is crucial for developing effective intervention programs. Increased awareness and routine screening for NAFLD in diabetic patients may help mitigate the risk of liver-related morbidity and improve overall health outcomes.

Background: Regular puncture for dialysis, treatment with anticoagulation and abnormal hemodynamics make infections, hematoma, thrombosis, limb oedema, cellulitis of limb, bleeding, pseudoaneurysms and true aneurysms a relatively common complication in patients with arteriovenous fistula (AVF) for hemodialysis. Aims: We aim to describe the presentations, treatment modalities and probable causative factors of true and pseudo aneurysms in CKD patients with arteriovenous access.Materials and Methodology: It was a retrospective observational study in the Department of Cardiothoracic and Vascular Surgery at IPGMER And SSKM Hospital, Kolkata, during the period July 2022 to July 2024. Results: In our study, 34.03% patients were in the age group 51-60 and 23.15% were in the age group 41-50. Of those studied, 61.4 % were male, the rest were female. All the patients had Stage V CKD. 68.77% patients had aneurysms of the brachiocephalic fistula while the rest had aneurysms of the radiocephalic fistula. Among comorbidities, 67.01% patients had Type 2 diabetes mellitus (T2DM), 86.31% patients were hypertensive, 64.21% patients had peripheral arterial disease, 36.14% patients had heart failure, 82.80% patients had dyslipidemia.In our study, 108 (37.80%) patients had Type Ia aneurysm, 142 (49.82%) had Type Ib aneurysm, 21 (7.36%) had Type IIa aneurysm, 14 (4.91%) had Type IIb aneurysm. 44.91% patients who presented were asymptomatic, while 40% presented as bleeding fistula and 15.09% presented as hematoma. Among treatment modalities undertaken, ligation of fistula was done for a significant 77.55% of cases, excision of aneurysm and repair for 16.84% and endovascular repair was done for 5.61 % of patients. Conclusions: Frequent monitoring of the arteriovenous access, avoiding repeated punctures in same site for dialysis, regular dressing and antibiotics to prevent infection may help identify and prevent aneurysms early and provide prompt treatment to avoid potentially fatal consequences like rupture, hemorrhage, thrombosis and stenosis. To determine the ideal treatment strategy and the appropriate time for intervention, studies outlining the etiology, natural history and development of aneurysms are necessary.

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with rising global prevalence, necessitating sustainable management strategies. Lifestyle interventions, including dietary modifications, physical activity, and behavioral strategies, play a crucial role in glycemic control, cardiovascular risk reduction, and weight management. However, long-term effectiveness and adherence remain challenges. Methods: A systematic review and meta-analysis of 32 studies (22 randomized controlled trials, 10 observational studies) assessed the effects of dietary patterns (Mediterranean, low-carbohydrate, plant-based diets), structured exercise (aerobic, resistance training), and behavioral interventions (cognitive-behavioral therapy, diabetes self-management education) on metabolic outcomes. Primary outcomes included HbA1c, fasting blood glucose (FBG), postprandial glucose (PPG), weight loss, BMI, lipid profile, and blood pressure. Results: Lifestyle interventions led to HbA1c reductions of 0.6%–1.8% and fasting glucose reductions of 20–60 mg/dL, with the greatest impact observed in combined diet and exercise programs. Weight loss (4.0–10.0 kg) and BMI reduction (2.5–4.0 kg/m²) were most significant in low-carbohydrate diets and structured exercise. Cardiovascular risk factors improved, with LDL reductions (10–35 mg/dL) and blood pressure reductions (5–15 mmHg). Medication use declined, with up to 50% reducing insulin therapy. Conclusion: Lifestyle interventions significantly improve T2DM outcomes. Integrating dietary, physical, and behavioral strategies enhances long-term success, though adherence remains a key challenge.

Background: Chronic kidney disease (CKD) is a growing health issue that poses both medical and financial challenges. For patients with CKD, kidney transplantation represents the best treatment option. Unfortunately, this option is often unattainable for many CKD patients, especially in developing countries like India. OBJECTIVES: To estimate the prevalence of lipid abnormalities in chronic kidney disease patients. To evaluate the Quantitative assessment of lipid abnormalities in chronic kidney disease patients. MATERIAL & METHODS: Study Design:  Hospital-based, cross-sectional study.  Study area: The study was conducted in the Department of General Medicine at Narayana Medical College, Nellore.  Study period: 1 year.  Sample size: The study consisted of a total of 30 subjects and 30 controls.  Sampling Technique:  Simple Random technique. Results: As compared to <150 and 150-199 among males, t= 9.241, P<0.001 is statistically highly significant. As compared to borderline high and high among males, t=5.047 P<0.001 is statistically highly significant. As compared to <150 and 150 – 199 among females, t=4.268, P<0.05 is statistically significant.    CONCLUSION: In conclusion, this study of 50 CKD patients revealed that Type 2 diabetes (38%) and hypertension (32%) were the leading causes, with most patients aged 41-50 years. A significant proportion of diabetic (52.6%) and hypertensive (75%) patients with 5-15 years of disease duration developed CKD

Background: Vascular complications are a major concern in Type 2 Diabetes Mellitus (T2DM), with obesity being a significant risk factor. However, non-obese individuals with T2DM also experience vascular complications, suggesting the involvement of other pathogenic mechanisms. This study evaluates and compares vascular complications in non-obese and obese T2DM patients. Materials and Methods: A total of 200 T2DM patients were included in the study, with 100 categorized as obese (BMI ≥ 30 kg/m²) and 100 as non-obese (BMI < 25 kg/m²). Vascular complications, including peripheral arterial disease (PAD), diabetic retinopathy, and nephropathy, were assessed using Doppler ultrasound, fundoscopic examination, and urine albumin-to-creatinine ratio. Glycemic control was evaluated using HbA1c levels, while lipid profiles and inflammatory markers were also analyzed. Results: Obese T2DM patients exhibited a significantly higher prevalence of vascular complications compared to non-obese patients (PAD: 45% vs. 30%; diabetic retinopathy: 50% vs. 35%; nephropathy: 40% vs. 25%). HbA1c levels were comparable between the groups (8.2% ± 1.3 vs. 7.9% ± 1.1, p = 0.08). However, obese patients demonstrated elevated inflammatory markers (CRP: 6.8 ± 2.1 mg/L vs. 4.2 ± 1.5 mg/L, p < 0.05) and dyslipidemia. Conclusion: Obesity in T2DM is associated with a higher prevalence of vascular complications, likely due to increased inflammation and dyslipidemia. However, non-obese T2DM patients also experience significant vascular risks, highlighting the need for comprehensive cardiovascular risk assessment beyond BMI.

Background: Diabetes mellitus (DM) is a chronic metabolic disorder with a rapidly increasing global prevalence, contributing significantly to morbidity and mortality. Poor glycemic control is a key factor leading to severe complications, particularly cardiovascular diseases (CVD). This study assesses demographic distribution, glycemic control, diabetes duration, management strategies, and cardiovascular risk factors among diabetic patients. Aim: To evaluate glycemic control, management strategies, and the prevalence of cardiovascular risk factors among diabetic patients attending a tertiary care hospital. Methods: A cross-sectional study was conducted among 100 diabetic patients. Data on demographic characteristics, mean HbA1c levels, duration of diabetes, management approaches, and cardiovascular risk factors were collected and analyzed using SPSS software. Results: Of the study population, 63% were male and 57% were aged 41–60 years. The mean HbA1c was 8.2, indicating poor glycemic control. Most patients (61%) had diabetes for over five years, and 56% required both oral hypoglycemic agents (OHA) and insulin. The most prevalent cardiovascular risk factors were dyslipidemia (63%), hypertension (41%), and a high-risk CVD category (37%). Tobacco use and alcohol consumption were observed in 19% and 29% of the patients, respectively. Conclusion: The study highlights poor glycemic control and a high prevalence of cardiovascular risk factors among diabetic patients, emphasizing the urgent need for targeted interventions. Multidisciplinary diabetes management, including early lifestyle modifications, optimal pharmacological strategies, and regular monitoring, is crucial in reducing diabetes-related complications. Future research should explore individualized intervention strategies and their long-term impacts on glycemic control and cardiovascular risk reduction.

Background: Diabetes mellitus (DM) is epidemic in India and showing sharp increase. DM patients have twice the risk of mortality as compared with non-DM patients, due to micro-and macro vascular complications of diabetes. Aim: This study aimed to assess the Systemic Immune Inflammation index (SII), Systemic Inflammation Response Index (SIRI) in T2DM patients. Materials and methods: A cross-sectional study design was conducted at Department of Biochemistry and Department of General Medicine, Akash Institute of Medical Sciences and Research Centre, Devanahalli, Bengaluru, Karnataka, India. A total of 200 subjects were recruited in this study. Among them, 100 were type 2 diabetes mellitus patients and 100 were non-diabetic subjects. Under aseptic conditions, fasting venous blood samples and post-prandial samples were collected, allowed to stand for 1 hour and centrifuged at 3000 rpm for 10 minutes to obtain serum sample. The serum sample was used for the estimation of fasting and post-prandial glucose, urea, creatinine by using commercially available auto analyzer kits. EDTA samples were used for complete blood count (CBC) analysis. SII, SIRI, NLR and PLR were calculated from CBC values. Blood pressure and BMI were recorded, in addition to family history and lifestyle parameters. Statistical Analysis: The results were expressed in mean and standard deviation. Categorical variables were expressed in percentages. Mann-Whitney U test was used for continuous non-normally distributed variables. P value <0.05 was considered as significant. Results: In this study, mean age (55.1±11.5 years) and BMI (26.5±3.1 kg/m²) was significantly high in T2DM cases than non-diabetics. Significant increase in blood pressure [(systolic (SBP) 120.1±7.3 mmHg), diastolic (DBP) (80.1±2.6 mmHg)], fasting blood sugar (FBS) (155.2±50.2 mg/dl), post-prandial blood sugar (PPBS) (248.2±80.2 mg/dl), urea (30.6±6.2 mg/dl), creatinine (1.2±0.1 mg/dl) and neutrophil count (68.6±10.9 %) was observed in T2DM cases compared with non-diabetic subjects. Significant decrease in lymphocytes (25.1±9.7 %) observed in T2DM cases. The inflammatory markers such as SII (14.9±4.5), SIRI (27.5±6.1), NLR (5.1±1.5) and PLR (0.21±0.02) were significantly increased in T2DM cases than non-diabetic subjects. Conclusion: This study results may conclude that increased values of SII, SIRI, NLR and PLR in T2DM and indicates systemic inflammation and may be associated with pathogenesis of the T2DM.

Background The management of glycemic control in critically ill patients admitted to the Intensive Care Unit (ICU) presents significant challenges, particularly when oral antidiabetic drugs (OADs) are discontinued. This study aims to evaluate the impact of discontinuation of OADs on glycemic control in ICU patients and identify factors associated with poor glycemic control during hospitalization. Materials and Methods A prospective cohort study was conducted over a 6-month period in the ICU of a tertiary care hospital. A total of 200 adult patients with type 2 diabetes mellitus (T2DM) who were admitted to the ICU and had their OADs discontinued upon admission were enrolled. Blood glucose levels were monitored daily, and glycemic control was assessed using mean blood glucose levels and HbA1c values at admission and discharge. Insulin therapy was initiated as required based on standard glycemic management protocols. Patient data, including demographics, comorbidities, type of OADs used, and ICU treatment modalities, were recorded and analyzed.  Results The mean age of the study population was 58 ± 12 years, with a male-to-female ratio of 1.5:1. At admission, the average HbA1c was 8.5% ± 1.2%, indicating poor glycemic control prior to hospitalization. The mean blood glucose levels during ICU stay were significantly higher in patients who were previously managed with sulfonylureas (220 ± 45 mg/dL) compared to those on metformin (190 ± 38 mg/dL) or DPP-4 inhibitors (185 ± 36 mg/dL). Insulin therapy was required in 75% of patients during their ICU stay. Poor glycemic control (mean blood glucose >200 mg/dL) was associated with prolonged ICU stay (average 12 ± 3 days) compared to patients with better control (average 8 ± 2 days).  Conclusion Discontinuation of OADs in ICU patients leads to suboptimal glycemic control, particularly among those previously managed with sulfonylureas. Effective glycemic management protocols, including timely initiation of insulin therapy, are essential for improving clinical outcomes and reducing ICU stay duration in diabetic patients. Future studies should focus on establishing guidelines for the safe transition from OADs to insulin therapy in critically ill patients.

Background: Type 2 diabetes mellitus (T2DM) is a global health concern, with microvascular complications such as diabetic nephropathy contributing to significant morbidity. Glycated haemoglobin (HbA1c) is a glycemic control marker, while albuminuria is an early indicator of renal dysfunction. Their interplay remains a crucial factor in diabetes management. Methods: This cross-sectional study included 150 patients with T2DM at Sheth V. S. General Hospital, Ahmedabad. Data collection included demographic parameters, disease duration, biochemical markers (HbA1c, lipid profile, serum creatinine, urine albumin-creatinine ratio), and complications such as neuropathy, retinopathy, and hypertension. Results: Among the participants, 66.6% had normoalbuminuria, 24% had microalbuminuria, and 9.3% had macroalbuminuria. Higher HbA1c levels (>7%) were significantly associated with microalbuminuria (75%) and macroalbuminuria (50%) (p<0.05). Dyslipidemia was prevalent, with 75% of microalbuminuric patients having total cholesterol >200 mg/dL. Hypertension was significantly linked to albuminuria (p=0.0382). Retinopathy was more frequent in microalbuminuric patients (p=0.0305). Conclusion: Poor glycemic control, dyslipidemia, and hypertension were strongly associated with albuminuria in T2DM patients. Early screening and aggressive management strategies targeting glycemic and lipid control may help mitigate renal complications

Background: Vitamin D plays a vital role in insulin sensitivity and glucose metabolism. Postmenopausal women face a higher risk of vitamin D deficiency due to aging, reduced sun exposure, and estrogen decline, which worsens insulin resistance. This study examines the relationship between vitamin D deficiency and insulin resistance in postmenopausal women. Materials and Methods: This cross-sectional study was conducted at Shaheed Nirmal Mahto Medical College, Dhanbad, in the Departments of Physiology and Medicine, with a sample size of 175 postmenopausal women aged 45–70 years. Participants were recruited from outpatient and inpatient services based on inclusion and exclusion criteria. A structured questionnaire was used to collect demographic, lifestyle, and clinical data. Biochemical parameters assessed included serum 25-hydroxyvitamin D levels (ECLIA method), fasting plasma glucose, postprandial blood glucose, glycated hemoglobin (HbA1c), fasting insulin, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Correlations between vitamin D levels and insulin resistance markers were analyzed using Pearson’s correlation and linear regression models. A p-value of less than 0.05 was considered statistically significant. Results: Vitamin D deficiency (<20 ng/mL) was prevalent in 56.0% of participants, with only 12.6% having sufficient levels (≥30 ng/mL). A strong inverse correlation was observed between vitamin D levels and insulin resistance markers, including fasting insulin (r = -0.39, p < 0.001) and HOMA-IR (r = -0.45, p < 0.001). Participants with vitamin D deficiency exhibited significantly higher fasting glucose (132.8 mg/dL), postprandial glucose (186.4 mg/dL), and HbA1c (7.4%), indicating poor glycemic control. Additionally, 81.6% of vitamin D-deficient individuals had an HbA1c >7%, compared to 22.7% in those with sufficient vitamin D levels (p < 0.001). The findings suggest a significant association between vitamin D insufficiency and increased insulin resistance in postmenopausal women. Conclusion: Vitamin D deficiency is highly prevalent in postmenopausal women and strongly correlates with insulin resistance. Routine vitamin D screening and targeted interventions, including supplementation and lifestyle modifications, may improve insulin sensitivity and metabolic health. Further studies are needed to explore vitamin D optimization in diabetes prevention

Background: Hypertension and obesity are common comorbidities in patients with type 2 diabetes mellitus (T2DM) and are associated with an increased risk of cardiovascular and microvascular complications. This cross-sectional study is aimed to investigate the association between body mass index (BMI) and hypertension in patients with T2DM. Methods: A total of 100 patients with T2DM were included in the study. Demographic and clinical data, including BMI, blood pressure measurements, and laboratory investigations, were collected. Participants were classified as underweight, normal weight, overweight, or obese based on BMI categories. Hypertension was defined according to the American College of Cardiology guidelines. Logistic regression analysis was performed to evaluate the association between BMI and hypertension, adjusting for potential confounders. Results: The mean age of participants was 58.5 ± 11.2 years, and 55% were male. The prevalence of hypertension increased significantly with increasing BMI categories, from 20% in the underweight group to 64% in the obese group (p < 0.001). Compared to the normal weight group, the overweight group had 2.67 times higher odds of hypertension (95% CI: 1.12-6.35, p = 0.027), while the obese group had 6.21 times higher odds (95% CI: 2.38-16.21, p = 0.0002). Conclusions: Overweight and obesity are the significant risk factors for hypertension in patients with T2DM. Effective strategies to control weight can keep a check on hypertension thus reducing the risk of cardiovascular and microvascular complications in patients with T2DM.

Introduction: Diabetes mellitus is an important risk factor for cardiovascular disease and atherosclerosis as it is a common secondary cause of hyperlipidemia when the glycemic control is poor. Present study was aimed to investigate the association between dyslipidemia, duration of type 2 diabetes mellitus, and HbA1c in patients with T2DM at a tertiary care center. Material and Methods: Present study was cross- sectional descriptive study, conducted in type 2 diabetes mellitus patients of age ≥ 18 years, either gender, willing to participate in the study and has given written consent. Results: Among 233 participants, majority of fall within the 41-50 years age group (43 %) & 169 participants were female (72.5%). Overall, total cholesterol, triglycerides, and LDL levels increase as HbA1c levels rise, suggesting a strong correlation between poor glycemic control and lipid abnormalities, while FBS and HDL do not show significant changes with HbA1c levels. Triglycerides and LDL cholesterol levels are significantly associated with the duration of diabetes, highlighting the progressive impact of the disease on lipid metabolism. There is significant difference in cholesterol, triglycerides, LDL, HDL, HBA1C levels in those have diabetes duration greater than 5 years and less than 5 years. there is no significant difference in FBS level in those have diabetes duration greater than 5 year and less than 5 years. The T Test shows significant difference in cholesterol, triglycerides, LDL levels in those have HBA1C greater than 7.5 and less than 7.5. there is no significant difference in FBS and HDL level in those have HBA1C greater than 7.5 and less than 7.5. Conclusion: The correlation analysis indicates that higher HbA1c levels are associated with elevated total cholesterol, triglycerides, and LDL, emphasizing the relationship between poor glycemic control and adverse biochemical profiles.

Introduction Taste and smell may influence the acceptance or rejection of food, allowing to recognize chemical characteristics and nutritive substances of ingested food. Previous studies reported that the activation of sensory receptors induces oral and gastrointestinal secretion, contributing to the metabolic and digestive process. Recent findings also showed that ectopic taste and smell receptors could act directly in the regulation of gastrointestinal functions, insulin and glucagon secretion, sense of satiety, and gut motility. Materials and methods This was a cross-sectional study comprising a sample size of 80. Patients aged 25 to 50 years with T2DM < 5 years duration with HBA1C ≤ 7 were recruited from a tertiary care hospital for the research. They were divided into 2 groups, Group I- with normal weight (BMI of 18.5 to <25) and Group II with grade 1 obesity (BMI of 30 to < 35). The duration of the study was 2 months Results Study Population Of a total of 80 T2DM patients recruited, only 50 met the selection criteria and were enrolled for the study. The characteristics of the T2DM patients and 50 control subjects are described. The two groups were similar for age, gender distribution, and body mass index (BMI), and differed only for fasting glucose values, as expected. Individual data for each type of stimulus are reported in Supplementary Conclusion Our study concludes that gustatory impairment for the tastants – sweet, salty, sour, and bitter was observed in obese Type 2 Diabetes mellitus patients having the disease for less than 5 years, though maintaining a fair glycaemic control. This may affect their choices of food items like preference for sweet- tasting food which can exacerbate hyperglycaemia and aggravate obesity.

Background: Hyperglycemia and insulin resistance are hallmarks of type-2 diabetes mellitus (T2DM), a chronic metabolic disease. According to new research, the pathophysiology of type 2 diabetes may be significantly influenced by mineral metabolism, including that of calcium, phosphorus, and vitamin D. Aim: Evaluating the correlation of serum calcium, phosphorus and vitamin-D in Type-2 diabetic mellitus patients. Material & Methods: This was a Hospital Based Prospective Cross-sectional study between case and control group carried out for a period of One year in the Department of Biochemistry and Physiology at a Tertiary care Centre.A total of 100patients were assessed out of which 50were healthy individuals (control group) and other 50 were individulas with type-2 diabetes mellitus patients (cases) .Blood samples were collected after overnight fasting under all aseptic conditions for fasting plasma glucose level, postprandial glucose level, glycated hemoglobin, vitamin-D, calcium and phosphorous level were studied. Results: This study include 100individuals which was divided into two groups. Group I(CASE GROUP): include diabetic patients (n=50), in which males were 33(66%) and females were 17(34%). The maximum number of diabetic patients were found in the age group of 61-70 (30%) .In diabetic patients, 31(77.5%) individuals have phosphorous level recorded with <3.4mg/dl. 15(37.5%) individuals have serum calcium level less than 8.4mg/dl and  only 22.5% of diabetic patients were observed to be less concentration of Vitamin-D level. Conclusion: Measuring serum calcium, phosphorus, and vitamin D levels is essential for tracking type 2 diabetes prognosis. These are the early indicators that should be taken into account when diagnosing type-2 diabetes.

Background: Chronic Total Occlusions (CTOs) represent a complete blockage of a coronary artery persisting for more than three months. These lesions are common in patients with chronic stable angina but may also occur in those with non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA). Historically considered complex with high procedural risks, CTO interventions have seen significant advancements in safety and success rates due to improvements in technology and operator expertise. Successful revascularization has been shown to improve myocardial perfusion, alleviate symptoms, and enhance overall cardiovascular outcomes.

Aims and Objectives:

1. To study the clinical and angiographic profile of patients undergoing CTO angioplasty at a tertiary care center.
2. To assess the immediate procedural outcomes and complication profile in this cohort.

Methods: This was a record-based descriptive study conducted in the Department of Cardiology, Government Medical College, Alappuzha. Data were collected from the CTO registry for a 2-year period (November 2022 to November 2024). Patients aged ≥18 years with angiographically confirmed CTO (duration >3 months) who underwent percutaneous coronary intervention (PCI) were included. Those with severe comorbidities, uncontrolled systemic conditions, or inability to provide consent were excluded. Data were extracted on demographics, comorbidities, clinical symptoms, angiographic features, procedural success, and complications, and were entered into a master chart for descriptive statistical analysis. Results: A total of 220 patients underwent CTO angioplasty during the study period. Most patients were elderly, with 66.36% aged >60 years. Males constituted 84.09% of the cohort. Hypertension (76.36%), type 2 diabetes mellitus (86.36%), and smoking (67.27%) were the most common risk factors. Prior PCI was seen in 50.90% and previous CABG in 15.45%. The predominant presenting symptoms were dyspnea on exertion (83.18%), easy fatigability (79.09%), and effort angina (71.36%), with most in NYHA Class II. The most common clinical presentation was UA/NSTEMI (55.45%), followed by chronic stable angina (37.27%) and STEMI (7.27%). Angiographically, double vessel disease was most frequent (69.54%), and the LAD was the most commonly involved CTO vessel (52.72%), followed by LCX (39.54%) and RCA (38.18%). Procedural success was achieved in 82.72% of cases. The most frequent complication was coronary perforation (15.45%), followed by nonfatal myocardial infarctions (10.45%), arrhythmias (8.18%), and no-flow/slow-flow phenomena (8.18%). Stroke and acute kidney injury were rare (1.36% and 0.91%, respectively). All-cause and cardiac-specific mortality were low at 0.91%. No patients required emergency CABG. Conclusion: CTO angioplasty, once considered a high-risk and low-success intervention, is now feasible and effective with a high procedural success rate and low mortality. Despite the complexity of cases and comorbid burden, the outcomes reflect improved technical capabilities and procedural safety. Early recognition, appropriate case selection, and expertise are crucial for favorable outcomes.

