Family History Of Type Research Articles

Type 2 Diabetes Mellitus in Children and Adolescents: An update

Childhood type 2 Diabetes Mellitus (DM) has increasingly been reported worldwide. It is commonly associated with childhood obesity.It may be presented with classical manifestation of DM such as polyuria, polydipsia, weight lossor acute complications like Diabetic ketoacidosis (DKA), Hyperglycemic Hyperosmolar State (HHS) or features of insulin resistance syndrome. Many a cases it may remain asymptomatic and hence undiagnosed.So,overweight children and adolescents who met screening criteria such as family history of type 2 DM, signs of insulin resistance, and high risk ethnics should undergo screening. Emphasis should be given on early diagnosis and optimum management plan to avoid grave consequences of it in early part of life. Diagnosis of type 2 Diabetes Mellitus in children should be done on the basis of standard diagnostic criteria such as American Diabetic Association (ADA) criteria. Both non-pharmacological and drug management are important equally. Multidisciplinary team approach including self-management plan is mandatory for obtaining optimal therapeutic goals of type 2 DM in children and adolescents. Lifestyle modification, dietary intervention, weight reduction, patient education, psychological support, and oral anti diabetic drugs and insulin therapy should be included in comprehensive diabetic management plan. Complications of type 2 DM should be minimized by all means with strict glycemic control and management of co-morbidity if any. Emphasis should also be given on prevention of type 2 DM by adopting a healthy lifestyle characterized by healthy eating behavior, regular physical activity and subsequent modest weight loss that can prevent the progression of impaired glucose tolerance to clinical diabetes mellitus.J Bangladesh Coll Phys Surg 2017; 35(1): 24-30

Exercise Trials In Co-morbid Adults

PURPOSE: Exercise (EX) trials in adults with co-morbid conditions such as type 2 diabetes offer an opportunity to address behavior changes needed to increase physical activity (PA) and improve long-term health. The aim of this study was to determine whether it was feasible to include a low-dose PA behavior change intervention in an EX trial. METHODS: For the original EX trial, participants were randomized to one of four groups, to test the interactive effects of metformin and post-exercise ingestion of protein versus carbohydrate on mitochondrial protein synthesis, and the blunting effect of metformin on EX response. Participants were ≥55 years of age, had fasting glucose values ≥100 mg/dl, hemoglobin A1c 5.7-6.4%, two hour postprandial glucose 140-200 mg/dl, or a family history of type 2 diabetes. All participants received supervised EX sessions, three times per week for 12 weeks. For the behavior change intervention, participants were randomized to receive a one-hour PA counselling session, or not, held after completion of the 12 week EX intervention. The session was based on social-cognitive theory, and the primary goal was to increase post-intervention PA maintenance through discussion of PA benefits, PA goal setting, and identifying and overcoming PA barriers. Self-reported PA was measured using the International PA Questionnaire (IPAQ), pre, post and three-months after the EX intervention. RESULTS: There was no additional time burden for participants or the principal investigators of the original EX trial. Baseline, post-intervention PA questionnaires, and the counselling session were done while participants were in the laboratory doing their oral glucose tolerance test, and the follow-up PA questionnaire was completed by mail or online. PA questionnaire completion rates were high; 30/31 (96.7%) completed baseline, 100% (N=17) completed post-intervention PA questionnaire and counselling session (if randomized to receive it), and 7/8 (87.5%) have completed the three-month follow up PA questionnaire. CONCLUSIONS: Based on the high completion rates and no added time commitment, including behavior change strategies as part of an exercise trial is feasible. This trial is ongoing, and upon completion, effectiveness of the counselling session for increasing PA at three-month follow-up will be examined.

High Prevalence of Polycystic Ovary Syndrome in Type 1 Diabetes Mellitus Adolescents: Is There a Difference Depending on the NIH and Rotterdam Criteria?

