Positive Family History Of Diabetes Research Articles

Prevalence of obesity in Chambal region and predictors of risk factors

Background: The prevalence of obesity is alarmingly high, affecting both developed and developing countries of all socio-economic groups, irrespective of age, sex or ethnicity. As the prevalence of obesity increases so does the burden of its associated co-morbidities. The purpose of this study was to evaluate the prevalences of overweight and obesity in our region, study the association between family history of diabetes (FHD) and body mass index (BMI) and to assess the relationship between family history of obesity and body mass index (BMI). Methods: A cross sectional population based study of 1017 randomly selected individuals was conducted. Pregnant patients and those with hypothyroidism, severe disability or severe psychiatric disturbance were excluded. Study included school going children, college going students, employees of medical college GRMC Gwalior and attendants of indoor and outdoor patients. Weight and height were measured and body mass index calculated. Patients with BMI > 23 kg/m2 were defined as overweight and those with BMI 27.5 kg/m 2 and above were labelled as obese as per the WHO recommendation for Asian population. Results: A total of 1017 patients were included in this study. There were 573 (56.34%) males and 444(43.66 %) females. Overall prevalence of overweight was 251(24.6%) and prevalence of obesity was (25) 2.4%. 93 (33.69%) of those with BMI >23 had family history of obesity while the figure was 81 (10.93%) in those with BMI <23. p value =0.000. 30 (10.86%) with BMI >23 had family history of diabetes and 40 (5.39%) with BMI <23 had the family history of diabetes. p value-0.004.18 (22.2%) with BMI >23 consumed alcohol compared to 11 (7.5%) cases with BMI <23 who did not. P value 0.004. Conclusions: The risk factors of overweight and obesity are multifactorial. The results show that the rise in the prevalence of overweight and obesity is accentuated by the presence of a positive family history of diabetes or obesity.

New-onset diabetes after kidney transplantation: Incidence, risk factors, and outcomes.

Many patients develop new-onset diabetes after kidney transplantation (NODAT). Its incidence and epidemiology are unknown in the Saudi population. We aimed to study the incidence, epidemiology, and outcomes of kidney transplant recipients who developed NODAT. This is a retrospective study of all adults who received kidney transplant between January 2003 and December 2009. NODAT was defined according to the criteria outlined in the 2003 International Consensus guidelines. A total of 500 patients were included in this study, 54% were male patients. One hundred thirty-six patients (27%) developed diabetes (NODAT group). In the univariate analysis, patients were older in the NODAT group (P <0.001), were of higher weight (P = 0.006), and had positive family history of diabetes (P = 0.002). Similarly, more patients in this group had impaired glucose tolerance before transplant (P = 0.01) and history of hepatitis C infection (P = 0.005). In the multivariate analysis, older age [odds ratio (OR) 1.06], family history of diabetes (OR 1.09), hepatitis C infection (OR 1.92), and impaired fasting glucose (OR 1.79) were significant risk factors for the development of NODAT. Mortality was 6% in the NODAT group and 0.5% in the non-diabetic group had died (P <0.001). Graft survival was not different between the groups (P = 0.35). In conclusion, there is a significant risk of developing diabetes after renal transplantation. Patients are at higher risk if they are older, have a family history of diabetes, pre-transplant impaired fasting/random glucose, and hepatitis C virus infection.

Etiology, risk factors, clinical features, and pitfalls in the management of newly diagnosed diabetic children and adolescents

