Metabolic syndrome among inmates of a 'home for aged' using IDF 2005 criteria.

To identify the metabolic syndrome (MetS) among inmates of a 'home for aged' using IDF 2005 criteria. 100 subjects from inmates of a 'home for aged' studied for the identification of metabolic syndrome using International Diabetes Federation (IDF) 2005 criteria. Presence of waist circumference (WC) (Men > or =90 cm, Women > or =80 cm) plus any two of the following four factors; triglycerides (TG) >150 mg/dl (1.7 mmol/l), (II) HDL-Cholesterol (HDL-C) <40 mg/dl (1.0 mmol/l) for men, <50 mg/dl (1.3 mmol/l) for women, fasting plasma glucose (FPG) > or =100 mg/dl (6.1 mmol/l) and blood pressure (BP) > or = 130/85 mm of Hg. Indicated the MetS. MetS was present in 57.0%. WC was common component, TG was increased in 71.9%, low HDL-C present in 86.0%, raised FPG present in 66.7% and hypertension in 45.6%. MetS was more common in older women than in men (63.6% vs. 48.8%) and decreased HDL-C is core components of the MetS in this population. High calorie diet and sedentary life style may be contributing factors of MetS in this population. MetS is common in elderly subjects. It is age-related, and is more common in elderly women.

Serum bicarbonate: can it be a marker of metformin induced acidosis in geriatrics?

Metformin is an oral antidiabetic agent, widely used in the treatment of type 2 diabetes mellitus. The serious side effect of metformin therapy is lactic acidosis. Contraindications for metformin therapy include renal insufficiency. A cut off value of 60 ml/min in creatinine clearance is suggested. Hundred type 2 diabetics receiving metformin as monotherapy or in combination with insulin/other oral antidiabetic agents, were enrolled in the study. Patients were on metformin for atleast one month prior to being enrolled. Patients' demographic data were taken. Baseline serum creatinine and bicarbonate were estimated. Creatinine clearance (Clcr ml/ min) was calculated. Patients were grouped into group 1-4 depending upon the doses of metformin they received. Patients were again grouped based on their Clcr as groupA (Clcr < 60 ml/min), group B (Clcr > 60.01 ml/min). Data was analysed using student's t test. Out of 100 patients 52 were males, 48 females. Mean age and SD of males and females were 69.92 +/- 6.95 and 66.85 +/- 5.72 respectively. Comparison of mean bicarbonate level in different doses of metformin did not show any statistical significance. But comparison of bicarbonate levels based on Clcr were highly statistically significant (p = 0.0084). In three patients whose bicarbonate level was very low (15, 16.4 and 19.2 mmol/L), doses of metformin was reduced and after one month their bicarbonate levels returned to normal (27.4, 25.6 and 26.2 mmol/L). Hence serum bicarbonate can be a marker to assess metformin induced acidosis in geriatrics patients with low creatinine clearance.