Prevalence of diabetes distress and its psychosocial determinants among Indian population with type II diabetes

Background: Diabetes distress (DD) refers to the negative emotional or affective experience resulting from the challenge of living with the demands of diabetes, regardless of the type of diabetes. In addition to the chronic treatment of diabetes, patients with type 2 diabetes mellitus (T2DM) often experience psychosocial difficulties which can go unnoticed. Hence, it is necessary to identify DD at an early stage to prevent its effect on the patients� long-term self-care and management plan. This study was conducted to assess the prevalence of DD and its psychosocial determinants among T2DM at a tertiary care centre. Methods: This was a cross sectional, observational study which included patients of either gender, who were between 18-65 years of age with T2DM for more than 3 months to 12 years. DD was assessed using the diabetes distress scale (DDS17) scale. In addition, association between the level of DD with the sociodemographic and clinical characteristics of the patients was assessed. Results: The prevalence of DD in type II diabetic patients in suburban population was found to be 17.69%. The psychosocial determinants which influence DD were found to be age, treatment modality, hypothyroidism, hypertension, and smoking. Conclusions: This study signifies the importance of identifying DD by the primary care physician which often remain unrecognized in clinical practice and to implement the interventions at early stages to improve the quality of life of diabetic patients.

Analysis on sliding helices and strands in protein structural comparisons: a case study with protein kinases.

Protein structural alignments are generally considered as 'golden standard' for the alignment at the level of amino acid residues. In this study we have compared the quality of pairwise and multiple structural alignments of about 5900 homologous proteins from 718 families of known 3-D structures. We observe shifts in the alignment of regular secondary structural elements (helices and strands) between pairwise and multiple structural alignments. The differences between pairwise and multiple structural alignments within helical and beta-strand regions often correspond to 4 and 2 residue positions respectively. Such shifts correspond approximately to "one turn" of these regular secondary structures. We have performed manual analysis explicitly on the family of protein kinases. We note shifts of one or two turns in helix-helix alignments obtained using pairwise and multiple structural alignments. Investigations on the quality of the equivalent helix-helix, strand-strand pairs in terms of their residue side-chain accessibilities have been made. Our results indicate that the quality of the pairwise alignments is comparable to that of the multiple structural alignments and, in fact, is often better. We propose that pairwise alignment of protein structures should also be used in formulation of methods for structure prediction and evolutionary analysis.

Study of inheritance of diabetes mellitus in Western Indian population by pedigree analysis.

OBJECTIVES: To study the inheritance pattern of diabetes mellitus in Western Indian population by analysing the pedigree of diabetes patients. METHODS: 3,921 individuals from 300 families were interviewed for family history in this study, out of which 770 were diabetic individuals. Statistical analysis of the data was carried out using T-test and Chi-square test. RESULTS: 37% cases of Type 1 DM and 58% cases of Type 2 DM showed family history of the disease. Of the cases showing family history for diabetes, 92% in case of Type 1 DM and 59% in case of Type 2 DM showed family history of Type 2 DM with a decrease in age of onset in the successive generations. Both the parents, when diabetic conferred equal risk of inheriting diabetes in offspring. The sex ratio of offspring suffering from diabetes was not influenced when only one of the parents was diabetic. However it was observed that the male offspring were highly susceptible when both parents were diabetic (Chi-square value=4.55 with 1 d.f.). The age of onset of diabetes did not show significant correlation with whether one or both the parents were diabetic. However, it was noteworthy that in case of familial history of diabetes there was a decrease in the age of onset in successive generations. CONCLUSION: This study suggests that family history of diabetes results in predisposition to early onset of the disease in successive generations and a cluster of genes involved in Type 2 DM may show a parental effect for predisposition to Type 1 DM in the offspring in this set of Indian population.