Frequency of chronic complications of type II diabetes

To assess the frequency of chronic complications of type II diabetes in subjects attending a tertiary care unit in Karachi, Pakistan. Design: A cross-sectional analytical study. Place and Duration of Study: First visit of all type II diabetic subjects attending the outpatient department of Baqai Institute of Diabetology and Endocrinology from September 1996 to December 2001. Subjects and Computerized clinical records of 2199 type II diabetic subjects were analyzed for this study. The clinical and laboratory variables were statistically evaluated with significance at p. Means of glycosylated hemoglobin HbA1c, fasting and random plasma glucose levels, systolic blood pressure, triglycerides and high density lipoproteins [HDL] were higher than the risk indicator value for both genders [p<0.005]. Mean body mass index and total blood cholesterol was higher for females only. Hyperglycemia was present in 88%, high HbA1c in 81%, low HDL in 81%, obesity in 66% and hypertriglyceridemia in 54%, neuropathy in 36%, proteinuria in 28% and hypertension in 50% of the subjects. Frequency of obesity, low HDL and hypertension was higher among females [p<0.001 in each case]. Retinopathy [p<0.05], nephropathy [p<0.005], neuropathy [p<0.005] and foot ulcers [p<0.001] were higher among males. Frequency of obesity was significantly higher among those with shorter duration and in younger group while frequency of other complications was higher among those with longer duration and in the older groups. Higher rates of complications were observed compared to previous studies. Certain variables showed significant association with gender and age as described above

Fatness, Lipids, Insulin sensitvity, and life style of children from high and low risk families

Children show variation in certain diabetes related risk factors according to the family history. Early detection of high risk groups could prevent or delay the onset of diabetes. Insulin level and fatness of Pakistani children has never been compared according to family history. This study was designed to observe the differences in insulin sensitivity, lipids and fatness in children from high and low risk families. Two groups of 8-10 year old school children were assessed for the differences in insulin sensitivity, lipids, fatness, food and activity habits. The first group had no family history for diabetes [low risk group, n=40] in any first or second degree relative. The second group had positive family history of diabetes [high risk group n=40] Data were collected through questionnaire sent to parents and children's interview. Blood test and anthropometric assessments were done at the schools by a physician. The two groups of children had similar level of insulin sensitivity. Children having positive family history for diabetes had markedly higher mean values for BMI, and arm fat% as compared to the controls. Though the low risk group had markedly higher level of total lipids and triglycerides the high risk group had markedly lower HDL and significantly higher LDL [p=0.008] and HDL-LDL [p=0.009] ratio than the low risk group. There was no significant difference in food and activity habits of the two groups. Marked variations in lipid profile of children from high and low risk families are evident at an early age. Presence of these differences in the absence of differences in food and activity habits and insulin sensitivity suggests that variation in lipid storage and metabolism could precede the appearance of reduced insulin sensitivity in children from high-risk families. Measures to control excessive fat deposition in childhood could be an initial step towards the prevention of diabetes and heart disease in adult life

Rural-urban differences in food and nutrient intake of Pakistani children

Global increase in urbanisation accompanied by increase in complexity of nutritional problems is a cause of concern for most nations. The aim of this study was to assess the differences in frequency of food consumption and nutrient intake of urban and rural Pakistani children. Forty rural, 59 middle income urban and 81 affluent urban children belonging to the province of Punjab. Children were recruited through schools in Lahore and Rayonpura, Kala-Shah-Kaku [Sheikhupura district]. Three-day estimated diet records were kept by a total of 180, 10-12 year old school-children. The nutrient intake was calculated by the nutritional analysis package COMP-EAT and analysed on SPSS. The results of the three groups were compared. Consumption of chapati, eggs, yoghurt and some of the traditional vegetarian snacks was very similar in all the three groups. Consumption of lentils, cooked vegetables, paratha [fried Asian bread] and tea decreased and that of milk, meat curry, chicken curry, chocolates, cakes, ice-cream, fruit and raw vegetables increased with urbanization. As compared with the rural children, the urban children had a higher mean daily intake of calories, sugar, protein, total fats, cholesterol, calcium, sodium, potassium, niacin, vitamin B12, folic acid, antioxidant vitamins A, C and E and lower intake of total carbohydrates, fibre and starch. It is concluded that although the macro-nutrient consumption pattern of rural children appears to be heart healthy lower consumption of protective micro-nutrients by them may put them at risk. In view of rapid urbanisation and its multidimensional impacts on the health of the populations living in the urban areas of the developing world, these dietary trends provide baseline information for health professionals