Background: Polycystic ovary syndrome (PCOS) is more frequently observed in type 1 diabetes mellitus (T1DM) adult women than in nondiabetic women. No such prevalence has yet been studied in adolescent girls with T1DM. Aim: The aim of this study was to evaluate the prevalence of PCOS in adolescent girls with T1DM and to determine the clinical and hormonal features associated with the disorder. Methods: A cross-sectional study of 53 adolescent girls (gynecological age >2 years) referred for routine evaluation for T1DM was conducted. We diagnosed PCOS using the National Institutes of Health (NIH) and Rotterdam criteria. Results: 26.4 and 47.9% of adolescents had PCOS according to NIH (NIH-PCOS) and Rotterdam (Rotterdam-PCOS) criteria. 66.7% of NIH-PCOS adolescents had a complete phenotype associated with hyperandrogenism, oligomenorrhea, and polycystic ovarian morphology, unlike only 33.3% of the Rotterdam-PCOS adolescents. A family history of type 2 diabetes mellitus (T2DM) was more frequent in PCOS than in non-PCOS girls, whichever criteria were used. Late pubertal development and a T1DM diagnosis close to puberty were factors associated with NIH-PCOS. Conclusion: Adolescents with T1DM had a high prevalence of PCOS. More differences between PCOS and non-PCOS patients were found using the NIH criteria, suggesting that clinical characteristics might be more accurate for diagnosing PCOS in girls with T1DM. A family history of T2DM is associated with a high risk of PCOS.

Obesity and obstetric complications are associated with rapid-cycling in Italian patients with bipolar disorder

IntroductionRapid cycling (RC) worsens the course of bipolar disorder (BD) being associated with poor response to pharmacotherapy. Previous results about clinical variables potentially associated with RCBD were discordant or unreplicated.ObjectivesAn early diagnosis should be the goal to properly treat RCBD patients.AimsTo compare clinical variables between RC and non-RC bipolar patients and to identify related risk factors.MethodsA sample of 238 bipolar patients was enrolled from three different community mental health centers. Descriptive analyses were performed on total sample and patients were compared in terms of sociodemographic and clinical variables according to the presence of RC by multivariate analyses of variance (MANOVAs, continuous variables) or χ2 tests (qualitative variables). Binary logistic regression was performed to calculate odds ratios.ResultsOverall, 28 patients (11.8%) had RC. The two groups were not different in terms of age, age at onset, gender distribution, type of family history, type of substance use disorder, history of antidepressant therapy, main antidepressant, psychotic symptoms, comorbid anxiety disorders, suicide attempts, thyroid diseases, diabetes, type of BD, duration of untreated illness, illness duration, duration of antidepressant treatment and GAF scores. In contrast, RC patients had more often a history of obstetric complications (P < 0.05), obesity (P < 0.05) and a trend to hypercholesterolemia (P = 0.08). In addition, RC bipolar patients presented more frequently lifetime MDMA misuse (P < 0.05) than patients without RC.ConclusionsObesity and obstetric complications are risk factors for the development of RC in BD. Lifetime MDMA misuse may be more frequent in RC bipolar patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The interaction of socioeconomic position and type 2 diabetes mellitus family history: a cross-sectional analysis of the Lifelines Cohort and Biobank Study

BackgroundLow socioeconomic position (SEP) and family history of type 2 diabetes mellitus (T2DM) contribute to increased T2DM risk, but it is unclear whether they exacerbate each other’s effect. This study...

Heritability, parental transmission and environment correlation of pediatric-onset type 2 diabetes mellitus and metabolic syndrome-related traits.

To estimate the heritability, parental transmission and environmental contributions to the phenotypic variation in type 2 diabetes mellitus and metabolic syndrome-related traits in families of Mexican children and adolescents. We performed a cross-sectional study of 184 tri-generational pedigrees with a total of 1160 individuals (99 families with a type 2 diabetes mellitus proband before age 19). The family history of type 2 diabetes mellitus in three generations was obtained by interview. Demographic, anthropometric, biochemical and lifestyle information was corroborated in parents and offspring. We obtained correlations for metabolic traits between relative pairs, and variance component methods were used to determine the heritability and environmental components. The heritability of early-onset of type 2 diabetes mellitus was 0.50 (p<1.0e-7). The heritability was greater than 0.5 for hypertension, hypoalphalipoproteinemia, hypercholesterolemia, body mass index, waist circumference, blood pressure, 2-h insulin, and cholesterol (p<0.001). In contrast, we observed a high environmental correlation (>0.50) for blood pressure, HbA1c and HDL-cholesterol after multivariate adjustment (p<0.05). Several traits, such as type 2 diabetes mellitus and insulin resistance, were significantly correlated only through the mother and others, such as hypertriglyceridemia, were significantly correlated only through the father. This study demonstrates that type 2 diabetes mellitus and metabolic syndrome-related traits are highly heritable among Mexican children and adolescents. Furthermore, several cardiometabolic factors have strong heritability and/or high environmental contributions that highlight the complex architecture of these alterations.