Background: Two of the most prevalent metabolic disorders in the world are diabetes mellitus (DM) and hypothyroidism. Both illnesses are becoming much more common, and if left untreated, they can have long-term consequences. Aim: this study aimed to evaluate the relationship between thyroid related hormones and vascular complication in type 2 diabetes mellitus patients in a tertiary level hospital. Methods: This cross-sectional study included one hundred Types 2 DM patients. Thyroid function tests were performed on the subjects. TSH was divided into three levels: 0.27–2.49 mU/L, 2.5–4.2 mU/L, and >4.2 mU/L. Every participant had their risk for diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy evaluated. TSH levels and microvascular consequences of type 2 diabetes were examined in relation to each other. Results: The TSH level and HbA1c did not significantly correlate (P>0.05). Microvascular disease affected 72% of the patients overall. There was no discernible correlation between TSH levels and neuropathy or retinopathy. There was no statistically significant correlation (P>0.05) between the presence of microalbuminuria and macroalbuminuria and elevated TSH levels. Higher TSH levels were shown to be significantly correlated with both diabetic kidney disease and reduced GFR (P<0.05). Conclusions: Since elevated TSH levels in Type 2 DM patients may be a sign of underlying microvascular problems, it is desirable to screen all patients for thyroid dysfunction.

Background: Obesity   is   emerging   as   an   important   health   issue. The rising prevalence of obesity in India has a direct correlation with the increasing prevalence of    obesity-related co-morbidities such as metabolic syndrome, dyslipidemia, type 2 diabetes mellitus (T2DM), hypertension and cardiovascular disease (CVD).  Aim: This study aimed to assess the correlation between BMI and serum lipid profile parameters among the young medical students of NRI Institute of Medical Sciences (NRIIMS), Visakhapatnam, Andhra Pradesh, India. Methods: This cross-sectional study was conducted in Department of Biochemistry, NRI Institute of Medical Sciences (NRIIMS), Sangivalasa, Visakhapatnam, Andhra Pradesh, India. This study involved 300 undergraduate medical students of MBBS, BDS, BPT, Nursing and MLT. Age of study subjects was 17 to 25 years and both genders were included. This study was approved by the Institutional Ethics Committee (IEC) and informed consent was obtained from all the subjects. Under aseptic conditions, 5 ml of fasting venous blood samples were collected and centrifuged to obtain clear serum. Serum sample was used for estimation of total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDLC). Low density lipoprotein cholesterol (LDLC) and very low-density lipoprotein cholesterol (VLDLC) were calculated by using Frieldwald’s formula.  BMI was calculated. Based on BMI value, subjects were classified as underweight [BMI <18.5 kg/m²], normal weight [BMI 18.5-24.9 kg/m²], overweight [BMI 25.0-29.9 kg/m²] and obese [BMI >30.0 kg/m²]. Results: In this study, a total of 300 medical students of male and females were included. Out of 300 subjects, males were 146 (48.7%) and females were 154 (51.3%). Based on BMI value, study subjects were categorized as underweight, normal weight, overweight and obese. In this study, underweight subjects were 58 (19.3%), normal weight subjects were 173 (57.6%), overweight subjects were 51 (17%) and obese subjects were 18 (6%).  Overall, significant increase in serum cholesterol (156.3±38.4 mg/dl), triglycerides (108.2±62.1 mg/dl) and VLDLC (21.6±12.4 mg/dl) was observed in overweight subjects compared to other groups. LDLC (82.7±36.6 mg/dl) was increased and HDLC (50.3±11.4mg/dl) was decreased in obese subjects compared to other groups. Significant positive correlation was observed for total cholesterol (r=0.171), triglycerides (r=0.252), LDLC (r=0.195), VLDL (r=0.252) with BMI and HDLC (r= -0.252) showed significant negative correlation with BMI. Lipid profile parameters were compared in MBBS students. Increase in serum cholesterol (158.3±29.6 mg/dl), triglycerides (109.2±67.6 mg/dl), LDLC (79.2±22.3 mg/dl) and VLDLC (21.8±13.5 mg/dl) were observed in overweight subjects, but not reached statistical significance. Significant decrease was observed in HDLC (55.9±7.6 mg/dl) in obese subjects than other groups. In MLT students, total cholesterol (199.2± 55.2 mg/dl), LDLC (135.6±45.2 mg/dl) were increased and HDLC (39.8±1.3 mg/dl) was decreased in obese subjects. Triglycerides (122.6±45.5 mg/dl) and VLDLC (24.5±9.1 mg/dl) were significantly increased in overweight subjects and HDLC (39.8±1.3 mg/dl) was decreased in obese subjects compared to other groups. In nursing students, HDLC (44.2±15.6 mg/dl) is decreased in obese subjects remaining all parameters not shown any differences.  Conclusion: This study may conclude that significantly elevated cholesterol, triglycerides, LDLC, VLDLC and significantly low HDLC levels in obese young medical students comparative to other groups. Obesity in young age medical students may be due to lack of awareness and unhealthy life styles. Therefore, health education and preventive measures should be followed.

Background: Semaglutide, a once-daily GLP-1 receptor agonist, has demonstrated significant efficacy in glycemic control and weight reduction in patients with type 2 diabetes mellitus (T2DM). However, real-world, dose-comparative data from South Indian populations remain limited. Methods This prospective, interventional, two-arm comparative study was conducted at Vels Medical College and Hospital, Tamil Nadu. Fifty patients with T2DM were randomized equally to receive either 3 mg or 7 mg of once daily oral Semaglutide over 12 weeks. Primary outcomes included change in body weight and HbA1c. Secondary outcomes included fasting and postprandial glucose levels, achievement of HbA1c <7%, ≥5% weight loss, and adverse events. Data were analyzed using SPSS and R software, with appropriate statistical tests and effect size reporting. Results The 7 mg group showed significantly greater reductions in both weight (−5.9 ± 1.3 kg vs. −3.2 ± 1.1 kg, p < 0.001) and HbA1c (−1.4 ± 0.4% vs. −0.8 ± 0.3%, p < 0.001) compared to the 3mg group. More patients on 7mg achieved HbA1c <7% (68% vs. 36%, p = 0.025) and ≥5% weight loss (64% vs. 28%, p = 0.011). Adverse events, mainly gastrointestinal, were mild and self-limiting in both groups. Conclusion Once daily  Semaglutide at 7 mg demonstrated superior short-term efficacy in both weight loss and glycemic control compared to 3mg, with acceptable tolerability in this South Indian cohort. These findings support the preferential use of the higher dose in individualized treatment strategies for T2DM

Background: Type 2 Diabetes Mellitus (T2DM) is a global health concern with increasing prevalence, particularly in developing countries. Early intervention strategies are essential in preventing disease progression. While pharmacological management with Metformin is widely prescribed, non-pharmacological approaches like lifestyle modification (LSM) are gaining emphasis. This study aims to compare the efficacy of Metformin and lifestyle modifications in glycemic control among newly diagnosed T2DM patients. Materials and Methods: A prospective, comparative, interventional study was conducted over 6 months among 100 newly diagnosed T2DM patients attending a tertiary care hospital. Patients were randomly allocated into two groups: Group A (n=50) received Metformin 500 mg twice daily, while Group B (n=50) followed structured lifestyle modification strategies including dietary counseling, physical activity (30 minutes/day, 5 days/week), and behavioral support. Glycemic indices, including fasting blood glucose (FBG), postprandial blood glucose (PPBG), and glycated hemoglobin (HbA1c), were recorded at baseline and at the end of 6 months. Statistical analysis was performed using SPSS v25.0. Results: At 6-month follow-up, Group A showed a mean reduction in HbA1c from 8.4% to 6.9%, while Group B had a reduction from 8.2% to 7.2%. FBG decreased from 162.3 mg/dL to 118.5 mg/dL in Group A and from 158.7 mg/dL to 124.2 mg/dL in Group B. PPBG reduced from 238.6 mg/dL to 170.8 mg/dL in Group A and from 232.1 mg/dL to 178.9 mg/dL in Group B. Although both interventions were effective, Group A showed statistically greater improvement in glycemic parameters (p<0.05). Conclusion: Both Metformin and lifestyle modification significantly improved glycemic control in newly diagnosed T2DM patients. However, Metformin demonstrated superior glycemic reduction over lifestyle changes alone. Incorporating both strategies might offer additive benefits in early diabetes management

Aim: The aim of the present study was to assess the relationship between serum Zinc level and HbA1C level in newly diagnosed type 2 diabetes mellitus and to compare serum Zinc level with its risk factors. Methods: The study was conducted at Sri Guru Ram Das University of Health Sciences, Sri Amritsar. Patient presenting in OPD/IPD of Medicine department who are known case recently diagnosed type 2 Diabetes Mellitus were recruited to current study after taking written and informed consent from January 1,2023 to March 31,2024. The present study included a total of 175 cases, comprising recently diagnosed type 2 DM patients, and 100 age and gender-matched healthy controls without any comorbidities.  Results: The findings from the present study emphasized that serum zinc levels are decreased in t2dm patients when compared to the healthy individuals, and the importance of maintaining adequate zinc levels and glycemic control to reduce the risk and severity of diabetic complications. Early intervention and comprehensive management strategies are crucial, particularly for patients with longer DM durations. Conclusion: This study underscores the significant reduction in serum zinc levels in patients with T2DM compared to healthy individuals. The data reveal a crucial relationship between diminished zinc levels and the increased risk and severity of both microvascular and macrovascular complications in T2DM patients. These findings highlight the importance of maintaining adequate zinc levels and achieving effective glycemic control to mitigate these complications.

Introduction: Obesity is a global health concern associated with increased risks of type 2 diabetes, cardiovascular disease, and metabolic disorders. Effective weight management and glycemic control are critical for reducing obesity-related complications. Tirzepatide, a dual agonist of the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has emerged as a promising treatment for obesity and diabetes. This study aims to evaluate the impact of Tirzepatide on weight management and glycemic control in obese patients.  Methods: This retrospective observational study was conducted in the Department of Cardiology, Uttara Adhunik Medical College Hospital, Labaid Cancer Hospital & Super Speciality Centre, Labaid Diagnostics Center, Uttara, Dhaka, Bangladesh, from July 2024 to February 2025. In this study, we included 70 patients with obesity who attended the cardiology department of our institution. Result: The mean age was 31.73 ± 10.24 years, with a mean BMI of 36.31 ± 6.24 kg/m². Obesity classifications ranged from Class II obesity (58.57%) to Class I (41.43%). Tirzepatide led to a significant 8.7% reduction in body weight (p = 0.0001), decreasing BMI from 36.31 kg/m² to 31.48 kg/m² (p < 0.0001). Glycemic control improved significantly, as evidenced by reductions in fasting blood sugar (6.78 to 5.63 mmol/L, p < 0.0001) and HbA1c levels (5.5% to 4.8%, p < 0.0001). Three patients (4.29%) with obstructive sleep apnea reported improvement after treatment. The most common side effects were nausea and vomiting (34.29%), itching at the injection site (30.00%), heartburn (27.14%), and general weakness (27.14%). Despite these side effects, 89% of participants reported satisfaction with the treatment. Conclusion: The findings of the study show that Tirzepatide has significant benefits in weight reduction, glycemic control, and lipid profile improvement among obese individuals. While some minor adverse effects were noted, overall patient satisfaction was high, highlighting its potential as an effective therapeutic option for obesity and T2DM management.

Background: The COVID-19 pandemic has posed unprecedented challenges, especially for individuals with underlying comorbidities. Among these, metabolic syndrome (MetS) — characterized by central obesity, dyslipidemia, hypertension, and insulin resistance — has emerged as a key determinant of adverse outcomes. This study aims to prospectively assess the long-term post-COVID complications in patients with pre-existing MetS, focusing on cardiometabolic, respiratory, and neuropsychiatric sequelae. Materials and Methods: A prospective cohort study was conducted across three tertiary healthcare centres in India. A total of 300 patients aged 30–65 years with laboratory-confirmed COVID-19 and pre-existing MetS (as per IDF criteria) were enrolled. Follow-up assessments were conducted at 3-, 6-, and 12-months post-recovery. Clinical outcomes including new-onset type 2 diabetes, exacerbation of hypertension, pulmonary fibrosis, persistent fatigue, and cognitive decline were evaluated using structured clinical assessments, laboratory tests, and imaging modalities. A control group of 200 COVID-19-recovered patients without MetS was also followed for comparison. Results: At 12 months follow-up, 42.3% of patients in the MetS group reported persistent fatigue compared to 18.5% in the control group (p<0.01). New-onset type 2 diabetes was observed in 26.7% of MetS patients versus 8.0% in controls (p<0.001). Pulmonary complications such as reduced DLCO and fibrotic changes were documented in 33.1% of MetS cases and 14.5% of controls (p<0.05). Neurocognitive issues, including memory deficits and anxiety, were more prevalent in the MetS group (38.5%) than in controls (21.0%) (p=0.02). Conclusion: Individuals with pre-existing metabolic syndrome are at significantly increased risk of developing long-term post-COVID complications, including cardiometabolic dysfunction, chronic respiratory impairment, and neuropsychiatric disturbances. These findings highlight the need for tailored post-COVID monitoring and management strategies in this high-risk population.

Introduction: Diabetic Peripheral Neuropathy (DPN) is a common yet often underdiagnosed complication of diabetes, leading to significant morbidity, including pain, sensory loss, and an increased risk of foot ulcers. This study aims to assess the prevalence of DPN and identify its key risk factors, aiding in early detection and effective management strategies. Material and Methods: This single-center, cross-sectional study at MGM Medical College, Navi Mumbai, assessed 160 Type 2 Diabetes Mellitus patients for Diabetic Peripheral Neuropathy (DPN) prevalence and risk factors. Ethical approval and informed consent were obtained. Evaluation included the Michigan Neuropathy Scale, Vibration Perception Threshold (VPT) assessment, and blood tests for HbA1c, glucose levels, lipid profile, and renal function. Data analysis was conducted, with a p-value <0.05 considered statistically significant. Results: Hypertension was present in 35% of subjects, and 85% were overweight (p<0.05). Smoking and alcohol consumption were observed in 10.6% and 3.8% of participants, respectively. The overall prevalence of Diabetic Peripheral Neuropathy (DPN) was 30.6% (MNSI) and 36.9% (VPT), with higher rates among overweight individuals, smokers (76.5%, p<0.01), hypertensive patients (39.3%, p<0.01), and those with prolonged diabetes (p<0.01). Elevated HbA1c, cholesterol, uric acid, and liver enzymes were significantly associated with DPN (p<0.01). The sensitivity and specificity of MNSI were 88.12% and 62.71%, with an accuracy of 78.75%. Conclusion: Diabetic Peripheral Neuropathy (DPN) is prevalent among Type 2 Diabetes Mellitus patients, with significant associations observed with hypertension, obesity, smoking, prolonged diabetes duration, and elevated metabolic markers.

Background: Coronary artery disease is one of the leading cause of morbidity & mortality in females especially postmenopausal women. The main aim of this study is to know about the clinical profile of coronary artery disease in postmenopausal women and also to learn about the major risk factors.The incidence of CAD in post menopausal women can be directly attributed to lack of estrogen and it’s direct and indirect cardioprotective effects. The advantage of protection by hormones is lost in postmenopausal females & so incidence equals to male counterparts.Hypertension, Type 2 Diabetes mellitus, Dyslipidemia, Smoking and Usage of Oral contraceptive pills etc are found to be major risk factors. Aims & objectives:

• To study the clinical profile of CAD in postmenopausal women visiting tertiary care centre.
• To study risk factors of coronary artery disease in post menopausal women.

Methods:

This Cross sectional study includes data collected from 100 post menopausal females visiting OPD of Krishna Rajendra Hospital, Mysore during the period of April 2022 to October 2022, without previous history suggestive of heart disease. The data was analysed by SPSS software version 2.0,and chi-square tests was applied for qualitative variables. Results: The study was conducted among 100 post menopausal women. The study showed almost equal distribution of subjects in the age group of 53-56yrs, 57-60yrs and 65-68yrs with each age group contributes about 26%, and the mean age was 60.3yrs. Among the presenting complaints studied, 35 % subjects presented with chest pain, 45 % presented to OPD with giddiness, 12% presented with dyspnoea and rest 8 % presented with palpitation. Risk factors like HTN, T2DM and Dyslipidemia was also analysed among study subjects and majority of the study subjects were hypertensives contributing about 46 %, 35 % of the study subjects had dyslipidemia and 9 % had T2DM. ECG was done for all patients, and 55% of study subjects had a normal  ECG  findings. Among the abnormal ECG findings, 18 % showed features suggestive of LVH in ECG, 19% had T inversions, 1 % showed ST depression, and 3% showed pathological Q waves, 4 % showed poor r wave progression. 2D Echo was also done among all patients, 53% had normal findings, 18% had LVH, 13%  had IHD with EF>50%, 9% had IHD with EF< 50% and 7 % had LV Diastolic dysfunction. Therefore a significant correlation was found about the occurrence of CAD in postmenopausal women. Conclusion: Coronary artery disease in the postmenopausal women is a great challenge to deal with unstable angina, which was the most common presentation. The occurrence of CAD was significantly associated with age, HTN, diabetes, dyslipidemia and significant correlation was found. Hence the study concluded that an early regular medical routine check- ups, awareness about occurrence of each clinical symptom is crucial in a postmenopausal women for early detection and prevention of coronary artery disease.

Diabetes Mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycaemia and is a major global health concern. Type 2 Diabetes Mellitus (T2DM) is associated with an increased risk of cardiovascular diseases, particularly Coronary Artery Disease (CAD), which often progresses silently in diabetic patients. Early detection of asymptomatic CAD is crucial to prevent severe outcomes. The Treadmill Test (TMT) is an effective non-invasive screening tool for detecting CAD in these patients. Aim & Objective: The aim of this study is to detect coronary artery disease early in asymptomatic patients of Type 2 DM. Methods: This hospital-based, cross-sectional study was conducted over one year at J.L.N Medical College, Ajmer and included 80 newly diagnosed (within 6 months) Type 2 DM patients aged 30-60 years. Patients were divided into two groups: Group 1 (normal ECG, no symptoms of CAD) and Group 2 (ECG changes but no symptoms). Various biochemical, clinical and TMT parameters were analyzed to assess the presence of CAD. Results: The study revealed that patients with abnormal ECG and positive TMT results had higher levels of HbA1c, fasting blood sugar, and postprandial blood sugar. Lipid profiles, including cholesterol, triglycerides, and LDL levels, were also elevated in this group. TMT showed positive results in 7 patients from Group 1 and 15 patients from Group 2. The mean BMI, pulse rate, and blood pressure were also higher in those with positive TMT results. Conclusion: T2DM significantly increases the risk of CAD and the Treadmill Test is a useful, non-invasive tool for early detection of asymptomatic CAD in diabetic patients. Early screening can help identify silent myocardial ischemia, enabling timely interventions to prevent severe cardiac events and reduce mortality.

Background: Pruritus represents a distressing but often neglected comorbidity of type 2 diabetes mellitus (DM2) with possible impacts on quality of life (QoL), glycemic management, and psychological status. However, there is a dearth of Indian clinical data on this entity. The present study was designed to find out the prevalence, severity and clinical as well as psychological correlates of pruritus among adult DM2 patients in a tertiary care hospital in India. Methodology: This is a cross-sectional study that was performed from February 2023-22 at the College of Medicine, a tertiary care hospital, in which 354 adult DM2 patients were thpatient: 1). Itch was evaluated according to the Numerical Rating Scale (NRS) and Four-Item Itch Questionnaire (4IIQ). Diabetic neuropathy was evaluated by Katzenwadel scale. ItchyQoL, Hospital Anxiety and Depression Scale (HADS). Metabolic indicators including HbA1c and FPG were compared among patients with and without pruritus. Results: One hundred and thirty-nine (39.3%) of the patients reported pruritus. Mild, moderate and severe itch accounted for 27.3%, 48.2%, and 24.5% of them, respectively. Patients with pruritus had higher HbA1c levels (8.6 ± 1.2 vs. 7.9 ± 1.0; p = 0.003) and FPG (165.2 ± 28.6 vs. 151.8 ± 25.9 mg/dL; p = 0.012). Psychologic assessment demonstrated higher levels of anxiety (9.3 ± 2.1), depression (8.1 ± 1.9), and stigmatization scores (5.4 ± 1.6) in pruritic patients. Conclusion: Pruritus is a prevalent and burdensome symptom in Indian patients with DM2, significantly associated with poor glycemic control, and diabetic neuropathy. It also imposes substantial psychosocial stress, highlighting the need for integrated dermatologic and psychological evaluation in routine diabetes management.

Background: The dual burden of type 2 diabetes mellitus (T2DM) and hypertension is a major contributor to cardiovascular morbidity and mortality. Integrated care models are essential for effective management. With the growing adoption of digital health technologies, telehealth has emerged as a potential alternative to conventional care. This study aimed to evaluate the clinical effectiveness of telehealth versus in-person care in the co-management of T2DM and hypertension. Materials and Methods: A total of 120 patients diagnosed with both T2DM and hypertension were randomly assigned into two groups: the Telehealth Group (n=60) and the In-Person Care Group (n=60). Inclusion criteria included age between 30–65 years, HbA1c ≥ 7%, and systolic BP ≥ 140 mmHg at baseline. The telehealth group received virtual consultations via a dedicated platform every 2 weeks, with remote monitoring of blood glucose and BP. The in-person group attended physical consultations at similar intervals. Primary outcomes were change in HbA1c and systolic blood pressure at 6 months. Secondary outcomes included medication adherence, patient satisfaction, and frequency of emergency visits. Results: At the end of 6 months, the telehealth group showed a mean reduction in HbA1c from 8.5% ± 1.1 to 7.2% ± 0.9 (p < 0.001), while the in-person group improved from 8.4% ± 1.0 to 7.5% ± 0.8 (p < 0.01). The reduction in systolic BP was also significant in both groups: from 148.2 ± 7.5 mmHg to 132.6 ± 6.3 mmHg in the telehealth group (p < 0.001), and from 147.9 ± 8.1 mmHg to 135.4 ± 7.1 mmHg in the in-person group (p < 0.01). Medication adherence was slightly higher in the telehealth group (92% vs. 87%, p = 0.04), and patient satisfaction scores were also greater (mean 4.5 vs. 3.9 on a 5-point Likert scale). No significant difference was observed in the number of emergency visits between the groups. Conclusion: Telehealth is a feasible and effective modality for the co-management of diabetes and hypertension, showing comparable or slightly superior outcomes in glycemic and blood pressure control compared to traditional in-person care. Improved adherence and satisfaction highlight the potential of remote monitoring in chronic disease management, particularly in resource-limited or rural settings.

