Association between carotid intima media thickness and metabolic syndrome

Background: Metabolic syndrome and its individual criteria pose a risk for atherosclerosis and cardiovascular disease (CVD). Carotid intima media thickness (CIMT) is a well-known marker of subclinical atherosclerosis. This study was aimed to assess CIMT in patients with metabolic syndrome.Methods: This one year cross-sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2016 to December 2016. A total of 100 patients diagnosed to have metabolic syndrome based on national cholesterol education program adult treatment panel III (NCEP ATP III) criteria were studied. All the patients were subjected to carotid B mode ultrasonography.Results: The most common age group was 51 to 60years (29%). Out of 100 individuals who were diagnosed to have metabolic syndrome, 60% had five criteria, 29% had four criteria and 3% had three criteria. Most of the of the individuals (61.00%) had normal (≤0.10cms) CIMT while high (>0.10cm) levels were noted in 39.00% of the individuals. The mean CIMT was noted as 0.13±0.16cms. The mean SBP (150.15±10.39 vs 142.98±20.09mmHg; p=0.042), DBP (94.51±6.53 vs 90.16±9.91 mmHg; p=0.017), total cholesterol levels (243.53±65.74 vs 195.95±29.8 mg/dL; p<0.001) and triglyceride levels (221.07±48.44 vs 180.85±24.74mg/dL; p <0.001) were noted in individuals with raised CIMT compared to individuals with normal CIMT. Majority of the individuals had abnormal HDL (93.00%) and 41.94% of the individuals with abnormal HDL had raised CIMT (p=0.027).Conclusions: Some individuals with metabolic syndrome are likely to have raised CIMT. The rise in CIMT among the patients with metabolic syndrome is associated with raised SBP, DBP, abnormal HDL (specifically in males), total cholesterol and triglycerides.

Fibrinogen levels in type II diabetes mellitus patients with microvascular complications

Background: Diabetes increases the morbidity and mortality due to its propensity to develop micro and macrovascular complications. Recently the role of haemostatic factors, particularly fibrinogen, in atherosclerosis and its complications has invited considerable attention. The present study was conducted to study plasma fibrinogen levels in type II diabetes mellitus patients with microvascular complications.Methods: One hundred patients aged 18years to 60years with type 2 diabetes mellitus with microvascular complications were included in the study. HBA1c, plasma fibrinogen, urine routine examination, fundoscopy, monofilament testing, FBS, PPBS were done. Descriptive statistics was used to analyse data.Results: Out of 100 diabetes patients with microvascular complication studies, 88 patients were found to have hyperfibrinogenaemia. Out of 100 patients 67 patients had HbA1c of more than 8%, and all of them had elevated fibrinogen levels (p <0.0001). The prevalence of hyperfibrinogenemia was higher in patients with diabetic retinopathy (90%), when compared to those without diabetic retinopathy (83.33%) although it was statistically not significant (p=0.266).Conclusions: Hyperfibrinogenemia among type 2 diabetes mellitus patients with microvascular complications was high. Glycaemic control has a significant impact on the fibrinogen levels. Longer the duration of diabetes, there was a higher prevalence of hyperfibrinogenemia.

Knowledge and practices of rural family physicians and obstetricians towards gestational diabetes mellitus.

Background: The Gestational Diabetes Mellitus (GDM) offers an important opportunity for prevention of type 2 diabetes (T2DM). The prevalence of GDM is increasing even in rural parts of India. Family Physicians (FPs) and obstetricians working in rural areas need to be well equipped to manage this disease. This study aimed at assessing the knowledge ant practices amongst these rural doctors. Methods: Validated, self-completion questionnaire administered to family physicians and obstetricians after taking the written consent for participation. The questionnaire was divided in to two sections. First section was to assess the knowledge and the second section was to assess the practices adopted by participants towards GDM. Results: The participants were the 18 FPs and 12 obstetricians working in rural areas and managing pregnancies. About 89% (16) of FPs and 50% (6) Obstetricians exactly knew the definition. More than 55% (10) FPs and 66.7% (8) obstetricians knew the approximate prevalence of GDM. Only 22% (4) FPs and 58.3% (7) obstetricians were practicing universal screening for GDM. Only 38.9% (7) FPs were using insulin for the treatment of GDM where as 75% (9) obstetricians using insulin. Only 17% (3) FPs and 50% (6) obstetricians were practicing at least once weekly blood glucose monitoring for GDM. Conclusions: There are gap in knowledge and practices both amongst FPs and obstetricians towards the management of GDM. Future research focusing on education strategy is required which may involve novel tools like internet and mobile devices.