Association of Self-perception Lifestyle with Overweight / Obesity among People with a Family History of Type 2 Diabetes: A Cross Sectional Study

Association of Self-perception Lifestyle with Overweight / Obesity among People with a Family History of Type 2 Diabetes: A Cross Sectional Study

Path Analysis on the Biopsychosocial Determinants of Type 2 Diabetes Mellitus and Depression at Dr. Moewardi Hospital, Surakarta

Background : Diabetes Mellitus (DM) is a a major disease that is threatening global population health. This disease ranks third by global public health priority. The incidence of type 2 DM in 2014 was 442 million patients worldwide. Indonesia is one of 10 countries with high DM incidence. The incidence of type 2 DM in Indonesia in 2014 was 10 million patients. This study aimed to examine the biopsychosocial determinants of type 2 Diabetes Melitus and depression at Dr. Moewardi Hospital, Surakarta, using path analysis. Subje cts and Met hod: This was an analytic and observational study with case control design. The study was conducted at Dr. Moewardi Hospital, Surakarta, from August to October, 2017. Sample consisting of 100 patients type 2 DMÂ and 100 non DM patients were selected for this study by fixed disease sampling. The dependent variable was type 2 DM. The independent variables were body age, mass index, education level, occupation, stres, family income, comorbidity, activity, and family history of type 2 DM. The data were collected using medical record and questionnaire. The data were analyzed by path analysis. Results : The risk of type 2 DM increased with higher body mass index (b= 2.66; 95% CI= 1.41 to 3.91; p<0.001), higher income (b=-0.93; 95% CI= -1.90 to 0.045; p=0.062), older age (b= 2.88; 95% CI= 0.62 to 5.15; p= 0.013), presence of DM family history (b= 2.56; 95% CI= 1.45 to 3.68; p <0.001), and comorbidity (b= 3.25; 95% CI= 2.07 to 4.43; p<0.001). The risk of depression increased by type 2 DM (b= 1.032; 95% CI= 0.42 to 1.63; p= 0.001). Body mass index increased with higher physical activity (b= -1.41; 95% CI= -2.03 to -0.79; p<0.001). Income increased with high education level (b= 2.58; 95% CI= 1.83 to 3.33; p<0.001). High physical activity increased with occupation (b=0.96; 95% CI= 0.38 to 1.53;p= 0.001). Conclusion : The risk of type 2 DM increased with higher body mass index, higher income, older age, presence of DM family history, and comorbidity. Keyword : biopsychosocial determinants, type 2 DM, depression Correspondence:Â Esty Budiarti. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email:estybudiarti21@gmail.com. Journal of Epidemiology and Public Health (2018), 3(1): 1-14 https://doi.org/10.26911/jepublichealth.2018.03.01.01Â

Alterations in the Vascular Physiology of Young Adults with Family History of Type 2 Diabetes Mellitus

Alterations in the Vascular Physiology of Young Adults with Family History of Type 2 Diabetes Mellitus

Effect of Metformin-sustained Release Therapy on Low-density Lipoprotein Size and Adiponectin in the South Indian Women with Polycystic Ovary Syndrome.