Background: Metabolic syndrome is characterized by a cluster of conditions including obesity, hypertension, and dyslipidaemia and insulin resistance often leading to cardiovascular complications. Micro albuminuria and hyperuricemia have been identified as potential markers of renal and metabolic dysfunction in these patients. Aims: Hyperuricemia is an independent risk factor for kidney dysfunction in diabetic patient. On the other hand micro albuminuria is considered as the predictor of early stages of diabetic nephropathy. We investigated the correlation between hyperuricemia and albuminuria in patients with Metabolic Syndrome. The aim of this study is to evaluate the association between serum uric acid & urinary Albumin to Creatinine Ratio (ACR) among patients with Metabolic Syndrome. Materials and methods: This study is a hospital-based, observational (cross-sectional) study to evaluate serum uric acid level & urinary Albumin Creatinine Ratio (ACR) in patients of Metabolic Syndrome in both younger & older age group (40 to 80 years). The study also evaluated the relation between normo albuminuria (ACR <30 ug/ mg), micro albuminuria (ACR between 30 ug/mg & 299 ug/mg) & macro albuminuria (ACR ≥ 300ug/mg) with serum uric acid levels. Although we have contemplated a study both in younger & older age group but eventually this was not done as the number of patients with Metabolic Syndrome in younger age group was inadequate and those who are younger than 40 years were excluded. Result: It is revealed that the patient group macroalbuminuria percentage is 19%, microalbuminuria percentage is 32 % and normalbuminuria percentage is 49 %, the patients, hyperuricemia percentage is 44 %, normouricemia percentage is 56 %, the patients with  Anti lipid therapy YES percentage is 48 %, No percentage is 52 %. Conclusion: We conclude that, the patients with Metabolic Syndrome showed a strong correlation between hyperuricemia and FBG, LDL, and triglycerides. Age, sex, weight, height, BMI, hypertension, and HDL were not shown to be significantly correlated with hyperuricemia. In individuals with Metabolic Syndrome, urinary ACR strongly linked with FBG, LDL, and triglycerides. There was no discernible relationship between urine ACR and BMI, HDL, age, sex, weight, height, or hypertension. Serum uric acid level and urine albumin creatinine ratio strongly associated in patients with metabolic syndrome. According to this study, individuals with Metabolic Syndrome who have hyperuricemia are more likely to have albuminuria, and patients with type 2 diabetes mellitus have serum uric acid as an independent predictor of urine ACR.

Background: Primary open angle glaucoma has been characterized by its adult onset, IOP >21mmHg at some point in the course of the disease, open angles on gonioscopy, glaucomatous visual field changes and glaucomatous optic nerve damage. Methods: This case control study was conducted to determine whether diabetes stands as a risk factor in development of glaucoma. The selected patients were divided into 3 groups based on inclusion and exclusion criteria. They were subjected to complete ocular examination including gonioscopy and perimetry. Results: The 16 patients from 50 of the diabetic group (28%) were found to have POAG. The p value was <0.005 which was statistically significant. Also, no correlation was found between blood sugar and IOP levels in these patients.  Conclusions: These data show a significant correlation between diabetes and glaucoma. Further studies are warranted to determine its actual role in pathogenesis of glaucoma

Background: Type-2 Diabetes Mellitus (T2DM) is a chronic condition that has reached epidemic proportions worldwide, affecting millions of individuals and representing a significant public health burden. The ratio of serum uric acid to creatinine (SUA/Cr ratio) has been proposed as a novel marker for assessing the risk of kidney damage and other metabolic disturbances, including in diabetic patients. Elevated SUA/Cr ratios have been linked to the early stages of diabetic nephropathy, including proteinuria, and may help identify individuals at risk before significant kidney dysfunction develops. Objectives: To estimate the correlation between serum uric acid to creatinine ratio and proteinuria in Diabetes Mellitus patients Methods: It’s a cross-sectional study conducted on 60 Diabetic patients visiting to K R Hospital, Mysuru from April 2023 to October 2024. Serum uricacid and creatinine ratio, proteinuria will be measured and then correlating these values with diabetic patients. Results

The analysis revealed a positive correlation (r = 0.42) between the serum uric acid to creatinine ratio and proteinuria in patients with type 2 diabetes mellitus, with a statistically significant p-value of 0.05. This suggests that as the serum uric acid to creatinine ratio increases, the level of proteinuria also tends to rise, indicating a potential link between this biochemical ratio and renal involvement in diabetic individuals. Conclusion: This study highlights the importance of early detection and monitoring of kidney disfunction in individuals with Type-2 DM particularly by using SUA/Cr ratio and proteinuria as a potential marker and demonstrates clear relationship between SUA/Cr ratio and proteinuria.

Background: Non-alcoholic fatty liver disease (NAFLD) is a common comorbidity among patients with Type 2 Diabetes Mellitus (T2DM) and is increasingly recognized as a hepatic manifestation of metabolic syndrome. Identifying its prevalence and associated risk factors in diabetic populations is essential for early intervention and management. Objectives: To determine the prevalence of NAFLD among patients with T2DM and to evaluate the associated clinical and metabolic risk factors. Methods: This cross-sectional study was conducted on 100 adult patients with T2DM attending the outpatient department of a tertiary care hospital. NAFLD was diagnosed using abdominal ultrasonography. Demographic and clinical data, including BMI, duration of diabetes, HbA1c levels, and other metabolic parameters, were recorded. Statistical analysis was performed to identify significant associations, and multivariate logistic regression was used to determine independent predictors. Results: The prevalence of NAFLD was found to be 56%. Higher prevalence was observed in males (62.5%) compared to females (50.0%). Significant associations were noted with BMI ≥25 kg/m² (66.2% vs 26.9%, p<0.001), diabetes duration ≥10 years (68.1% vs 45.3%, p=0.009), and HbA1c ≥7% (61.8% vs 37.5%, p=0.006). On multivariate analysis, BMI ≥25 kg/m² (OR=3.6), HbA1c ≥7% (OR=2.9), and diabetes duration ≥10 years (OR=2.4) were independent predictors of NAFLD. Conclusion: NAFLD is highly prevalent among patients with T2DM. Obesity, poor glycemic control, and longer duration of diabetes are significant risk factors. Routine screening and metabolic optimization are recommended to prevent hepatic complications.

Background: Diabetes mellitus is one of the most common chronic diseases has been related to various liver illnesses such as liver enzyme derangements, non-alcoholic fatty liver disease, hepatocellular carcinoma, and cirrhosis. There has been increased interest on the contribution of liver enzymes to prediction of diabetes and glycemic control.  Aims and Objectives: The aim is study was to correlate liver enzymes with type 2 diabetes mellitus (T2DM) and non-diabetic individuals.  Materials and Methods: Diabetic patients seen on Outpatient Department basis or admitted as inpatients are included in this study. Information is collected and detailed history is taken using pre-formed proforma at the time of admission. Liver function tests are measured to all participants, and HbA1C value is measured. Liver enzymes are correlated with HbA1C values. Results: Majority of the participants were males (64% in cases & 60% in control). The mean age among cases was 53.5 ± 9.3 and among control was 49.8 ± 5.6 years. The mean duration of diabetes is 7.86±5.38, mean HbA1c is 8.48±3.25. Mean fasting blood sugar and post-prandial blood sugar were 169.5±91.3 and 242.3±133.6, respectively. Liver enzymes like Aspartate transferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) were statistically significantly raised in diabetes mellitus cases (p<0.05) as compared to non-diabetic cases Conclusion: We have found significant association among AST, ALT, ALP and GGT with type 2 diabetes mellitus; all were negatively correlated with HbA1C level, Hence the monitoring the liver function tests in uncontrolled T2DM patients was essential.

Background: Type 2 diabetes mellitus (T2DM) is associated with a significantly increased risk of cardiovascular disease (CVD). Inflammation plays a critical role in the pathogenesis of atherosclerosis, and high-sensitivity C-reactive protein (hs-CRP) is an established marker of systemic inflammation. This study aimed to assess the association between hs-CRP levels and cardiovascular risk in patients with T2DM. Methods: A cross-sectional study was conducted among 100 patients with T2DM attending a tertiary care hospital. hs-CRP levels were measured, and cardiovascular risk was assessed using the Framingham Risk Score. Patients were categorized into low, moderate, and high cardiovascular risk groups. Statistical analysis included ANOVA and Pearson’s correlation coefficient. Results: Among 100 participants, 35% were categorized as high cardiovascular risk. Mean hs-CRP levels significantly increased across low (2.1 ± 0.9 mg/L), moderate (3.8 ± 1.2 mg/L), and high (6.2 ± 2.0 mg/L) risk groups (p < 0.001). A strong positive correlation (r = 0.684, p < 0.001) was observed between hs-CRP levels and Framingham scores. Conclusion: Elevated hs-CRP levels are strongly associated with higher cardiovascular risk in T2DM patients. hs-CRP may serve as an effective adjunctive marker in cardiovascular risk prediction and management in diabetic individuals.

Introduction: The rise of life expectancy as a result of the antiretroviral therapy (ART) in subjects with human immunodeficiency virus (HIV) has increased the prevalence of chronic medical conditions, such as kidney disease. Kidney disease prevalence in subjects with HIV infection is reported between 3.5% and 48.5%. Second-generation INSTIs are currently the class of choice in ART regimens due to their high potency, good tolerability, low toxicity and high genetic barrier to resistance. INSTIs are believed to work by chelating magnesium ion to prevent HIV from integrating into host DNA. Magnesium is involved in the regulation of mitochondrial function, inflammatory process and immune defense, allergy, growth and stress and in the control of neuronal activity, cardiac excitability, neuromuscular transmission, vasomotor tone and blood pressure. Magnesium is an intracellular component of bone cells. A number of studies have reported changes in bone density accompanied by changes in serum levels of phosphate, alkaline phosphate and serum magnesium.  Thus, this study is being conducted to estimate the Serum Magnesium levels in people living with HIV on ART. Materials: This case-control study was performed among 25 People living with HIV on ART and 25 age and sex matched controls attending the department of general medicine, Kempegowda institute of medical sciences during an 18-month period. Serum Magnesium levels were evaluated among all the cases and controls. The data was collected and compiled in MS Excel. Descriptive statistics has been used to present the data. To analyse the data SPSS (Version 26.0) was used. Significance level was fixed as 5% (α = 0.05. Qualitative variables are expressed as frequency and percentages and Quantitative variables are expressed as Mean and Standard Deviation. To compare the association between numerical and categorical variables, student t test was used and to compare the association between categorical variables chi square test was used.  Observation: The mean age of the cases and controls were found to be 49.32+7.587 and 49.28+7.531 respectively. 84% of the study participants in each group were males. 4% of the study participants in each group had type 2 diabetes mellitus. The mean duration of ART among the cases was found to be 13.48+4.736 months. The mean serum magnesium among the cases and controls were found to be 1.7188+0.238 and 2.0300+0.232 respectively. The mean serum magnesium levels were found to be lower among the cases than the controls with statistical significance (P<0.05). Conclusion: Serum magnesium levels have to be routinely checked among all HIV patients to prevent bone complications. Serum bone profiling a potentially non-invasive, inexpensive method that can be used routinely to detect changes in bone metabolism in the HIV infected patients.

Background: Type 2 diabetes mellitus (T2DM) is a growing global health concern, associated with substantial morbidity and mortality due to its metabolic and vascular complications. Among the markers of insulin resistance, the triglyceride-glucose (TyG) index has emerged as a validated surrogate indicator. Zinc and magnesium, as essential trace elements, are intricately involved in insulin function, glucose metabolism, and lipid regulation. The present study was undertaken to evaluate the correlation between serum zinc, magnesium, and TyG index in individuals with type 2 diabetes, in comparison to healthy controls. Methods: This cross-sectional study was conducted in the Department of Biochemistry at Mahavir Institute of Medical Sciences, Vikarabad. A total of 50 subjects were enrolled after informed consent, comprising 25 type 2 diabetic patients and 25 healthy controls. Fasting venous samples were collected and analyzed for serum triglycerides, fasting glucose, zinc, and magnesium levels. The TyG index was calculated using the formula: Ln [Triglyceride (mg/dL) × Glucose (mg/dL)/2]. Statistical significance between groups was determined using the unpaired t-test. Results: The TyG index was significantly elevated in the diabetic group (10.253 ± 0.5131) compared to controls (8.792 ± 0.178), with a p-value of 0.0037. Serum magnesium and zinc levels were significantly lower in diabetics (Mg: 1.396 ± 0.2346 mg/dL, Zn: 38.961 ± 7.8713 μg/dL) than in controls (Mg: 2.532 ± 0.154 mg/dL, Zn: 129.96 ± 34.536 μg/dL), with p-values of 0.0023 and 0.0069, respectively. Conclusion: The results show significant inverse correlation among the serum zinc and magnesium concentrations and the TyG index in type 2 diabetes patients. These trace element deficiencies could be partly responsible for greater insulin resistance and cardiovascular complication risk. Multicentric larger studies are required to assess the therapeutic role of trace element supplementation in the treatment of diabetes.

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is a common liver condition associated with Type 2 Diabetes Mellitus (T2DM). The high prevalence of NAFLD in diabetic patients is a growing concern due to its potential to progress to more severe liver conditions, such as non-alcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. This study aimed to assess the prevalence and risk factors associated with NAFLD in T2DM patients in Central India. Methods: A cross-sectional observational study was conducted over 12 months at a tertiary care hospital in Central India. A total of 100 adult T2DM patients aged 40-70 years were included. Data were collected through structured questionnaires, physical examinations, and biochemical tests. Liver ultrasound was used to diagnose NAFLD and assess its severity. The risk factors for NAFLD, including age, gender, obesity, hypertension, dyslipidemia, family history of NAFLD, and duration of diabetes, were analyzed. Results: The prevalence of NAFLD in T2DM patients was found to be 65%. Significant risk factors for NAFLD included obesity (69.2%), hypertension (76.9%), dyslipidemia (73.8%), a family history of NAFLD (61.5%), and longer duration of diabetes (mean 8.5 years). Liver ultrasound showed that 46.2% of patients had mild NAFLD, 30.8% had moderate NAFLD, and 23.1% had severe NAFLD. Biochemical markers, including elevated ALT and AST levels, and higher fasting blood glucose, were significantly associated with NAFLD. Lifestyle modifications, weight loss, and regular monitoring of liver function were the primary management approaches. Conclusion: This study highlights the high prevalence of NAFLD in T2DM patients and identifies key risk factors such as obesity, hypertension, and dyslipidemia. Early detection and management through lifestyle interventions, regular monitoring of liver function, and appropriate pharmacotherapy are crucial for mitigating the adverse effects of NAFLD and improving long-term outcomes in diabetic patients.

Background: Type 2 diabetes mellitus (T2DM) and pre-diabetes are major global health concerns characterized by insulin resistance and impaired glucose metabolism. Vitamin D has been implicated in glucose homeostasis, and moderate physical activity is a well-established intervention to improve insulin sensitivity. This study investigates the combined effects of vitamin D supplementation and moderate exercise on plasma insulin levels in individuals with pre-diabetes and T2DM. Objective: To evaluate whether vitamin D supplementation in conjunction with moderate exercise enhances plasma insulin levels in pre-diabetic and T2DM patients. Methods: A randomized controlled trial was conducted with 200 participants (100 pre-diabetics, 100 T2DM patients) aged 30–65 years. Subjects were randomly assigned to four groups: Control (no intervention), Vitamin D only, Exercise only, and Combined (Vitamin D + Exercise). Vitamin D3 was administered at a dose of 4000 IU/day for 6 months. Exercise consisted of 45 minutes of moderate-intensity aerobic activity five days per week. Fasting plasma insulin levels were measured at baseline, 3 months, and 6 months. Results: The combined group showed a statistically significant increase in plasma insulin levels compared to the control and individual intervention groups (p<0.01). Improvements were more pronounced in the pre-diabetic subgroup. Multivariate analysis indicated synergistic effects of vitamin D and exercise on insulin secretion. Conclusion: Vitamin D supplementation combined with moderate exercise significantly enhances plasma insulin levels in pre-diabetic and T2DM patients. These findings support a multi-modal approach to diabetes prevention and management.

Background: Type 2 diabetes mellitus (T2DM) is frequently associated with dyslipidaemia and insulin resistance, both of which contribute to increased cardiovascular risk. Metformin remains the first-line pharmacotherapy; however, combining it with insulin-sensitising agents like pioglitazone may offer additional metabolic benefits. This study compares the effects of metformin monotherapy versus metformin combined with pioglitazone on lipid profile and insulin sensitivity in T2DM patients. Objectives: To evaluate and compare changes in lipid parameters (total cholesterol, LDL-C, HDL-C, triglycerides) and insulin resistance indices between patients treated with metformin alone and those receiving combination therapy with metformin plus pioglitazone. Materials and Methods: A prospective, open-label, parallel-group study was conducted on 80 patients with newly diagnosed T2DM attending the Endocrinology OPD of a tertiary care hospital. Participants were randomised into two groups: Group A received metformin 1000 mg/day, while Group B received metformin 1000 mg/day plus pioglitazone 30 mg/day. Fasting lipid profile and insulin resistance (measured using HOMA-IR) were assessed at baseline and after 12 weeks of treatment. Data were analysed using paired and unpaired t-tests; p-values <0.05 were considered significant. Results: After 12 weeks, Group B showed a significantly greater reduction in mean total cholesterol (from 214.5 ± 18.2 mg/dL to 184.2 ± 15.6 mg/dL) compared to Group A (from 212.7 ± 19.5 mg/dL to 198.1 ± 16.3 mg/dL; p = 0.02). LDL-C decreased more substantially in Group B (from 132.8 ± 12.5 mg/dL to 108.4 ± 10.7 mg/dL) than in Group A (from 131.5 ± 11.9 mg/dL to 120.7 ± 10.3 mg/dL; p = 0.01). HDL-C increased significantly in Group B (from 38.2 ± 4.1 mg/dL to 45.6 ± 5.0 mg/dL) versus a modest rise in Group A (from 37.9 ± 4.3 mg/dL to 40.1 ± 4.7 mg/dL; p = 0.03). Triglycerides declined in both groups but more markedly in Group B (p = 0.04). The mean HOMA-IR decreased from 4.8 ± 0.9 to 3.2 ± 0.7 in Group A and from 4.7 ± 0.8 to 2.5 ± 0.5 in Group B (p = 0.01). Discussion: Combination therapy with metformin and pioglitazone demonstrated superior improvements in lipid parameters and insulin sensitivity compared to metformin monotherapy. These findings support the synergistic role of pioglitazone as an adjunct to metformin in optimising metabolic outcomes in T2DM patients, aligning with previous studies highlighting the additive effects of thiazolidinediones on insulin resistance and dyslipidaemia. Conclusion: Metformin plus pioglitazone therapy is more effective than metformin alone in improving lipid profiles and reducing insulin resistance in newly diagnosed T2DM patients. Incorporating pioglitazone may offer additional cardiometabolic benefits when lifestyle interventions and metformin monotherapy are insufficient.

Background: Type 2 Diabetes Mellitus (T2DM) is associated with chronic low-grade inflammation, which may elevate plasma fibrinogen levels—an established risk marker for cardiovascular and microvascular complications. Objective: To evaluate fibrinogen levels in T2DM patients and examine their association with glycemic control (HbA1c), microalbuminuria, and other cardiovascular risk factors. Methods: This cross-sectional analytical study included 50 T2DM patients and 50 age- and sex-matched controls. Clinical data, HbA1c, urinary albumin excretion, lipid profile, and plasma fibrinogen levels (via Clauss method) were assessed. Statistical analysis included t-tests, correlation coefficients, and multivariate logistic regression to identify independent predictors of elevated fibrinogen. Results: Diabetic patients had significantly higher fibrinogen levels than controls (396.64 ± 164.73 vs. 252.6 ± 79.26 mg/dL, p < 0.05). Fibrinogen correlated strongly with HbA1c (r = 0.622), microalbuminuria (r = 0.647), and diabetes duration (r = 0.482). Patients with poor glycemic control (HbA1c > 7%) and microalbuminuria exhibited markedly elevated fibrinogen levels. Significant associations were also observed with dyslipidemia and diabetic retinopathy. Multivariate analysis identified duration of diabetes > 5 years (OR = 2.8, p = 0.008), total cholesterol > 200 mg/dL (OR = 2.5, p = 0.024), and microalbuminuria (OR = 3.6, p = 0.003) as independent predictors of elevated fibrinogen. Conclusion: Fibrinogen levels are significantly elevated in T2DM and correlate with poor glycemic control, nephropathy, and dyslipidemia. These findings support the potential utility of fibrinogen as a marker of cardiovascular and microvascular risk in diabetic populations.

Background: Non-alcoholic fatty liver disease (NAFLD) is increasingly recognized as a common comorbidity in patients with type 2 diabetes mellitus (T2DM). Early detection and identification of associated risk factors are crucial for timely intervention. Objectives: To determine the prevalence of NAFLD among patients with T2DM and to evaluate the associated clinical and biochemical risk factors. Methods: A cross-sectional study was conducted on 100 patients with T2DM attending a tertiary care hospital. Demographic data, clinical parameters, anthropometric measurements, and biochemical investigations were recorded. NAFLD was diagnosed based on ultrasonographic evidence of hepatic steatosis in the absence of significant alcohol consumption. Statistical analysis was performed using appropriate tests, and multivariate logistic regression was used to identify independent predictors. Results: The prevalence of NAFLD was found to be 62%. NAFLD was more common in males (67.3%) than females (55.6%), with the highest prevalence in the 51–60 years age group (68.4%). Patients with NAFLD had significantly higher mean BMI (29.8 ± 3.6 kg/m²), HbA1c levels (8.1 ± 1.3%), and higher rates of dyslipidemia and elevated ALT levels (p < 0.05). Logistic regression analysis identified BMI ≥ 25 kg/m² (OR: 3.8), HbA1c ≥ 7% (OR: 2.6), and triglycerides ≥ 150 mg/dL (OR: 3.1) as significant independent predictors of NAFLD. Conclusion: NAFLD is highly prevalent among patients with T2DM and is significantly associated with obesity, poor glycemic control, and hypertriglyceridemia. Regular screening and early management of NAFLD in diabetic patients may help reduce long-term hepatic and cardiovascular complications.

Background: Type 2 diabetes mellitus (T2DM) is increasingly prevalent among young individuals due to sedentary lifestyles and unhealthy dietary habits. While awareness regarding diabetes prevention exists, there is often a gap between knowledge and its application in daily life. This study assesses the knowledge, attitude, and practice (KAP) of young students in Ghaziabad regarding diet and exercise in diabetes prevention. Methods: A cross-sectional survey was conducted among 300 students (mean age: 21.3 ± 1.9 years) between January and June 2024. A self-administered questionnaire measured KAP using a 5-point Likert scale. Statistical analyses, including t-tests, ANOVA, Pearson correlation, and linear regression, were performed to assess the relationships between demographic variables and KAP scores. Results: The findings revealed intermediate knowledge (Mean = 3.6 ± 0.8), positive attitudes (Mean = 4.1 ± 0.6), but poor practices (Mean = 3.3 ± 0.7). Male students, those with a family history of diabetes, and postgraduates had significantly higher knowledge and practice scores (p < 0.05). Pearson’s correlation showed significant positive relationships between knowledge-attitude (r = 0.42, p < 0.01) and knowledge-practice (r = 0.39, p < 0.01). Regression analysis identified knowledge score, gender, and family history as significant predictors of healthy practices (p < 0.05). Conclusion: Despite good knowledge and attitudes, students demonstrated poor implementation of preventive behaviors. Educational interventions targeting behavioral changes are essential for reducing diabetes risk among youth.