Objective The aim of this study was to identify the etiology, risk factors, and the most common clinical features of newly diagnosed diabetes in children and adolescents, in addition to the factors related to delayed diagnosis or mismanagement in these children. Materials and methods Ninety-nine children and adolescents aged from one month to 13 years with newly diagnosed type 1 diabetes (T1DM) were recruited from the inpatient department of the Diabetic, Endocrine, and Metabolic Pediatric Unit (DEMPU), New Children Hospital, Cairo University. Results Classic symptoms (polyuria and polydipsia, and weight loss) were the most common symptoms (the first two symptoms in 95.9 and the last one in 90.7%) preceding the diagnosis, and diabetic ketoacidosis was present in 51.5% of cases. Delayed and missed diagnosis was recorded in 49.5% of patients, with no significant relation with age, district of accommodation, or family history of diabetes. Cow’s milk feeding was more frequent, being recorded in 75.2% vs. 19.6% with exclusive breast feeding, and positive family history of diabetes was recorded in 77.3%. Severity at presentation showed no significant relation with age, type of feeding, family history of diabetes, or C-peptide level. Conclusion Increased public awareness of early symptoms of diabetes is needed to reduce the frequency and severity of ketoacidosis. In addition, greater medical alertness to the possibility of T1DM in a young child should be stressed. Breastfeeding and avoidance of early cow milk introduction should be encouraged to decrease the risk for T1DM during infancy with its early complications and morbidity.

The profile of diabetic children in Benghazi, Libya 2013

Background and Objectives: Diabetes is a public health challenge and its prevalence appears to be increasing worldwide. We aimed to assess the epidemiological characteristics of diabetes mellitus in children, and to describe its effect of on health. Materials and Methods: Descriptive cross sectional study was conducted in Benghazi pediatric diabetic clinics by interviews questionnaires to the parents of the patients based on published international and national guidelines. Results: Female to male ratio was 1:1.2. History of parental consanguinity was 32.7%. Positive family history of diabetes was 48%. Glycosylated hemoglobin and random blood glucose clinic values indicated suboptimal control. No psychological support in the clinics, but nutritional education was present. Delayed growth or pubertal development reported in 38% of the children. Conclusions: Patients with T1DM do attend on fairly regular follow-up to the clinics, families share the children in healthy diet but health education does not seem adequate and formal psychological support is non-existing whereas it should have been an integral part of standard management. Metabolic control in this convenience sample was poor. There is an amble room for improvement to bring practices to the internationally and nationally accepted standards.

Common familial risk factors for schizophrenia and diabetes mellitus.

The co-occurrence of type 2 diabetes and psychosis is an important form of medical comorbidity within individuals, but no large-scale study has evaluated comorbidity within families. The aim of this study was to determine whether there is evidence for familial comorbidity between type 2 diabetes and psychosis. Data were analysed from an observational study of a nationally representative sample of 1642 people with psychosis who were in contact with psychiatric services at the time of survey (The 2010 Australian National Survey of Psychosis). Participants were aged 18-64 years and met World Health Organization's International Classification of Diseases, 10th Revision diagnostic criteria for a psychotic disorder (857 with schizophrenia, 319 with bipolar disorder with psychotic features, 293 with schizoaffective disorder, 81 with depressive psychosis and 92 with delusional disorder or other non-organic psychoses). Logistic regression was used to estimate the association between a family history of diabetes and a family history of schizophrenia. A positive family history of diabetes was associated with a positive family history of schizophrenia in those with a psychotic disorder (odds ratio = 1.35, p = 0.01, adjusted for age and gender). The association was different in those with an affective versus non-affective psychosis (odds ratio = 0.613, p = 0.019, adjusted for age and gender) and was significant only in those with a non-affective psychosis, specifically schizophrenia (odds ratio = 1.58, p = 0.005, adjusted for age and sex). Adjustment for demographic factors in those with schizophrenia slightly strengthened the association (odds ratio = 1.74, p = 0.001, adjusted for age, gender, diagnosis, ethnicity, education, employment, income and marital status). Elevated risk for type 2 diabetes in people with schizophrenia is not simply a consequence of antipsychotic medication; type 2 diabetes and schizophrenia share familial risk factors.

