Association of blood groups/Rh and diabetes mellitus in Karachi city, Pakistan

Abstract The main purpose of this study was to find out a possible association between ABO blood groups or Rh and diabetes mellitus (DM) in the local population of eight (8) different towns of Karachi, Pakistan. For this purpose a survey was carried out in Karachi to have a practical observation of these towns during the period of 9 months from June 2019 to Feb. 2020. Out of eighteen (18) towns of Karachi, samples (N= 584) were collected from only eight (8) Towns of Karachi and gave a code-number to each town. Diabetic group sample was (n1=432) & pre-diabetes sample was (n2 =152). A standard Abbot Company Glucometer for Random Blood Sugar (RBS) and Fasting Blood Sugar (FBS) tests, standard blood anti sera were used for ABO/Rh blood type. Health assessment techniques were performed ethically by taking informed consent from all registered subjects. Finally data was analyzed by SPSS version 20.0. In our current study, the comparison of ABO blood groups frequencies between diabetic and pre-diabetic individuals were carried out. The percentage values of blood Group-B as given as: (32% in DM vs. 31% in pre-diabetics), followed by blood Group-O as: (18% in DM vs. 11% in pre-diabetics). Contrary to Group-B & O, blood Group-A and Group-AB were distribution percentage higher pre-diabetic as compared to DM patients, as given as: Group-A (32% in pre-diabetics vs. 26% in DM) & Group-AB (26% in pre-diabetics vs. 24% in diabetics patients). In addition, percentage distribution of Rh system was also calculated, in which Rh+ve Group was high and more common in DM patients as compared to pre-diabetics; numerically given as: Rh+ve Group (80% in DM vs. 72% in pre-diabetics). Different views and dimensions of the research topic were studied through literature support, some have found no any association and some established a positive association still some were not clear in making a solid conclusion. It is concluded that DM has a positive correlation with ABO blood groups, and people with Group-B have increased susceptibility to DM disease.

Resumo O objetivo principal deste estudo foi descobrir uma possível associação entre grupos sanguíneos ABO ou Rh e diabetes mellitus (DM) na população local de oito (8) diferentes cidades de Karachi, Paquistão. Para tanto, foi realizado um levantamento em Karachi para observação prática dessas cidades durante o período de 9 meses de junho de 2019 a fevereiro de 2020.De dezoito (18) cidades de Karachi, as amostras (N = 584) foram coletadas de apenas oito (8) cidades de Karachi e deram um número-código para cada cidade. A amostra do grupo de diabéticos foi (n1 = 432) e a amostra de pré-diabetes foi (n2 = 152). Um glicômetro padrão da Abbot Company para testes de açúcar no sangue aleatório (RBS) e açúcar no sangue em jejum (FBS), antissoros de sangue padrão foram usados para o tipo de sangue ABO / Rh. As técnicas de avaliação de saúde foram realizadas de forma ética, tomando o consentimento informado de todos os indivíduos registrados. Finalmente, os dados foram analisados pelo SPSS versão 20.0.No presente estudo, foi realizada a comparação das frequências dos grupos sanguíneos ABO entre diabéticos e pré-diabéticos. Os valores percentuais do sangue do Grupo-B são dados como: (32% em DM vs. 31% em pré-diabéticos), seguido pelo sangue do Grupo-O como: (18% em DM vs. 11% em pré-diabéticos). Ao contrário dos Grupos B e O, sangue do Grupo-A e Grupo-AB tiveram distribuição percentual maior de pré-diabéticos em comparação com pacientes com DM, dado como: Grupo-A (32% em pré-diabéticos vs. 26% em DM) e Grupo AB (26% em pré-diabéticos vs. 24% em pacientes diabéticos). Além disso, também foi calculada a distribuição percentual do sistema Rh, no qual o Grupo Rh + ve foi elevado e mais comum em pacientes com DM em comparação aos pré-diabéticos; dados numericamente como: Grupo Rh + ve (80% em DM vs. 72% em pré-diabéticos). Diferentes visões e dimensões do tema de pesquisa foram estudadas com o suporte da literatura, alguns não encontraram nenhuma associação e alguns estabeleceram uma associação positiva, embora alguns não estivessem claros em fazer uma conclusão sólida. Conclui-se que o DM tem correlação positiva com os grupos sanguíneos ABO, e as pessoas com o Grupo B têm maior suscetibilidade à doença DM.

Association of blood groups/Rh and diabetes mellitus in Karachi city, Pakistan / Associação de grupos sanguíneos/Rh e diabetes mellitus na cidade de Karchi, Paquistão