Background: Non-alcoholic fatty liver disease (NAFLD) is an increasingly recognized hepatic complication of Type 2 Diabetes Mellitus (T2DM), particularly in resource-limited settings where routine screening remains low. This study aimed to estimate the prevalence of NAFLD and its correlation with glycemic control among T2DM patients at a private referral hospital in northern Gujarat. Methods: A cross-sectional observational study was conducted in Dhanera, Gujarat, between August 2023 and August 2024, enrolling 25 adult T2DM patients. Clinical data, BMI, HbA1c levels, and ultrasonography findings were recorded. Chi-square test and Pearson’s correlation were used to assess statistical significance. Results: NAFLD was present in 68% of the participants. Grade I steatosis was most common. A statistically significant association was found between poor glycemic control (HbA1c ≥9%) and the presence of NAFLD (p = 0.031). Most patients with NAFLD were also overweight or obese. Conclusion: The study highlights a high burden of NAFLD among diabetic patients, even in semi-urban areas, and its significant correlation with poor glycemic control. Regular screening for NAFLD and tighter glycemic control should be emphasized in diabetes care.

Background: Patients with diabetes mellitus are at elevated risk for cardiovascular disease (CVD). Statins are widely recommended for CVD prevention in this population, but real-world effectiveness data remain variable. This study evaluates the impact of statin therapy on cardiovascular outcomes in a large retrospective cohort of patients with type 2 diabetes. Methods: We conducted a retrospective cohort study using data from a multi-hospital electronic health record database between January 2015 and December 2021. Adult patients with type 2 diabetes and no prior CVD were included. Patients were stratified into statin users (n=4,132) and non-users (n=3,921) based on medication records. The primary outcome was the incidence of major adverse cardiovascular events (MACE), including myocardial infarction, stroke, and cardiovascular death, over a 5-year follow-up. Cox proportional hazards models were used to assess risk. Results: Statin use was associated with a significantly lower incidence of MACE (8.4%) compared to non-users (13.1%) [HR 0.61; 95% CI 0.55–0.68; p<0.001]. The reduction was consistent across age, sex, and baseline LDL-C subgroups. All-cause mortality was also reduced in the statin group (5.2% vs. 8.0%). Conclusion: In this large retrospective study, statin therapy significantly reduced the risk of major cardiovascular events in diabetic patients without prior CVD. These findings support current guideline recommendations for routine statin use in primary cardiovascular prevention in diabetes.

Introduction: Coronary risk factors in type 2 diabetes patients vary significantly between urban and rural populations due to differences in lifestyle, socioeconomic status, and healthcare access. AIM: To study the occurrence of coronary risk factors in urban and rural patients with type 2 diabetes mellitus in a tertiary care hospital. Methodology: The study was initiated after obtaining approval from the Institute’s Scientific Research Committee and the Institute’s Ethical Committee. It was conducted in the Department of General Medicine at Mahatma Gandhi Medical College & Hospital, Jaipur. Result: This study found high rates of CHD risk factors in T2DM patients, including dyslipidemia, hypertension, microalbuminuria, and sedentary lifestyle, with urban populations showing worse lipid profiles. Overall, microalbuminuria emerged as the strongest independent predictor of CHD, highlighting the urgent need for early screening and risk-factor management. Conclusion: This study underscores the urgent need for early, targeted interventions addressing dyslipidemia, microalbuminuria, and modifiable risk factors to lower CHD risk in T2DM. Microalbuminuria emerged as the strongest independent predictor of CHD, highlighting its critical role in cardiovascular risk assessment.

Introduction: Thyroid dysfunction is a common endocrine disorder that can significantly affect the management of type 2 diabetes mellitus (T2DM). This study aimed to investigate the prevalence, characteristics and factors associated with thyroid dysfunction in T2DM patients. Methods: This retrospective observational study included 250 T2DM patients admitted to a tertiary care hospital between October 2018 and February 2020. Demographic data, clinical characteristics and laboratory parameters were collected and analyzed. Findings: The prevalence of thyroid dysfunction in T2DM patients was 23.6%. Subclinical hypothyroidism was the most common type, followed by overt hypothyroidism and hyperthyroidism. The incidence of thyroid dysfunction was significantly higher in women than in males. Age, duration of diabetes, glycemic control and dyslipidemia were not significantly associated with thyroid dysfunction. Anti-TPO positivity is more prevalent in females with thyroid dysfunction Conclusion: Thyroid dysfunction is a common co-morbidity in T2DM patients, particularly in females. Screening for thyroid dysfunction is recommended in T2DM patients, especially those with risk factors such as female gender and a family history of thyroid disease. The early detection and treatment of thyroid dysfunction can improve glycemic control and reduce the risk of complications in T2DM patients.

Background: Polycystic ovarian syndrome is associated with increased rates of endometrial cancer, cardiovascular disease, dyslipidaemia, and type 2 diabetes mellitus and other diseases Materials and Methods: A total of 120 patients attending the gynaecology outpatient department with polycystic ovarian syndrome were included. The study was conducted by the Department of Physiology, Kurnool Medical College, Kurnool. Polycystic ovarian syndrome patients were suggested to undergo hormonal analysis of gonadotropins and BMI was calculated in the study Results: The mean patient waist-hip ratio (WHR) was 0.73 ± 0.031, FSH was 6.21 ± 2.74, LH was 8.92 ± 4.68, LH/FSH was 1.56 ± 1.21, and the patient mean age was 23.28 ± 4.13, BMI was 25.12 ± 5.86 noted. The women with polycystic ovarian syndrome, 109(91.0%) had polycystic ovaries, 106(88.3%) had oligomenorrhea,71(59.16%) had hirsutism, and 53(44.16%) had acne were noted. The patients with oligomenorrhea (62), acne(30), hirsutism(43), and polycystic ovaries(68) had LH/FSH ratio >2/1. The patients with oligomenorrhea (21), acne(11), hirsutism(36), and polycystic ovaries(32) had FSH ratio >7. The patients with oligomenorrhea (29), acne(29), hirsutism(31), and polycystic ovaries(41) had FSH ratio >10. Around 58% of patients with polycystic ovaries had Body mass index value of 25.0 in the current study was noted. Conclusion: The polycystic ovaries and oligomenorrhea were present in most of the patients. There was a  substantial correlation between the LH/FSH ratio, LH, and FSH levels and the feature of polycystic ovaries noted in the present study.

Background: Diabetes mellitus, a major public health concern, is closely linked to chronic kidney disease (CKD), traditionally assessed through albuminuria. However, emerging evidence highlights the presence of renal impairment even in normoalbuminuric patients. This cross-sectional observational study, conducted at a tertiary care hospital in South India, evaluated glomerular filtration rate (GFR) using the MDRD formula in 185 normoalbuminuric diabetic patients (25 with Type 1 and 160 with Type 2 diabetes). A striking 79.5% of participants exhibited reduced GFR despite the absence of albuminuria—60% in the Type 1 group and 82.5% in the Type 2 group. The study revealed that early renal dysfunction is common among diabetics without proteinuria, particularly in newly diagnosed Type 2 diabetics, many of whom also presented with cardiovascular and microvascular complications. These findings challenge the classical reliance on albuminuria as a sole marker for diabetic kidney disease and underscore the clinical relevance of non-albuminuric diabetic kidney disease (NA-DKD). The integration of GFR estimation into routine diabetes care is strongly recommended for timely detection and intervention. While the study was limited by its single-center, cross-sectional design and reliance on the MDRD formula, it contributes valuable insight into the early detection of renal compromise in the diabetic population.

Purpose: The purpose of this study is Association of Ocular Manifestation with Glycemic Control in Patients with Type 2 Diabetes Mellitus. Methodology: This is a prospective, observational study of patients attending the outpatient department and those referred to the KMC Medical College & Hospital, tertiary care teaching hospital in Maharajganj district of Uttar Pradesh from August 2024 to Janurary 2025. Type 2 diabetic patients were recruited on the basis of history, clinical examination, and blood investigations. Along with detailed demographic history, all participants underwent complete slit‑lamp anterior segment, posterior segment examination and intraocular pressure measurement was done. Estimation of random blood sugar at admission and fasting blood sugar and postprandial blood sugar second day of admission along with urine sugar, albumin, and microscopy. If necessary, based on the indication, fundus fluorescein angiography was also performed.  Results: Out of 350 patients evaluated,211 were male (60.3%) and 139 (39.7%) were female. Diabetic retinopathy (DR) was the most common complication (36.8%), followed by cataract 35.4%, glaucoma (4.6%), and other pathologies such as conjunctivitis, recurrent hordeolum, and dacrocystitis. The strongest predictor for the prevalence of retinopathy in persons with Type 2 diabetes is the duration of diabetes and was proven statistically significant. Both prevalence and severity of retinopathy correlate with HBA1C level in our study group. The most common type of cataract found was cortical type (41.2%) followed by senile posterior cortical (29.8%). Diabetes predisposes to infection in different body parts, and ocular structures are not an exception.  Conclusion: DR was the most common ocular complication of diabetes, followed by cataract and primary open angle glaucoma. The prevalence and severity of DR were higher in patients with the longer duration of diabetes.

Background: Medication adherence plays a crucial role in achieving optimal glycemic control among patients with Type 2 Diabetes Mellitus (T2DM). This study aimed to assess real-world patterns of medication adherence, treatment regimens, and glycemic outcomes in patients using oral hypoglycemic agents (OHAs). Methods An observational, cross-sectional study was conducted among 100 patients with T2DM who had been on OHAs for a minimum of six months. Data were collected through structured interviews, medical records, and laboratory reports. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Glycemic control was evaluated using recent HbA1c levels. Statistical analysis was performed to assess the association between adherence levels and glycemic outcomes. Results The mean age of participants was 56.4 ± 9.2 years, with 60% males. High, medium, and low adherence were observed in 28%, 46%, and 26% of patients, respectively. Forgetfulness (54%), medication cost (18%), and lack of awareness (14%) were the main reasons for poor adherence. Glycemic control was good (HbA1c <7%) in 32% of patients, moderate in 40%, and poor in 28%. A significant association was found between higher adherence and better glycemic control (p < 0.01). The most common regimen was metformin monotherapy (38%). Adverse effects were reported by 15% of patients, with gastrointestinal issues being most frequent. Lifestyle factors like regular exercise and diet adherence were present in 45% and 52% of patients, respectively. Conclusion Higher medication adherence is significantly associated with improved glycemic control in T2DM patients. Strategies to enhance adherence, such as patient education and routine follow-up, are essential for better treatment outcomes

Background: Ascites is the most frequent complication seen in patients with decompensated cirrhosis, with approximately half of those with compensated cirrhosis developing ascites over a ten-year span. The accumulation of ascitic fluid significantly increases the risk of infections due to weakened host defense mechanisms, including immune system dysfunction and reduced bactericidal capacity of the ascitic fluid. Aim: To study the diagnostic significance of Ascitic fluid lactate dehydrogenase (LDH) as a diagnostic marker of spontaneous bacterial peritonitis ( SBP). Methodology: This hospital-based prospective observational study will be conducted over a period of 18 months following approval from the Institute Ethics Committee (IEC) at Mahatma Gandhi Medical College & Hospital. Prior to enrolment, written and informed consent will be obtained from all participating patients. Result: In our study, 32.1% of ascitic patients were diagnosed with spontaneous bacterial peritonitis (SBP), with a statistically significant association (p = 0.001). Gram staining showed no pus in all 137 cases, while bacterial cultures were sterile in 61.3% and polymicrobial in 38.7%. Conclusion: Ascitic fluid LDH serves as a useful diagnostic marker for spontaneous bacterial peritonitis (SBP), particularly in cases with polymicrobial growth. Early detection using bedside methods like leukocyte esterase strips can significantly reduce SBP-related morbidity and mortality

Background: Helicobacter pylori is a common infection globally, and its association with type 2 diabetes mellitus (T2DM) is still unclear. Objectives: To assess the prevalence and clinical profile of H. pylori infection in T2DM patients and its relationship with glycemic status. Methods: This hospital-based observational study included 150 T2DM patients assessed using the rapid urease test and standard glycemic parameters. Results: H. pylori was detected in 45.3% of patients. No significant correlation was found between infection and FBS, PPBS, or HbA1c. GI symptoms like reflux and diarrhea were less frequent in infected individuals. Conclusion: While H. pylori infection is common in T2DM, its association with glycemic control is not statistically significant. Further studies are needed to clarify this relationship.

Background: Cardiac Autonomic Neuropathy (CAN) is a common form of Diabetic Autonomic Neuropathy (DAN) that causes abnormalities in heart rate control as well as central and peripheral vascular dynamics. CAN is clinically important form of DAN, as it is associated with increased risk of mortality responsible for silent myocardial infarction and sudden death in diabetics. Recognizing CAN early, which is asymptomatic, can be helpful to arrest its progression and adverse outcomes related to it.  Objective: Prospective cross-sectional study of 50 Type II Diabetes Mellitus patients to evaluate the prevalence of CAN and to find the correlation between CAN with duration of diabetes was carried out. Results: Prevalence of CAN in the study was 60 % of which 36 % had definite CAN and 24% had borderline/early CAN. The Prevalence of CAN increased with increased duration of DM. From the patients with duration of DM >10 years, 75 % had definite CAN.Conclusion: As development of CAN is more prevalent in patients with longer duration of DM, early detection can prevent a patient from worst outcomes. With the help of Ewing’s criteria, a physician can diagnose CAN at the earliest. So, identifying early CAN patients who are at risk of developing major neuropathy can direct us to have better outcomes.

Background: Type 2 diabetes mellitus (T2DM) is associated with various systemic complications, but its impact on pulmonary function remains underexplored. Poor glycemic control may lead to pulmonary dysfunction through mechanisms including protein glycosylation, microangiopathy, and chronic inflammation. Objective: To evaluate the correlation between pulmonary function tests and glycemic control (HbA1c) in patients with type 2 diabetes mellitus. Methods: This cross-sectional study included 143 patients with T2DM aged 30-60 years. Demographic data, anthropometric measurements, and HbA1c levels were recorded. Pulmonary function tests including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were performed using computerized spirometry. Pearson correlation analysis was used to assess the relationship between HbA1c and pulmonary function parameters. Results: The study included 82 males (57.3%) and 61 females (42.7%) with mean age distribution across 30-60 years. Restrictive pulmonary dysfunction was observed in 81 patients (56.6%). HbA1c showed significant negative correlations with FVC % predicted (r=-0.213, p=0.01), FEV1 % predicted (r=-0.202, p=0.02), and PEFR % predicted (r=-0.172, p=0.04). A positive correlation was found between HbA1c and FEV1/FVC ratio (r=0.178, p=0.03). Patients with HbA1c >8% demonstrated lower pulmonary function parameters compared to those with better glycemic control. Conclusion: Poor glycemic control in T2DM patients is significantly associated with reduced pulmonary function, predominantly showing a restrictive pattern. Regular pulmonary function assessment should be considered in diabetic patients, particularly those with poor glycemic control.

Introduction: Psychiatric comorbidity with type 2 diabetes mellitus is common. Comorbidity of diabetes and psychiatric disorders can present in different patterns, which are associated with impaired quality of life, increased cost of care, poor treatment adherence, poor glycaemia control and increased emergency room visits. The present study was planned to assess the relationship between psychiatric comorbidities in individuals with type 2 diabetes mellitus and quality of life. Aim And Objectives: To study the relationship between psychiatric comorbidities in individuals with type 2 diabetes mellitus and quality of life and to study the association between psychiatric comorbidity, socio demographic and clinical variables in such patients. Material And Methods:  This is a hospital based observational study where 150 consecutive patients visiting the Department of Medicine OPD or admitted in ward for the treatment of Diabetes, at Rama Medical College, Hospital & Research Centre Hapur and fulfilling the inclusion and exclusion criteria were recruited. All the subject under study were interviewed and a detailed history and clinical examination was done by using a semi-Structured performa, General Health Questionnaire 12 (GHQ12), Hospital Anxiety and Depression Scale (HADS), Brief Psychiatric rating scale (BPRS), WHO Quality Of Life BREF (Brief Hindi Version) and KUPPUSAMY SOCIO ECONOMIC STATUS SCALE. The results were tabulated and analyzed using the Chi (χ2) square test. The correlation coefficient was measured between scores of all scales using Pearson’s formula. Results: 51(51.5%) patients with psychiatric comorbidity and 43(84.3%) patients without psychiatric comorbidity were males. While 48(48.5%) patients with psychiatric comorbidity and 8(15.7%) patients without psychiatric comorbidity were females. The P value was found to be significant (0.00). 48(32.0%) patients had generalized anxiety disorder, 30(20%) had depression, 13(8.6%) had mixed anxiety and depressive disorder, 6(4%) had specific phobia (needle phobia) and 2(1.2%) had adjustment disorder. In patients without Psychiatric Co-morbidity, the mean Overall quality of life (mean± s.d.) of patients was 3.00± 1. 732.In patients with Psychiatric Comorbidity, the mean Overall quality of life (mean± s.d.) of patients was 2.46±1.593. Distribution of mean Overall quality of life with Psychiatric Co-morbidity was statistically significant (p=0.032). Conclusion:  This study concludes that in patients with Type 2 Diabetes disorder socio demographic variables like marital status, family type, education, socioeconomic status occupation have a significant impact on patient of Type 2 Diabetes disorder with psychiatric comorbidity. Quality of life is poor in patients with Type 2 Diabetes disorder with comorbidpsychiatricillness.

Background: Diabetic foot complications remain a major contributor to morbidity, disability, and amputations, particularly in resource-constrained settings. Despite being preventable, these complications remain prevalent due to inadequate awareness and suboptimal foot care practices. This study assessed the knowledge, attitude, and practice (KAP) related to foot care among individuals with diabetes in rural Chennai and identified the associated factors. Methods: An analytical cross-sectional study was conducted between May and November 2019 at a rural health center in Chennai, Tamil Nadu. A total of 832 adults aged ≥30 years with a type 2 Diabetes Mellitus were selected through systematic random sampling. Data was collected using pre-tested semi-structured questionnaire adapted from validated tools. KAP scores were categorized using modified Bloom’s criteria. Descriptive and analytical statistics were done, with p-values <0.05 considered statistically significant. Results: Of the 832 participants, 54.3% had adequate knowledge of foot care, while only 41.4% followed good foot care practices. While most participants recognized the importance of medication adherence (88.1%) and daily foot inspection (83%), only a few were aware of sensory loss risks (25.7%) and correct nail care practices (9.5%). Although 88.6% supported lifestyle changes, only 57.1% endorsed regular self-foot examination. Risk behaviors like walking barefoot indoors (90%) and outdoors (68.6%) were common. Adequate knowledge was significantly associated with good practices (OR = 3.71; 95% CI: 2.75–4.99; p<0.0001). Male gender, higher socioeconomic status, and history of foot ulcers were linked to adequate knowledge and good practices. Conclusion: Significant gaps exist between foot care knowledge and practices among diabetics in rural Chennai, despite favorable attitude. This emphasizes the urgent need for integrating culturally tailored health education, behavior change strategies and regular foot screening into routine diabetic care. Strengthening community-level approaches and empowering frontline health workers are essential to reduce the burden of diabetic foot complications in rural settings.

Introduction: Diabetes mellitus is a chronic metabolic disorder with a rapidly growing prevalence worldwide. Rational prescribing of antidiabetic medications is essential for achieving glycemic control and minimizing complications. This study evaluates the prescribing patterns of antidiabetic drugs in a tertiary care teaching hospital. Materials and Methods: A hospital-based cross-sectional study was conducted over three months in the outpatient department. A total of 600 prescriptions were analyzed. Inclusion criteria included patients diagnosed with type 2 diabetes mellitus and attending the outpatient clinic. Exclusion criteria were pregnant women and patients with incomplete data. WHO core drug prescribing indicators were applied. Results: Metformin was the most commonly prescribed drug (78.3%), followed by sulfonylureas (36.5%) and DPP-4 inhibitors (22.1%). Combination therapy was observed in 65% of prescriptions. Average number of drugs per prescription was 2.4. Rational use was assessed based on generic prescribing and adherence to essential drug lists. Conclusion: The study reveals adherence to rational prescribing norms, but polypharmacy and brand-name prescribing still exist. Periodic prescription audits and awareness among prescribers are needed to improve practices.

Introduction: Diabetic retinopathy (DR) is a microvascular complication of type 2 diabetes mellitus (T2DM) that may reflect systemic vascular damage. This study aimed to investigate the relationship between Diabetic retinopathy severity and cardiovascular risk factors, including glycemic control, lipid profile, hypertension, and electrocardiographic (ECG) changes. Methods: An analytical cross-sectional study was conducted on 126 patients with type 2 diabetes mellitus and Diabetic retinopathy. Diabetic retinopathy severity was classified as mild, moderate, or severe non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). Data on duration of diabetes, HbA1c, serum cholesterol, blood pressure, and ECG findings were collected and analyzed using appropriate statistical tests. Results: A significant correlation was observed between Diabetic retinopathy severity and age (p<0.001), duration of diabetes >10 years (p<0.001), HbA1c >8.5% (p<0.001), and serum cholesterol>200 mg/dL (p=0.033). Among patients with PDR, 70% had ECG changes, compared to only 23.3% in mild non-proliferative diabetic retinopathy, indicating a progressive increase in cardiac abnormalities with worsening Diabetic retinopathy. Hypertension was present in 29 patients, of whom 72% exhibited ECG changes (p<0.001). Tobacco use and family history of coronary artery disease did not show significant associations with Diabetic retinopathy severity or cardiac changes. Conclusion: Diabetic Retinopathy severity is significantly associated with poor glycemic control, hypercholesterolemia, prolonged diabetes duration, and cardiac abnormalities. These findings highlight the importance of using diabetic Retinopathy as a clinical marker for cardiovascular risk stratification in diabetic patients. Comprehensive management addressing both ocular and cardiovascular health is essential to reduce systemic complications.

Introduction: Introduction: Diabetes mellitus (DM), a chronic endocrine disease characterised by increased blood glucose levels due to abnormalities in insulin secretion, action or insulin resistance (IR). Recently, systemic immune-inflammation (SII) index and the systemic inflammation response index (SIRI), are considered as a novel biomarkers and are capable of providing a more comprehensive reflection of the inflammatory state and immune response of the body. The present study aimed to associate Systemic Immune Inflammation (SII) index, Systemic Inflammation Response Index (SIRI) with blood sugar and HbA1c in T2DM patients.  Materials and methods: A prospective case-control study was conducted in the Department of Biochemistry, Lt Shri BRKM Govt. Medical College, Dimrapal, Jagdalpur, Chattisgarh - 494 001, India. After following inclusion and exclusion criteria 110 T2DM patients as cases and 110 non-diabetic subjects as controls were involved in this study. Under aseptic conditions, fasting and post-prandial blood samples were collected, centrifuged to obtain clear serum sample. The obtained serum sample was used for the estimation of fasting and post-prandial glucose, urea, creatinine by using commercially available auto analyzer kits. EDTA samples were used for complete blood count (CBC) analysis and HbA1c. SII index and SIRI were calculated from CBC values. In addition to this, demographic details such as age, BMI and blood pressure were recorded.  Results:  In this study, out of 110 T2DM subjects, 65 (59.1%) were males and 45 (40.9%) were females. In non-diabetic subjects, 59 (53.6%) were males and 51 (46.3%) were females. In this study, mean age (57.1±11.5 years) and BMI (27.3±3.2 kg/m²) was significantly high in T2DM cases than non-diabetics. Significant increase in systolic blood pressure (SBP) (120.1±15.4 mmHg), diastolic blood pressure (DBP) (80.6±5.4 mmHg), fasting blood sugar (FBS) (149.6±45.6 mg/dl), post-prandial blood sugar (PPBS) (202.2±51.6 mg/dl), HbA1c (7.9±2.6%), urea (38.1±5.3 mg/dl), creatinine (1.1±0.3 mg/dl) and neutrophil count (71.5±12.3 %) was observed in T2DM cases compared with non-diabetic subjects. Significant decrease in lymphocytes (20.9±11.5 %) observed in T2DM. Concerned with the inflammatory markers such as SII index (12.3±2.5) and SIRI (25.2±3.5) were significantly increased in T2DM cases as compared to controls. In this study, FBS showed significant positive correlation with SII index (r=0.602) and SIRI (r=0.381). However, HbA1c also showed positive correlation, but not reached statistical significance.  Conclusion: This study results may conclude that increased levels of SII index, SIRI and their positive association with fasting blood sugar and HbA1c. Therefore, SII and SIRI may indicate systemic inflammation and may be associated with pathogenesis of the T2DM.

