Search

Introduction: Diabetic autonomic neuropathy (DAN), a serious complication of diabetes, is a significant contributor to increased morbidity and mortality. Although DAN often coexists with different peripheral neuropathies and other complications, it may also present in isolation. The present study aimed to understand the DAN status of a cohort of ambulatory type 2 diabetics in a tertiary care setting. Methods: A single-arm prospective observational study was carried out, where enrolled patients were interviewed for basic demographics and comorbidities, screened for symptoms of autonomic dysregulation, and other risk factors such as smoking and alcoholism. Based on the presence of overt symptoms, they were divided into two groups with or without any overt symptoms of autonomic neuropathy. Both groups were subjected to a battery of autonomic neuropathy tests, and their DAN status was characterized based on the observed scores. Results: The overall prevalence of DAN, as observed in our study, was 36%. Of 108 patients, 97 presented with one or more symptoms of autonomic dysregulation, whereas the rest, 10.1%, were without any symptoms. Among heart rate-based tests, a significant (P < 0.001) decrease followed by an increase in the Valsalva ratio was observed in 6 months and 12 months, respectively. A significant decrease (P < 0.001) in deep breathing test (E: I) values was observed in the 12th month. Most of the DAN patients presented with moderate autonomic dysfunction, followed by mild and severe, respectively. However, no significant change in DAN severity was noted with time. Conclusion: Using simple cardiovascular tests, DAN can be detected during the asymptomatic phase of the disease. [ABSTRACT FROM AUTHOR]

Background: Several studies have proved the advantages of second-generation insulin analogs in lowering intra-individual variability in plasma insulin levels, flexibility in dosing, a sustained glucose-lowering effect, and decreasing the risk of hypoglycemia. Glargine 300 is one of the newer second-generation basal insulin analogs to have been approved for both type 1 and 2 diabetes. The present study aims to assess the real-world clinical effectiveness and safety of Glargine U300 (Toujeo®) initiation after oral antidiabetic drug failure in insulin-naïve patients with T2DM. Methods: A prospective, observational study was conducted where participants were interviewed regarding their basic demographics, body weight, and treatment details. Glycemic parameters (HbA1C%, Fasting Plasma Glucose, and Post Prandial Blood Glucose) were observed in the initial 6 months, and changes were noted and compared. Any hypoglycemic events or other complications were also noted. Data collected were statistically analyzed. Results: The study included a total of 188 patients. Treatment with glargine 300 significantly reduced the mean HbA1C level from 9.78% at baseline to 7.90% at the end of 6 months of treatment (p < 0.001). 10.60% of patients achieved the glycemic target of ≤7.0% by the end of 6 months, while only 6.90% were within the target range at baseline. Similarly, significant reduction in FPG was observed at the end of 6 months treatment period with Glargine U300. A significant increase in dose requirement was observed throughout the study phase (p < 0.001). Incidence of hypoglycemia was noted in 2.12% of subjects. Conclusion: The lower incidence statistics of hypoglycemia coupled with sustained positive glycemic effects, stands out to be a prominent advantage of Glargine U300 over its other congeners. [ABSTRACT FROM AUTHOR]

BACKGROUND: Obesity has been an increasing problem globally, and attempts have been made to identify the best anthropometric predictor of chronic diseases in various populations. Owing to increased cost and methodological complexities, imaging diagnostics has been a challenge in resource constraint settings. Thus, anthropometric markers have been assumed to be a better predictor in this regard. Addressing the dearth of research in this arena from this part of the country, the present study was conducted in regular footballers who were assessed for their anthropometric parameters as a probable risk indicator for type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: This cross-sectional study involved 136 athletes, who were screened for risk factors and assessed for their measures such as height, weight, body circumferences, fat level, skeletal muscle, and skinfold thickness. Baseline laboratory investigations of serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase, fasting glucose, and insulin were done. Homeostatic model assessment of insulin resistance (HOMA-IR) was assessed for all the participants. A 3-day dietary recall history was obtained from all respondents for calculation of total nutrient intake. RESULTS: The mean age of respondents was 13.96 ± 1.91 years. While body mass index was recorded in normal range for 41 participants, 94 were in the "under" range and 1 was overweight. The mean waist, hip, and mid-thigh circumferences were 65.8 cm, 72.15 cm, and 43.86 cm, respectively. HOMA-IR derangement was noted in 11 participants. Increased fasting glucose and SGOT levels were noted in 9 participants, respectively. CONCLUSION: Anthropometric measures may serve as an easy and inexpensive marker for T2DM prediction. However, assessment of its utility across genders and various subgroup populations mandates further research. [ABSTRACT FROM AUTHOR]