Abstract The main purpose of this study was to find out a possible association between ABO blood groups or Rh and diabetes mellitus (DM) in the local population of eight (8) different towns of Karachi, Pakistan. For this purpose a survey was carried out in Karachi to have a practical observation of these towns during the period of 9 months from June 2019 to Feb. 2020. Out of eighteen (18) towns of Karachi, samples (N= 584) were collected from only eight (8) Towns of Karachi and gave a code-number to each town. Diabetic group sample was (n1=432) & pre-diabetes sample was (n2 =152). A standard Abbot Company Glucometer for Random Blood Sugar (RBS) and Fasting Blood Sugar (FBS) tests, standard blood anti sera were used for ABO/Rh blood type. Health assessment techniques were performed ethically by taking informed consent from all registered subjects. Finally data was analyzed by SPSS version 20.0. In our current study, the comparison of ABO blood groups frequencies between diabetic and pre-diabetic individuals were carried out. The percentage values of blood Group-B as given as: (32% in DM vs. 31% in pre-diabetics), followed by blood Group-O as: (18% in DM vs. 11% in pre-diabetics). Contrary to Group-"B" & "O", blood Group-A and Group-AB were distribution percentage higher pre-diabetic as compared to DM patients, as given as: Group-A (32% in pre-diabetics vs. 26% in DM) & Group-AB (26% in pre-diabetics vs. 24% in diabetic's patients). In addition, percentage distribution of Rh system was also calculated, in which Rh+ve Group was high and more common in DM patients as compared to pre-diabetics; numerically given as: Rh+ve Group (80% in DM vs. 72% in pre-diabetics). Different views and dimensions of the research topic were studied through literature support, some have found no any association and some established a positive association still some were not clear in making a solid conclusion. It is concluded that DM has a positive correlation with ABO blood groups, and people with Group-B have increased susceptibility to DM disease.

Resumo O objetivo principal deste estudo foi descobrir uma possível associação entre grupos sanguíneos ABO ou Rh e diabetes mellitus (DM) na população local de oito (8) diferentes cidades de Karachi, Paquistão. Para tanto, foi realizado um levantamento em Karachi para observação prática dessas cidades durante o período de 9 meses de junho de 2019 a fevereiro de 2020.De dezoito (18) cidades de Karachi, as amostras (N = 584) foram coletadas de apenas oito (8) cidades de Karachi e deram um número-código para cada cidade. A amostra do grupo de diabéticos foi (n1 = 432) e a amostra de pré-diabetes foi (n2 = 152). Um glicômetro padrão da Abbot Company para testes de açúcar no sangue aleatório (RBS) e açúcar no sangue em jejum (FBS), antissoros de sangue padrão foram usados ​​para o tipo de sangue ABO / Rh. As técnicas de avaliação de saúde foram realizadas de forma ética, tomando o consentimento informado de todos os indivíduos registrados. Finalmente, os dados foram analisados ​​pelo SPSS versão 20.0.No presente estudo, foi realizada a comparação das frequências dos grupos sanguíneos ABO entre diabéticos e pré-diabéticos. Os valores percentuais do sangue do Grupo-B são dados como: (32% em DM vs. 31% em pré-diabéticos), seguido pelo sangue do Grupo-O como: (18% em DM vs. 11% em pré-diabéticos). Ao contrário dos Grupos "B" e "O", sangue do Grupo-A e Grupo-AB tiveram distribuição percentual maior de pré-diabéticos em comparação com pacientes com DM, dado como: Grupo-A (32% em pré-diabéticos vs. 26% em DM) e Grupo AB (26% em pré-diabéticos vs. 24% em pacientes diabéticos). Além disso, também foi calculada a distribuição percentual do sistema Rh, no qual o Grupo Rh + ve foi elevado e mais comum em pacientes com DM em comparação aos pré-diabéticos; dados numericamente como: Grupo Rh + ve (80% em DM vs. 72% em pré-diabéticos). Diferentes visões e dimensões do tema de pesquisa foram estudadas com o suporte da literatura, alguns não encontraram nenhuma associação e alguns estabeleceram uma associação positiva, embora alguns não estivessem claros em fazer uma conclusão sólida. Conclui-se que o DM tem correlação positiva com os grupos sanguíneos ABO, e as pessoas com o Grupo B têm maior suscetibilidade à doença DM.

Effectiveness of yoga practice on the glycemic status and body mass index in pre-diabetic individuals

Background: Yoga is a healthy lifestyle intervention practice that has claimed beneficial effect in the management of several metabolic syndromes including diabetes mellitus. It has favorable effect on maintaining blood pressure and insulin resistance in pre-diabetic individual. Aim and Objectives: The aim of the study was to assess the effect of yoga practice on the blood glucose levels and body mass index (BMI) in pre-diabetic individuals. Materials and Methods: Cases attending outpatient department of between age group 21–55 years under pre-diabetic category (n = 128) based on laboratory investigations and BMI were recruited. Participants were divided in to two groups, that is, group 1 (Pre-diabetics with yoga practice) and Group 2 (Pre-diabetics without yoga practice). Participants of Group 1 were advised to attend the yoga sessions for 180 days and blood glucose levels and BMI was assessed. Results: In Group 1, the mean blood glucose level was gradually decreased from the beginning (121.57 mg/dl in Group 1 and 121.98 mg/dl in Group 2) to end of 180 days (89.32 mg/dl in Group 1% 105.65 mg/dl in Group 2). The mean BMI was significantly decreased from the beginning (27.63 in Group 1 and 27.24 in Group 2) to the end of 180 days (21.33 in Group 1 and 24.26 in Group 2) in both study groups. The mean difference of glucose levels and BMI among both study groups was statistically significant (P < 0.05). Conclusion: Yoga practice was significantly reduced the BMI and blood glucose in pre-diabetic participants. However, the rate of decline in the levels of blood glucose and BMI was high in pre-diabetics under yoga practice. Continuous yoga adherence and healthy lifestyle practices can improve.