Background: Diabetes Mellitus, a chronic metabolic disorder  characterised by elevated blood glucose values, due to decreased insulin secretion and increased resistance to action of Insulin in peripheral tissue. T2DM is associated with decreased 25-OH Vit D compared to controls Vit D deficiency in diabetes is also associated with poor glycaemic control.    Ferritin, one of the key proteins regulating iron homeostasis, is a widely available clinical biomarker to evaluate iron status and especially important for detecting iron deficiency.  Aim: To  assess Serum Vit D  ,  Serum Vit B 12  and Ferritin levels in type 2 Diabetes mellitus patients  and to compare them with healthy controls  to understand the prevalence of Vit D deficiency, Vit B12 deficiency and Hyperferritinaemia  and correlate to Glycated Hemoglobin, Glycaemic status marker in diabetic patients attending our hospital.  Material and Methods :A comparative  cross sectional study was conducted in the Department of Biochemistry,  24 hrs Laboratory- RMC , KKD over a period of 6  months, March  2024-  August 2024. Grouping newly diagnosed Diabetic patients in group I and normoglycemic controls  in group II as controls. 50 newly diagnosed type 2 DM  patients  constitute group I, 50 age and sex matched Healthy individuals are enrolled in group II. Study participants are advised to be on overnight fast and blood sample is collected in morning  in labelled red topped  vacutainer for  Fasting Plasma Glucose (FPG),  Serum Vit B12, Serum Vit D ,  Serum  Ferritin) and violet topped vacutainer for glycated Hemoglobin  and also in Post Prandial conditions ( 1 hr 30 min  after breakfast for Post Prandial Plasma Glucose  under strict aseptic conditions. Results: The mean age of diabetic patients was significantly higher (44.5 ± 12.7 years) compared to controls (34.43 ± 11.05 years), with a p-value of 0.018, indicating a statistically significant difference. Fasting Plasma Glucose (FPG) levels were markedly elevated in the diabetic group (134.1 ± 50.1 mg/dL) compared to controls (75.3 ± 19.8 mg/dL), with a highly significant p-value of 0.0001. Similarly, Postprandial Plasma Glucose (PPPG) was significantly higher among diabetic patients (217.8 ± 60.1 mg/dL) than in controls (120.1 ± 21.5 mg/dL), also with a p-value of 0.0001. Additionally, HbA1c levels—a marker of long-term glycemic control—were substantially elevated in the diabetic group (11.2 ± 3.1%) versus the control group (5.1 ± 0.7%), with a p-value of 0.0001, further validating the diagnosis of chronic hyperglycemia. Serum Vitamin D levels were significantly lower in diabetics (23.9 ± 15.4 ng/mL) compared to controls (33.9 ± 16.6 ng/mL), with a p-value of 0.0187. This finding supports existing evidence linking Vitamin D deficiency with insulin resistance and impaired glucose metabolism. Conclusion Elevated fasting and postprandial glucose levels, along with increased HbA1c, reaffirm the hyperglycemic state characteristic of diabetes. Importantly, the study also revealed significant deficiencies in Vitamin D and Vitamin B12, as well as reduced ferritin levels in diabetic individuals—even before the initiation of any pharmacological treatment..

Introduction: Type 2 Diabetes Mellitus (T2DM) has severe motor impairments with negative implications on hand dexterity and quality of life. Although there are long-term effects of yoga practices proving to be beneficial at the metabolic and psychological level in T2DM, the acute effects of pranayama (yogic breathing) on fine motor function are yet to be explored. The purpose of this research was to determine the acute effect of one session of pranayama on hand dexterity among patients with uncomplicated T2DM and also to compare metabolic and demographic factors with motor performance results. Methodology: Fourteen subjects (mean age 48.2 ± 6.2 years) with uncomplicated T2DM were included. Each was exposed to a baseline trial and measurement by means of the Modified O'Connor Tweezer Dexterity Test. Participants next practiced 5 minutes of Anuloma Viloma and 5 minutes of Bhramari pranayama, in alternating order, with a 2-minute break between. Post-intervention dexterity was tested again. Statistical analysis involved paired t-tests to compare pre- and post-test scores and Spearman correlation to examine associations between age, BMI, HbA1c, and dexterity parameters. Results: Post-pranayama, the hand dexterity improved considerably (mean difference: –81.1 seconds; p < 0.001; Cohen's dz = –2.01). All of them improved, with decrease in time varying from 31 to 193 seconds. The exploratory analysis demonstrated strong negative correlation between BMI and dexterity improvement (r = –0.77, p = 0.001), and between age and HbA1c (r = –0.85, p < 0.001), suggesting possible modulatory influence of metabolic factors on motor function. Conclusion: One session of pranayama increased hand dexterity in uncomplicated T2DM patients significantly. The results advocate including pranayama as an adjunctive, non-pharmacological treatment to enhance fine motor function. Yet, because of the limited sample and absence of a control group, larger cohorts of randomized controlled trials need to be performed to substantiate the outcomes and clarify underlying mechanisms.

Background: Peripheral arterial disease (PAD) is one of the macrovascular complications of type 2 Diabetes Mellitus (DM). Patients with peripheral arterial disease, even in the absence of a history of myocardial infarction or ischemic stroke, have approximately the same relative risk of death from cardiovascular causes. Objective: A cross-sectional study of 150 cases to evaluate the association of asymptomatic PAD with degree and duration of hyperglycemia as well as with coronary artery disease (CAD). Methods: All the patients were subjected to detailed history, thorough clinical examination and laboratory investigations which included examination of risk factors and detailed assessment of peripheral arterial system. Patients were also examined for coronary artery disease and microvascular complications of Type 2 Diabetes Mellitus. Statistical software SPSS 23.0 was used for the analysis of data to find the association of CAD, degree and duration of Diabetes with asymptomatic PAD. Results: In the present study of total 150 cases the Prevalence of PAD was 16%. Mean HbA1c value with SD was 7.9±1.4 %, mean duration of DM with SD was 7.1 ± 5.6 years.Prevalence of Hypertension was 68% while that of CAD 27.33%.There was strong statistically significant association of Duration of DM with PAD which was observed with the Chi square value 29.128 and p value 0.000 which was much less than 0.05. Statistically significant association of HbA1c level with PAD was also observed with the Chi square value 6.406 and p value 0.011.We found that strong statistically significant association of presence of CAD with PAD and the Chi square value 13.824 and p value 0.000 for the same. Conclusion: The Prevalence of asymptomatic PAD also increased in presence of Hypertension and CAD. The Prevalence of PAD in study cases increased with increased duration of DM. There was statistically significant correlation of PAD with HbA1c. 

Background and Objectives: The relationship between diabetes and hearing loss has been widely studied over the years. However, limited research has focused on this association within our local population. This study aimed to determine the prevalence of hearing loss in individuals with type 2 diabetes mellitus compared to healthy, non-diabetic controls using pure tone audiometry. It also analyzed the influence of age and duration of diabetes on hearing ability.  Methods:  A comparative study was conducted at the Department of ENT, Andhra Medical College, from March to July 2025. The study population was divided into two groups: Group A comprised 50 individuals diagnosed with type 2 diabetes, while Group B included 50 healthy controls matched for age and gender, with no history of diabetes. All participants underwent pure tone audiometry to assess the type and severity of hearing impairment. The prevalence of hearing loss was expressed as a percentage. The relationships between age and hearing loss, as well as diabetes duration and hearing loss, were analyzed using the chi-square test. A p-value less than 0.05 was considered statistically significant.  Results:  Among the 50 diabetic participants, 33 (66%) had bilateral, mild sensorineural hearing loss. A prevalence of 66% of SNHL was found among diabetics, compared to 4% in the control group. Sensorineural hearing loss (SNHL) was most prevalent among participants with a diabetes duration exceeding 10 years (95%), followed by those with 5 to 10 years of diabetes (87.5%). Notably, none of the individuals with diabetes for less than five years exhibited SNHL.  Conclusion:  Hearing loss is common among individuals with type 2 diabetes mellitus, primarily presenting as bilateral, mild SNHL. The likelihood of developing sensorineural hearing loss (SNHL) rises significantly after five years of type 2 diabetes mellitus, reaching its peak among individuals with a disease duration of more than ten years. These findings underscore the importance of early audiological screening using pure tone audiometry in diabetic patients, particularly as the duration of the condition progresses.  

Background: Cardiac autonomic neuropathy (CAN) is a common but underdiagnosed complication of type 2 diabetes mellitus (T2DM), associated with increased morbidity and mortality. QTc interval and QT dispersion (QTd) are potential non-invasive markers for detecting CAN early in its course. Aim: To calculate QTc prolongation and QT dispersion in patients with T2DM, compare findings between those with and without CAN, and evaluate the diagnostic significance of these parameters. Material and Methods: A total of 120 T2DM patients underwent electrocardiographic assessment and cardiac autonomic function tests. QTc intervals were calculated using Bazett’s formula, and QT dispersion was determined from 12-lead ECGs. Data were analyzed to correlate QT metrics with CAN presence and severity. Results: Patients with CAN had significantly higher QTc intervals and QTd values. A higher prevalence of microvascular complications was also observed in these patients. QT abnormalities correlated well with the severity of CAN as determined by Ewing’s tests. Conclusion: QTc prolongation and QT dispersion are valuable non-invasive indicators for detecting cardiac autonomic neuropathy in diabetic patients. Their integration into routine screening may facilitate early diagnosis and improved clinical outcomes.

Introduction: Type 2 diabetes mellitus (T2DM) is among the most common forms of chronic metabolic disorders, accounting for about 90% of all people with diabetes. Carotid intima-media thickness (CIMT) is related to cardiovascular risk factors and diseases, and its measurement by means of ultrasound makes it possible to detect thickening in the initial phases of atherosclerosis. Methodology: It was an observational cross-sectional study. It included 120 patients according to inclusion criteria. The study was approved by institutional ethical committee and all participants signed informed consent forms before enrolment. It was an observational cross-sectional study. It included 120 patients according to inclusion criteria. The study was approved by institutional ethical committee and all participants signed informed consent forms before enrolment. patint were enrolled according to inclusion and exclusion criteria.  Result: Majority patients were within the 51-60 years age group (34.2%), followed by the 61-70 years (28.3%) and 41-50 years (15.8%) age groups. A significant proportion of patients (37.5%) had normal or near-normal right CIMT values (≤0.80 mm). However, a combined 55% of patients exhibited increased CIMT values, with 25% in the 0.81-1.00 mm range and 30% in the 1.01-1.20 mm range, suggesting subclinical atherosclerosis., more than half of the patients (64.2%) showed increased CIMT values, with 25.8% in the 0.81-1.00 mm range, 30.0% in the 1.01-1.20 mm range, and 8.3% with values exceeding 1.21 mm. Conclusion: We find that patients with poorly controlled type 2 diabetes (DM2) who have macrovascular disease show more severe vascular dysfunction, as indicated by non-invasive markers of subclinical atherosclerosis. Additionally, patients who have been diagnosed with diabetes for less than 5 years tend to have a significantly better vascular profile.

Background: Type 2 Diabetes Mellitus (T2DM) is a major public health issue globally and a leading cause of cardiovascular complications. Subclinical cardiac dysfunction often remains undetected in asymptomatic diabetic patients. Myocardial Performance Index (MPI) and N-terminal pro B-type Natriuretic Peptide (NT-pro BNP) are two promising markers for early cardiac dysfunction. This study aims to assess the correlation between MPI and serum NT-pro BNP levels in asymptomatic T2DM patients. Methods: A cross-sectional observational study was conducted on 80 asymptomatic T2DM patients aged ≥18 years attending the tertiary care centre. MPI was measured using Doppler echocardiography, and serum NT-pro BNP levels were assessed using standardized biochemical methods. Correlations between MPI, NT-pro BNP, age, and glycaemic indices (HbA1c and fasting plasma glucose) were analysed using appropriate statistical tools.  Results: The study population had a mean age of 57.3±8.4 years with a male (60%) predominance. A statistically significant positive correlation was found between MPI and NT-pro BNP (r =0.926, p < 0.001). MPI also showed positive correlation with age (r=0.782) and HbA1c levels (r=0.854). Receiver Operating Characteristic (ROC) analysis indicated that NT-pro BNP is a reliable predictor of abnormal MPI (≥0.40).  Conclusion: MPI serves as a simple and non-invasive tool to detect the early systolic and diastolic Left ventricular dysfunction in patients with type 2 diabetes mellitus

Background: The ketogenic diet (KD), characterized by high-fat, moderate-protein, and very low-carbohydrate intake, has garnered widespread attention for its therapeutic potential in various clinical conditions. Traditionally used in the management of refractory epilepsy, KD has evolved to demonstrate beneficial effects in metabolic disorders such as obesity, type 2 diabetes, and even neurological conditions like Alzheimer's disease. The core mechanism of KD involves shifting the body's primary energy source from glucose to ketone bodies, resulting in altered metabolic and physiological processes.  Materials and Methods This is a Case-control study was conducted in the Department of Physiology at Index Medical College. Data was collected from consenting participants attending the outpatient departments (OPD) of General Medicine and Physiology at Index Medical College and hospital from January 2023 to December 2024. Participants were recruited after meeting inclusion criteria and providing informed consent. Participants will follow a monitored KD consisting of <10% carbs, ~70% fats, and ~20% proteins. Participants will continue a balanced Indian diet based on standard dietary recommendations. Results The KD group demonstrated substantial reductions in CRP (−0.8 mg/L), IL-6 (−0.9 pg/mL), TNF-α (−1.3 pg/mL), and fecal calprotectin (~15% decline). These improvements are in agreement with several clinical and preclinical studies.  Conclusion While the anti-inflammatory and motility effects may hold clinical promise, caution is warranted regarding microbiota diversity and distal transit changes. Personalization and careful monitoring should guide KD implementation for gastrointestinal and immunological health optimization.

Background: The ketogenic diet (KD), a dietary regimen characterized by a pronounced shift in macronutrient composition—high fat (typically 70-80% of total calories), moderate protein (15-20%), and very low carbohydrate (often <50g or 5-10% of calories)—has transcended its origins as a therapeutic intervention for refractory epilepsy. It now garners significant scientific and public interest for its potential benefits across a spectrum of clinical conditions. Substantial evidence supports its efficacy in managing metabolic disorders, including obesity and type 2 diabetes mellitus, primarily through mechanisms like enhanced satiety, reduced insulin resistance, and improved lipid profiles.  Materials and Methods This is a Case-control study was conducted in the Department of Physiology at Index Medical College. Data was collected from consenting participants attending the outpatient departments (OPD) of General Medicine and Physiology at Index Medical College and hospital from January 2023 to December 2024. Participants were recruited after meeting inclusion criteria and providing informed consent. Using non-invasive techniques such as ultrasonographic assessment of gastric emptying and/or scintigraphy where feasible. Including measurement of gastric acid output, stool fat content, and bowel transit time. Including serum cytokines (IL-6, TNF-alpha), CRP levels, and fecal calprotectin.  Results After 8 weeks, the KD group demonstrated a significant improvement in gastric motility compared with controls. Gastric emptying time (GE T½) decreased significantly in the KD group (115.3 ± 14.5 to 104.2 ± 13.8 min; p < 0.001), whereas the control group showed minimal change (114.8 ± 15.2 to 113.0 ± 14.9 min). Similarly, scintigraphy retention percentage was reduced in the KD group (62.4 ± 6.8% to 55.1 ± 6.5%), with little change in controls (62.1 ± 7.0% to 61.0 ± 6.9%) (p < 0.001). The KD group exhibited significant alterations in gastric function after 8 weeks. Gastric acid output increased from 14.1 ± 2.3 to 15.2 ± 2.4 mmol/hr, compared to a negligible rise in controls (14.0 ± 2.2 to 14.1 ± 2.3; p = 0.002). Stool fat content markedly increased in the KD group (4.2 ± 1.1 to 8.9 ± 2.0 g/day), reflecting the high-fat nature of the diet, whereas the control group showed no significant change (p < 0.001). Additionally, bowel transit time increased modestly in the KD group (36.5 ± 6.4 to 39.8 ± 6.6 hrs) compared to controls (36.2 ± 6.6 to 36.5 ± 6.7 hrs; p = 0.001) Conclusion This study provides novel evidence that an 8-week KD in healthy Indian adults accelerates gastric emptying, increases gastric acid secretion, alters distal gut transit, reduces systemic and intestinal inflammation, and reshapes the gut microbiota. These changes are directionally consistent with several prior KD studies but offer new insights into gastrointestinal physiology in a non-Western dietary context.

Background: Individuals with diabetes mellitus (DM) face a two- to four-fold higher risk of cardiovascular disease (CVD) compared to the general population, making cardiac health awareness and preventive practices critical. India, home to over 77 million diabetics, is experiencing a surge in diabetes-related cardiovascular morbidity and mortality. However, data on awareness, preventive behaviors, and emergency preparedness in this group remain limited. Materials and Methods: A descriptive, cross-sectional study was conducted using a structured, validated questionnaire distributed via Google Forms. The survey assessed socio-demographic characteristics, medical history, knowledge of cardiac risks and emergency measures (20-item questionnaire), and adoption of preventive practices. Participants (n = 400) were adults with self-reported diabetes residing in India. Knowledge scores were categorized as Excellent (16–20), Good (12–15), Fair (8–11), and Poor (0–7). Statistical analysis employed chi-square tests and multivariate logistic regression to identify determinants of good knowledge (SPSS v 25; p < 0.05 considered significant). Results: The majority of respondents were aged 45–54 years (34.5%), male (55%), and urban residents (61%). Type 2 diabetes predominated (90.5%), with 67% reporting hypertension and 48.5% dyslipidemia. While 77% recognized diabetes as a major cardiovascular risk factor and 71.5% understood the role of hypertension, only 38.5% knew optimal BP targets and 43% knew HbA1c goals. Awareness of CPR and aspirin use during emergencies was poor (46.5% and 42%, respectively). Preventive behaviors were inconsistent: blood glucose monitoring (93.5%) and medication adherence (84%) were high, but only 42% underwent regular cardiac check-ups and 46% engaged in daily physical activity. Overall, 17% achieved excellent knowledge, while 34.5% scored fair and 18% poor. Education (p < 0.001), urban residence (p = 0.002), and occupation (p = 0.008) were significantly associated with higher knowledge levels. Multivariate analysis confirmed education and prior CPR awareness as strong predictors. Conclusion: Cardiac health awareness among Indian diabetics remains suboptimal, with critical gaps in practical knowledge and emergency preparedness. Despite good adherence to basic diabetes management, comprehensive cardiovascular risk reduction strategies are inadequately practiced. Targeted interventions—emphasizing lifestyle modification, structured education, and community-based CPR training—are essential to mitigate the rising burden of diabetes-related cardiovascular complications in India

Background: Type 2 diabetes mellitus (T2DM) requires effective glycemic control to prevent complications. Combining agents with complementary mechanisms may improve outcomes. Objective: To evaluate the safety and efficacy of the repaglinide plus voglibose combination in T2DM patients over one year. Methods: A prospective study was conducted involving 180 T2DM patients receiving repaglinide plus voglibose. Glycemic parameters, including fasting blood glucose (FBG), postprandial blood glucose (PPBG), and HbA1c, were measured at baseline and after 12 months. Safety was assessed by monitoring adverse events and hypoglycemic episodes. Results: Significant reductions were observed in mean FBG (156.8 ± 28.5 to 120.5 ± 22.3 mg/dL), PPBG (240.3 ± 35.7 to 170.7 ± 28.1 mg/dL), and HbA1c (8.2 ± 0.7 to 6.9 ± 0.6%) after 12 months (p < 0.001 for all). The combination was well tolerated, with mild hypoglycemia reported in 6.7% of patients and mild gastrointestinal side effects. Conclusion: Repaglinide plus voglibose combination therapy is effective and safe for improving glycemic control in T2DM patients, offering a viable option for optimizing diabetes management.

Background: Vitamin D, traditionally known for its role in bone metabolism, is now recognized as a pleiotropic hormone with significant immunomodulatory and metabolic functions. A growing body of evidence suggests a link between vitamin D deficiency and the pathogenesis and control of type 2 diabetes mellitus (T2DM). However, the prevalence and clinical correlates of this deficiency vary across populations. Methods: We conducted a cross-sectional study involving 412 adult patients with T2DM attending a tertiary care diabetes clinic. Data on demographics, duration of diabetes, and current medications were collected. Fasting blood samples were analyzed for serum 25-hydroxyvitamin D [25(OH)D] and glycated hemoglobin (HbA1c). Vitamin D status was categorized as deficient (<20 ng/mL), insufficient (20–29 ng/mL), or sufficient (≥30 ng/mL). Patients were also stratified by glycemic control (good: HbA1c <7.0%; moderate: HbA1c 7.0–8.0%; poor: HbA1c >8.0%). Results: The mean age of the cohort was 58.6 ± 10.2 years, with a mean diabetes duration of 11.4 ± 6.8 years. The overall mean serum 25(OH)D level was 21.3 ± 9.5 ng/mL. The prevalence of vitamin D deficiency was 46.1% (n=190), while 30.3% (n=125) were insufficient, yielding a combined prevalence of hypovitaminosis D of 76.4%. A significant inverse relationship was observed between vitamin D levels and glycemic control. The mean 25(OH)D level was significantly lower in patients with poor glycemic control (17.8 ± 7.2 ng/mL) compared to those with good control (26.5 ± 8.1 ng/mL; p<0.001). Furthermore, Pearson correlation analysis revealed a significant negative correlation between serum 25(OH)D and HbA1c (r = -0.42, p<0.001). Patients with a longer duration of diabetes (>10 years) also had significantly lower mean 25(OH)D levels than those with a shorter duration (<5 years) (18.9 ± 8.5 ng/mL vs. 24.1 ± 9.8 ng/mL; p=0.002). Conclusion: Vitamin D deficiency and insufficiency are highly prevalent among patients with T2DM. Lower vitamin D status is significantly associated with poorer glycemic control and longer disease duration. These findings suggest that screening for and potentially correcting vitamin D deficiency should be considered as part of the comprehensive management of patients with T2DM

Introduction: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder requiring long-term pharmacotherapy. Polypharmacy is common in T2DM patients due to coexisting comorbidities, increasing the risk of adverse drug reactions, drug interactions, non-adherence, and reduced quality of life. Medication deprescribing, defined as the planned and supervised reduction or discontinuation of medications that may no longer be beneficial or may be causing harm, has emerged as an important strategy to optimize patient outcomes. Objectives: The primary objective of this study was to evaluate the prevalence, patterns, and outcomes of medication deprescribing among patients with T2DM. Secondary objectives included identifying barriers and facilitators to deprescribing and assessing the impact on glycemic control, adverse drug events, and patient satisfaction. Methods: This observational prospective study was conducted over a period of six months at Medicare Multi-Speciality Hospital, including a total of 200 patients diagnosed with type 2 diabetes mellitus. Patients were selected based on established diagnostic criteria for type 2 diabetes. Data were collected on key variables including age, gender, duration of diabetes, comorbidities, medications, dietary adherence, lifestyle factors, and treatment outcomes. The study aimed to assess patterns of medication use, deprescribing, adherence to diet and physical activity, and overall treatment success, providing insights into the management of type 2 diabetes in a real-world clinical setting. Results: Among 200 patients with type 2 diabetes mellitus (mean age 54.3 ± 11.3 years; 61.5% female), hypertension (48%), hypothyroidism (16%), and dyslipidemia (7%) were the most common comorbidities. Of 65 patients reviewed for deprescribing, sulfonylureas and insulin were most frequently deprescribed, while other antidiabetics were reduced to a lesser extent. Positive family history was noted in 28%, and 22% showed medication non-compliance. Most patients had no notable habits (73.5%), limited dietary adherence, and low to moderate physical activity. Treatment success was complete in 17%, partial in 15.5%, and absent in 7%, with 60.5% not applicable. Conclusion: Medication deprescribing in patients with T2DM is feasible, safe, and can improve medication adherence and overall patient satisfaction without adversely affecting glycemic control. Incorporating structured deprescribing strategies into routine clinical practice may enhance the quality of care and reduce medication-related complications in this population. Further large-scale studies are warranted to develop standardized deprescribing guidelines for T2DM

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder frequently complicated by cutaneous infections due to impaired immunity, poor glycemic control, and long disease duration. Understanding the prevalence and spectrum of dermatological manifestations in diabetics provides insights for early diagnosis and prevention. Aim: To evaluate the association between T2DM and cutaneous infections among patients attending a tertiary care hospital. Materials and Methods: A cross-sectional study was conducted on 100 patients with T2DM. Detailed demographic data, duration of diabetes, and glycemic status (HbA1c) were recorded. Dermatological examination was performed to identify cutaneous infections. Data were analyzed, and associations were tested using chi-square statistics. Results: The mean age of participants was 54.6 ± 11.2 years, with a male-to-female ratio of 1.3:1. Poor glycemic control (HbA1c ≥ 7%) was observed in 68% of patients. Cutaneous infections were detected in 74% of cases, with fungal infections being most common (40%), followed by bacterial (22%) and viral infections (8%). Mixed infections were observed in 4%. Patients with poor glycemic control demonstrated significantly higher prevalence of infections (85%) compared to those with adequate control (50%) (p < 0.05). A longer duration of diabetes was also strongly associated with infections, rising from 58% in patients with < 5 years of disease to 88% in those with > 10 years (p < 0.05). Conclusion: Cutaneous infections are highly prevalent among patients with T2DM, particularly in those with poor glycemic control and long-standing disease. Early recognition and strict glycemic management may reduce dermatological morbidity in this population.