Objectives:The aim of the study is to compare surrogate markers of cardiovascular disease (CVD) risk, such as adiponectin (APN) levels and low-density lipoprotein (LDL) size, before and after sustained release metformin (Met-SR) therapy in women with polycystic ovarian syndrome (PCOS).Methods:Sixty women with PCOS and sixty age-matched controls in the age group 18–45 years were recruited after obtaining informed consent. Women with PCOS were initiated on Met-SR 1 g orally, which was increased to 1.5 g after 2 weeks and continued up to 24 weeks. Demographic data along with family history of type 2 diabetes mellitus, PCOS, and CVD were collected. Lipid profile plasma APN levels and LDL size were measured before and after therapy in the PCOS group. Data analysis was performed using the GraphPad Prism-5 software.Results:Women with PCOS had greater dyslipidemia, lower APN level and LDL size, and increased lipid accumulating product index as compared to controls. After 6 months of Met-SR therapy, women with PCOS demonstrated significant increase in plasma APN levels and LDL size and significant decrease in weight, waist-hip ratio (WHR), waist circumference (WC), and blood pressure (BP). A significant decrease was observed in body mass index (BMI) in the overweight and obese PCOS subgroups.Conclusion:Met-SR increases LDL size, APN concentration and decreases weight, WC, WHR, and BP in patients with PCOS. Met-SR may have salutary effects on LDL particle size through effects on APN levels in women with PCOS.

Syncronous medullar thyroid cancer and primary hyperparathyroidism on a female within the sixth decade of life with positive family history for type 2A MEN syndrome

Medullar thyroid cancer (MTC) may be sporadic or familial, either linked with pheocromocytoma (PHEO) and primary hyperparathyrodism (PHP), as seen in type 2A MEN (Multiple Endocrine Neoplasia) syndrome, either isolated. This is a 56-year old female known with mild arterial hypertension controlled under therapy, having a daughter with type 2A MEN syndrome (PHEO, MTC, PHP). Mild hypercalcemia and high parathormone were consistent for PHP, while calcitonin was 20 times above the upper normal limit for MTC. The PHEO tests were negative. Anterior cervical ultrasound confirmed a 2.7 cm thyroid nodule, local lymph nodes, and enlargement of inferior and superior left prarathyroids. After total thyroidectomy with bilateral neck dissection and excision of the left inferior and superior parathyroid glands, MTC and parathyroid hyperplasia was confirmed. Calcitonin decreased to 5 times above the normal level. Further close follow-up and therapy of residual MTC is needed. MEN 2A Syndrome may embrace various clinical presentations with more or less aggressive tumours, sometimes allowing a long time survival without neoplasia confirmation or incomplete phenotype until advanced age.

Family History of Type 2 Diabetes: Does Having a Diabetic Parent Increase the Risk?

It is well established that there is an important genetic predisposition for type 2 diabetes mellitus (T2DM). To summarise available epidemiological data regarding T2DM transmission in various populations. Narrative review. The estimated risk for the diagnosis of T2DM increases approximately by 2-4 times, when father, mother or both have this condition. Conversely, many T2DM patients have family members with DM. Studies have suggested that the likelihood of T2DM in the next generation is higher in the event of a diabetic mother than father. Both genetic factors, such as mitochondrial DNA mutations, and environmental components, such as intra-uterine environment, have been implicated in the higher maternal transmission of T2DM. Despite the above findings, some studies in populations with high frequency of T2DM have not corroborated the predominantly maternal transmission. Such works have shown either an excess paternal or an equal transmission of T2DM. It appears that potential biases in reporting family history data, especially between the various racial groups, have contributed to the controversy over the existence of excess maternal transmission of DM.

Early Antenatal Prediction of Gestational Diabetes in Obese Women: Development of Prediction Tools for Targeted Intervention.