Relationship of diabetes and prediabetes with lipid ratios in Changzhou Residents of Jiangsu Province / 上海预防医学

ObjectiveTo investigate the association of lipid ratios with diabetes and pre-diabetes in residents aged 35-75 years in Changzhou City. MethodsA multistage whole-group random sampling method was used to survey permanent residents aged 35-75 years in Tianning and Wujin districts of Changzhou City， and the study data were obtained by questionnaires， physical examination and laboratory tests. The relationship between lipid ratios and diabetes and pre-diabetes was analyzed by dichotomous logistic regression method. ResultsThe prevalence of diabetes in the surveyed population in Changzhou was 18.69%， and the prevalence of pre-diabetes was 10.53%. In the total population， the risk of pre-diabetes was significantly increased in the highest TC/HDL-C， TG/HDL-C and LDL-C/HDL-C groups， by 68%， 93% and 38%， respectively； the risk of diabetes was also significantly increased in the highest TC/HDL-C， TG/HDL-C and LDL-C/HDL-C groups， by 105%， 149% and 78%， respectively. The risk of diabetes was also significantly increased in the highest TC/HDL-C， TG/HDL-C and LDL-C/HDL-C groups， by 105%， 149% and 78%， respectively. All three lipid ratios increased in women compared to men， leading to a stronger association with increased risk of diabetes and pre-diabetes. ConclusionLipid ratios TC/HDL-C， TG/HDL-C， and LDL-C/HDL-C were correlated with the risk of diabetes and pre-diabetes in people aged 35-75 years， with TG/HDL-C having the strongest association with diabetes and pre-diabetes， and is expected to be a key predictor for assessing the development of diabetes.

Evaluación del consumo de macronutrientes y micronutrientes por individuos prediabéticos / Evaluation of consumption of macronutrients and micronutrients by pre-diabetic individuals

Resumen Introducción La alimentación es una importante estrategia para el control de la glucemia, así como para reducir/eliminar el riesgo del desarrollo de la diabetes. Objetivo Este artículo evaluó el consumo de macronutrientes y micronutrientes de individuos prediabéticos de Santa Cruz do Sul, RS, Brasil. Método El consumo de nutrientes se ha determinado en el programa DietWin® y la prevalencia de adecuación de los macronutrientes fue clasificada según la Sociedad Brasileña de Diabetes y la ingesta inadecuada de micronutrientes por la Dietary Reference Intake. Resultados Los prediabéticos presentaron consumo excesivo de proteínas y grasas totales (28,1% y 31,6%, respectivamente), así como de ácidos grasos saturados y colesterol (91,2% y 35,1%, respectivamente). La ingesta de fibras se presentó insuficiente en 93%. Considerando el consumo de micronutrientes, la vitamina D, el calcio y el selenio se presentaron con una insuficiencia de más del 80%. Conclusión La dieta habitual de individuos prediabéticos demuestra ser excesiva en proteínas y en grasas totales que, relacionado al consumo excesivo de ácidos grasos saturados y colesterol, puede aumentar el riesgo cardiovascular. Esto, junto a la ingestión pobre en fibras e inadecuada en algunos micronutrientes, tales como vitamina D, calcio y selenio pueden afectar el control de la glucemia de estos individuos.

Abstract: Background The diet is an important strategy for glycemic control as well as reducing/eliminating the risk of developing diabetes. Objective This article evaluated the consumption of macronutrients and micronutrients of pre-diabetic individuals from Santa Cruz do Sul, in the state of Rio Grande do Sul (RS), Brazil. Method The nutrients intake was determined in the DietWin® program and the evaluation of the prevalence of adequacy macronutrients was classified according to Guidelines of the Brazilian Society of Diabetes and the evaluation of inadequacy of the micronutrients intake by Dietary Reference Intake were used. Results The pre-diabetic individuals had excessive protein and total fat intake (28.1% and 31.6%, respectively), as well as saturated fatty acids and cholesterol (91.2% and 35.1%, respectively). The fibers intake in this population showed an inadequacy of 93.0%. Considering the micronutrients intakes, vitamin D, calcium and selenium presented an insufficiency greater than 80.0%. Conclusion The usual diet of pre-diabetic individuals showed to be excessive for proteins and total fats, which associated with excessive consumption of saturated fatty acids and cholesterol, can increase cardiovascular risk. This, coupled with inadequate consumption of some micronutrients such as vitamin D, calcium and selenium and low fiber can affect the control of glycemia in these individuals.

Association of low total testosterone levels and impaired blood glucose levels in middle aged men – A cross-sectional study

Background: Recent studies have shown that men with impaired glucose levels (pre-diabetes)/diabetes have lower serum total testosterone (TT) levels as compared to normoglycemic men. India has a high incidence and prevalence of diabetes mellitus (DM)/pre-diabetes in the middle aged population too. Most studies have researched about the serum TT levels in elderly pre-diabetic/diabetic men, but there is lack of information about such association in middle aged men. Aims and Objectives: These objectives of this study are to study the levels of serum TT in middle aged men with DM/pre-diabetes; to compare the serum TT levels in men with DM/ pre-diabetes with normoglycemic men; and to observe the correlation between fasting blood glucose (FBG) and serum TT, body mass index (BMI), and waist circumference (WC). Materials and Methods: It is a cross-sectional, observational study. The study subjects were 150 nonsmoking, nontobacco addict, and nonalcoholic men aged between 31 and 60 years. Anthropometric measurements, serum FBG levels, and serum TT were measured. Results: The pre-diabetic and diabetic men had significantly low levels of serum TT as compared to non-diabetic men. Furthermore, serum TT levels correlated negatively with WC, BMI and blood sugar levels, but significant correlation was found only in the case of WC. Conclusion: Low serum TT levels are associated with pre-diabetes as well as diabetes. Whether the association is casual or not requires prospective study.

