Macrovascular and Microvascular Complications in Newly Diagnosed Type 2 Diabetes Mellitus.

Objectives: To study the prevalence and clinical profile of microvascular and macrovascular complications in newly diagnosed type 2 diabetes mellitus patients in and around Bellary, Karnataka. Study design: The study was an observational cross-sectional study of 100 newly detected type 2 diabetics attending Dept. of Medicine (outpatient/inpatient), VIMS combined hospitals, Bellary, from October 2012 to June 2013 (9 months) who matched the inclusion criteria. Material and methods: Cases were screened for vascular complications as per ADA criteria, data tabulated and analyzed. Statistical analysis: SPSS software package was used for analysis. Statistical significance was defined as a p value <0.05. Results: The mean age of presentation was 54.05 ± 13.24 with male:female ratio of 1.6:1. The prevalence of diabetic retinopathy, nephropathy, neuropathy, cardiovascular, cerebrovascular and peripheral vascular disease was 20%, 37%, 16%, 26%, 8% and 11%, respectively; retinopathy, nephropathy and coronary artery disease screening being significant (p < 0.05). Conclusion: There was a significant correlation between prevalence of diabetes and increased waist circumference and body mass index. There was high prevalence of coronary artery disease, nephropathy and retinopathy in South Indian population at diagnosis. Screening for all cases of diabetes at diagnosis for complications is recommended.

Anton’s Syndrome and Cortical Blindness.

Introduction: Anton’s syndrome is a condition where the patient is unaware of being blind and denies the problem even when it is pointed out to him. On the contrary, in cortical blindness patient is aware of his blindness and does not deny it. In both, bilateral lesions of the occipital lobes are seen. Case presentation: We present two cases of cortical blindness, Case 1 being consistent with diagnosis of Anton’s syndrome where patient denied of her blindness. Both cases revealed bilateral occipital lobe infarcts. Conclusions: Cerebrovascular disease is the most common cause of cortical blindness. These occur as a result of successive infarctions as seen in Case 1 or from a single embolic or thrombotic occlusion as seen in Case 2. First case is Anton’s syndrome with patient denying blindness, whereas second case is cortical blindness. It is due to involvement of other cortical centers in Anton’s syndrome that patient denies blindness.