Interaction of poor sleep quality, family history of type 2 diabetes, and abdominal obesity on impaired fasting glucose: a population-based cross-sectional survey in China

This study aims to explore the interaction of sleep quality, family history of type 2 diabetes, and obesity in relation to impaired fasting glucose in a Chinese population. A representative population-based cross-sectional study was conducted, and 15,145 residents aged between 18 and 75 years were selected from 11 districts of Xuzhou City, Jiangsu Province. The Pittsburgh Sleep Quality Index was used to evaluate sleep conditions, with categories of good and poor. Impaired fasting glucose (IFG) was assessed by fasting blood glucose. Interaction of sleep quality, obesity, and family history of diabetes (FHD) on IFG was analyzed by logistic regression. Relative excess risk due to interaction (RERI) and the synergy index (SI) were applied to evaluate the additive interaction between the two factors. Either poor sleep or positive FHD was independently associated with an increased odds ratio (OR) for IFG. Those with both poor sleep and positive FHD had a significantly increased risk compared with those without poor sleep and FHD (OR 20.6, 95 % confidence interval (CI) 16.4–29.0, P < 0.001). The corresponding RERI and SI was 14.6 (8.6–20.6) and 3.7 (1.4–5.1), respectively. Both abdominal obesity and FHD significantly increased the risk of being IFG. The synergistic effect of abdominal obesity and FHD on IFG was statistically significant (OR 40.1, 95 % CI 28.8–61.5). The results suggest that additive interactions exist between poor sleep quality, abdominal obesity, and family history of diabetes in relation to impaired fasting glucose.

Parity and diabetes risk among hispanic women from Colombia: cross-sectional evidence.

ObjectiveThe association between parity and type 2 diabetes has been studied in developed countries and in Singapore and Chinese women but not in Hispanics. Herein we evaluated the association between parity (number of live births) with diabetes in a group of Hispanic postmenopausal women from Colombia.Research design and methodsHerein we evaluated the association between parity and diabetes in a population of 1,795 women from Colombia. Women were divided in birth categories (0 [referent], 1 or 2, 3–5, 6 or > births). Medical history of diabetes and anthropometric characteristics were recorded. Logistic regressions were performed in order to find the association between parity and diabetes in bivariable and multivariable models after controlling for age, body mass index (BMI), waist hip ratio (WHR) and diabetes family history, among other variables.ResultsIn our study, there was an association between parity and diabetes after adjusting for age, BMI and diabetes family history in the multiparous women groups when compared to the women with no births (Referent group) [1–2 births vs. referent OR 5.2 (95 CI 1.2–22.9), 3–5 births vs. referent OR 5.5 (1.3–23.0) and ≥6 births vs. referent OR 7.5 (1.8–31.8), respectively]. The association was maintained in two of the groups in the multivariable analysis [OR 5.0 (1.1–22.9) and 5.3 (1.2–23.5)], for 1 or 2 births and 6 or > births versus 0 births, respectively. Positive diabetes family history and WHR were also associated with an increased risk of diabetes [OR 4.6 (3.0–7.0) and 4.1 (2.0–8.1), respectively].ConclusionsIn postmenopausal Hispanic women, multiparity, as well as a positive family history of diabetes and a high waist-hip ratio were associated with higher diabetes risk.

Factors associated with nonadherence to diet and physical activity among nepalese type 2 diabetes patients; a cross sectional study

BackgroundNonadherence to diet and physical activity is a major problem in the management of diabetes mellitus and its complications. This study was undertaken to measure the factors associated with nonadherence to diet and physical activity advice among Nepalese type 2 diabetic patients.MethodsAn analytical cross-sectional study was conducted among type 2 diabetic patients (age, M ± SD, 54.4 ± 11.5 yrs) and interviewed using three days recall method for dietary history and Compendium of Physical Activity for physical activity. Data were analysed by univariate and multivariate statistics.ResultsOut of 385 patients, 87.5% were nonadherent and 12.5% poorly adherent to dietary advice. 42.1% were nonadherent, 36.6% partially adherent while 21.3% good adherent to physical activity. Adherence to dietary advice was higher in males than females (M ± SD, 33 ± 16.7 vs 27 ± 15.5, p = 0.001), those staying nearer to hospital than farther (M ± SD, 32 ± 18.6 vs 28 ± 13.5, p = 0.013), those advice by physician than others (p = 0.001) and from nuclear family than joint and extended (p = 0.001). With increasing age, dietary advice adherence decreased (p = 0.06) and was positively correlated with the knowledge about diabetes mellitus (r = 0.115, p = 0.024). Physical activity adherence was higher in those with positive family history of diabetes than others (M ± SD, 74 ± 24.2 vs 65 ± 23.6, p = 0.001), upper middle socioeconomic class respondents than lower ones (p = 0.047) and from extended family than nuclear or joint ones (p = 0.041). Divorced were more nonadherent to physical activity than married and widowed patients (p = 0.021).ConclusionsDeterminants of nonadherence to dietary advice: Female gender, increasing age, joint or extended family members, farther distance from hospital, poor knowledge about diabetes mellitus and advice by others than physicians. Determinants for nonadherence to physical activity: negative family history of DM, divorced status, lower socioeconomic class.