In Hospital Mortality in Patients with Impaired Fasting Glucose and Acute Myocardial Infarction in a Tertiary Care Centre of Rural Bengal

Introduction : The Cardiovascular mortality in Diabetics is 2-4 times higher than in Non-diabetic population. But there is still controversy regarding Pre-diabetes (IFG and IGT) as a Cardiovascular Risk Factor. Aims and Objectives : In this study we aimed to investigate the early in-hospital mortality among Acute Myocardial Infarction (AMI) patients having Impaired Fasting Glucose (IFG) during the first 7 days of hospitalization. Materials and Methods: A total of 150 AMI patients were evaluated and followed up for their glycemic status and early in hospital mortality (first 7 days) at Burdwan Medical College, Burdwan, West Bengal. Result and Analysis: Mortality in patients having IFG (18%) was higher and as much as in DM (20%) compared to euglycemic (4%) patients but the mortality is not correlated with mean Fasting Plasma Glucose (FPG) level. Conclusion : IFG (ie, pre-diabetes) increases Cardiovascular mortality as much as diabetes. So, IFG may be a marker or risk factor for mortality but lowering FPG in AMI patients is unlikely to yield beneficial effect regarding mortality.

Presentation and character for adult patients with diabetes in Libya

Diabetes is a global issue, the diabetes epidemic is expected to continue, and the burden of diabetes causes catastrophic expenditure for healthcare system. The current study aimed to determine the presentation, the clinical feature and cardio-vascular risk factors in patients with diabetes. A retrospective observational study had been conducted in out-patients department at Almustaqpal Almosherq Centre during September, 2013 till September, 2020, the total number of attended out-patients department were 1 024, 820 patients who were selected for this study. A special perform was completed for every patient, which included details about patient's demographics, points in clinical history, relevant investigations and clinical examinations were recorded. The study reported that out of 820 patients, 66% (n = 538) was female and their age range was between 14 - 87 years with a mean age of 56.53 ± 13.49 years, 96% (n = 791) were clinically diagnosed as type II diabetes, 07% of the patients were diagnosed as pre-diabetes, the duration of diabetes ranged from newly diagnosed to more than 10 years, with 46% (n = 379) of the studied population were more than 10 years diabetes duration, 70% (581) were presented with classical symptoms of diabetes. Initial treatment for diabetes also different in the studied sample, were absent of anti-diabetic medications in 30% (n = 248) of the patients, they refused to start glucose lowering drugs, 34.6% (n = 284) of them have morbid obesity (body mass index is more than 40), 80% (n = 662) have high HBA1c (more than 8 g%), 40.3% (n = 240/596) were uncontrolled hypertension on anti-hypertension drugs, 95.6% (n = 682/713) were controlled on treatment of lipid lowering drugs. This study showing the presentation of diabetes were the common, type II diabetes, at age group between 41 - 66 years about 65%, female sex, with high body mass index, high glycated hemglobulin and uncontrolled hypertension. There is concern that diabetic patients were occurring at a high frequency in younger adults, where longer duration of illness could increase the risk of developing more complications in later life. The rate of coexist cardiovascular risk factors (hypertension, dyslipidaemia and obesity) in Libyan patients with diabetes is highlighted.

Effects of different types of exercise on type 2 diabetes risk in patients with pre-diabetes: One 2-year prospective randomized controlled study / 中华内分泌代谢杂志

Objective:To evaluate the impacts of resistance training(RT)and aerobic training(AT)for 24 months on the risk of type 2 diabetes in patients with pre-diabetes.Methods:Two hundred forty-eight pre-diabetic patients were enrolled in this multi-center randomized controlled trial. All patients were randomly divided into 3 groups: RT( n=82), AT( n=83), and control( n=83)groups. The participants in RT and AT groups undertook moderate RT or AT 3 times a week(150 minutes/week)under supervision in 3 research centers for 24 months. Elastic bands were used in each session of RT, with intensity of 60% 1RM(maximum weight that muscle can lift at once). Patients in AT group performed aerobic dance at 60%-70% of maximum heart rate. Assessments for each subject were made at baseline and by the end of 6, 12 and 24 months. Primary outcomes were changes in the risk of type 2 diabetes. Secondary outcomes included changes in blood glucose, blood lipids, and blood pressure. Results:There were 217, 206, and 173 subjects who completed the follow-up of 6, 12, and 24 months, respectively. The mean ages of RT, AT, and control groups at baseline were(59.91±5.92), (60.93±5.71), and(60.73±5.83)years. Compared to control group, both RT and AT groups revealed a significant reduction in HbA 1C( P<0.05), and a significant increase in homeostasis model assessment for β-cell function index(HOMA2-β, P<0.01)by the end of 12 and 24 months. Adjusted for age, gender, statin use, lipid profile, blood pressure, and body mass index, COX regression analysis showed that RT and AT reduced the risk of type 2 diabetes by 55.6%( P=0.012)and 59.8%( P=0.010). Conclusions:This study demonstrates that 24-month moderate RT and AT have comparable effects on reducing insulin resistance, improving β-cell function, blood glucose and lipid, and reducing the risk of type 2 diabetes.

