Evaluation of vitamin-D status in premenopausal and postmenopausal type-2 diabetic women and its relation to glycemic control

Background: Vitamin D deficiency is a public health problem around the world. In 2008, it was estimated that 1 billion persons present with vitamin D insufficiency or deficiency. Vitamin D is obtained through exposure to ultraviolet B (UVB) sunlight as well as nutritional sources. Despite the high UVB sunlight exposure in tropical countries, studies suggest Vitamin D deficiency is highly prevalent. Vitamin D is believed to help improve the body’s sensitivity to insulin, the hormone responsible for regulating blood sugar levels, thus reducing the risk of insulin resistance, which is often a precursor to Type-2 diabetes. Aim and objective of the study was to evaluate and compare the Vitamin-D levels in Premenopausal and Postmenopausal Type-2 Diabetic women and to evaluate if their Vitamin-D levels have any co-relation with their glycemic control.Methods: The study was conducted in Government Medical College Jammu and its associated hospital on 60 Type-2 Diabetic women, 30 premenopausal and 30 postmenopausal. Vitamin-D [25(OH) Vitamin D] levels were assessed by Chemiluminescence method in the Biochemistry Lab. of Govt. Medical College Jammu. Blood sugar levels, both fasting and postprandial, were assessed by Glucose oxidase-peroxidase method in the same Lab.HbA1C was assessed by HPLC [High Performance Liquid Chromatography] assay.Results: Vitamin-D deficiency [Vitamin-D levels <20 ng/ml] was seen in 16.67% of premenopausal type-2 diabetics and in 36.67% postmenopausal type-2 diabetics. This was not related to the glycemic control as HbA1C was increased in both the groups.Conclusions: Vitamin-D deficiency is more prevalent in postmenopausal Type-2 diabetics, as compared to premenopausal type-2 diabetics.

Effect of Graded Head-Up Tilt & Head-Reverse Tilt on the Sympathetic Nervous System Versus Parasympathetic Nervous System

The study was undertaken on 150 healthy human subjects of both the sexes in the age group of 18- 38 years to assess the effect of graded head-up tilt (HUT) and head-reverse tilt (HRT) on sympathetic nervous system Vs parasympathetic nervous system. The tilt positions used were 00, 300, 600, 300R and 00R. The parameters and test performed were pulse rate, blood pressure, cold pressor test, QTC interval, valsalva ratio and expiratory-inspiratory (E:I) ratio. On graded head-up tilt (600) pulse rate and diastolic blood pressure showed significant increase. Cold pressor test and QTc interval showed significant increase from 300 to 600 tilt. The valsalva and E:I ratios did not show any significant change on graded HUT. On reversal of tilt all the parameters showing significant increase returned to near pre-tilt values. These responses clearly indicate that graded HUT leads to decrease in parasympathetic reactivity but increase in sympathetic reactivity, which is more significant during higher tilt levels (300 to 600). On reversal of tilt both the parasympathetic reactivity and the sympathetic reactivity i.e. autonomic reactivity return to normal pre-tilt level.