Maternal hyperglycemia according to IADPSG criteria as a predictor of perinatal complications in women with gestational diabetes: a retrospective observational study

Objective: We investigated the association between abnormal maternal glucose levels according to International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and perinatal complications.Materials and methods: Retrospective observational study of data of 492 women in singleton pregnancy and gestational diabetes (GDM) diagnosed according to WHO criteria. Perinatal outcome and maternal characteristics were compared between normo- and hyperglycemic patients using IADPSG criteria and odds ratios calculated for particular outcomes.Results: Maternal fasting hyperglycemia (≥5.1 mmol/L) was associated with significantly higher proportion of birth weight ≥ 4000 g (19.3% versus 9.7%, p = 0.004, OR: 2.2; 95% CI: 1.3–3.8), gestational insulin therapy (27.7% versus 9.1%, p < 0.001, OR: 3.8; 95% CI: 2.3–6.5), poor long-term metabolic control (HbA1c at diagnosis ≥ 6.5% [48 mmol/mol]: 19.9% versus 4.6%, p < 0.001, OR: 5.2; 95% CI: 2.5–10.9). Pre-pregnancy obesity (BMI ≥ 30 kg/m2, 26.0% versus 11.9%, p < 0.001, OR: 2.6; 95% CI: 1.6–4.3) and positive family history of diabetes (45.2% versus 30.8%, p < 0.002, OR: 1.8; 95% CI: 1.3–2.7) was more frequent in women with fasting hyperglycemia. Two-hour post-load hyperglycemia was only associated with increased prevalence of gestational hypertension (5.1% versus 11.4%, p = 0.046).Conclusions: Women with fasting but not 2-h hyperglycemia according to IADPSG criteria are at significantly elevated risk of perinatal complications.

Postpartum glucose tolerance status 6 to 12 weeks after gestational diabetes mellitus: a Brazilian cohort

The aims of this study were to estimate the local rate of postpartum diabetes screening after gestational diabetes mellitus (GDM) pregnancies, and to identify clinical variables associated with retesting rates and with the persistence of decreased glucose tolerance. Prospective cohort of GDM women with prenatal delivery at a specialized center, from November 2009 to May 2012. All women were advised to schedule a 6 weeks postpartum 75-g oral glucose tolerance test (OGTT). Of the 209 women included, 108 (51.7%) returned to be tested with fasting plasma glucose (n=14), OGTT (n=93) or random glucose (n=1). Return was associated with lower parity rate (2 vs. 3, p<0.001) and higher pregnancy 2-h OGTT (165 vs. 155 mg/dL, p=0.034), but not with socio-demographic characteristics. Four women (3.7%) had diabetes, 22 (20.4%) had impaired fasting glucose or impaired glucose tolerance. Persistent hyperglycemia was associated with a positive family history of diabetes (relative risk-RR 2.41, p=0.050), diagnostic 2-h OGTT in pregnancy (RR 1.01, p=0.045), insulin use during pregnancy (RR 2.37, p=0.014), and cesarean section (RR 2.61, p=0.015). Even though postpartum abnormalities were frequent in GDM, rates of postpartum diabetes screening were undesirably low. As no specific clinical profile defines who will adhere to postpartum testing, it is essential to encourage all women to reevaluate their glucose status, particularly those with a family history of diabetes and more severe hyperglycemia.