Efecto de tres tipos de entrenamientos sobre indicadores bioquímicos y antropométricos en personas con prediabetes: una revisión sistemática / Effect of three types of training on biochemical and anthropometric parameters in prediabetes: a systematic review

Resumen La prediabetes es un trastorno metabólico que, si no se atiende, puede avanzar progresivamente hacia una diabetes tipo 2. Para poder revertir este proceso, el tratamiento es multidisciplinario e incluye mejora en el estilo de vida, alimentación y ejercicio. El objetivo de esta revisión sistemática fue indagar acerca de cuál es la mejor alternativa de ejercicio para la remisión de la prediabetes. Se comparó entre el entrenamiento aeróbico continuo (EAC), entrenamiento contra resistencia (ER) y entrenamiento por intervalos de alta intensidad (HIIT, por sus siglas en inglés). La búsqueda se realizó en Web of Science, PubMed, Scopus y SportDiscus, en mayo de 2019, para estudios experimentales y pre-experimentales en sujetos con prediabetes que realizaran alguno de estos tres entrenamientos de forma crónica y midieran parámetros bioquímicos y/o antropométricos relacionados con la condición de prediabetes. Se obtuvo en total 231; de los cuales, 11 cumplieron los requisitos de inclusión. Los resultados arrojados indican que EAC, ER y HIIT mejoran los indicadores de prediabetes bioquímicos y antropométricos en estudios de 13 días a 16 semanas con frecuencias de 2 a 5 veces por semana. Algunas investigaciones no encontraron resultados significativos. Además, hay gran diversidad de metodologías utilizadas que pudieron haber causado sesgos en las mediciones. Se recomienda, para futuros estudios, el uso de la hemoglobina glicosilada (HbA1c) en intervenciones de al menos 12 semanas para disminuir el sesgo.

Abstract Prediabetes is a metabolic condition that, if untreated, can progressively develop into type 2 diabetes. To reverse the process, a multidisciplinary treatment is required including lifestyle improvement, a healthy diet and exercise. The aim of this systematic review was to study the best exercise alternatives for prediabetes remission. Continuous Aerobic Training (CAT), Resistance Training (RT), and High Intensity Interval Training (HIIT) were compared. The search was conducted in Web of Science, PubMed, Scopus, and SportDiscus in May 2019 and included experimental and pre-experimental studies with prediabetic participants having any of the aforementioned types of training and using anthropometric and/or biochemical outcomes. A total of 231 records were obtained, from which 11 met the inclusion criteria. Results showed that CAT, RT, and HIIT improved in metabolic and anthropometric prediabetic indicators in trials from 13 days to 16 weeks with a frequency of 2 to 5 times/week. Some of the studies did not find any significant differences. In addition, the vast diversity of methodologies implemented could have caused bias. Glycosylated hemoglobin (HbA1c) is recommended for future trials with a minimum of a 12-week intervention to reduce the risk of bias.

Resumo A pré-diabetes é um transtorno metabólico que, se não for tratada, pode avançar progressivamente até o desenvolvimento de uma diabetes tipo 2. Para poder reverter o processo, o tratamento é multidisciplinar e inclui melhora no estilo de vida, na alimentação e no exercício. Esta revisão sistemática teve como objetivo indagar sobre qual é a melhor alternativa de exercício para a remissão da pré-diabetes. Houve uma comparação entre o treinamento aeróbico contínuo (TAC), treinamento contrarresistência (TR) e treinamento por intervalos de alta intensidade (HIIT, por suas siglas em inglês). A busca foi realizada na Web of Science, PubMed, Scopus e SportDiscus em maio de 2019 para estudos experimentais e pré-experimentais em indivíduos com pré-diabetes que realizaram um dos três treinamentos repetidamente e mediram parâmetros bioquímicos e/ou antropométricos relacionados com a condição de pré-diabetes. Foram obtidos no total 231; dentre os quais, 11 atenderam às exigências de inclusão. Os resultados indicam que EAC, ER e HIIT melhoram os indicadores de pré-diabetes bioquímicos e antropométricos em estudos de 13 dias a 16 semanas com frequências de 2 a 5 vezes por semana. Algumas pesquisas não encontraram resultados significativos. Além disso, há grande diversidade de metodologias utilizadas que podem ter causado distorções nas medições. Recomenda-se, para futuros estudos, o uso da hemoglobina glicada (HbA1c) em intervenções de pelo menos 12 semanas para diminuir as distorções.

Identification And Assessment Of Prediabetes-A Rural Indian Study (A Correlative Study Between Questionnaire And Biochemical Analysis)

Objective: To identify and prevent the vulnerable prediabetic population becoming diabetic patients in the future using the Indian Diabetic Risk Score (IDRS) and to evaluate the performance of the IDRS questionnaire for detecting prediabetes and predicting the risk of Type 2 Diabetes Mellitus in Chidambaram rural Indian population. Methods: A cross-sectional descriptive study was carried out among patients attending a master health check-up of RMMCH hospital located at Chidambaram. The IDRS was calculated by using four simple measures of age, family history of diabetes, physical activity, and waist measurement. The relevant blood test, like Fasting plasma glucose (FBS), Glycated hemoglobin (HbA1C) test, were observed for identifying prediabetes. Subjects were classified as Normoglycemic, prediabetics, and diabetics based on the questionnaire and diagnostic criteria of the Indian Council of Medical Research (ICMR) guidelines. Results: In the study, sensitivity and specificity of IDRS score were found to be 84.21% and 63.4% respectively for detecting prediabetes in community with the positive predictive value of 51.6% and negative predictive value of 89.6% and prevalence of prediabetes in the Chidambaram rural population is 31.6% among the 60 participants. Conclusion: The Indian diabetic risk score questionnaire designed by Ma­dras diabetic research federation is a useful screening tool to identify unknown type 2 diabetes mellitus. The question­naire is a reliable, valuable, and easy to use screening tool which can be used in a primary care setup.

