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.

Introduction The most prevalent form of the disease, type 2 Diabetes Mellitus is often asymptomatic in the early stages and it may remain undiagnosed for many years.The insulin resistance in the liver leads to failure of the hyperinsulinaemia to suppress the gluconeogenesis, which increases fasting glucose levels and decreases. glycogen storage by the liver in the postprandial phase. Increased glucose production in the liver occurs early in the course of diabetes, and it is likely in skeletal muscles after the onset of the insulin secretory abnormalities and the insulin resistance. Due to the insulin resistance in the adipose tissue and obesity, the free fatty acid (FFA) flux from the adipocytes is increased, which in turn leads to an increase in lipid [very low-density lipoprotein (VLDL) and triglycerides] synthesis in the hepatocytes. This is responsible for the dyslipidaemia which is found in type2 diabetes mellitus [elevated triglycerides, reduced HDL, and increased low-density lipoprotein (LDL) particles. Individuals with type 2 diabetes mellitus are at increased risk of developing microvascular and macrovascular complications Materials and Methods This was a cross-sectional study of newly diagnosed type 2 DM patients in the Department of Physiology, Shadan Institute of Medical Sciences Teaching Hospital & Research Centre. Demographic, clinical and laboratory data were extracted from the case notes of eligible patients and analyzed using STATA version 14. Continuous variables were presented as mean ± standard deviation (SD), or median and interquartile range (IQR) while categorical variables were as frequencies and percentages. Student t and chi-square tests were used to test for association at p < 0.05. Results The study included 160 diabetic patients to evaluate the significance of postprandial dyslipidemia. Patients were categorized based on their glycemic status, lipid profiles, and postprandial lipid levels.  Postprandial dyslipidemia, characterized by elevated triglycerides and reduced HDL-C levels, was a significant finding in this study. These abnormalities were more pronounced in patients with poor glycemic control, highlighting the importance of postprandial lipid monitoring and its potential role in managing cardiovascular risk in diabetic patients. Conclusion Postprandial dyslipidemia is prevalent among diabetic patients and is significantly associated with poor glycemic control. Monitoring postprandial lipid levels could be essential in managing cardiovascular risk in this population

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.