Cardiovascular disease risk factors in the South Asian population living in Kuwait: a cross‐sectional study

High rates of diabetes and cardiovascular disease have been reported in South Asian immigrants in many countries. However, the prevalence and characteristics of cardiovascular disease risk factors among a South Asian population living in Kuwait have not yet been investigated. This study was therefore designed to estimate the prevalence of cardiovascular disease risk factors and determine whether they are independently associated with diabetes in such a population. A population-based cross-sectional study was conducted on 1094 South Asians (781 men and 313 women), mainly Indian and Pakistani (≥ 18 years of age), of whom 75.1% were Indians. Interviews were carried out, during which socio-demographic and anthropometric data were collected, followed by a physical examination and collection of fasting blood samples for laboratory investigations. Diabetes was defined by fasting plasma glucose ≥ 7 mmol/l, or being on treatment, and/or self-reported previously diagnosed Type 2 diabetes. The prevalence of diabetes was 21.1%, with 3.4% of that percentage of people being newly diagnosed. Using BMI measurements, 24.0% of those who participated in the study were obese and 46.1% were overweight. Dyslipidaemia was found in 77.6% and hypertension in 44.8%. Advancing age (≥ 40 years), male gender, high LDL, high total cholesterol, hypertension and positive family history of diabetes were significantly associated with increased risk of diabetes. Our study shows that the prevalence of cardiovascular disease risk factors in South Asian expatriates in Kuwait exceeds prevalence rates reported in their homeland and other countries. This may suggest the added stress of environmental factors on the development of cardiovascular disease risk factors in such populations. Specialized prevention programmes targeting such high-risk ethnic populations are paramount and need to be implemented.

A prospective single arm study of the effect of an acute oral glucose loading on the endothelial function of healthy participants

BackgroundHyperglycaemic load has been shown to cause endothelial dysfunction in patients diagnosed with diabetes mellitus or the pre-diabetic state of glucose intolerance. In the non-disease state such as in healthy subjects, the effect of glucose loading is still uncertain with conflicting results. The aim of this study was to test the hypothesis that an oral 75 g glucose load will not adversely attenuate the endothelial function of healthy participants, 2 hours postprandial.MethodsThis is a prospective single arm study evaluating the brachial artery flow-mediated vasodilation of 12 healthy participants before and after a 75 g glucose loading. Participants’ age, body mass index, family history of diabetes, fasting blood glucose and 2 hour postprandial glucose levels were recorded. All data were analysed with SPSS 17.0 using Wilcoxon test.ResultsPrimary analysis of the participants’ brachial artery flow mediated vasodilation before and 2 hours after 75 g oral glucose loading did not show any statistically significant attenuation (p > 0.05) in brachial artery flow-mediated vasodilation, although a trend for reduction in endothelial relaxation was observed. Subgroup analysis of healthy participants with a positive family history of diabetes confirmed a statistically significant attenuation (p < 0.05) in brachial artery flow-mediated vasodilation after acute glucose loading even though the 2 hour postprandial blood glucose level, with a median value of 4.6 ± 2.2 mmol/L was within normal limits. This was not observed in the group without a positive family history of diabetes.ConclusionAcute oral glucose loading significantly attenuates endothelial relaxation in healthy subjects with positive family history of diabetes but showed no effect in those without a positive family history of diabetes. The attenuation in endothelial relaxation was observed in the presence of normal glucose metabolism, suggesting a defect in endothelium relaxation even in the non-disease state in the group predisposed to diabetes.