Study of Glycosylated Haemoglobin (Hba1c) Levels in Non-Diabetic Patients with Hypothyroidism

Introduction: HbA1c used for the assessment of glycemicstatus of the diabetic patients is widely recommended for itsuse for diagnosing diabetes. A positive association betweenthyroid disorder and diabetes mellitus is well recognizedbut to study the effect of thyroid disorders on glucosemetabolism in non diabetic patients is an area for extensiveresearch. Objective of the study was to study the glycosylatedhaemoglobin (HbA1c) levels in Non diabetic patients withhypothyroidism.Material and methods: Patients attending teaching hospitalsattached to BMCRI who fulfilled the inclusion criteria weretaken into study during the period from November 2017-May2019. It was a cross sectional study. Descriptive statistics likemean, standard deviation were calculated. Inferential statisticslike Mann-whitney test was used to compare the parametersbetween two groups.Results: During the period of study, 130 patients were studiedof these, 65 were cases who were non diabetic patients withhypothyroidism, 65 controls who were non diabetic euthyroidpatients. Among 65 cases 5 patients had normal HbA1C levels(7.7%) and 60 patients had increased HbA1C levels (Prediabetes) (92.3%), among 65 controls 56 patients had normalHbA1C levels (86.2%) and 9 patients had increased HbA1Clevels (13.8%).Conclusion: From the results of the present study it can beconcluded HbA1c levels were significantly higher in nondiabetic patients with hypothyroidism when compared tonon diabetic patients with normal thyroid function (meanHbA1C levels were 5.87± 0.23 vs 5.42 ± 0.24) (P <0.0001)which was statistically significant. Therefore it is suggestedthat the effects of the hypothyroidism on the HbA1c must beconsidered when interpreting the HbA1c for the diagnosis ofprediabetes.

Screening for diabetes mellitus among the rural population applying Indian diabetes risk score in field practice areas of Kamineni Academy of Medical Sciences and Research Centre

Background: Globally an estimated 422 million adults are living with Diabetes as per WHO data 2014, and 85 to 90% cases are type 2 diabetes. Maximum number of people with diabetes mellitus are in the age group of 40 to 59 yrs. Among them 50% are undiagnosed. Sedentary lifestyle, diet, dietary fiber, mal-nutrition, some chemical agents, stress, alcohol, viral infections, etc., are some environmental risk factors.Methods: A cross sectional, community based study. Details of the study subjects were recorded using structured predesigned and pretested questionnaire. All the data collected was entered and analyzed with MS Excel software 2007 and Epi info 3.5.3. All tests were considered significant at p <0.05 level.Results: In our study, majority of population participated in the screening camp are between 30 to 35 years of age, Female (53.2%) participants were more. We found that 38 (24.1%) persons were found to be in pre-diabetic stage, 57 (37.3%) are having high risk of getting diabetes.Conclusions: There is significant relationship between smoking, alcohol consumption and sedentary lifestyle (p<0.05) to the risk of diabetes as per Indian diabetes risk score.

The Chinese patent medicine, Jin-tang-ning, ameliorates hyperglycemia through improving β cell function in pre-diabetic KKAy mice / 中国天然药物

Jin-tang-ning (JTN), a Chinese patent medicine, mainly comprised of Bombyx moriL., has been proved to show α-glucosidase inhibitory efficacy and clinically effective for the treatment of type 2 diabetes (T2DM). Recently, we have reported that JTN could ameliorate postprandial hyperglycemia and improved β cell function in monosodium glutamate (MSG)-induced obese mice, suggesting that JTN might play a potential role in preventing the conversion of impaired glucose tolerance (IGT) to T2DM. In this study, we evaluated the effect of JTN on the progression of T2DM in the pre-diabetic KKAy mice. During the 10 weeks of treatment, blood biochemical analysis and oral glucose tolerance tests were performed to evaluate glucose and lipid profiles. The β cell function was quantified using hyperglycemic clamp at the end of the study. JTN-treated groups exhibited slowly raised fasting and postprandial blood glucose levels, and also ameliorated lipid profile. JTN improved glucose intolerance after 8 weeks of treatment. Meanwhile, JTN restored glucose-stimulated first-phase of insulin secretion and induced higher maximum insulin levels in the hyperglycemic clamp. Thus, to investigate the underlying mechanisms of JTN in protecting β cell function, the morphologic changes of the pancreatic islets were observed by optical microscope and immunofluorescence of hormones (insulin and glucagon). Pancreatic protein expression levels of key factors involving in insulin secretion-related pathway and ER stress were also detected by Western blot. Pre-diabetic KKAy mice exhibited a compensatory augment in β cell mass and abnormal α cell distribution. Long-term treatment of JTN recovered islet morphology accompanied by reducing α cell area in KKAy mice. JTN upregulated expression levels of glucokinase (GCK), pyruvate carboxylase (PCB) and pancreas duodenum homeobox-1 (PDX-1), while down-regulating C/EBP homologous protein (Chop) expression in pancreas of the hyperglycemic clamp, which indicated the improvement of mitochondrial metabolism and relief of endoplasmic reticulum (ER) stress of β cells after JTN treatment. These results will provide a new insight into exploring a novel strategy of JTN for protecting β cell function and preventing the onset of pre-diabetes to T2DM.

