Association of cognitive impairment with sleep quality, depression and cardiometabolic risk factors in individuals with type 2 diabetes mellitus: A cross sectional study.

AIM: The aim of this study was to evaluate the association of cognitive impairment with sleep quality, depression, and cardiometabolic risk factors among participants with type 2 diabetes mellitus. METHODS: Subjects underwent clinical interview to capture socio-demographic details, medical history, sleep quality, presence of depression, along with anthropometric and biochemical measurements. A detailed neuropsychological assessment [Montreal cognitive assessment scale (MoCA), Trail making A and B, Digit span, Spatial span, Letter Number Sequencing] was done. Cognitive impairment was defined as MoCA score of <23. RESULTS: Participants (n=250, 50% women, 63.6% middle-age) had a mean (±SD) age of 53.6 (±9.1) years and HbA1c of 55.1±6.8mmol/mol (7.2±0.6%). Cognitive impairment was present in 57 (22.8%) participants. In the middle-age subgroup, cognitive impairment was higher (23.9%) than those in the fourth decade (6.3%), but comparable (24.0%) to the older age (60-70years) individuals. Diabetes-related vascular complications [Odds ratio (95% CI) 2.03 (1.05, 3.94)]; hypertension [2.00 (1.04, 3.84)], depression [2.37 (1.24, 4.55)] and lower education [2.73 (1.42, 5.23)] had a significant association with cognitive impairment on multivariate logistic regression analysis. CONCLUSION: The high burden of cognitive impairment calls for an urgent need to establish longitudinal cohorts in midlife to understand this population's cognitive trajectories and see the influence of various bio-psychosocial variables.

Prevalence of non-alcoholic fatty liver disease and factors associated with it in Indian women with a history of gestational diabetes mellitus.

AIMS/INTRODUCTION: This study aims to evaluate the prevalence of and factors associated with non-alcoholic fatty liver disease (NAFLD) in Indian women with prior gestational diabetes mellitus (GDM) diagnosed using International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. MATERIALS AND METHODS: This cross-sectional study (2018-2019) enrolled women with and without prior GDM. Study participants underwent detailed assessments, including relevant medical, obstetric and demographic details; 75-g oral glucose tolerance test with glucose and insulin estimation at 0, 30 and 120 min; and other relevant biochemical and anthropometric measurements. NAFLD status was defined by ultrasonography. RESULTS: We evaluated a total of 309 women (201 and 108 with and without prior GDM, respectively) at a mean age of 31.9 ± 5.0 years and median of 16 months (interquartile range 9-38 months) following the index delivery. The prevalence of NAFLD was significantly higher in women with prior GDM (62.7% vs 50.0%, P = 0.038; grade 2 and 3 disease, 13.9% vs 6.5%). On logistic regression analysis (fully adjusted model), the odds of NAFLD were 2.11-fold higher in women with prior GDM (95% confidence interval 1.16-3.85, P = 0.014). Overweight/obesity, metabolic syndrome, prediabetes and homeostasis model of assessment of insulin resistance (a measure of insulin resistance) were positively associated with NAFLD, whereas the Matsuda index (a measure of insulin sensitivity) showed a negative association with NAFLD. CONCLUSIONS: The prevalence of NAFLD is high in women with prior GDM. Such women also have a high burden of cardiometabolic risk factors. Future studies should evaluate the intermediate and long-term hepatic and cardiovascular risk, and the impact of lifestyle interventions in reducing morbidity in such women.

Glycemic profile of women with normoglycemia and gestational diabetes mellitus during early pregnancy using continuous glucose monitoring system.

AIM: We studied women between 8 and 20 weeks of gestation with the aim of evaluating and comparing those having normoglycemia and GDM according to WHO 2013 criteria. METHODS: In this cross-sectional study (2017-2019), eligible pregnant women underwent a 75-g OGTT, followed by placement of a CGMS. RESULTS: Women (n = 96, 58 with normoglycemia and 38 with GDM) were enrolled at 14.0 ± 3.2 weeks of gestation. Mean preprandial, 1-h and 2-h postprandial and peak glucose values were significantly higher in women with GDM. Peak glucose value was achieved 60.0 ± 12.3 and 64.3 ± 11.6 min after meal in the normoglycemia and GDM group, respectively. 24-h mean glucose (5.8 ± 0.6 vs. 5.3 ± 0.4 mmol/L), mean daytime glucose (6.0 ± 0.6 vs. 5.5 ± 0.4 mmol/L) and mean nocturnal glucose (5.4 ± 0.7 vs. 5.0 0 ± 0.5 mmol/L) were significantly higher in women with GDM. Total time spent in range was significantly lower in the GDM group compared to the normoglycemia group (92.1 vs. 98.2%). CONCLUSIONS: This study highlights differences in glycemic patterns between women with normoglycemia and GDM in the context of a South Asian population where burden of GDM is high but good quality data in early pregnancy are limited.

Rh(iii)-catalyzed alkynylation: synthesis of functionalized quinolines from aminohydrazones.

Rhodium-catalyzed, chemo- and regioselective synthesis of functionalized quinolines using 2-aminohydrazones and terminal alkynes has been described. The reaction is oxidant/base-free and tolerates a wide variety of functional groups and has been successfully extended with 1,3 and 1,4-bis(phenylethynyl)benzenes to afford 1,3- and 1,4-bis(4-methylquinolin-2-yl)benzenes and 2-(3/4-ethynylphenyl)-4-methylquinolines. Furthermore, the control experiment supports the proposed reaction mechanism.

Substrate-Controlled Regio- and Stereoselective Synthesis of ( Z)- and ( E)- N-Styrylated Carbazoles, Aza-carbazoles, and γ-Carbolines via Hydroamination of Alkynes.

We report herein the substrate-controlled regio- and stereoselective hydroamination of carbazoles, aza-carbazoles, and γ-carbolines with functionalized aromatic as well as aliphatic alkynes in a KOH/DMSO system in good yields. The electronic effect of the substrates governs the stereochemistry of the product. Electron-donating alkynes provided ( Z)-stereoselective products, and electron-withdrawing alkynes provided ( E)-stereoselective products. This approach also provides an easy route for the synthesis of mono- and bis-hydroaminated product. The deuterium-labeling studies were also conducted to support the mechanistic pathway.

Chemo-, Regio-, and Stereoselective N-Alkenylation of Pyrazoles/Benzpyrazoles Using Activated and Unactivated Alkynes.

Transition-metal-free chemo-, regio-, and stereoselective synthesis of (Z) and (E) styryl pyrazoles and benzpyrazoles by the addition of N-heterocycles onto functionalized terminal and internal alkynes using a super basic solution of KOH/DMSO has been described. The stereochemical outcome of the reaction was governed by time and quantity of the base. The reaction of pyrazoles and benzpyrazoles onto alkynes takes place chemoselectively without affecting the free -NH2 group of pyrazoles and -OH group of alkynes. The designed protocol was well implemented on alkynes bearing long alkyl chain, an alicyclic ring, hydroxy, ether, and ester functionality, which offer the N-alkenylated products in good yields. This developed methodology also provides easy access for the synthesis of bis-vinylated heterocycles. The presence of free -NH2, -OH, -COOR, and halo group in styryl pyrazoles, could be further utilized for synthetic elaboration, which is advantageous for biological evaluation. For the first time, we have disclosed the base-mediated conversion of (Z)-styryl pyrazoles to (E)-styryl pyrazoles in KOH/DMSO system. The cis-trans isomerization was supported by the control experiments and deuterium labeling studies.