Risk assessment for developing type 2 diabetes mellitus and its determinants among adults attending Dubai primary health care centres, 2012

Introduction: Type 2 Diabetes mellitus is one of the most prevalent andcostly chronic health conditions in the United Arab Emirates. Earlyidentification of people who are at risk is a pivotal step to initiativepreventive measures. Objectives: To assess level of risk of developingtype 2 diabetes mellitus and to identify the determinants of risk fordeveloping type 2 diabetes mellitus. Methodology:Across-sectional study was carried out among adults attending the primary healthcare centers in Dubai, UAE. A total of 515 adults were selected by systematic randomsample and assessed using an interview questionnaire. Results: More thanforty percent of the participants demonstrated a risk for developing type 2diabetes mellitus. It was found that, 21.6%, 19.4% and 1.9% of participantswere at moderate, high and very high risk respectively to develop T2DM within10 years. The results of stepwise logistic regression, revealed ten predictors associated with the risk of developing T2DM which wereage 45 years or more, positive family history of diabetes mellitus, poor knowledgelevel, low perception level about diabetes, eating refine grains or fried foodon daily basis, history of high blood glucose, physica lactivity < 30minutes/day, BMI ≥25kg/m2 in addition to high waist circumference. Conclusion: The overallrisk of developing type 2 diabetes mellitus among adults attending the primaryhealth care centers was alarming. The participants at risk were characterizedby obesity, central obesity, physical inactivity and positive family history ofdiabetes. Recommendations:The use ofdiabetes risk assessment questionnaire as initial step for type 2 diabetesmellitus screening in the PHC centers. In addition to implementation of astructured lifestyle modification program to be delivered to those at moderateand high risk of developing T2DM to improve their health and to delay orprevent type 2 diabetes mellitus.

Gestational diabetes: Perinatal and maternal complication in 24-28 weeks

Background: Gestational diabetes mellitus (GDM) is a glucose tolerance disorder that occurs or is diagnosed for the first time during pregnancy. Perinatal morbidity is more and women with GDM have more risk of developing diabetes. Uttar Pradesh is a state of India with one of the highest rate of infant as well as maternal mortality which might be, at least partially, due to GDM. Thus, appropriate assessment and management of GDM can improve the outcomes. Aims & Objectives: Primary objective of this study was to determine the prevalence of GDM and evaluate the maternal and fetal outcome in and around Kanpur. Thus, this study was undertaken to know the extent of burden on the healthcare, before scope of intervention could be defined. Materials and Methods: A prospective study (September, 2012 - October, 2014) was done at 198 healthcare facilities. 24,656 mothers were screened (24th- 28th weeks of pregnancy) as per guidelines of Diabetes in Pregnancy Study Group India (DIPSI) and Federation of Obstetric and Gynecological Societies of India (FOGSI). Results: > 94% pregnant women did not know about GDM. Prevalence of GDM was 14.42%. Stillbirth, Perinatal & neonatal mortality were respectively 2, 3.3 & 6 times higher in GDM. Most of the GDM were diagnosed in primigravida (62%). Congenital Malformation was 8 times higher. Low Birth Weight (LBW) was 35% in GDM (16% in Non GDM). GDM positive cases had 20.6% positive family history of diabetes (compared to 6.5% in non-GDM). Relative risks for PBU (post birth unit), LGA (large for gestational age), LBW (low birth weight), pre-eclampsia and jaundice were also higher. Conclusion: A well predictive screening criteria is needed. As the ignorance about GDM among pregnant ladies is high, to reduce the risk, awareness can be an area of thrust.

Pattern of serum lipid profile and glycosylated Hb in Indian diabetic patients

Background: Diabetes is rising globally, particularly in India. India is the second largest country in terms of diabetic population. Majority of Diabetic patients also do suffer from dyslipidaemia. Aims & Objective: This is an observational study done to establish the relationship between glycosylated Hb level and lipid profile in Indian diabetic population. Materials and Methods: This is an observational study. 50 diabetic patients were studied between the period of 1990- 2000 between February to November. 16 patients were (32%) females and 34 (68%) were males. They were from 25-72 years of age. Results: 17 (34%) patients were >60 years of age, 16 (32%) were between 50-60 years of age, 9(18%) were between 40-50 years of age, 6(12%) patient were between 30-40 years of age where only 2 (4%) patient were between 20-30 years of age. Out of the 50, 39 (78%) patients were on oral hypoglycemic drugs, 7 (14%) patients were on insulin and 4 (8%) patients were on insulin and oral hypoglycemic agents. 34 (68%) patients were regularly taking drugs whereas 16 (32%) patients were on irregular treatment. Positive family history of diabetes was found in 7 (14%) and hypertension in 11 (22%) of the diabetic patients and 36 (72%) patients had negative family history. Laboratory results showed a mean FBS of 174mg/dL and PPBS of 264mg/dL. More than two thirds [33 (66%)] of the participants had HbA1c >10% and the rest 17 (34%) had HbA1c 10% vs.