Valor de corte del índice cintura/cadera como predictor independiente de disglucemias / Cutoff value of the waist-hip ratio as an independent predictor of dysglycemia

RESUMEN Introducción: En Cuba, no existe consenso acerca de qué valor del índice cintura/cadera debe ser considerado de riesgo para identificar disglucemias. Objetivos: Determinar el punto de corte del índice cintura/cadera como predictor de disglucemias para ambos sexos, en personas con sospecha de padecer diabetes mellitus. Métodos: Estudio descriptivo transversal con 975 personas, de ellas 523 mujeres y 452 hombres. La muestra no fue obtenida de población general y no fue aleatoria. A los sujetos se les realizó interrogatorio, examen físico y estudios complementarios. Se determinaron distribuciones de frecuencia de las variables cualitativas y cuantitativas. Se utilizó para el procesamiento estadístico el coeficiente de correlación de Pearson, análisis de regresión logística y el análisis de curvas Receiver Operator Characteristic. Se empleó la prueba Chi Cuadrado para evaluar la significación estadística. Resultados: En ambos sexos observamos una correlación directamente proporcional y significativa entre el índice cintura/cadera y las diferentes variables estudiadas, entre ellas: glucemia en ayunas y a las 2h, insulinemia en ayunas, triglicéridos, ácido úrico y el índice de resistencia a la insulina (HOMA-IR). El colesterol se comportó de la misma forma en los hombres, pero en las mujeres se verificó una correlación débil y no significativa. El punto de corte óptimo del índice cintura/cadera, como predictor independiente de disglucemias, fue de 0,85 en las mujeres y 0,93 en los hombres. El índice cintura/cadera presentó un buen poder predictivo para identificar a sujetos con y sin disglucemias para ambos sexos y superior al de la edad. Conclusiones: El punto de corte óptimo del índice cintura/cadera, como predictor independiente de disglucemias, es de 0,85 en las mujeres y 0,93 en los hombres. Su poder predictor de disglucemias fue bueno(AU)

ABSTRACT Introduction: In Cuba, there is no consensus about what value of the waist-hip ratio must be considered as a risk to identify dysglycemia. Objectives: To determine the cut-off point of the waist-hip ratio as a predictor of dysglycemias for both sexes, in people suspected of suffering from diabetes mellitus. Methods: Descriptive cross-sectional study with 975 people, including 523 women and 452 men. The sample was not obtained from general population and it was not random. The subjects underwent interrogation, physical examination and complementary studies. There were identified frequency distributions of qualitative and quantitative variables. It was used for the statistical processing the Pearson's correlation coefficient, logistic regression analysis and the curves analysis called Receiver Operator Characteristic. It was used the chi-square test to assess the statistical significance. Results: In both sexes, it was observed a directly proportional and significant correlation between the waist-hip ratio and the different variables studied, including: fasting and after 2 hours glycemia, fasting insulinemia, triglycerides, uric acid and the insulin resistance index (HOMA-IR). Cholesterol behaved the same way in men, but in women there was a weak and not significant correlation. The optimal cut-point of the waist-hip ratio, as an independent predictor of dysglycemia, was 0.85 in women and 0.93 in men. The waist-hip ratio presented a good predictive power to identify subjects with and without dysglycemia for both sexes and it was higher than that of the age. Conclusions: The optimal cut-point of the waist-hip ratio, as an independent predictor of dysglycemia, was 0.85 in women and 0.93 in men. Its power as predictor of dysglycemia was good(AU)

A Study of Changes in Lipid Profile among Pre-diabetics and Diabetics in Population of Lucknow

Introduction: Cardio vascular disease (CVD) is the leadingcause of mortality and morbidity in diabetes mellitus (DM)contributing to 65% of all deaths with diabetic complications.Detection of the deranged lipid profile in the pre-diabeticstate has been shown to be associated with increased risk ofatherosclerosis. This study was planned to compare changesin lipid profiles of patients with pre-diabetes and diabetes inpopulation of Lucknow, India.Material and Methods: A total of 236 cases (115 Pre-diabeticand 121 Diabetic) who fulfilled the inclusion and exclusioncriteria of this study were enrolled. The patients were evaluatedfor serum fasting blood sugar (FBS), post prandial blood sugar(PPBS), HbA1c, total cholesterol (TC), triglycerides (TGs), inthe two groups. The results were statistically analysed usingSPSS statistical package version 20.Results: The mean value of total cholesterol were179.21±8.12mg/dl in pre-diabetics and 182.31±7.99mg/dl indiabetics, which was statistically not significant (p=0.003).The mean value of triglyceride in pre-diabetics was134.43±5.21mg/dl and in diabetics 167.87±7.37mg/dl whichis statistically significant (p<0.001).Conclusion: The altered lipid profile in pre-diabetics signifiesan increased susceptibility to CVD in the long run. Therefore,screening of pre-diabetics for dyslipidemia is recommendedto arrest the development of cardiovascular complications.