All obese women are categorised as being of equally high risk of gestational diabetes (GDM) whereas the majority do not develop the disorder. Lifestyle and pharmacological interventions in unselected obese pregnant women have been unsuccessful in preventing GDM. Our aim was to develop a prediction tool for early identification of obese women at high risk of GDM to facilitate targeted interventions in those most likely to benefit. Clinical and anthropometric data and non-fasting blood samples were obtained at 15+0–18+6 weeks’ gestation in 1303 obese pregnant women from UPBEAT, a randomised controlled trial of a behavioural intervention. Twenty one candidate biomarkers associated with insulin resistance, and a targeted nuclear magnetic resonance (NMR) metabolome were measured. Prediction models were constructed using stepwise logistic regression. Twenty six percent of women (n = 337) developed GDM (International Association of Diabetes and Pregnancy Study Groups criteria). A model based on clinical and anthropometric variables (age, previous GDM, family history of type 2 diabetes, systolic blood pressure, sum of skinfold thicknesses, waist:height and neck:thigh ratios) provided an area under the curve of 0.71 (95%CI 0.68–0.74). This increased to 0.77 (95%CI 0.73–0.80) with addition of candidate biomarkers (random glucose, haemoglobin A1c (HbA1c), fructosamine, adiponectin, sex hormone binding globulin, triglycerides), but was not improved by addition of NMR metabolites (0.77; 95%CI 0.74–0.81). Clinically translatable models for GDM prediction including readily measurable variables e.g. mid-arm circumference, age, systolic blood pressure, HbA1c and adiponectin are described. Using a ≥35% risk threshold, all models identified a group of high risk obese women of whom approximately 50% (positive predictive value) later developed GDM, with a negative predictive value of 80%. Tools for early pregnancy identification of obese women at risk of GDM are described which could enable targeted interventions for GDM prevention in women who will benefit the most.

The frequency of polycystic ovary syndrome in young reproductive females in Qatar.

This was a prospective cross-sectional study in which 126 female students between the ages of 18 and 30 years were evaluated for the frequency of polycystic ovary syndrome (PCOS) through clinical interview, questionnaire, and anthropometric measurements. The diagnostic criteria of the US National Institutes of Health criteria were used. Menstrual irregularities (MI) were identified, and clinical hyperandrogenism was evaluated by self-assessment of hirsutism using modified Ferriman–Gallwey score. Blood analysis was done for measurement of prolactin, thyroid-stimulating hormone, and the androgen hormones. Of all the students, 37 (30.8%) had MI, 38 (31.7%) had clinical hirsutism, 37 (30.8%) had acne, and 76 (63.3%) had a family history of type 2 diabetes. The estimated frequency of PCOS was 18.33% according to the US National Institutes of Health definition. Hormonal analysis demonstrated a significant increase in androgens (total testosterone, dehydroepiandrosterone sulfate, and free testosterone), and a significant decrease in sex hormone-binding globulin in our PCOS group, with a P-value <0.05. This study revealed a higher level of the androgen hormones among PCOS subjects with a frequency of PCOS (18.33%) similar to the global estimates of 10%–20%.

Obesity and obstetric complications are associated with rapid-cycling in Italian patients with bipolar disorder

BackgroundRapid cycling (RC) worsens the course of bipolar disorder (BD) being associated with poor response to pharmacotherapy. Previous studies identified clinical variables potentially associated with RCBD: however, in many cases, results were discordant or unreplicated. The present study was aimed to compare clinical variables between RC and non RC bipolar patients and to identify related risk factors. MethodsA sample of 238 bipolar patients was enrolled from 3 different community mental health centers. Descriptive analyses were performed on total sample, and patients were compared in terms of socio-demographic and clinical variables according to the presence of RC by multivariate analyses of variance (MANOVAs, continuous variables) or χ2 tests (qualitative variables). Binary logistic regression was performed to calculate odds ratios. ResultsTwenty-eight patients (11.8%) had RC. The two groups were not different in terms of age, age at onset, gender distribution, type of family history, type of substance use disorder, history of antidepressant therapy, main antidepressant, psychotic symptoms, comorbid anxiety disorders, suicide attempts, thyroid diseases, diabetes, type of BD, duration of untreated illness, illness duration, duration of antidepressant treatment and GAF scores. In contrast, RC patients had more often a history of obstetric complications (p<0.05), obesity (p<0.05) and a trend to hypercholesterolemia (p=0.08). In addition, RC bipolar patients presented more frequently lifetime MDMA misuse (p<0.05) than patients without RC. DiscussionFindings from the present study seem to indicate that obesity and obstetric complications are risk factors for the development of RC in BD. In addition, lifetime MDMA misuse may be more frequent in RC bipolar patients.