Prevalence of gestational diabetes mellitus in rural Haryana: A community-based study

Background and Objectives:Gestational diabetes mellitus (GDM) is a global health concern as it affects health status of both mother and fetus. In India, prevalence of GDM varies in different populations and no data is available from rural Haryana. This study was undertaken to determine the prevalence of GDM and risk factors associated with it in rural women of Haryana.Materials and Methods:Nine hundred and thirteen women, with estimated gestational age above 24 weeks from a rural block of Haryana who consented to participate were given a standardized 2-h 75-g oral glucose tolerance test (OGTT). Pro forma containing general information on demographic characteristics, educational level, gravida, family history of diabetes, and past history of GDM was filled-up. A World Health Organization (WHO) criterion for 2-h 75-g OGTT was used for diagnosing GDM.Results:GDM was diagnosed in 127/913 (13.9%) women with higher mean age as compared to non-GDM women. Majority (78.4%) of the women were housewives, rest engaged in agriculture (9.2%) and labor (5.5%). Women with gravida ≥3 and positive family history of diabetes had significantly higher prevalence of GDM. History of macrosomia (birth weight ≥4 kg) was significantly associated with prevalence of GDM (P = 0.002). On multiple logistic regression analysis, risk factors found to be significantly associated with GDM were maternal age >25 years, gravida >3, history of macrosomic baby, and family history of diabetes.Conclusion:The prevalence of GDM has been found quite high in rural Haryana. Appropriate interventions are required for control and risk factor modifications.

Awareness among Patients with T2DM regarding the Disease at a Tertiary Care Referral Center

ABSTRACTObjectiveTo assess the knowledge of patients with T2DM regarding their disease at a tertiary care referral centre.Patients and methodsUsing purposive sampling technique, a total of 200 patients of diabetes were enrolled. The pretested questionnaire consisting of 40 items with maximum score of 40 was administered to the participants after appropriate validation. Information was obtained regarding the demographic variables, presenting symptoms of diabetes, and awareness of the subjects regarding their disease. The data was analyzed by using SPSS version 16.Results and conclusionMean age of the subjects was 54.2 ± 1.2 years with the range of 16 to 80 years. More than half (52.5%) were women and 54.5% were in the age group of 41 to 60 years, and 50.5% belonged to urban locality. Majority were married (96.5%). Polyuria was the presenting symptoms in 43.5% of patients. The mean knowledge score was 26.0 ± 8.9 out of 40 (maximum attainable score) with the range of 3 to 39. More than half (63%) of the patients achieved good (≥60%) and above category of knowledge score. The patients with higher education status, male, and with positive family history of diabetes had significantly more knowledge score (r = 0.3, – 0.2, – 0.2, p &lt; 0.01 for all).ConclusionIn the present study, almost two third of the patients with T2DM had good knowledge about the disease; however, more efforts are required to further improve the knowledge among them.How to cite this articleKaur S, Mandal L, Nair P, Kaur N, Pathak P, Bhansali A. Awareness among Patients with T2DM regarding the Disease at a Tertiary Care Referral Center. J Postgrad Med Edu Res 2014;48(3):117-122.