Background and objectives: To study the effects of obesity on blood glucose levels in adolescents. Methods: Total 110 patients with 10-19 years of age, who were willing to participate in the study, were free from any substance abuse and were not under any long term medication, were included in this study.  Results: In our study, we noted that 59.1% were male and the rest were female with a mean age of 14.50±2.51 years adolescent subjects. 70.0% of adolescents had non-vegetarian dietaryhabits, 51.8 % were living in the rural living area and 48.2% were in middle socioeconomic status. We observed statistically significant higher fasting blood sugar and HbA1c in the obese group incomparison to the overweight and control group (P<0.05). We noted that >110mg/dl fasting blood sugar and >6.5g% HbA1c levelwere significantly higher in overweight and obese cases in comparison to a control group(p<0.001). Conclusion:  A higher body weight predisposes kids to severe obesity related issues and impaired glucose metabolism. Prompt intervention might result from appropriate risk stratification, which could help doctors identify overweight kids who are more likely to develop type 2 diabetes.

Background: Ventilator-associated pneumonia (VAP) is defined as nosocomial pneumonia in patients on mechanical ventilation which develops more than 48 h after initiation of mechanical ventilation (MV). VAP arises when there is bacterial invasion of the pulmonary parenchyma in a patient on mechanical ventilation. As in the literature it has been found that there is considerable mortality due to delay in initiation of antibiotics therefore this study was planned to assess risk factor and clinico -microbiological profile of VAP patients. Methods: This was a cross-sectional study conducted between june 2021 to december 2022 in department of medicine icu (MICU), head injury icu (HICU) and respiratory medicine icu (RICU) of UPUMS, Saifai, Etawah. patients who were admitted to the RICU/MICU/HICU and developed pneumonia after 48 hours of initiation of invasive mechanical ventilation. Result: A total of 130 VAP patients were included in this study among which 92(70.8%) were male and 38(29.2%) were female. Out of 130 study participants bacterial growth seen in 114(88%) endotracheal aspirate sample while in 16(12%) sample no growth is seen. The primary underlying diagnosis and comorbidities were COPD (Chronic obstructive pulmonary disease) and Asthma in 39(30%) patients, hypertension in 30(23.1%) patients, Type 2 Diabetes mellitus in 26(20%) patients, post tb sequele in  15(11.5%) patients and head injury in 15(11.5%) patients . Gram-negative agents were the major pathogen (Pseudomonas accounting for 30.6%). The infection in 34 case (82.9%) was multi-drug resistant (MDR) pathogen. Pseudomonas MDR pathogens was associated with higher mortality rate compare with other MDR pathogens (p<0.01). Conclusion: Ventilator-associated pneumonia is a serious ICU complication that is associated with increased in hospital mortality. MDR Pseudomonas infection, underlying chronic obstructive pulmonary disease (COPD) are associated with increased risk in-hospital mortality in such patients. Identification of risk factor for in hospital mortality in such patents is important in term of further their modification and reduction of mortality rate

Introduction: Diabetic kidney disease (DKD) is a leading cause of chronic kidney disease and end-stage renal failure. Early detection of renal hemodynamic changes is crucial as functional impairment often precedes overt biochemical derangements. Doppler ultrasound provides a non-invasive means of assessing intrarenal vascular resistance indices, particularly the resistive index (RI) and pulsatility index (PI). However, limited consensus exists on their diagnostic value in DKD when compared with conventional biochemical markers. Material and Methods: This cross-sectional study was conducted in the Department of Radiology, including 100 patients with type 2 diabetes mellitus and evidence of DKD. All participants underwent renal ultrasound and Doppler evaluation using a high-resolution machine with a 3.5–5 MHz curvilinear probe. RI and PI were measured in the main, segmental, and interlobar arteries. Biochemical investigations included fasting blood glucose, glycated hemoglobin (HbA1c), serum creatinine, blood urea, estimated glomerular filtration rate (eGFR, CKD-EPI), and urinary albumin excretion. Correlations between Doppler and biochemical parameters were analyzed using Pearson’s correlation. Results: The mean RI was 0.73 ± 0.06, and the mean PI was 1.35 ± 0.18. RI correlated positively with serum creatinine (r = 0.46, p < 0.001) and urinary albumin excretion (r = 0.42, p < 0.01), and negatively with eGFR (r = –0.41, p < 0.001). HbA1c showed a mild but significant correlation with RI (r = 0.32, p < 0.05). Violin and box plots demonstrated progressive increases in RI across albuminuria categories (normo-, micro-, macroalbuminuria) and CKD stages (G1–G5). Bland–Altman analysis confirmed good repeatability of RI measurement. Conclusion: Renal Doppler indices, especially RI, are strongly associated with key biochemical markers of renal function and disease severity in DKD. Doppler ultrasound offers a reliable, non-invasive adjunct to biochemical assessment and may facilitate earlier detection and monitoring of DKD progression. Larger longitudinal studies are warranted to establish prognostic thresholds and validate the role of RI/PI in risk stratification.

Background: Lipoprotein(a) [Lp(a)] is an emerging biomarker for cardiovascular diseases, but its role in ischemic stroke among patients with type 2 diabetes mellitus (T2DM) remains understudied. This study aimed to assess the association between serum Lp(a) levels and ischemic stroke in T2DM patients compared to non-diabetic stroke patients. Methods: A case-control study was conducted on 122 ischemic stroke patients (61 with T2DM and 61 without T2DM). Demographic, biochemical, and Lp(a) levels were analyzed. Statistical significance was set at *p* < 0.05. Results: Mean Lp(a) levels were significantly higher in T2DM stroke patients (2.51 ± 0.69 g/L) than in non-diabetic stroke patients (1.48 ± 0.35 g/L; *p* < 0.001). Elevated Lp(a) (>1.60 g/L) was observed in 75.81% of T2DM patients versus 38.34% of non-diabetics. T2DM patients also exhibited higher triglycerides (140.19 mg/dL vs. 123.32 mg/dL; *p* = 0.039) and younger stroke onset (mean age 62.09 vs. 66.14 years; *p* = 0.005). Conclusion: Elevated Lp(a) is strongly associated with ischemic stroke in T2DM patients, suggesting its potential as a biomarker for stroke risk stratification. Routine Lp(a) screening and targeted therapies may improve stroke prevention in high-risk diabetic populations.

Introduction: Diabetic retinopathy (DR), the most common microvascular complication of type 2 diabetes mellitus (T2DM), has been increasingly linked to macrovascular disease, particularly coronary artery disease (CAD). The retina provides a non-invasive marker of systemic vascular injury, but evidence from Indian cohorts using standardized DR grading and angiography-confirmed CAD is limited. This study aimed to assess whether DR severity is independently associated with CAD in T2DM. Materials and Methods: A cross-sectional study was conducted on 150 T2DM patients at the Department of General Medicine, Mamata Medical College, Khammam. Demographic and clinical data, including age, sex, diabetes duration, hypertension, smoking, and alcohol use, were recorded. Biochemical evaluation included fasting plasma glucose, HbA1c, lipid profile, and renal function tests. DR was graded using the Early Treatment Diabetic Retinopathy Study (ETDRS) classification. Cardiovascular evaluation included ECG, echocardiography, treadmill test, and coronary angiography. CAD was defined as ≥50% stenosis in a major epicardial coronary artery. Logistic regression assessed the association between DR severity and CAD after adjusting for confounders. Results: The mean age was 56.2 ± 9.1 years, with 61.3% males. DR was present in 48%: mild NPDR (12%), moderate NPDR (11.3%), severe NPDR (7.3%), PDR (12%), and DME (5.3%). CAD was diagnosed in 64 patients (42.7%), with prevalence rising from 31.2% in those without DR to 72.2% in those with PDR. Multivariate analysis confirmed significant associations for moderate NPDR (OR 2.35), severe NPDR (OR 2.98), PDR (OR 4.12), and DME (OR 3.54). Conclusion: DR severity is strongly and independently associated with angiography-confirmed CAD in T2DM. Advanced DR should be considered a marker for comprehensive cardiovascular evaluation.

Background: As insulin resistance frequently precedes overt diabetes, its early detection is crucial for preventing disease progression and associated complications such as cardiovascular disease. Elevated fasting C-peptide levels often indicate increased insulin secretion, usually as a compensatory mechanism for insulin resistance. Understanding the association between fasting C-peptide levels, insulin resistance, and anthropometric measures in diabetic patients helps in assessing disease severity and tailoring therapeutic interventions. Methods: This was an observational cross-sectional study conducted over a period of one year involving 216 patients above 18 years of age. 5000 patients were screened using random blood sugar and 216 patients were diagnosed as diabetics. Anthropometric measurements (weight, height, body mass index and waist-to-hip ratio) were recorded. Laboratory investigations including complete blood count, renal function test, serum electrolytes, HbA1c, fasting blood sugar, fasting C-peptide levels and lipid profile were performed. Results: The association between C-peptide and age was significant (p-value =0.001). A significant association was observed between C-peptide levels and BMI categories (X2: 51.355, df: 8, p=0.001). High C-peptide levels were associated with a high waist-to-hip ratio of >0.80 in both sexes. The relationship between C-peptide and peripheral signs of resistance was found to be significantly associated (p-value-0.001). The relationship between C-peptide and HbA1c levels was found to be significantly associated (P value-0.001) with a bidirectional effect wherein fasting C-peptide levels in the normal range actually had lower HbA1c levels with an increase as we move away from this group. There was a statistically significant difference in serum triglyceride levels among different fasting C-peptide levels with a p-value of 0.014. Serum VLDL levels and C-peptide levels had a significant association (p-value<0.05), whereas fasting C-peptide had no significant association with serum cholesterol, HDL and S. LDL levels (p-0.117, 0.102, 0.622 respectively). Conclusion: Fasting C-peptide level is strongly associated with insulin resistance and key anthropometric measures in patients with type 2 diabetes mellitus.

Introduction: Skin and soft tissue infections are infections involving the skin and the underlying muscles, the underlying fascia, or the underlying subcutaneous tissue. The severity of skin and soft tissue infections (SSTIs) varies, ranging from superficial epidermal infections to necrotizing fasciitis, a potentially fatal condition. It is often difficult to diagnose and treat infections that range from mild to severe because these infections show a variety of different presentations and because there is a lot of overlap in terms of presentation, etiology, and severity. Determining the degree of severity is therefore crucial to reducing the number of cases of illness or death and to guaranteeing that SSTIs are treated effectively and promptly. Aims And Objectives: To study the clinical profile of patients with community acquired skin and soft tissue infections (SSTIs) coming to a tertiary level hospital and identify factors responsible for extending the hospital stay and poor outcome in patients with SSTIs. Methodology: A case series study was conducted at Rajarajeswari Medical College and Hospital over a period of 18 months comprising of 125 patients diagnosed with skin and soft tissue infections (SSTIs) and results were drawn. All demographic data was tabulated and graphed and the inferential statistics were obtained using Chi-square test.  Results: Most common age group involved in skin and soft tissue infections were between the ages of 21-40 years (40%) and adult males were more affected with abscess formation being the most common clinical presentation (60%). Type 2 diabetes mellitus was the most common associated comorbidity. Staphylococcus aureus was the most common cultured organism (38%), followed by E. coli (26%).  90% of the SSTIs were managed surgically via incision and drainage or debridement followed by intravenous antibiotics administration.   Conclusion:SSTIs are divided into three severity levels according to the patient's clinical and demographic characteristics. Along with other risk factors like smoking and Type 2 Diabetes Mellitus, the most prevalent predisposing factor for SSTIs was found to be adult males from lower socioeconomic backgrounds who were more likely to experience trauma as a result of their living and working conditions. A severity stratification algorithm is developed that can assist in appropriately managing patients through medical or surgical intervention, thereby lowering the related morbidity and mortality.

Background -Non-fasting lipid testing has been introduced into several guidelines over the past decade or so however, the uptake into clincal practice has not been universal. In addition, non-fasting lipid panels can provide clinicians with incremental knowledge in assessing cardiovascular risk (CVD) patients, particularly for triglycerides. Recently triglyceride levels have emerged as a predictor and therapeutic target for the reduction of cardiovascular diseases. In 2018, the American College of Cardiology/American Heart Association (ACC/AHA )  cholesterol guidelines modified previous 2013 recommendations for fasting and allowed  nonfasting for routine screening,   re-iterated again in the  2019 ACC/AHA prevention guidelines Method -This is a  Cross-sectional, hospital based comparitive study  carried out  among   93 diagnosed patients of Type 2 Diabetes mellitus  (according to American Diabetes Association guidelines )  attending  out-patient  Medicine department in Sri Venkateswara RR Govt.Hospital, Tirupati.    Both   male and female of  age  group    between   35- 65 years,  with  duration of  Type 2 Diabetes mellitus for  >5 yr. Results- In this study it was observed that  there is no significant difference between the fasting  triglycerides and non-fasting triglycerides in Type2 diabetics (p<0.6). An increase of only  6mg/dl was observed in triglycerides   in non-fasting state compared with fasting state.

Background: Metabolic syndrome (Mets) is a cluster of cardiometabolic risk factors that significantly increases the risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Biomarkers such as serum uric acid and ferritin have emerged as potential predictors of metabolic dysfunction. Objective: To assess serum uric acid and ferritin levels in Mets patients with and without diabetes and evaluate their association with metabolic abnormalities. Methods: A cross-sectional study was conducted at ESIC Model Hospital, Jaipur, involving 110 Mets patients (45 with T2DM, 65 without). Serum uric acid and ferritin were measured and compared across groups. Lipid profile and glycemic parameters were also analyzed. Results: Diabetic Mets patients exhibited significantly higher mean serum uric acid (6.97 ± 0.92 vs. 4.18 ± 0.77 mg/dL, p < 0.0001) and ferritin levels (330.84 ± 596.31 vs. 213.54 ± 369.06 ng/mL p < 0.0001) compared to non-diabetic counterparts. Elevated uric acid and ferritin correlated positively with triglycerides and LDL, and negatively with HDL. Conclusion: Elevated uric acid and ferritin levels are associated with worsened metabolic profiles in diabetic Mets patients. These biomarkers may serve as early predictors of disease severity, aiding in risk stratification and targeted interventions.

Background: Type 2 diabetes mellitus (T2DM) is a major risk factor for heart failure (HF), and the two conditions frequently coexist, leading to a synergistic increase in morbidity and mortality. While the prognostic implications are well-established, detailed comparative analyses of the clinical phenotype at presentation are needed to guide targeted management. Methods: We conducted a prospective, single-center, observational cohort study involving 400 patients with a primary diagnosis of HF, enrolled between January 2021 and December 2022. Patients were divided into two groups: HF-T2DM (n=185) and HF-non-DM (n=215). Data on demographics, clinical parameters, New York Heart Association (NYHA) functional class, comorbidities, laboratory biomarkers (NT-proBNP, HbA1c, eGFR), and echocardiographic findings (LVEF, diastolic function) were collected and analyzed. Independent t-tests and Chi-square tests were used for statistical comparison. Key Findings: The HF-T2DM group, compared to the HF-non-DM group, was characterized by a higher body mass index (31.2 ± 4.5 vs. 28.1 ± 3.9 kg/m², p<0.001) and a greater proportion of patients in NYHA functional class III/IV (65.4% vs. 48.8%, p=0.002). The HF-T2DM cohort exhibited significantly higher levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) (3450 ± 1280 vs. 2150 ± 990 pg/mL, p<0.001) and worse renal function (mean eGFR 55.4 ± 15.2 vs. 68.3 ± 16.5 mL/min/1.73m², p<0.001). Echocardiographically, heart failure with preserved ejection fraction (HFpEF) was significantly more prevalent in the HF-T2DM group (61.1% vs. 42.8%, p=0.001). Furthermore, comorbidities such as hypertension (88.1% vs. 72.1%, p<0.001) and chronic kidney disease (45.9% vs. 27.0%, p<0.001) were more common in diabetic patients. Conclusion: Patients with heart failure and T2DM present with a more adverse clinical phenotype characterized by worse functional status, greater fluid retention, higher cardiac wall stress, impaired renal function, and a higher prevalence of HFpEF and comorbidities. These findings highlight the distinct pathophysiology of diabetic heart disease and underscore the need for integrated, multi-system management strategies for this high-risk population.

Introduction: Type 2 Diabetes Mellitus (T2DM), a chronic metabolic disorder characterized by hyperglycemia, caused by insulin resistance and a relative deficiency of insulin, leading to a variety of complications that affect both the microvascular and macrovascular systems. A number of studies have indicated that hyperuricemia may be an independent risk factor for development T2DM Present study was aimed to study correlation of fasting serum uric acid level with fasting blood glucose level and its association with glycemic status in type 2 diabetes mellitus patients attending a tertiary care hospital. Material and Methods: This is a cross-sectional observational study conducted in patients attending Diabetology OPD and admitted in medicine wards diagnosed with T2DM. Results: Significant proportion of participants around 39.54% had elevated serum uric acid levels with significance P=0.02. The correlation analysis exhibited that the fasting blood glucose level had a positive moderate correlation with fasting serum uric acid level (r = 0.35, p < 0.001). Additionally, a significant majority (70.6%) have fasting blood glucose levels above the glycemic target range (>130 mg/dL) with significance(p=0.04). Conclusion: The study observed a clear distinction between participants with adequate glycemic control and those with poor control. Patients with fasting blood glucose levels above the target range demonstrated significantly higher serum uric acid levels, reinforcing the association between poor glycemic control and hyperuricemia.

Background: While glycated hemoglobin (HbA1c) is the established standard for glycemic control, growing evidence suggests that glycemic variability (GV)—the amplitude, frequency, and duration of glucose fluctuations—may be an independent risk factor for diabetic complications. However, long-term data linking GV to the incidence and progression of microvascular complications are limited. Methods: We conducted a prospective cohort study of 352 T2DM patients recruited from a tertiary diabetes center. At baseline and annually for five years, participants underwent 14-day continuous glucose monitoring (CGM) to calculate GV metrics, primarily the Mean Amplitude of Glycemic Excursions (MAGE). Comprehensive assessments for retinopathy, nephropathy, and neuropathy were performed at baseline and at the end of the study. Patients were stratified into tertiles based on their 5-year average MAGE (Low, Moderate, High GV). Cox proportional hazards regression was used to analyze the association between GV tertiles and a composite microvascular outcome. Results: Over a median follow-up of 5.1 years, 102 patients (29.0%) developed the composite microvascular outcome. The incidence was significantly higher in the high GV tertile (45.3%) compared to the moderate (26.5%) and low GV (15.4%) tertiles (p<0.001). The mean 5-year HbA1c was similar across groups (7.4% ± 0.6% vs. 7.6% ± 0.7% vs. 7.7% ± 0.8% for low, moderate, and high GV, respectively; p=0.112). After adjusting for mean HbA1c, age, sex, diabetes duration, and other confounders, the high GV tertile was associated with a significantly increased risk of the composite outcome (Hazard Ratio [HR] 2.92, 95% CI 1.68–5.08, p<0.001) compared to the low GV tertile. Conclusion: Long-term high glycemic variability is a potent and independent predictor of the incidence and progression of microvascular complications in patients with T2DM. These findings suggest that targeting GV, in addition to achieving HbA1c goals, may be a crucial strategy for preventing long-term diabetic complications

Background: Hypertriglyceridemia (HTG) is a well-recognized metabolic abnormality, but extremely severe forms with triglyceride (TG) levels exceeding 2000 mg/dl are uncommon. Such cases often present with acute pancreatitis or other complications. Asymptomatic presentation at very high TG levels is exceptionally rare and clinically significant, as delayed recognition may lead to life-threatening consequences. Case Presentation: We report a 42-year-old woman with a six-year history of type 2 diabetes mellitus on insulin therapy, who presented with polydipsia, polyuria, and burning feet. She denied alcohol intake or drug use, and her vitals were stable. Laboratory evaluation revealed a TG level of 2229 mg/dl, total cholesterol of 326 mg/dl, low HDL (20 mg/dl), LDL 33 mg/dl, and HbA1c of 11.9%. Centrifuged blood appeared lipemic, and fundus examination showed lipemic retinalis. Serum lipase, thyroid profile, abdominal ultrasound, and cardiovascular evaluation were normal. Initial management with intravenous insulin, dextrose-containing fluids, and subcutaneous heparin was ineffective in achieving adequate TG reduction. Plasmapheresis was performed, which successfully reduced TG levels to 350 mg/dl, with clinical stabilization and no complications. Conclusion: This case illustrates that extremely severe hypertriglyceridemia may remain asymptomatic and highlights the importance of prompt recognition. Plasmapheresis, in conjunction with intensive medical therapy and glycemic control, plays a vital role in rapid TG reduction and preventing potential complications