Association between gestational weight gain per trimester/total gestational weight gain and gestational diabetes mellitus

Objective: To understand the association between gestational weight gain (GWG) per trimester/total (GWG) and gestational diabetes mellitus (GDM). Methods: A prospective cohort study was conducted among 829 healthy pregnant women from Chengdu who delivered a singleton during March-September 2013. Basic information about pre-pregnancy was collected at the first time, exercise information per trimester, dietary intake information per trimester and gestational age at delivery were obtained by questionnaire. Weight at the (12 ± 1)th, (28 ± 1)th, (36 ± 1)th and last week before delivery were measured. GDM was diagnosed according to the National Diabetes and Pregnancy Prevention Guidelines (2014). At last, a total of 682 pregnant women were analyzed. After controlling the potential confounders, multiple logistic regression models were used to test the associations between GWG per trimester/total GWG and GDM. Results: After adjusting for age at delivery, pre-pregnancy body mass index, family histories of type 2 diabetes and hypertension, exercise in the first trimester, parity and energy intake in trimester and other potential confounders. Compared with adequate GWG in the first trimester, insufficient and excessive GWG in the first trimester were associated with increased risk of GDM (OR=1.23, 95%CI: 0.63-2.38, and OR=2.20, 95%CI: 1.12-4.35). Compared with adequate GWG in the second trimester, insufficient and excessive GWG in the second trimester were associated with decreased risk of GDM (OR=0.47, 95%CI: 0.18-1.19, and OR=0.78, 95% CI: 0.43-1.42). Compared with adequate GWG in the third trimester, insufficient GWG in the third trimester was associated with increased risk of GDM (OR=1.48, 95%CI: 0.77-2.84), excessive GWG in the third trimester was associated with decreased risk of GDM (OR= 0.53, 95% CI: 0.28-0.99). Compared with adequate total GWG in pregnancy, insufficient GWG in pregnancy was associated with increased risk of GDM (OR=2.16, 95% CI: 1.04-4.46), excessive GWG in pregnancy was associated with decreased risk of GDM (OR=0.74, 95% CI: 0.38-1.46). Conclusions: Insufficient and excessive GWG in the first trimester were associated with increased risk of GDM, the first trimester may represent a critical period for risk of GDM. The effects of GWG in the second and third trimester on GDM need further study.

Increased Metabolic Disorders and Impaired Insulin Secretory Function in the First-Degree Relatives of Type 2 Diabetic Patients with Normal Glucose Tolerance.

To compare the metabolic status and pancreatic β-cell function in first-degree relatives (FDRs) of type 2 diabetic patients with normal glucose tolerance (NGT). Three hundred twelve subjects, who were NGT-FDR of type 2 diabetic patients and 1348 subjects, who were NGT individuals with no family history of diabetes, were defined as NGT-FDRs and NGT-controls (NGT-C), respectively. Blood pressure, body weight, waist circumference, plasma glucose, lipid profile, and insulin levels were measured in all subjects. Homeostasis model assessment of insulin resistance (HOMA-IR), HOMA-β, insulin sensitivity index (ISI), and disposition index (DI) was used to evaluate insulin resistance and insulin sensitivity. The HOMA-IR and HOMA-β indices were significantly higher in the NGT-FDR group relative to the NGT-C, while the ISI, DI, and ΔI30/ΔG30 were lower (P < 0.05). The prevalence rate of greater than or equal to three metabolic disorders was higher in the NGT-FDR group compared to the NGT-C (P < 0.05). In the NGT-FDR group, compared to people with normal metabolism, HOMA-β decreased when there was only one metabolic disorder, increased slightly when there were two to three metabolic abnormalities, and decreased again when there were four or more metabolic abnormalities. The data also indicated that having a family history of type 2 diabetes maybe an independent risk factor of β-cell dysfunction. Metabolic disorders developed frequently in the NGT-FDRs of type 2 diabetic patients. As the number of coexisting metabolic disorders increased, pancreatic β-cell secretory ability and insulin sensitivity decreased. Therefore, it is necessary to provide early preventive interventions and monitoring of metabolic indices for NGT-FDRs of type 2 diabetic patients.

Prevalence of comorbidities in obese New Zealand children and adolescents at enrolment in a community-based obesity programme.