De novo mutations of GCK, HNF1A and HNF4A may be more frequent in MODY than previously assumed

MODY is mainly characterised by an early onset of diabetes and a positive family history of diabetes with an autosomal dominant mode of inheritance. However, de novo mutations have been reported anecdotally. The aim of this study was to systematically revisit a large collection of MODY patients to determine the minimum prevalence of de novo mutations in the most prevalent MODY genes (i.e. GCK, HNF1A, HNF4A). Analysis of 922 patients from two national MODY centres (Slovakia and the Czech Republic) identified 150 probands (16%) who came from pedigrees that did not fulfil the criterion of two generations with diabetes but did fulfil the remaining criteria. The GCK, HNF1A and HNF4A genes were analysed by direct sequencing. Mutations in GCK, HNF1A or HNF4A genes were detected in 58 of 150 individuals. Parents of 28 probands were unavailable for further analysis, and in 19 probands the mutation was inherited from an asymptomatic parent. In 11 probands the mutations arose de novo. In our cohort of MODY patients from two national centres the de novo mutations in GCK, HNF1A and HNF4A were present in 7.3% of the 150 families without a history of diabetes and 1.2% of all of the referrals for MODY testing. This is the largest collection of de novo MODY mutations to date, and our findings indicate a much higher frequency of de novo mutations than previously assumed. Therefore, genetic testing of MODY could be considered for carefully selected individuals without a family history of diabetes.

High prevalence of type 2 diabetes among the urban middle class in Bangladesh

BackgroundThe prevalence of type-2 diabetes and metabolic syndrome are increasing in the developing world; we assessed their prevalence among the urban middle class in Bangladesh.MethodsIn this cross-sectional survey (n = 402), we randomly selected consenting adults (≥ 30 years) from a middle-income neighborhood in Dhaka. We assessed demography, lifestyle, and health status, measured physical indices and blood pressure and obtained blood samples. We evaluated two primary outcomes: (1) type-2 diabetes (fasting blood glucose ≥ 7.0 mmol/L or hemoglobin A1C ≥ 6.5% (48 mmol/mol) or diabetes medication use) and (2) insulin resistance (type-2 diabetes or metabolic syndrome using International Diabetes Federation criteria).ResultsMean age and Quételet’s (body mass) index were 49.4 ± 12.6 years and 27.0 ± 5.1 kg/m2; 83% were married, 41% had ≥12 years of education, 47% were employed, 47% had a family history of diabetes. Thirty-five percent had type-2 diabetes and 45% had metabolic syndrome. In multivariate models older age and family history of diabetes were significantly associated with type-2 diabetes. Older age, female sex, overweight or obese, high wealth index and positive family history of diabetes were significantly associated with insulin resistance. Participants with type-2 diabetes or insulin resistance had significantly poorer physical health only if they had associated cardiovascular disease.ConclusionsThe prevalence of type-2 diabetes and metabolic syndrome among the middle class in Dhaka is alarmingly high. Screening services should be implemented while researchers focus on strategies to lessen the incidence and morbidity associated with these conditions.

Risk of Diabetes in Subjects with Sedentary Profession and the Synergistic Effect of Positive Family History of Diabetes

Sedentarism in the workplace, which accelerates risk of diabetes, is least explored in the Indian population. The primary objective of this study was to assess whether prolonged sitting hours in work place predisposes individuals to risk of diabetes and also to estimate risk of diabetes in sedentary workers with a positive family history of diabetes (FHD). Data of age-matched 514 subjects previously undiagnosed with diabetes from two different occupational groups (bank employees and schoolteachers) in Chennai, India from opportunistic screening were taken for analysis. The important explanatory variables were body mass index, waist circumference, duration of physical activity, positive FHD, and random capillary blood glucose (RCBG). Logistic regression analyses were done separately to identify determinants of diabetes in each group. Another logistic regression was performed after combining data to estimate risk associated with diabetes among sedentary subjects with positive FHD. Factors associated with elevated RCBG among schoolteachers were systolic and diastolic blood pressure, whereas among bank employees, in addition to blood pressure, duration of sitting in work place and positive FHD were significantly associated with diabetes. Combined data analysis showed that subjects with duration of sitting of ≥180 min/day and a positive FHD are three times at risk of developing diabetes. Adjusting for total physical activity revealed that risk was higher among male subjects. Increased sitting duration for ≥180 min/day at the workplace was associated with elevated RCBG. There was a threefold higher risk for diabetes among these subjects with positive FHD. Encouraging physical activities in such groups, particularly in men, can be beneficial.