Background: Vitamin D, beyond its classical role in bone and mineral metabolism, has been implicated in glucose homeostasis and insulin sensitivity. Deficiency of vitamin D is highly prevalent in India and may contribute to poor glycaemic control in type 2 diabetes mellitus (T2DM). This study aimed to evaluate the association between serum vitamin D levels and glycaemic as well as lipid parameters in patients with T2DM. Methods: A cross-sectional study was conducted at a tertiary care hospital in eastern India over three months. A total of 150 adult T2DM patients on metformin monotherapy were enrolled, comprising 75 cases with vitamin D deficiency (<20 ng/ml) and 75 controls with sufficient levels (≥20 ng/ml). Groups were matched for age, gender, BMI, and duration of diabetes. Primary outcome was glycated hemoglobin (HbA1c), while secondary outcomes included fasting blood sugar (FBS), postprandial blood sugar (PPBS), and lipid profile (total cholesterol, LDL, HDL, triglycerides). Data were analyzed using unpaired t-test and Fisher’s exact test, with p<0.05 considered significant. Results: Patients with vitamin D deficiency had significantly higher HbA1c (7.29% vs. 6.97%, p=0.0497), FBS (157.89 vs. 145.23 mg/dl, p=0.0048), and PPBS (203.54 vs. 181.49 mg/dl, p<0.0001) compared to controls. Only 36% of deficient patients achieved HbA1c <7.0%, versus 52% in controls. Lipid analysis revealed significantly higher total cholesterol (210.83 vs. 195.07 mg/dl, p=0.0221) and LDL (137.28 vs. 124.56 mg/dl, p=0.0380) in deficient patients, while HDL and triglycerides showed no significant difference. Conclusion: Vitamin D deficiency is significantly associated with poorer glycaemic control and adverse lipid parameters in T2DM patients. Routine screening and correction of vitamin D deficiency may represent a valuable adjunctive strategy in comprehensive diabetes management, particularly in populations with high prevalence of deficiency

Background: Diabetes mellitus (DM) is a metabolic culprit known to perpetuate several disease processes. The relationship between hearing loss (HL) and type 2 DM (T2DM) remains unclear despite the vast volume of research devoted to this topic. We conducted this study with the aim to evaluate HL among T2DM patients and to assess the relationship between severity of HL, glycosylated hemoglobin (HbA1c) levels and duration of T2DM. Diabetes mellitus (DM) has become a global health concern, with type 2 diabetes mellitus (T2DM) accounting for the vast majority of cases. While the cardiovascular complications of T2DM are well-recognized less attention is given to other systemic effects such as hearing loss. Emerging evidence suggests that T2DM contributes to subtle auditory dysfunction primarily due to microangiopathy and neuropathy affecting the cochlea and auditory nerve. These early changes in hearing are often undetected without audiometric screening. This study aims to evaluate the prevalence and severity of hearing impairment in T2DM patients.  Materials and Methods: This cross-sectional study was conducted in the Department of ENT at a tertiary care medical college. A total of 50 patients diagnosed with type 2 diabetes mellitus (Group A) were enrolled based on predefined inclusion and exclusion criteria, alongside 50 age-matched healthy individuals (Group B) as controls. Demographic data, medical history, and comorbidities were recorded for both groups. A detailed ENT examination was performed to rule out ear conditions affecting hearing. Audiometric testing, including air and bone conduction, was conducted at frequencies ranging from 250 to 8000 Hz using a pure tone audiometer. Data were analyzed using SPSS software, with a p-value of <0.05 considered statistically significant. Results: Patients with type 2 diabetes mellitus (T2DM) had significantly higher systolic (149.82 mmHg vs. 140.15 mmHg, P = 0.0016) and diastolic (90.76 mmHg vs. 85.34 mmHg, P < 0.0001) blood pressure compared to healthy controls. Fasting blood sugar, triglycerides, waist circumference, and BMI were also elevated, while HDL cholesterol was lower in the diabetic group (P < 0.0001 for all). Bone and air conduction hearing thresholds were consistently higher in T2DM patients across all tested frequencies for both ears, demonstrating significant auditory impairment compared to controls (P < 0.05 for all frequencies). Conclusion: Patients with type 2 diabetes mellitus (T2DM) were found to have significant auditory impairment as evidenced by higher bone and air conduction thresholds compared to healthy controls. Regular hearing screenings in T2DM patients, particularly those with poor glycaemic control, are crucial for early detection and prevention of further hearing loss, thereby improving patient outcomes and quality of life.

Introduction: Diabetic retinopathy (DR), the most common microvascular complication of type 2 diabetes mellitus (T2DM), has been increasingly linked to macrovascular disease, particularly coronary artery disease (CAD). The retina provides a non-invasive marker of systemic vascular injury, but evidence from Indian cohorts using standardized DR grading and angiography-confirmed CAD is limited. This study aimed to assess whether DR severity is independently associated with CAD in T2DM. Materials and Methods: A cross-sectional study was conducted on 150 T2DM patients at the Department of General Medicine, Mamata Medical College, Khammam. Demographic and clinical data, including age, sex, diabetes duration, hypertension, smoking, and alcohol use, were recorded. Biochemical evaluation included fasting plasma glucose, HbA1c, lipid profile, and renal function tests. DR was graded using the Early Treatment Diabetic Retinopathy Study (ETDRS) classification. Cardiovascular evaluation included ECG, echocardiography, treadmill test, and coronary angiography. CAD was defined as ≥50% stenosis in a major epicardial coronary artery. Logistic regression assessed the association between DR severity and CAD after adjusting for confounders. Results: The mean age was 56.2 ± 9.1 years, with 61.3% males. DR was present in 48%: mild NPDR (12%), moderate NPDR (11.3%), severe NPDR (7.3%), PDR (12%), and DME (5.3%). CAD was diagnosed in 64 patients (42.7%), with prevalence rising from 31.2% in those without DR to 72.2% in those with PDR. Multivariate analysis confirmed significant associations for moderate NPDR (OR 2.35), severe NPDR (OR 2.98), PDR (OR 4.12), and DME (OR 3.54). Conclusion: DR severity is strongly and independently associated with angiography-confirmed CAD in T2DM. Advanced DR should be considered a marker for comprehensive cardiovascular evaluation.

Background: Type 2 diabetes mellitus (T2DM) is a main worldwide health challenge requiring long-term pharmacological management. Multiple antidiabetic drug classes are available, but direct comparative evidence on efficacy and safety remains limited. Methods: A Retrospective observational study was led in a Internal Medicine clinic Prime Specialist Medical Centre, including 100 patients with T2DM. Participants were randomized into five groups of 20 patients each, with one group assigned to each drug class. Over one year, effectiveness endpoints included HbA1c, plasma fasting glucose, or postprandial glucose changes. Safety outcomes included unfavourable events, hypoglycaemic events, weight fluctuations, and hospitalisation. The study utilised ANOVA for continuous variables and chi-square testing for categorical outcomes. Results: All drug classes significantly reduced HbA1c levels (p<0.05). GLP-1 receptor agonists (-1.6%) and SGLT2 inhibitors (-1.4%) showed the greatest HbA1c reductions, along with favourable weight loss and low hypoglycaemia risk. Metformin achieved solid efficacy (-1.2%) but was associated with gastrointestinal side effects. Sulfonylureas demonstrated strong glycaemic control (-1.3%) but had the highest hypoglycaemia incidence (25%). DPP-4 inhibitors were well tolerated but showed modest efficacy (-0.9%). Conclusion: GLP-1 receptor agonists and SGLT2 inhibitors offered the best balance of efficacy and safety. Metformin remains a robust first-line therapy, while sulfonylureas require cautious use due to hypoglycaemia risk. Larger multicentre trials are recommended to validate these findings and assess long-term outcomes

Background and objectives: Tuberculosis is a major public health problem in India. India is reported to have the highest burden of TB globally, with 2.4 million cases reported in the National TB Program of India in 2019^. Both type 2 diabetes (T2DM) and tuberculosis (TB) are prevalent in India. There is a bidirectional relationship between Diabetes Mellitus and infections, and it is true for TB as well. This study was planned to find out any association between Diabetes Mellitus and sputum conversion at 2 months. Methods: This prospective observational study enrolled new and previously treated sputum smear positive patients coming under NITRD DOTS area from 1^st September 2019 to 31^st October 2019 and the history of Diabetes Mellitus and sputum smear conversion rate were assessed at the end of 2 months. Results: The mean age ± standard deviation of the study sample was 33.52 ± 15.90 years. Among the 100 patients, 60 (60%) were male and 40 (40%) were female. The study found a statistically significant association between a history of diabetes mellitus and delayed sputum smear conversion in pulmonary tuberculosis patients at the end of the intensive phase (2 months), with a p-value < 0.01. Conclusion: In our study, we found that Diabetes Mellitus was associated with delayed sputum smear conversion at the end of the second month of treatment, and this association was statistically significant.

Background Type 2 diabetes mellitus (T2DM) has been increasingly linked to cognitive dysfunction through mechanisms involving chronic hyperglycemia, microvascular disease, and neurodegeneration. Magnetic Resonance Imaging (MRI) provides an objective method to assess these brain changes.  Aim: To compare MRI brain changes in Type 2 diabetic patients with and without cognitive impairment. Materials and Methods: A hospital-based cross-sectional comparative study was conducted on 120 Type 2 diabetic patients divided into two groups: 60 with cognitive impairment (CI+) and 60 without (CI-). Cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). MRI scans were analyzed for white matter hyperintensities (Fazekas score), hippocampal volume, cortical thickness, lacunes, microbleeds, and diffusion tensor imaging parameters (FA and ADC). Data were statistically analyzed using Student’s t-test, Chi-square test, and correlation analyses, with p < 0.05 considered significant. Results: Patients with cognitive impairment were older (64.1 ± 7.8 vs 60.3 ± 7.5 years; p = 0.007), had longer diabetes duration (12.3 ± 4.6 vs 9.7 ± 4.1 years; p = 0.0015), and higher HbA1c (8.7 ± 1.1 vs 7.9 ± 1.0; p < 0.001). MRI revealed higher Fazekas WMH scores (2.4 ± 0.8 vs 1.6 ± 0.7; p < 0.001), lower hippocampal volume (6.2 ± 0.7 vs 6.8 ± 0.6 cm³; p < 0.001), and thinner cortex (2.38 ± 0.12 vs 2.46 ± 0.11 mm; p < 0.001) in CI+ patients. WMH and hippocampal volume correlated significantly with MoCA scores (r = -0.56 and +0.49, respectively; p < 0.001). Logistic regression identified diabetes duration, HbA1c, hypertension, and LDL as independent predictors of MRI changes. Conclusion: T2DM patients with cognitive impairment exhibit distinct MRI abnormalities indicating both vascular and neurodegenerative pathology. Poor glycemic control and longer disease duration significantly contribute to these brain changes. Early neuroimaging screening in diabetic individuals may aid in detecting subclinical brain injury and preventing cognitive decline.

Background: Homocysteine metabolism is closely linked to Vitamin B12 and folate status, and disturbances in this pathway are recognized contributors to vascular pathology. Elevated homocysteine levels have been increasingly associated with ischemic stroke, particularly in individuals presenting for the first time. Understanding these biochemical patterns at initial presentation may aid in targeted prevention and secondary risk reduction. Aim: To assess serum homocysteine, Vitamin B12, and folate levels in patients with first-episode ischemic stroke and determine the prevalence of metabolic derangements. Materials and Methods: This observational study included 50 adult patients diagnosed with first-episode ischemic stroke based on clinical assessment and neuroimaging. Demographic details and clinical risk factors were recorded. Fasting blood samples were analyzed for serum homocysteine, Vitamin B12, and folate levels. Standard laboratory cut-off values were used to categorize abnormalities. Data were summarized using descriptive statistics. Results: The mean age of the participants was 58.4 ± 9.6 years, with males constituting 62%. Hypertension (56%) and Type 2 diabetes mellitus (42%) were commonly observed clinical risk factors. The mean serum homocysteine level was 19.8 ± 6.7 µmol/L, and elevated homocysteine (>15 µmol/L) was detected in 64% of subjects. Vitamin B12 deficiency was present in 56% of patients, while low folate levels were found in 36%. A noticeable proportion of patients with hyperhomocysteinemia also had concomitant Vitamin B12 or folate deficiency. Conclusion: A significant number of patients with first-episode ischemic stroke exhibited elevated homocysteine levels alongside reduced Vitamin B12 and folate status. These findings highlight the importance of routinely evaluating and correcting these metabolic parameters in acute stroke care as part of comprehensive vascular risk management

Background: Occupation and eating patterns play a vital role in the risk of cardiovascular disease (CVD). Some jobs, especially those characterised by limited physical activity or high stress, can elevate the risk of CVD. Meanwhile, food selections are essential in both the onset and prevention of heart disease. The objective of the study was to find out the relationship between food and occupation with cardiovascular risk. Materials and Methods: This cross-sectional, community-based study was conducted among reproductive-aged women in 25-45 years, with 200 working women and 200 nonworking women. A stratified random sampling technique recruited study participants from different districts of West Bengal. Mann-Whitney U and Kruskal-Wallis H Test were calculated by using SPSS software. P value ≤ 0.05 was considered statistically significant. Results: Positive family history of lifestyle disorders, consumption of processed food, reduced dietary fibers, fruits and vegetables, and increased smoking statistically correlated with type 2 diabetes, angina, hypertension and hyperlipidemia in both the groups, with subtle differences in manifestation. Biochemical parameters correlated well with ECG findings and adverse cardiovascular events in the follow-up period. Conclusions: Major proportion of asymptomatic women between 25 and 45 years of age, inhabiting the southern part of West Bengal, were exposed to cardiovascular risk factors, which might take the shape of overt disease in future, posing a significant public health burden. Findings are significant for policymakers and various stakeholders in implementing measures that effectively reduce the increasing prevalence of coronary heart disease in this age group.

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder associated with long-term complications, including cognitive dysfunction. Prolonged hyperglycemia, insulin resistance, and vascular comorbidities may impair attention, memory, and executive function. Despite the growing burden of diabetes, cognitive assessment is often overlooked in routine care, particularly in developing countries. The study aimed to assess cognitive function among patients with T2DM using the Mini-Mental State Examination (MMSE) and to evaluate its association with clinical and biochemical parameters. Methods: This cross-sectional study was conducted at a tertiary care centre from January 2024 to June 2025. A total of 100 adults aged 40–75 years with T2DM of at least one-year duration were enrolled. Individuals with Type 1 diabetes, neurological or psychiatric disorders, alcohol dependence, sensory impairments, or medications affecting cognition were excluded. Sociodemographic and clinical data were collected, and anthropometric measurements and blood pressure were recorded. Glycemic control was assessed via fasting and postprandial glucose and HbA1c levels. Cognitive function was evaluated using the MMSE, with scores ≥27 considered normal, 21–26 indicating mild impairment, 10–20 moderate impairment, and <10 severe impairment.  Results: Among participants, 25% exhibited cognitive impairment, predominantly mild (22%) and moderate (3%). Impaired individuals were older (61.1 ± 7.5 vs. 56.1 ± 8.8 years), had longer diabetes duration (9.5 ± 4.6 vs. 6.4 ± 3.7 years), higher HbA1c (8.5 ± 1.3 vs. 7.9 ± 1.1%), and elevated systolic blood pressure (138.4 ± 14.6 vs. 131.2 ± 12.9 mmHg). MMSE scores negatively correlated with age (r = –0.39), diabetes duration (r = –0.36), HbA1c (r = –0.28), and systolic BP (r = –0.20) (all p < 0.05). Conclusion: Cognitive impairment affects a significant subset of patients with T2DM and is associated with older age, longer disease duration, poor glycemic control, and higher blood pressure. Routine cognitive screening with MMSE may facilitate early identification and intervention to improve diabetes management and quality of life.

Background: Male hypogonadism, characterized by testosterone deficiency, is highly prevalent among men with obesity and type 2 diabetes mellitus (T2DM). These conditions often coexist, contributing to metabolic derangements and increased cardiovascular (CV) risk. Testosterone replacement therapy (TRT) has been widely used to alleviate symptoms of testosterone deficiency; however, concerns remain about its long term cardiovascular safety. Aim: To systematically review evidence on TRT in hypogonadal men with T2DM and/or obesity, with a focus on cardiovascular outcomes. Methods: Databases (PubMed, Web of Science, Cochrane Library, Google Scholar) were searched until August 2021 using predefined terms. Studies were included if they assessed TRT in hypogonadal men with obesity and/or T2DM and reported CV outcomes. A total of 320 articles were screened, and 198 were eligible (86 RCTs, 112 observational studies). Results: Of the 198 included studies, 16 RCTs (n = 2,605 participants) and 15 observational studies (n = 1,836,513 participants) specifically assessed TRT’s impact on cardiometabolic and CV outcomes. Most RCTs demonstrated metabolic and symptomatic benefits without significant increases in major CV events, although a few trials showed neutral outcomes. Observational studies reported reduced mortality, improved insulin sensitivity, and decreased obesity related risk factors in TRT groups. However, some registry based retrospective studies highlighted possible increased CV risk. Conclusion: TRT in hypogonadal men with T2DM/obesity appears beneficial for metabolic and sexual health outcomes, but evidence regarding CV safety remains conflicting. Larger, long term randomized controlled trials are warranted before definitive recommendations can be made

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with persistent hyperglycemia, chronic low-grade inflammation, and an increased risk of cardiovascular and microvascular complications. Glycated hemoglobin (HbA1c) remains the gold standard for assessing long-term glycemic control but does not fully capture the inflammatory state that contributes to disease progression.  Methodology: A hospital-based cross-sectional observational study was conducted in the Department of Medicine at MKCG Medical College and Hospital, Berhampur, Odisha, India. A total of 180 adults aged 18–70 years with T2DM, diagnosed according to ADA criteria, were enrolled using a simple random sampling method. Patients with inflammatory, hepatic, renal, or hematological disorders were excluded. Clinical data, hematological parameters, HbA1c, NLR, and MLR were recorded.  Results: The mean age of participants was 54.1 ± 8.3 years. Most patients in both groups were aged 50–59 years, and no significant association was found between gender and glycemic control. Elevated NLR (>2) was present in 62.99% of uncontrolled patients compared to 42.31% of controlled patients (p < 0.05). Similarly, elevated MLR (>2) was observed in 63.64% of uncontrolled patients versus 34.62% of controlled patients (p < 0.05). Both NLR and MLR showed significant positive correlations with HbA1c, indicating their potential as markers of poor glycemic control. Discussion: The findings highlight that subclinical inflammation, as reflected by elevated NLR and MLR, is closely associated with poor glycemic control in T2DM. These results support previous studies demonstrating that inflammatory pathways play a pivotal role in diabetes progression and complications.  Conclusion: This study demonstrates a significant positive association between elevated NLR and MLR and poor glycemic control in patients with T2DM. Incorporating these inflammatory markers into clinical practice alongside HbA1c could enhance patient monitoring, risk stratification, and early detection of complications

Background: Type 2 diabetes mellitus (T2DM) is a metabolic disorder that results in insulin resistance and impaired glucose metabolism. Lifestyle intervention continues to be a cornerstone of its control, supporting pharmacologic therapy. The aim of this research was to assess the role of intensive lifestyle changes on glycemic control in patients with T2DM over the long term. Methods: Longitudinal study was performed among adult patients with T2DM. Patients were provided with individualized diet counseling, physical activity advice, and behavioral support. Fasting plasma glucose, postprandial glucose, and HbA1c were measured at baseline, 6 months, and 12 months. Statistical analysis was carried out to assess the change in glycemic parameters over time and its relation to compliance with recommendations for lifestyle. Results: A notable decrease in mean fasting plasma glucose, postprandial glucose, and HbA1c was seen following 12 months of intervention (p < 0.001). Increased adherence to lifestyle change was associated with greater improvements in glycemic control. Positivity was also seen in body mass index and lipid profile, reflective of better overall metabolic health. Conclusion: The evidence supports that organized lifestyle treatment significantly improves glycemic control and metabolic parameters in T2DM patients. Regular exercise, adequate nutrition, and ongoing behavioral reinforcement are some of the factors that lead to long-term improvements. Incorporation of digital health platforms and patient education may also ensure long-term adherence and minimize the risk of diabetes complications.

This study investigated the role of Red Cell Distribution Width (RDW) as a surrogate biomarker for diabetic nephropathy, retinopathy, and vascular dysfunction among 160 participants, including type 2 diabetes mellitus (T2DM) patients with and without complications and healthy controls. Conducted at Mahatma Gandhi Medical College and M.Y. Hospital, Indore, the study revealed a significant rise in RDW values from controls (12.7 ± 0.8%) to diabetics with complications (15.3 ± 1.6%; p < 0.001). RDW showed a positive correlation with HbA1c (r = 0.61), urine albumin–creatinine ratio (r = 0.57), and duration of diabetes (r = 0.42), while it negatively correlated with eGFR (r = –0.48). Logistic regression identified RDW ≥ 14.5% as an independent predictor of diabetic complications (OR = 3.26, p = 0.001). The findings suggest that elevated RDW reflects oxidative stress, inflammation, and endothelial dysfunction in diabetes, serving as a cost-effective, non-invasive biomarker for early detection and risk stratification of vascular complications in T2DM.

Background: Diabetic neuropathy is one of the most frequent and disabling chronic complications of type 2 diabetes mellitus (T2DM), involving both peripheral and autonomic nervous systems. While peripheral neuropathy is commonly recognised in clinical practice, cardiac autonomic neuropathy (CAN) often remains underdiagnosed despite its strong association with cardiovascular morbidity and mortality. Objectives To evaluate the clinical spectrum of peripheral and cardiac autonomic neuropathy in patients with T2DM and to analyse their relationship with duration of diabetes and glycaemic control. Methods This hospital-based cross-sectional observational study was conducted at a tertiary care centre over 18 months. Ninety-eight adults with T2DM underwent detailed clinical evaluation, nerve conduction studies, autonomic symptom assessment, galvanic skin response testing, and standardised cardiac autonomic reflex tests. Glycaemic parameters included fasting blood glucose, post-prandial blood glucose, and HbA1c. Statistical analysis was performed using SPSS version 20.0. Results Peripheral neuropathy was detected in 39.8% of patients, with distal symmetrical sensorimotor polyneuropathy being the most common subtype. Cardiac autonomic neuropathy was identified in 98.98% of patients, with 80.6% showing severe or advanced involvement. Parasympathetic dysfunction was the most frequent abnormality. Although neuropathy was more common with longer duration of diabetes and poorer glycaemic indices, these differences were not statistically significant. Autonomic neuropathy showed a strong association with diabetic retinopathy. Conclusion Both peripheral and cardiac autonomic neuropathy are highly prevalent in patients with long-standing T2DM. Cardiac autonomic neuropathy may occur early and independently of HbA1c levels, highlighting the importance of routine autonomic assessment in diabetes care.

Background Metformin is the first-line therapy for type 2 diabetes mellitus, but its long-term use is associated with vitamin B12 deficiency, a condition with potential hematological and neurological consequences. This study aims to determine the prevalence of vitamin B12 deficiency in long-term metformin users, identify key predictive factors, and evaluate its association with adverse clinical outcomes. Methods We conducted a retrospective cohort study using electronic health records from a multi-center diabetic clinic. The study included 850 patients with type 2 diabetes who had been using metformin continuously for at least two years. Data on demographics, metformin dose and duration, concurrent medication use (e.g., proton pump inhibitors), and laboratory values (serum B12, hemoglobin, Mean Corpuscular Volume) were extracted. The primary outcome was vitamin B12 deficiency, defined as a serum level <150 pmol/L. Secondary outcomes included peripheral neuropathy and macrocytic anemia. Logistic regression was used to identify predictors of deficiency. Results The overall prevalence of vitamin B12 deficiency (<150 pmol/L) was 22.4%, with an additional 31.5% having borderline levels (150-220 pmol/L). In the multivariate logistic regression analysis, significant independent predictors for B12 deficiency included a longer duration of metformin use (OR 1.15 per year, 95% CI 1.08-1.22), a higher daily dose (OR 1.88 per 1000 mg/day increase, 95% CI 1.45-2.43), older age (OR 1.03 per year, 95% CI 1.01-1.05), and concurrent use of proton pump inhibitors (OR 2.10, 95% CI 1.55-2.85). Clinically, deficient patients had a significantly higher prevalence of peripheral neuropathy (35.8% vs. 14.7%, p < 0.001) and macrocytic anemia (11.6% vs. 3.9%, p < 0.01) compared to patients with sufficient B12 levels. Conclusion Vitamin B12 deficiency is highly prevalent among long-term metformin users and is strongly associated with dose, duration, age, and PPI use. Given the significant link to adverse neurological and hematological outcomes, routine screening for vitamin B12 levels should be considered a standard of care for this patient population.

