Assessment of autonomic functions and its association with telomerase level, oxidative stress and inflammation in complete glycemic spectrum- an exploratory study.

AIMS: In the present study we intended to study autonomic functions and its association with telomerase level, oxidative stress and inflammation in complete glycemic spectrum. MATERIALS AND METHODS: Age, gender and BMI matched 28 subjects in the age group of 25-50 years were recruited across complete glycemic spectrum as follows: 1) Normoglycemics (controls) 2) Prediabetics and 3) Frank diabetics. We assessed heart rate variability, cardiac autonomic function, lipid profile, adiponectin, malondialdehyde and telomerase level. RESULTS: Time domain parameters and frequency domain parameters were significantly lower, and LFnu and LF/HF ratio were significantly higher in prediabetes and diabetes than control. Serum Adiponectin and HDL levels were significantly lower in diabetes than prediabetes and control, and prediabetes had significantly lower HDL than controls. Other lipid profile parameters (TC, TG, VLDL, LDL, non-HDL & derived lipid parameters were significantly higher in diabetes than prediabetes and control and prediabetes had significantly higher values than controls. MDA levels were significantly higher and TAS was significantly lower in diabetics than prediabetics and control group. Telomerase level was significantly higher in diabetes as compared to prediabetes and control. Telomerase had significantly negative correlation with SDNN, HF, TP, HDL and adiponectin, and significant positive correlation with MDA, fasting insulin, HOMA IR, TC, and AIP. CONCLUSION: Oxidative damage, inflammation and autonomic dysregulation may be involved in Telomere/Telomerase dysregulation in diabetes and telomerase levels can be used as a cardio-metabolic marker of diabetes.

Effectiveness of micro health insurance on financial protection: Evidence from India.

Iatrogenic poverty caused by inadequate public expenditure on health, lack of social health insurance and low penetration of private health insurance can be mitigated by micro health insurance (MHI) schemes that provide financial protection. The empirical evidence on the impact of MHI on financial protection is limited in India. This paper elucidates the effect of Sampoorna Suraksha Programme (SSP), a MHI scheme in Karnataka on financial protection. Cross-sectional study was undertaken in Karnataka and the data was gathered from 416 insured, 366 newly insured and 364 uninsured households. The impact of SSP on out of pocket expenses (OOPE), catastrophic health expenditure (CHE), non-medical consumption expenditure, hardship financing and labour supply was analysed using linear and logistic regression methods. Results of the study demonstrate that insured members incurred lower OOPE, CHE and hardship finance. There was no effect on consumption expenditure and no direct impact on labour supply measured in terms of withdrawal from workforce and substitution of labour. We advocate a larger role of MHI in health financing in India since it curtails impoverishment of households in informal sector by reducing OOPE and hardship financing.

Health seeking behavior in karnataka: does micro-health insurance matter?

BACKGROUND: Health seeking behaviour in the event of illness is influenced by the availability of good health care facilities and health care financing mechanisms. Micro health insurance not only promotes formal health care utilization at private providers but also reduces the cost of care by providing the insurance coverage. OBJECTIVES: This paper explores the impact of Sampoorna Suraksha Programme, a micro health insurance scheme on the health seeking behaviour of households during illness in Karnataka, India. MATERIALS AND METHODS: The study was conducted in three randomly selected districts in Karnataka, India in the first half of the year 2011. The hypothesis was tested using binary logistic regression analysis on the data collected from randomly selected 1146 households consisting of 4961 individuals. RESULTS: Insured individuals were seeking care at private hospitals than public hospitals due to the reduction in financial barrier. Moreover, equity in health seeking behaviour among insured individuals was observed. CONCLUSION: Our finding does represent a desirable result for health policy makers and micro finance institutions to advocate for the inclusion of health insurance in their portfolio, at least from the HSB perspective.