A study on the lipid ratios and inflammatory markers in pre-diabetic and diabetic patients

Background: One of the leading causes of diabetic mortality is cardiovascular disease. Diabetes progression is preceded by pre-diabetic phase which is also at higher cardiovascular risk. Both hyperglycemia and atherosclerotic processes are inflammatory phenomenon. Keeping this in view, it was aimed to evaluate atherogenic indices and correlate them with inflammatory mediators.Methods: This study included 80 controls, 80 pre-diabetic and 80 diabetic patients. Anthropometric parameters (BMI, WHR) and blood parameters like fasting glucose, HbA1c, lipid profile (cholesterol, HDL, LDL TG, VLDL), adiponectin, IL-6, CRP, fibrinogen and uric acid were analysed.Results: Significantly high atherogenic indices were observed in pre-diabetic and diabetic subjects compared to healthy controls. The indices were also significantly correlated with BMI, fasting sugar, HbA1c, cholesterol, HDL, TG and LDL. The correlation with HDL was negative and with other parameters, the correlation was positive. In pre-diabetic patients, adiponectin showed significant negative correlation while fibrinogen and CRP showed significant positive correlation with cardiac risk indices. IL-6 was positively correlated only with AIP while correlation of uric acid with these indices was insignificant. In case of diabetic patients, the cardiac risk indices were significantly correlated with adiponectin, IL-6, CRP, fibrinogen and uric acid. The correlation with adiponectin was negative.Conclusions: The altered atherogenic indices and their significant association with inflammatory markers signify the direct association of inflammation with CVD risks. Thus, there is requirement of novel approaches that can retard inflammatory responses and arrest unwanted cardiac health outcomes.

Prevalence of impaired glucose tolerance in different grades of obesity

Background: Surgical Background: Impaired glucose tolerance is known precursor of type-2 diabetes mellitus and more prevalent in obese people, different studies have varied results and true prevalence is still debatable. Aims of this study to investigate the prevalence of IGT in different grades of obesity.Methods: Authors have studied100 patients with obesity Grade1 (BMI >25 kg/m2 but <30) and Grade2 (BMI >30 kg/m2) at Gandhi Medical College, Bhopal during April to June 2019. Complete physical examination and blood tests including fasting blood glucose and oral glucose tolerance test (OGTT) were done.Results: Results shows that 16% male and 14% female subjects had IGT. Male of age more than 60yrs and female aged between 51 to 60 were more pre-diabetic. Males having weight 71 to 80 kg and female of 51-60 kg were more pre-diabetic. Subjects with grade 1 obesity, 6.12% male and 5.88% female had IGT. Similarly, in grade 2-obese subjects 10.20% males and 7.84% females had IGT.Conclusion: IGT is more prevalent in grade-1 and grade-2 obese population and a strong indicator of diabetes.

Inflammatory Markers in Pre-diabetes and Diabetes: A Comparative Study

Diabetes is a metabolic disorder associated with chronic inflammation. It is preceded by pre-diabetic phase that is also influenced with the inflammatory mechanisms which finally culminate into diabetes and its associated complications. Thus the main objective of this study was to assess the level of inflammatory mediators in pre-diabetic and diabetic patients. Methods: This case control study was conducted with 100 controls, 145 pre-diabetic patients and 126 diabetic patients in Santosh medical College and Hospital, Ghaziabad. Serum routine parameters like fasting glucose, HbA1c, lipid and inflammatory mediators like adiponectin, fibrinogen, IL-6, CRP and uric acid were estimated using kit based methods. Results: We observed significantly low adiponectin and significantly high CRP, IL-6, fibrinogen and uric acid in pre-diabetic and diabetic patients compared to controls. The level showed gradual decrease from control-prediabetic-diabetic groups in case of adiponectin while the trend was increasing in case of CRP, IL-6, fibrinogen and uric acid. We also found significant negative correlation of adiponectin with CRP, IL-6, fibrinogen and uric acid in both the patient groups but the correlation with uric acid in pre-diabetic patients was insignificant. Conclusion: These results reveal the involvement of inflammatory mechanisms in progression from normoglycemia to impaired fasting glucose and finally to hyperglycemia. Therefore the development of mechanisms that aid in reducing pro-inflammatory and alleviating ntiinflammatory mediators may be fruitful in reducing diabetes risks.

To Determine the Usefulness of ADA Risk Score to Predict T2dm/Pre Diabetes in South Indian Rural Population

Introduction: Diabetes mellitus – so called “epidemic diseaseof the century” has become a serious public health issue. Ourstudy was aimed to determine the effectiveness of ADA riskscoring in the south Indian rural population in predicting prediabetic and diabetic among the study population.Material and methods: This was an observational study todetermine the the effectiveness of ADA risk scoring in southIndian rural population in predicting pre diabetic and diabeticamong study population. In the present study of selectedsubjects were assessed for ADA scoring and HbA1c was done.Results: In the present study, the mean HbA1C of patientwith score less than 5 was 4.7 ± 0.1, mean HbA1C of patientwith score more than or equal to 5 was 6.07 ± 0.02.which wassignificant with a P value of <0.01.Conclusion: In our study we conclude that ADA risk scoringis a good indicator for identifying pre diabetes and type 2diabetes mellitus in our population.