Vitamin D deficiency in long-term hospitalization psychiatric wards in an equatorial nation.

INTRODUCTION: Vitamin D deficiency and insufficiency have been shown to be prevalent in several populations, including in people who have a mental illness. Deficiency has been linked to specific mental health sequelae. Furthermore, deficiency may be perpetuated by medications routinely prescribed to people with severe mental illness. Therefore, symptoms of mental illness may be exacerbated by deficient levels of vitamin D, and treatments for mental illness may exacerbate deficiency. This study sought to determine the vitamin D levels of people hospitalized for a period longer than a year in an equatorial nation, Singapore. The inpatient population was then categorized according to levels to determine the need for supplementation. METHODS: Total 25-hydroxy vitamin D in serum and plasma levels were tested in 403 individuals in long-term psychiatric wards. Blood serum and plasma levels were classified into three groups. Regression models were constructed to test the associations between levels and clinical covariates. RESULTS: Forty (9.9%) people had vitamin D levels that were sufficient. A link was found between vitamin D levels and medications given for gastrointestinal illnesses (ß -2.48, p = .014, 95%CI -4.46 to-0.51) and between vitamin D levels and length of stay (ß -0.13, p = .027, 95%CI -0.24 to-0.01). No other relationships were statistically significant. DISCUSSION: Despite its geographic location and opportunities for regular outdoor activity, vitamin D deficiency, and insufficiency are prevalent among people hospitalized for long periods of time in an equatorial nation. The level of deficiency is comparable to those observed in other settings.

Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Haryana cohort of the A1chieve study.

BACKGROUND: The A1chieve, a multicentric (28 countries), 24-week, non-interventional study evaluated the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents. MATERIALS AND METHODS: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Haryana, India. RESULTS: A total of 345 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Patients had started on or were switched to biphasic insulin aspart (n = 236), insulin detemir (n = 66), insulin aspart (n = 28), basal insulin plus insulin aspart (n = 1) and other insulin combinations (n = 14). At baseline glycaemic control was poor for both insulin naïve (mean HbA1c: 10.7%) and insulin user (mean HbA1c: 10.5%) groups. After 24 weeks of treatment, both the groups showed improvement in HbA1c (insulin naïve: -3.9%, insulin users: -3.3%). SADRs including major hypoglycaemic events or episodes did not occur in any of the study patients. CONCLUSION: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia.