REAL-world evidence of risk factors and comorbidities in YOUNG Indian adults with type 2 diabetes mellitus: A REAL YOUNG (diabetes) study.

OBJECTIVE: To assess the clinical characteristics, risk factors, and comorbidities associated with type 2 diabetes mellitus (T2DM) in young adult patients. METHODS: This is a retrospective, multicentric real-world study that included young adults (18-45 years) with T2DM. Primary information including demographics, medical and family history, biochemical measures (pre-and post-prandial blood glucose levels, glycosylated hemoglobin [HbA1c] and blood pressure, and lipid parameters) smoking and drinking habits were collected retrospectively from the medical records of the respective hospitals/clinics. Data were analyzed using descriptive and appropriate comparative statistics. RESULTS: A total of 22,921 patients from 623 sites were included. The median age was 37.0 years and the majority were men (61.6%). The proportion of patients from the age group >35-≤45 years was 62.7%. Among all patients, 46.9% had only T2DM; however, 53.1% of patients had T2DM with other comorbidities (T2DM with hypertension, dyslipidemia, and both). The majority of patients had elevated body mass index (BMI) (overweight, 46.6%; and obese, 22.9%). Family history of T2DM (68.1%) was most common in overall population. Sedentary lifestyle (63.1%), alcohol consumption (38.9%), and regular smoking (23.1%) were the most common associations in patients with T2DM with dyslipidemia and hypertension. Uncontrolled HbA1c level (≥7%) were observed in 79.2% of patients. The level of HbA1c was significantly increased with the duration of T2DM and sedentary lifestyle (p < 0.001). CONCLUSION: Higher BMI, family history of T2DM, sedentary lifestyle, alcohol consumption, and smoking were the most common risk facors, while hypertension and dyslipidemia were the most prevalent comorbidities associated with T2DM in young Indian adults.

Adoption of Gla-100 in India and its Impact on Insulin Usage Patterns.

Fueled by perceptions regarding Indian dietary patterns and premixed insulin's claim to fame of providing dual fasting and post-prandial control, there was a greater inclination towards using premixed insulins in clinical practice until the last decade. However, the advent of insulin glargine 100 U/mL (Gla-100) opened up a new dimension in insulin therapy landscape in India. The data from the last 5 years reveal that Gla-100 has gained more traction among Indian clinical practitioners. Basis evidences that have emerged from various clinical studies, this present review elaborates on certain key issues which have helped Gla-100 carve its own niche and effected a progressive shift in insulin prescription pattern in India.

To Evaluate the Association of Neck Circumference with Metabolic Syndrome and Cardiovascular Risk Factors.

BACKGROUND: It is accepted that metabolic syndrome increases the relative risk of cardiovascular disease and visceral adiposity lies at root of the cardio-metabolic risk. Upper body fat distribution has long been recognized as associated with metabolic syndrome and increased cardiovascular risk; hence the present study was conducted with the objective to evaluate the association of neck circumference with metabolic syndrome and cardiovascular risk factors. MATERIAL AND METHODS: The present study was a hospital based observational, Descriptive and comparative analysis, conducted at Department of General Medicine at a tertiary care centre of west India after Ethical clearance from the institute's ethical committee and written informed consent. A total of 405 subjects aged 18 - 60 years were selected consecutively after inclusion and exclusion criteria. Subjects were evaluated for metabolic syndrome components and cardiovascular risk factors. Neck circumference of ≥ 37 cm in males and ≥ 34 cm in females was considered abnormal. RESULTS: Metabolic syndrome was seen in 189 (46.7%) subjects. Raised triglyceride level was the most common (52.8%) component. Neck circumference was found to be statistically significant associated with metabolic syndrome (p<0.001) as well as cardiovascular risk factors like BMI, Waist circumference, Hypertension, Fasting blood sugar, TG and HDL were also found to be statistically significant associated with neck circumference. CONCLUSION: Neck Circumference can be used as a sensitive tool for metabolic syndrome and cardiovascular risk factors. Patients with abnormal Neck circumference should be screened for cardiovascular risk factors to detect abnormality for early and appropriate intervention.

Early Detection of Right Ventricular Dysfunction in Chronic Obstructive Pulmonary Disease by Echocardiography.

OBJECTIVE: This study is designed to investigate the effects of pulmonary arterial hypertension on RV systolic and diastolic functions in cases of COPD and to correlate RV systolic and diastolic functions with pulmonary arterial pressure. MATERIALS AND METHODS: 100 patients admitted in various medical wards of tertiary care Hospital and a primary care hospital with stable chronic obstructive pulmonary disease persons with age and sex-matched. 35 age and sex matched person without any associated and known disease were taken as control subjects. Selection of cases has been made on basis of detailed history, thorough clinical examination, electrocardiography, chest x-ray, pulmonary function tests. OBSERVATION: RV Systolic function (RVEF and RVWT) are significantly abnormal in patients of stable compensated COPD and they are significantly correlated with PAP(p< 0.002). RV diastolic function i.e., E/A ratio and PFR are altered in 60%(n-60) of patients of COPD studied against control subjects and significantly correlated with PAP(p< 0.002). CONCLUSION: Echocardiography is a non invasive method to detect changes of right ventricular dysfunctions in early stages with very good significant sensitivity and specificity.