Body Mass composition among Underweight Type 2 Diabetes Mellitus Patients-A Cross-sectional Comparative Study.

BACKGROUND: Over the past decades, various epidemiological data have shown that the pattern and profile of diabetes mellitus in India are different. The present study was carried out with an aim to study body mass composition in underweight type 2 diabetics and to compare with the normal population. MATERIALS AND METHODS: The cross-sectional comparative study was conducted between January 2015 and December 2016 and included 60 participants who were selected using the convenient sampling technique. Newly diagnosed patients with type 2 diabetes mellitus and BMI less than 18.5 kg/m2 were considered for the study. Chi square test and Independent student t test were used for finding the statistically significant difference in proportions and between means, respectively; Pearson correlation coefficient was estimated for finding the linear association between two continuous variables. RESULTS: No statistically significant difference was observed between the two groups in terms of age, waist-hip ratio, and BMI. Higher amount of fat mass and percentage were observed among the patients with diabetes as compared to that of the control group (P value < 0.05). However, there was no statistically significant difference between the underweight and the control group patients (P value > 0.05). A significant positive correlation was observed between HbA1c values and body fat mass values (P value < 0.05). CONCLUSION: Underweight type 2 diabetic patients were found to have high body fat mass as compared to healthy controls and the HbA1C values of the study participants were found to be positively correlated with fat mass.

A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS).

Myxedema coma or hypothyroid crisis is an endocrine emergency and needs ICU management. Neuroleptic malignant syndrome (NMS) is another medical emergency which needs high degree of clinical suspicion else mortality can be high. There is a paradox in co existence of myxedema coma and NMS. While one is hypometabolic state another is hypermetabolic state and both can be precipitated by antipsychotics use. Hypothermia and flaccidity commonly expected in myxedema coma may mask fever and rigidity of classical NMS contributing to diagnostic problem and treatment delay. Scientific literature on coexistance of myxedema coma and NMS is sparse. We hereby report first case with coexisting myxedema coma and NMS in a patient of schizophrenia treated with antipsychotic, where classical symptoms of NMS were masked by myxedema coma. Prompt diagnosis and effective management by a team resulted in favourable outcome in our patient. This case is reported to alert intensive care physicians to atypical manifestations of NMS in presence of hypothyroidism.