ABSTRACT
Metformin is considered as gold standard anti-diabetic drug and is the preferred initial pharmacologic agent for most of the patients with type 2 diabetes mellitus. Metformin is cheap, widely available and safe, backed by pharmaco-epidemiological evidence of more than 60 years regular use in clinical practice. Due to its durable efficacy, once initiated, metformin will be continued as long as it is tolerated and not contraindicated. It has got additional benefits on cholesterol, liver, cardio vascular system and cancer. Recent evidence and recall of metformin extended release formulation due to detection of excess amount of cancer-causing nitrosamine impurities has created concern among health care providers and patients. Adherence to regulatory guidelines and use of approved technologies in manufacturing and quality control may help in solving the issue.
ABSTRACT
Background: Recent studies have shown that wrist circumference is correlated with insulin resistance, obesity and new onset diabetes. Being easy to measure, it may be useful in identifying individuals at risk for cardio- metabolic disorders.Methods: 112 consecutive subjects with new onset type 2 diabetes in the age group 18-44 years were included in the study. Socio demographic characteristics, anthropometric and biochemical measurements were carried out using standard techniques. Pearson product movement Correlation Coefficient was used to find out correlation with other measures of obesity and ROC curve to determine its cut off values.Results: Wrist circumference showed moderate positive correlation with BMI (r+0.389) and waist circumference (r+0.443). The cut off value of wrist circumference when compared with BMI in defining obesity was 16.5cm in male and 15.7 cm in female. The cut off value of wrist circumference with waist circumference in male was 16.2cm.Conclusions: Measurement of wrist circumference may supplement in assessing obesity especially when other measures of obesity like BMI or Waist circumference measurements are difficult or not feasible.