Background: Teneligliptin is a long-acting DPP-4 inhibitor with a plasma half-life of ~24 hours, allowing sustained glycaemic control with once-daily dosing. Its pharmacokinetic profile suggests that alternate-day dosing may maintain efficacy while reducing cost and pill burden, a strategy particularly relevant in resource-limited settings. (PMC) Objectives: To compare the efficacy and safety of alternate-day versus daily Teneligliptin therapy in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on metformin and sulfonylureas. Methods: In this prospective, open-label, randomised, parallel-group study, adults with T2DM (HbA1c 7.5–10%) on stable metformin + sulfonylurea were randomised (1:1) to receive Teneligliptin 20 mg once daily (Daily group) or every other day (Alternate-day group) for 12 weeks, in addition to their background therapy. Primary endpoint: change in HbA1c at 12 weeks. Secondary endpoints: fasting plasma glucose (FPG), post-prandial glucose (PPG), proportion achieving HbA1c < 7%, weight change, adverse events (AEs), hypoglycaemia, and laboratory safety parameters. Data were analysed using intention-to-treat principles. Results: A total of 120 participants were randomised (Daily n = 60; Alternate-day n = 60). Baseline characteristics were comparable. Mean HbA1c reduction at 12 weeks was −1.2 ± 0.4% in the Daily group vs −1.0 ± 0.5% in the Alternate-day group (between-group p = 0.08). FPG and PPG decreased significantly within both groups (p < 0.001), with no statistically significant between-group differences. The proportion achieving HbA1c < 7% was 48.3% vs 41.7% (p = 0.42) in the Daily and Alternate-day groups, respectively. Hypoglycaemic episodes (all mild–moderate) were numerically higher in the Daily group (18.3% vs 10%; p = 0.19). No significant changes in liver or renal function were observed. Drug-related AEs were mild and comparable between groups. Conclusion: Alternate-day Teneligliptin provided clinically meaningful and statistically significant improvements in glycaemic parameters, appearing non-inferior to daily dosing within the precision limits of this study, with a similar safety profile and potential cost advantage. These findings support alternate-day Teneligliptin as a rational dose-sparing strategy in selected T2DM patients uncontrolled on metformin and sulfonylureas.

Background: Diabetes mellitus is an established cause of subclinical myocardial involvement, frequently manifesting as left ventricular diastolic dysfunction (LVDD) before the onset of overt cardiovascular disease. Diabetic cardiomyopathy is characterized by impaired myocardial relaxation and increased ventricular stiffness, leading to elevated filling pressures while systolic function remains preserved. As this condition often remains asymptomatic for prolonged periods, early identification of LVDD is essential to prevent progression to heart failure with preserved ejection fraction. Despite the high prevalence of diabetes in India, region-specific data from central India on echocardiographic assessment of diastolic dysfunction remain limited. Objectives: To evaluate left ventricular diastolic function in patients with type 2 diabetes mellitus using transthoracic echocardiography and to determine the prevalence, grades, and independent predictors of diastolic dysfunction at a tertiary care centre in Nagpur. Methods: This hospital-based cross-sectional study was conducted over one year at a tertiary care centre in Nagpur and included 220 adult patients with type 2 diabetes mellitus and preserved systolic function. Patients with ischemic heart disease, significant valvular disease, cardiomyopathy, arrhythmias, or left ventricular ejection fraction <50% were excluded. All participants underwent clinical evaluation, laboratory assessment including HbA1c, and transthoracic echocardiography. Left ventricular diastolic function was assessed using Doppler and tissue Doppler parameters and graded according to the 2016 American Society of Echocardiography and European Association of Cardiovascular Imaging guidelines. Results: Left ventricular diastolic dysfunction was identified in 95 patients (43.2%). Grade I diastolic dysfunction was the most common pattern (26.4%), followed by Grade II (11.4%) and Grade III (5.4%). Patients with LVDD were significantly older and had a longer duration of diabetes, higher body mass index, higher prevalence of hypertension, and poorer glycaemic control compared to those with normal diastolic function (p < 0.05). Left ventricular ejection fraction was preserved and comparable between groups. On multivariate analysis, advancing age, longer duration of diabetes, hypertension, HbA1c ≥8%, and increased body mass index emerged as independent predictors of diastolic dysfunction. Conclusion: Diastolic dysfunction is common among patients with type 2 diabetes mellitus despite preserved systolic function. Routine echocardiographic screening in high-risk diabetic patients may enable early detection and targeted intervention, potentially reducing progression to symptomatic heart failure

Background: Type 2 Diabetes Mellitus (T2DM) is a major public health problem and is frequently associated with microvascular and macrovascular complications that significantly increase morbidity and mortality. Magnesium plays an essential role in glucose metabolism, insulin action, and vascular function. Hypomagnesemia is commonly observed in patients with T2DM and has been implicated in the development of diabetic complications. Objectives: To evaluate serum magnesium levels in patients with Type 2 Diabetes Mellitus and to assess their role in predicting the presence of diabetic complications. Methods: levels were This prospective observational study was conducted over a period of one year at PDU Medical College and attached group of Hospital (Dedraj Bhartiya Hospital -Churu). A total of 100 patients with Type 2 Diabetes Mellitus were enrolled. Serum magnesium measured at baseline, and patients were assessed for the presence of diabetic microvascular and macrovascular complications using standard clinical and laboratory criteria. Data were analyzed to determine the association between serum magnesium levels and diabetic complications using appropriate statistical tests, with a p-value of <0.05 considered statistically significant. Results: Hypomagnesemia was observed in 37% of the study participants. Diabetic complications were present in 54% of patients and were significantly more common among those with low serum magnesium levels. The prevalence of hypomagnesemia was markedly higher in patients with complications compared to those without complications. Mean serum magnesium levels were significantly lower in patients with complications than in those without. A significant association was also observed between longer duration of diabetes and the presence of complications, while gender showed no significant association. Conclusion: Hypomagnesemia is common in patients with Type 2 Diabetes Mellitus and is significantly associated with diabetic complications. Serum magnesium estimation may serve as a simple and cost-effective tool for early identification of patients at higher risk for complications, supporting its inclusion in routine diabetic evaluation and management.

Background: Sleep disturbances are increasingly recognized as an important factor influencing glucose metabolism and metabolic control in patients with Type 2 Diabetes Mellitus (T2DM). While HbA1c reflects average glycemic control, glycemic variability provides additional insight into short-term glucose fluctuations that contribute to diabetic complications. Objectives: To evaluate the association between sleep quality and glycemic variability in patients with Type 2 Diabetes Mellitus. Methods: This prospective observational study was conducted over one year at PDU Medical College and attached group of Hospital (Dedraj Bhartiya Hospital -Churu). A total of 100 patients with T2DM were enrolled. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and patients were categorized into good and poor sleep quality groups. Glycemic variability was evaluated using fasting blood glucose, standard deviation of glucose values, coefficient of variation, and mean amplitude of glycemic excursions. HbA1c was measured to assess overall glycemic control. Statistical analysis was performed to determine the association between sleep quality and glycemic variability. Results: Poor sleep quality was observed in 54% of the study participants. Patients with poor sleep quality demonstrated significantly higher fasting blood glucose levels, greater glycemic variability, and higher HbA1c compared to those with good sleep quality. Increased glycemic variability was present in a substantially higher proportion of patients with poor sleep quality, indicating a strong association between impaired sleep and glucose instability. Conclusion: Poor sleep quality is common among patients with Type 2 Diabetes Mellitus and is significantly associated with increased glycemic variability and suboptimal glycemic control. Routine assessment of sleep quality may serve as an important component of comprehensive diabetes management and may help identify patients at higher risk for glycemic instability and related complications.

Background: Dyslipidemia is a central metabolic abnormality in type-2 diabetes mellitus (T2DM) and contributes to accelerated atherosclerotic cardiovascular disease. Since humans spend most hours in the non‑fasting state, post‑prandial lipemia can expose the arterial wall to triglyceride‑rich lipoproteins and remnant particles for prolonged periods. Objectives: To assess and compare fasting and post‑prandial lipid profile parameters among T2DM patients and healthy controls, and to examine within‑group changes from fasting to post‑prandial state in T2DM. Methods: A case–control study was conducted in one hundred adults aged 40–65 years were enrolled (50 T2DM cases and 50 apparently healthy controls). Fasting blood samples were collected after an overnight fast; post‑prandial samples were obtained 2 hours after a usual mixed meal. Glycemic indices (fasting blood sugar, HbA1c) and lipid profile (total cholesterol, triglycerides, HDL‑C, LDL‑C, VLDL‑C) were measured and compared between groups and between fasting vs post‑prandial states. Continuous variables were expressed as mean ± SD and compared using independent and paired t‑tests; p<0.05 was considered significant. Results: The groups were comparable in age and sex distribution. BMI was higher in T2DM cases than controls (27.1 ± 3.4 vs 23.8 ± 2.9 kg/m²; p<0.001). Fasting blood sugar and HbA1c were markedly higher in cases (154.6 ± 32.8 mg/dL and 8.2 ± 1.4%) than controls (92.4 ± 10.6 mg/dL and 5.4 ± 0.6%; both p<0.001). In both fasting and post‑prandial states, total cholesterol, triglycerides, LDL‑C and VLDL‑C were significantly higher, while HDL‑C was significantly lower in T2DM compared to controls (all p<0.001). Within T2DM, post‑prandial levels increased significantly for total cholesterol, triglycerides, LDL‑C and VLDL‑C, whereas HDL‑C showed no significant change. Conclusion: T2DM patients demonstrated an atherogenic lipid pattern in both fasting and post‑prandial states, with additional worsening after meals—particularly for triglycerides and VLDL‑C. Post‑prandial lipid assessment provides clinically meaningful information and supports comprehensive dyslipidemia evaluation in T2DM

Background: Diabetes mellitus is a major chronic health condition associated with significant morbidity, mortality, and healthcare burden worldwide. Achieving optimal glycaemic control is critical to preventing complications, and adherence to prescribed antidiabetic medications plays a pivotal role in this process. Despite the availability of effective therapies, poor adherence remains a leading cause of uncontrolled diabetes and adverse outcomes. Objective: This study examines the interaction between controlling blood sugar levels and taking diabetes medicines as prescribed in Type 2 Diabetes Mellitus patients from India, attending the Medicine Department, Central Hospital, Kalla. Methods: From June 2024 to June 2025, EMR records from 100 adults with diabetes were used in a retrospective observational study. For type 2 diabetes, six months of diabetes medicine and HbA1c statistics were required. Patients' adherence was rated as high, average, or low by the Medication Possession Ratio (MPR). HbA1c numbers (<7%, ≥7%) show the way glucose levels are controlled. For statistical research, we used SPSS and Pearson's coefficient (p < 0.05) to find correlations. Results: Patient adherence was 46% strong, 32% moderate, and 22% poor. Lower HbA1c levels were associated with higher adherence, decreasing the connection between poor glycaemic management (p < 0.05). Conclusion: Higher blood sugar results with better medicine adherence. Patient education, follow-ups, and adherence-monitoring technology are needed to improve diabetic management in India.

Background: Type 2 diabetes mellitus (T2DM) is frequently associated with metabolic syndrome (MS), a constellation of metabolic abnormalities that significantly increases cardiovascular morbidity and mortality. Gamma-glutamyl transferase (GGT), traditionally regarded as a hepatic enzyme, has emerged as a potential biomarker of oxidative stress and metabolic risk. Elevated GGT levels have been linked to individual components of MS and cardiovascular disease, even in the absence of overt liver pathology. Aim & Objective: To evaluate serum Gamma-glutamyl transferase levels in patients with Type 2 diabetes mellitus with metabolic syndrome and to assess its association with metabolic syndrome in comparison with T2DM patients without metabolic syndrome and healthy controls. Materials & Methods: This cross-sectional analytical study was conducted at a tertiary care hospital in Tamil Nadu from April to July 2024. A total of 105 participants aged 30–60 years were enrolled and divided into three groups: healthy controls (n=35), T2DM patients without metabolic syndrome (n=35), and T2DM patients with metabolic syndrome (n=35), diagnosed using NCEP-ATP III criteria. Anthropometric measurements, blood pressure, fasting and postprandial glucose, lipid profile, and serum GGT levels were assessed. Statistical analysis was performed using SPSS version 16.0, with ANOVA and Bonferroni post-hoc tests applied. A p-value <0.05 was considered statistically significant. Results: Serum GGT levels were significantly higher in T2DM patients with metabolic syndrome (52.58 ± 48.10 U/L) compared to T2DM patients without metabolic syndrome (24.97 ± 14.62 U/L) and healthy controls (20.16 ± 8.37 U/L) (p < 0.001). Waist circumference, systolic and diastolic blood pressure, total cholesterol, and triglyceride levels were also significantly elevated in the metabolic syndrome group. No statistically significant difference in GGT levels was observed between T2DM patients without metabolic syndrome and healthy controls. Conclusion: Serum Gamma-glutamyl transferase levels are significantly elevated in T2DM patients with metabolic syndrome. Incorporating GGT estimation into routine evaluation of patients with Type 2 diabetes mellitus may facilitate early identification of metabolic syndrome and help reduce future cardiovascular morbidity and mortality.

Introduction: Diabetes mellitus markedly increases cardiovascular morbidity and mortality due to the combined effects of hyperglycemia, insulin resistance, hypertension, obesity, and dyslipidemia, which accelerate atherosclerosis and vascular dysfunction. Diabetic patients often develop silent myocardial ischemia, leading to late presentation with severe cardiac events. Chronic subclinical elevation of cardiac biomarkers such as CK total, CK-MB, and LDH in diabetes suggests ongoing myocardial injury. This study evaluates the association of these biomarkers with cardiovascular risk factors in type 2 diabetes compared with non-diabetic individuals. Material and methods: This cross-sectional study was conducted at a tertiary care hospital in Surat, India. Serum creatine kinase total (CK total), CK-MB, and lactate dehydrogenase (LDH) were analyzed in 149 diabetic and 149 non-diabetic individuals using an Erba XL-640 fully automated chemistry analyzer. Height and weight were recorded to calculate body mass index (BMI). Statistical analysis was performed using SPSS version 16. Result and discussion: We had observed significantly (p<0.001) higher level of CK total (158 ± 75.10 U/l) in diabetic and non-diabetic (127.5 ± 73.9 U/l) individuals. We had observed significantly (p<0.001) higher level of CK-MB (41.18 ± 14.6 U/l) in diabetic and non-diabetic (29.19 ± 19.1 U/l) individuals. We had observed significantly (p<0.001) higher level of LDH (687 ± 180 U/l) in diabetic and non-diabetic (428 ± 197 U/l) individuals. We had also observed significant higher level of CK total, CK-MB and LDH in all age and BMI groups in diabetic subjects compared to non-diabetic individuals.  Conclusion: This study demonstrates that, Serum CK total, CK-MB, and LDH are significantly elevated in type 2 diabetes mellitus, reflecting early, subclinical myocardial injury driven by chronic hyperglycemia, oxidative stress, and metabolic inflammation. Despite the availability of high-sensitivity troponins, CK-MB and LDH remain reliable, cost-effective markers of cardiac stress and respond to metabolic control and antioxidant therapy. Routine monitoring of these enzymes, alongside glycemic and lipid parameters, can facilitate early cardiovascular risk detection and guide preventive strategies to reduce future cardiac events in diabetic patients.

Background: Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) frequently coexist and together substantially increase cardiovascular morbidity and mortality. Data from tertiary care settings in India remain limited. Objectives: To determine the prevalence of MetS among T2DM patients, also evaluate the association between MetS and demographic, anthropometric, and biochemical parameters. Methods: A hospital-based cross-sectional study was conducted over 12 months among 70 patients aged >35 years with diagnosed T2DM attending outpatient and inpatient services of a tertiary care hospital. MetS was diagnosed using standard criteria. Anthropometric indices, blood pressure, glycaemic parameters, lipid profile, and liver function tests were recorded. Statistical analysis was performed using SPSS v21. Results: MetS was present in 39 (55.7%) patients. Smoking status showed a significant association with MetS (p=0.048). Patients with MetS had significantly higher BMI (30.5±2.6 vs. 27.8±2.4 kg/m², p<0.001), waist circumference (101.2±5.3 vs. 94.4±9.8 cm, p<0.001), hip circumference (93.1±7.2 vs. 87.6±16.9 cm, p=0.026), waist–hip ratio (1.09±0.07 vs. 0.98±0.13, p<0.001), and fasting blood sugar (150.1±64.8 vs. 119.8±42.5 mg/dL, p=0.016). No significant association was observed with age, gender, area of residence, alcohol intake, duration of diabetes, HbA1c, PPBS, or liver enzymes. Conclusion: More than half of patients with T2DM had coexisting MetS. Obesity and central adiposity were the strongest correlates. Routine screening and aggressive management of MetS components in patients with T2DM are essential to reduce cardiovascular risk

Background: Type 2 diabetes mellitus (T2DM) frequently coexists with hypertension, increasing cardiovascular risk and treatment complexity. Understanding real-world prescribing patterns and short-term outcomes supports rational pharmacotherapy and improved follow-up care.  Objectives: To describe prescription patterns of antidiabetic and antihypertensive drugs among adults with T2DM and coexisting hypertension and to evaluate follow-up changes in glycaemic control, blood pressure, adherence, and adverse drug reactions (ADRs).  Methods: A prospective observational study was conducted in a tertiary care teaching hospital from January to June 2022. A total of 100 eligible adults were enrolled. Baseline demographic and clinical characteristics, antidiabetic and antihypertensive medications, and fasting plasma glucose, HbA1c, and blood pressure were recorded. The same parameters were reassessed at follow-up. Adherence and ADRs were documented using a structured proforma and standard causality assessment. Results: The mean age was 56.4 ± 9.8 years and 58% were males. Metformin was prescribed in 82% and 62% received combination antidiabetic therapy. ACE inhibitor/ARB use was 68% and 59% received two or more antihypertensive drugs. Fasting plasma glucose decreased from 156.2 ± 28.5 to 128.4 ± 22.6 mg/dL and HbA1c from 8.2 ± 1.1% to 7.4 ± 0.9%, with 44% achieving HbA1c <7%. Blood pressure decreased to 132.8 ± 10.6/84.3 ± 7.2 mmHg and 52% achieved <140/90. Satisfactory adherence was 74%. Any ADR occurred in 18%, commonly hypoglycaemia (8%) and metformin-related gastrointestinal intolerance (6%).  Conclusion: Metformin-based regimens and ACE inhibitor/ARB-centred antihypertensive therapy were common. Short-term follow-up demonstrated improved glycaemic and blood pressure control, with good adherence and acceptable safety in this cohort

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia due to insulin resistance and/or impaired insulin secretion. This study aimed to evaluate the association between various biochemical markers and glycemic control in T2DM patients. A cross-sectional analysis was conducted on 200 patients recruited from a tertiary care hospital. Data collection included demographic information, anthropometric measurements, and laboratory tests for fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), lipid profile, adipokines (adiponectin, leptin), inflammatory markers (CRP, IL-6), and oxidative stress markers (MDA, TAC). Results indicated significant correlations between several biochemical markers and HbA1c levels. FPG, total cholesterol, LDL-C, CRP, IL-6, and MDA were positively correlated with HbA1c, indicating poorer glycemic control. Conversely, adiponectin and TAC showed negative correlations with HbA1c, suggesting a protective role. Multiple linear regression analysis identified FPG, CRP, and adiponectin as significant independent predictors of HbA1c levels. The findings underscore the critical role of a comprehensive panel of biochemical markers in the management of T2DM. Incorporating inflammatory and oxidative stress markers into routine monitoring could enhance the precision of glycemic control strategies and improve patient outcomes. Future research should focus on longitudinal studies and intervention trials to further elucidate these associations and develop targeted therapeutic intervention

Introduction: Diabetic Retinopathy (DR) is a well-known consequence of long standing and poorly controlled Diabetes Mellitus (DM). Several studies have demonstrated both a qualitative and quantitative reduction in health related quality of life in persons with DR. But no such study has been done in the Indian population.  Aim: To study the impact of diabetic retinopathy on quality of life in Indian diabetic patients. Materials and Methods: The present study included two groups of patients with Type 1 and Type 2 diabetes. Cases included 97 patients with DR. The control group (n=26) consisted of diabetic cases with no clinically detectable DR changes. After taking informed consent, health and vision related quality of life was assessed using National Eye Institute 25-Item Visual Function Questionnaire (NEI-VFQ-25). Demographic information, social history and diabetic history were also obtained from all patients. DR was graded using the Early Treatment Diabetic Retinopathy Study (ETDRS) classification. Results: Of the 97 cases with DR, 42.3% were females. Of the 26 controls, 53.8% were females. The mean±SD age in years of the cases was 55.09±9.56 and controls were 54.12±13.01. The mean±SD of DM in years for the cases was 10.98±5.62 and for controls was 6.69±2.29. There were statistically significant (p<0.001) lower VFQ-25 composite and sub scale scores of the cases when compared with controls. As the grade of DR increased, VFQ-25 sub-scale scores decreased and this was statistically significant for composite and all sub scales (p<0.005) except ocular pain. Mann-Whitney test Z-value was highest in general health, general vision, composite score and mental health. Conclusion: Quality of life was significantly lower in diabetics with DR when compared with those without DR with maximum effect seen on general health, general vision and mental health. Quality of life decreased as the duration of retinopathy and severity of retinopathy increased.

Background: Diabetes Mellitus (DM) is a major public health concern in India, with rapidly rising prevalence due to urbanization, sedentary lifestyle, and dietary transitions. One of the most significant metabolic derangements associated with diabetes is dyslipidemia, which substantially increases the risk of cardiovascular diseases (CVD). Glycated hemoglobin (HbA1c), a marker of long-term glycemic control, has been increasingly studied for its association with lipid abnormalities. Understanding the relationship between dyslipidemia and HbA1c levels is crucial for early intervention and prevention of complications. In India, Type 2 Diabetes Mellitus (T2DM) is one of the main causes of public health issues. One of the leading causes of morbidity and mortality in diabetes mellitus is cardiovascular disease (CVD). One of the key risk factors for atherosclerosis and CVD is dyslipidaemia, a consequence of diabetes mellitus.  Aim: To evaluation of dyslipidemia with HbA1c levels in diabetes mellitus.  Materials and Methods: Between January 2019 and June 2019, 110 diabetic individuals who were not using any lipid-lowering medication participated in the trial. Fasting blood sugar, glycated haemoglobin, total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were just a few of the variables examined. AIP, or atherogenic index of plasma, was developed.  Result: 85.5% of total diabetic patients were detected to have dyslipidaemia. Most common type was isolated single parameter dyslipidaemia with low HDL (39.1%). Mixed dyslipidaemia was found in 7.3% diabetic patients. Individuals with poor glycaemic control (HbA1c≥ 7) were shown to have higher total and LDL cholesterol levels than patients with good glycaemic control (HbA1c <7) (p value<0.05). AIP > 0.24 indicated that 82.7% of all diabetic individuals were at high risk for CVD.  Conclusion: Patients with type 2 diabetes mellitus were reported to have a high frequency of dyslipidaemia. Isolated single parameter dyslipidaemia with low HDL was the most prevalent form. According to AIP, the majority of patients were discovered to be at high risk for CVD.