The aim of this study was to describe the characteristics at enrolment of children and adolescents referred to an obesity programme and to determine how the prevalence of comorbidities differed in Indigenous versus non-Indigenous children. Participants were residents of a semi-rural region of New Zealand (NZ). Eligibility was defined by a body mass index (BMI) of ≥98th percentile or >91st centile with weight-related comorbidities. Fasting blood, medical and physical assessments were obtained. During the recruitment period from January 2012 to August 2014, 239 participants, aged 4.8-16.8 years, undertook assessment. Average BMI standard deviation score was 3.09 (standard deviation (SD) = 0.60, range 1.52-5.34 SD). The majority of participants were of either Maori (NZ's indigenous people (45%)) or NZ European (45%) ethnicity; 29% of participants were from the most deprived quintile of household deprivation. Maori participants were more likely than NZ Europeans to have a mother who smoked during pregnancy (52% vs. 28%, P = 0.001), a family history of type 2 diabetes (66% vs. 53%, P = 0.04), acanthosis nigricans on examination (58% vs. 20%, P < 0.0001), a low serum high-density lipoprotein cholesterol (27% vs. 14%, P = 0.03) or high serum triglyceride (38% vs. 24%, P = 0.03) concentration. The unique aspect of this study was the ability to recruit high levels of Maori participants and those from most deprived areas, indicating a high level of acceptability for these target groups. Comorbidities were prevalent in this cohort of overweight/obese school-aged children. While there were some differences in comorbidity prevalence between Maori and NZ Europeans, the overall clinical picture in our cohort, irrespective of ethnicity, was of concern.

Association of Nutritional Status and Serum Leptin in Offsprings of Diabetic Parents of Karachi, Pakistan

Objective: Prevalence of diabetes in Pakistan in the year 2014 was 6.9 million and is expected to rise to approximately 13 million in 2035, ranking Pakistan at 8th position among world's top 10 countries having diabetes. Materials and Methods: The study design is young subjects were taken aged 18 to 24 and were classified according to their family history of type 2 diabetes mellitus (T2DM) into those with single diabetic parent (SDP), both diabetic parents (BDP) and subjects having no family history of diabetes (NDP). Body composition was assessed by measuring body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR). Fasting venous blood was analyzed for glucose and leptin levels (measured by immunoenzymetric assay). Results: The offspring of BDP had significantly higher body weight as compared to those of SDP and NDP (p<0.05). The mean fasting serum leptin levels among NDP, SDP and BDP were significantly different (p<0.05), and were respectively, 4.91±6.78, 15.55±13.49 and19.04 ±14.57 ng/mL. Conclusion: Hyperleptinemia and anthropometric indices are the most prominent indicators of T2DM in individuals with a history of diabetes in the family

Prevalence of Metabolic Syndrome in Children With Type 1 Diabetes in South of Iran

Objectives: The aim of this study was to investigate the prevalence of metabolic syndrome, in children with type one diabetes mellitus (T1DM) for the first time in a population in the Middle East, and assess the influence of type of insulin therapy, daily dosage of insulin, family history of type 2 diabetes, gender and level of HbA1c on the prevalence of metabolic syndrome. Methods: This cross-sectional study was conducted on children with T1DM aged 2 years during years 2013 to 2014. Waist circumference, blood pressure, height and weight of children with diabetes, for calculation of body mass index (BMI), were measured by one physician. Fasting blood glucose and lipids were also measured. According to the age-modified standards of the ATPIII, metabolic syndrome was defined. All data were analyzed using the SPSS 18 software. Results: In this study, 87 children with diabetes (48 females and 39 males) aged 12.38 ± 4.2 were enrolled. Overall, 40.9% of our patients had hypertension, 55.2% had hypertriglyceridemia, 36.8% had low high-density lipoprotein (HDL) and 6.9% of patients had abdominal obesity. Furthermore, 29.9% of these children had metabolic syndrome, which did not have a significant association with the type of insulin regimen (P = 0.97), nor the daily dosage of insulin (P = 0.234), however the serum concentration of HbA1c had a significant correlation with metabolic syndrome (P = 0.027). Conclusions: This study provides evidence indicating high prevalence of metabolic syndrome in children with T1DM in southern Iran. Preventive programs aimed towards decreasing the risk factors of metabolic syndrome and interpretation of a healthier diet and physical activity for children with T1DM should be considered in our country.