Sex Differences in Cardiovascular Risk Factors among People with Diabetes in South India.

OBJECTIVE: To assess the sex differences in the prevalence of cardiovascular risk factors among patients with type 2 diabetes, visiting the hospital between March-December 2012. METHODS: A cross-sectional study was performed among the type 2 diabetes patients attending M.V. Hospital for Diabetes, a tertiary centre specialized in diabetes care, Chennai, South India. We collected information on obesity (body mass index ≥25 kg/m2), hypertension, dyslipidemia, smoking, alcohol consumption and glycemic control (HbA1c >8% considered poor control). RESULTS: Risk factors (prevalence) among 6113 (58% males; mean age 54 years) patients were obesity (68.4%), poor glycemic control (51.4%), hypertension (37.9%), dyslipidemia (34.7%), smoking (9.6%) and consumption of alcohol (10.3%), respectively. Women had a higher prevalence of obesity (75.7 vs 63.2%) and poor glycemic control while men had a higher prevalence of smoking and alcohol consumption. There were no sex differences in prevalence of hypertension and dyslipidemia. Cardiovascular risk factors were not associated with duration of diabetes. CONCLUSIONS: Cardiovascular risk factors were highly prevalent among patients with type 2 diabetes attending a tertiary care centre in South India, with different risk profiles among men and women. We recommend a gender-sensitive approach in planning interventions (counseling and treatment) to reduce the risk of cardiovascular disease.

Cost of medical care among type 2 diabetic patients with a co-morbid condition--hypertension in India.

The aim was to estimate the cost of medical care among hospitalized diabetic patients and to assess the influence of an additional co-morbid condition-hypertension. A pre tested and validated questionnaire was interviewer administered among 443 (male:female, 235:208) hospitalized diabetic patients. The JNC VII criteria for hypertension was considered to divide the study population into two groups; group I - diabetic patients without hypertension (n=269) and group II - diabetic patients with hypertension (n=174). Details of cost of inpatient and out-patient care and expenditure on hospitalization for the previous 2 years were obtained. The prevalence of hypertension among the study subjects was 39.3% (174 subjects). Presence of hypertension made a significant impact on the expenditure pattern. On an average a diabetic patient with hypertension spent 1.4 times more than a diabetic subject without hypertension. Median cost per hospitalization, length of stay during admission, and cost of 2 years for inpatient admission were all significantly higher for diabetic patients with a co-morbid condition. There is a need to develop a protocol on cost effective strategy for diabetes care. Strict control of hypertension should be targeted to avoid excess treatment cost on diabetes care.

Type 2 diabetes in Asian-Indian urban children.

OBJECTIVE: Due to a background of high prevalence of type 2 diabetes and the increasing rate of obesity occurring in relatively young urban children, we felt the need to look for type 2 diabetes in children. RESEARCH DESIGN AND METHODS: A study of cases of type 2 diabetes with age at diagnosis of /=0.6 pmol/ml on stimulation), and negligible GAD(65) antibodies indicating the presence of type 2 diabetes. The children were nonketotic; nine were obese, four had acanthosis nigricans, and one had polycystic ovary syndrome. Positive family history of diabetes was present in all cases. CONCLUSIONS: The clinical, immunological, and biochemical profile showed that the children had type 2 diabetes. The profile of type 2 diabetes was similar to that described in children in many other countries. Although less common than type 1 diabetes, type 2 diabetes in children is a condition that needs to be recognized and looked for in Asian-Indians.