Prevalence of Type 2 Diabetes and Prediabetes in the Gwalior-Chambal Region of Central India.

AIM: This study evaluated the prevalence of prediabetes and type 2 diabetes mellitus in the Gwalior-Chambal region of India. METHODS: A cross-sectional house-to-house survey was conducted on a population of 7608 subjects, aged between 20 and 79 years for fasting blood glucose level in finger-prick blood. Participants were stratified based on blood glucose levels, gender, age, family history, etc. to assess their impact. RESULT: The prevalence of type 2 diabetes and prediabetes in the Gwalior-Chambal region was found to be 11.4% and 5.7%, respectively. The prevalence of diabetes was significantly higher in the urban population (12.7%) while that of prediabetes was higher in the rural population (7.9%). Male subjects recorded a higher prevalence of prediabetes (8.2%, OR 1.54 in rural; 5.1%, OR 1.26 in urban) as well as diabetes (rural 9.2%, OR 3.15; urban 16.5%, OR 1.57). Both prediabetes and diabetes were recorded as being higher in those subjects leading a sedentary lifestyle and in the aged population. The prevalence of hyperglycemia was much higher in those with a family history of type 2 diabetes (30.6% in rural, 21.5% in urban). Almost half of the diabetics in the rural population were diagnosed for the first time. The multivariate regression analysis identified male gender, increasing age of 30 years and above, and positive family history as significant risk factors for diabetes whereas age of 40 to 79 and less physical activity were significant risk factors for prediabetes. CONCLUSION: Family history of diabetes, and sedentary lifestyle appeared as key factors promoting prediabetes and diabetes in the Gwalior-Chambal region. A lack of awareness appeared as one of the major causes of the high prevalence in the rural region.

Prevalence of metabolic syndrome in Gwalior region of Central India: A comparative study using NCEP ATP III, IDF and Harmonized criteria.

BACKGROUND: The aim of this study is to determine the prevalence of Metabolic syndrome (MetS) in the people of Gwalior. Three criteria viz., National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, International Diabetes Federation (IDF) criteria and Harmonized criteria for MetS were employed to assess the prevalence of metabolic syndrome in this region, their concordance with respect to this population was recorded. METHODS: The cross-sectional study involved the people, who had attended the Diabetes clinic at the Centre for Translational Research, Jiwaji University during 2015-2017. A total of 1190 participants within the age group of 20-79 years of either gender were included in the study. Anthropometric parameters, blood pressure, blood glucose and lipid profile of all subjects were assessed. Student's 't' test, Kappa statistics and Binary logistic regression model were used to analyze the data. RESULTS: The percentage of prevalent MetS was found to be 72.7, 50.2 and 53.9 following Harmonized criteria, NCEP ATPIII and IDF criteria respectively. The prevalence was found to be maximum in centrally obese female population, aged between 51 and 60 years with the presence of hyperglycemia and reduced HDL- C. Harmonized and IDF criteria showed good agreement (κ 0.85). Regression analysis showed that, high body mass index, hypertension and dyslipedimia were the most critical predictive risk factors of MetS. CONCLUSIONS: Maximum prevalence of MetS was recorded when the Harmonized criteria was followed. A good agreement was observed between Harmonized vs. IDF criteria. MetS if detected early especially in apparently healthy subjects; paves way for preventive measures to be designed in order to avert the incidence of diabetes and other risks related to cardio vascular disease.

Status of antioxidant and lipid peroxidation in type 2 diabetic human subjects diagnosed with and without metabolic syndrome by using NCEP-ATPIII, IDF and WHO criteria.

BACKGROUND: Antioxidants play a very crucial role in terms of disease incidence and its complications. Type 2 diabetes and metabolic syndrome (MetS) are now more prevalent than any other disorder. In this regard this study focuses on type 2 diabetic subjects with MetS having highest incidence of cardiovascular disease. Hence the aim of the study was to reveal the level of antioxidants and lipid peroxidation in MetS and non-MetS groups of type 2 diabetic subjects characterized by three different criteria. METHODS: Present study was based on 70 type 2 diabetic subjects and 20 healthy controls. The metabolic syndrome criteria were defined by National Cholesterol Education Program (NCEP)-Adult Treatment Panel III (ATPIII), International Diabetes Federation (IDF), and World Health Organization (WHO). The selected subjects were of similar age group. The participants were selected from a diabetic camp being run in the University Campus. The antioxidant enzymes estimated were reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) while Thiobarbituric acid reactive substances (TBARS) measured as a marker of lipid peroxidation. RESULTS: The level of GSH, CAT, SOD decreases in non-MetS and MetS subjects as compared to normal. When comparison was made for GSH & SOD in the mentioned groups resulted a significant differences in non-MetS and MetS compared with normal subjects. TBARS levels was increased in non-MetS and MetS group of subjects. The results indicate reduction in antioxidant enzymes and elevation of lipid peroxidation in type 2 diabetic subjects with or without MetS defined by using any of the International criteria. CONCLUSIONS: The study revealed that absolute reduction of antioxidant and involvement of lipid peroxidation in MetS group may lead to progressive intensification of cardiovascular disease in type 2 diabetic subjects irrespective of using any criteria.

Lipid-lowering and antioxidant functions of bottle gourd (Lagenaria siceraria) extract in human dyslipidemia.

The study validated the antidyslipidemic, antioxidant, and antihyperglycemic effects of Lagenaria siceraria fruit extract in human subjects with dyslipidemia along with subjects of normal health. A total of 200 mL of freshly prepared Lagenaria siceraria fruit extract was administered daily on empty stomach for 90 days. Significant reductions (P < .01) were found in triglycerides and total cholesterol levels in blood. Cardiac risk ratio, atherogenic coefficient, and atherogenicity index of plasma were also improved. Appreciable reductions in body mass index (P < .01) and blood pressure (systolic P < .01, diastolic P < .05) along with a significant reduction (P < .05) in fasting blood glucose levels were also observed in these subjects. Lagenaria siceraria fruit extract exhibited significant antioxidant activity in dyslipidemic subjects as evident from elevations in SOD (P < .05) and GSH levels (P < .01) with marked improvement in catalase (P < .01) and TBARS levels (P < .05). Phytochemical screening confirmed the presence of saponins, glycosides, flavonoids, terpenoids, and phenolic compounds. Lagenaria siceraria fruit extract serves as dietary adjunct in treatment of human dyslipidemia and cardiovascular disease.