Background: As type 2 DM has posed challenging and formidable problem globally lots of scientific research work have been targeted and concepts are evolving every other day to unleash newer etiological factor in its causation and side by side risk factors so that proper aggressive strategy can be instituted to contain the disease at the very outset. Keeping these ideas in the back of our mind we embarked upon this small but compact path finding study. Methodology:The study conducted in the Dept. of Endocrinology, Medical College and Hospital, Kolkata. Patients suffering from Type-2 DM (diagnosed by ADA criterion) attending our diabetic clinic and diabetic patients admitted including the Dept. of Endocrinology and Internal Medicine were selected for this study. Study was conducted from March 2013 to December 2014. 276, Type-2 diabetic patients and 117 healthy control subjects among the relative of patients and volunteers were selected for this study to compare distribution of ABO blood groups. All the study subjects were selected by random sampling technique. ABO blood grouping (determined by using Tulip Diagnostic Kit). Screening of complications done by appropriate clinical examinations and laboratory investigations.Results: Total 276 patients with type 2 DM were included in this study. Of those 276 diabetic patients 152(55%) were male and 124(45%) were female. 117 healthy control subjects among the relative of patients and volunteers were selected for this study to compare distribution of ABO blood groups. Mean age of diabetic patient was 50.46(±10.38) and non-diabetic control subjects was 40.52(±12.21). Mean BMI was 24.18(±3.77) in diabetic subjects and was 25.40(±3.92) in control population. Chi-square statistical analysis among different blood groups between non-diabetic (n=111) and diabetic population (N=276) revealed no significant relationship of any blood group with type 2 DM (p˃0.05). But relative risk (RR) were calculated in reference to blood group O, it has been observed that slight increase of risk of developing type 2 DM among AB( RR 1.075), A(1.044) and B(1.033).With regards to distribution of patients (in number) with type 2 DM with different microvascular complications, Nephropathy was the most common complication observed among different blood groups (37.2% in B, 36.6% in O, 36.5% in A and 34.5% in AB).Further exploring the association between specific blood groups in type 2 diabetes subjects and microvascular complications, no significant association observed with type 2 DM and neuropathy, nephropathy and retinopathy (p˃0.05). However, taking blood group O as a reference group, Blood group AB (RR 0.583 and blood group A(RR0.698) were less likely to develop neuropathy compare to blood group O. However no difference in relative risk found for development of nephropathy and retinopathy. Conclusion:We found that person with O+ve blood group has least chance of developing Type 2 DM whereas subject with AB+ve blood group are more vulnerable to develop Type 2 DM. Therefore, the effects of blood group...

Diabetic kidney disease (DKD) occurs in approximately 20-40% of patients with type 2 diabetes mellitus. Patients with DKD have a higher risk of cardiovascular and all-cause mortality. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and antihyperglycemic drugs form the mainstay of DKD management and aim to restrict progression to more severe stages of DKD. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) control hyperglycemia by blocking renal glucose reabsorption in addition to preventing inflammation, thereby improving endothelial function and reducing oxidative stress; consequently, this class of prescription medicines is emerging as an important addition to the therapeutic armamentarium. The EMPA-REG OUTCOME, DECLARE TIMI 58, and CANVAS trials demonstrated the renoprotective effects of SGLT2i, such as restricting decline in glomerular filtration rate, in the progression of albuminuria, and in death due to renal causes.

Platelet signatures indicating differential dysfunction, hyperactivation, aggregation or adhesion are capable of expressing their characters during the journey of a disease process, and can be utilized as cost effective biomarkers with immense clinical value. Type 2 diabetes mellitus (T2DM) is a major lifestyle disease of contemporary world with progression to diabetes associated cardiovascular diseases (DM-CVD). We identified a few potential biomarkers in platelets of T2DM to analyze the thrombotic risk in diabetes subjects by utilizing flow cytometric quantification with different flurochrome conjugated monoclonal antibodies. Our study describes interesting correlations (p < 0.0001) for different clinical parameters of concurrent threat for vessel occlusion and the status of indices like reactive oxygen species, von Willebrand factor and mitochondrial membrane potential using western blotting and fluorescence techniques. Our study involved 32 T2DM, and 31 T2DM -CVD subjects compared to 29 healthy controls without any history of T2DM or CVD. An altered expression of platelet surface markers P-selectin (CD62p) and GpIIb/IIIa (CD 41/61, PAC1) along with changes in the platelet size due to agonist induced activation contributed to the enhanced thrombotic potential in the patients. This work elucidates the prospect of platelet biomarkers as diagnostic tool to predict cardiovascular risk in DM subjects.

A diagnosis of congenital adrenal hyperplasia (CAH) in a ‘46, XX’ newborn with ambiguous genitalia is like a ‘knee jerk reaction’ of the paediatrician because of its higher frequency and life-threatening consequences if remain undiagnosed and hence untreated. Aromatase deficiency (AD), a rare cause of ‘46, XX’ disorder of sex development, mimics virilising CAH in many aspects; thus, the disease is often overlooked. Diagnosis of AD in women is much easier around puberty due to the presence of primary amenorrhoea, undeveloped breasts, androgen excess and tall stature with eunuchoid proportions. Diagnosing AD with confidence immediately after birth or during early childhood is a challenging task without genetic analysis. In resource-restricted settings, AD remains a diagnosis of exclusion particularly in this age group and history of maternal virilisation, non-progressive genital ambiguity, elevated gonadotrophins (follicle-stimulating hormone >>luteinising hormone), mildly delayed bone age with/without enlarged polycystic ovaries serve as important clues to the underlying AD.

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