Background:Subclinical Hypothyroidism (ScHt) affects 3–15% of the adult population. It's clinical and biochemical profile is not well defined, especially in Indian scenario. Our study aimed at screening normal population to define normative ranges of thyroid hormones and Serum thyroid stimulating hormone (S.TSH) and prevalence of ScHt and thyroid autoimmunity.Materials and Methods:Two-hundred thirty-seven normal subjects without family history of thyroid disease were evaluated for symptoms and laboratory tests for thyroid dysfunction and autoimmunity.Results:The thyroid function tests were as follows:Euthyroid Group:Mean values were: T3: 1.79 ± 0.42 ng/mL, T4: 10.23 ± 2.25 μg/dL, FT3: 1.88 ± 0.19 pg/mL, FT4: 1.12 ± 0.21 ng/dL, S.TSH: 2.22 ± 1.06 μlu/mL. 10.2% of euthyroid subjects had antimicrosomal antibodies (AMA) +ve (mean titer 1:918) and 23.6% were anti-thyroid peroxidase autoantibody (anti-TPO) +ve (mean titer 15.06 Au/mL). The euthyroid outlier range for S.TSH was 0.3–4.6 μlu/mL. The values were comparable in both the sexes. Those with S.TSH ≥ 5 μlu/mL were defined to have ScHt.ScHt Group:Prevalence of ScHt was 11.3% (M:F ratio 1:3.7). 74% belonged to 35–54 years age group and prevalence increased with age (post-menopausal females: prevalence 20%). S.TSH was 9.8 ± 7.22 μlu/mL, mean S.AMA was 1:5079 (40.7% positivity) and mean S.anti-TPO was 260 Au/mL (47.6% positivity). Majority were agoitrous (74%), and stage I goiter was seen in 26% of this population. Symptom score of 5–8 was seen in 55% ScHt subjects versus 35% normal subjects.Conclusion:Mean S.TSH in our population was 2.22 μlu/mL (euthyroid outliers: 0.3–4.6 μlu/mL); hence, S.TSH above 4.6 μlu/mL should be considered as abnormal. The prevalence of thyroid autoimmunity increases after age of 35 years. ScHt presents mainly in agoitrous form and with positive antibodies, suggesting autoimmunity as the cause.

Purpose: The aims of this study were to correlate diabetic retinopathy (DR) changes with insulin-like growth factor 1 (IGF-1) levels in patients with type 1 diabetes of pubertal age group and to correlate the level of retinopathy with IGF-1 levels. Methods: This cross-sectional study was done over 2 years and involved patients with type 1 diabetes of age 8 to 25 years. Patients presenting to Ophthalmology OPD and inpatient department along with active recruitment from old pediatrics and endocrinology records were taken for the study. Fasting serum IGF-1 was calculated using enzyme-linked immunosorbent assay technique. Fasting blood sugar levels were taken. Detailed ophthalmic examination was done and DR was noted in all the patients and correlated with IGF-1 levels. Results: A total of 46 patients with type 1 diabetes were recruited into the study. The mean age of the patients was 14.33 ± 4.36 years, with a female-to-male ratio of 3:2. No relationship of IGF-1 with age of onset of diabetes ( P = 0.7) or fasting capillary blood glucose (CBG) ( P = 0.6) was found, but a significant relationship was found with duration of diabetes ( P = 0.001) and low IGF-1 levels ( P < 0.0001). Conclusions: Severity of DR in patients with type 1 diabetes is inversely related to serum IGF-1 levels. Low IGF levels are an indicator for closer follow-up and strict management of diabetes and retinopathy.

Aim: Our objective was to determine nature of antidiabetes prescriptions across the Apollo Sugar Ecosystem, India, a healthcare organization with more than 30 centres (as standalones, secondary and tertiary institutions) that provide care to patients with diabetes Methods: An eligible 206prescriptions with a diagnosis of T2DM from Jan 2016 to June 2017 were included in this analysis to determine the choice of therapy, frequency of usage of different class of anti-iabetes medications, types of insulin, combination and of number of OHAs with insulin. Descriptive analysis was used to report the results. Results: The mean age of the patients was 53.2 years, 63% males and 37% females. The majority of the patients were on OHAs (68.2%) with 22.8% of patients on OHAs+insulin and 9.0% on insulin alone. Biguanides (55.7%) were most commonly prescribed in combination with other OHAs followed by DPP-4 inhibitors (DPP-4i) (35%). 63% of patients requiring insulin were using at least one oral drug. The most common drugs used along with insulin included biguanides (50.5%) followed by DPP-4i (46.7%). Among Insulins short acting insulin was most commonly prescribed followed by Insulin glargine (22.5%) and premixed insulin and analogues (13.55). Conclusions: Several observations stand out from this large cross sectional analysis. 1 A significant number of patients are on monotherapies other than MF. 2. Use of DPP-4i as the most common drug after MF when two drugs are used reflects a significant shift from a SU dominated practice system in India. 3. SGLT2i and insulin find progressive inclusion when three or more drugs are required. 4. A greater adoption of basal and short acting insulin as opposed to premix insulin in a country that was traditionally considered a premix market. The data provided here give a snap shot of the changing trends in adoption of therapeutic practices with availability of newer medications, physician education and patient ability to afford care. Disclosure K.G. Seshadri: None. V. S.: None. M. Rm: None. D. Cs: None. B. Ts: None. N. Nk: None. J. Gopal: None. S. Duvuru: None. U. Ayyagari: None. A. Behl: None.

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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 Karnataka, India.Results:A total of 2243 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 = 1855), insulin detemir (n = 211), insulin aspart (n = 111), basal insulin plus insulin aspart (n = 16) and other insulin combinations (n = 40). At baseline glycaemic control was poor for both insulin naïve (mean HbA1c: 9.2%) and insulin user (mean HbA1c: 9.0%) groups. After 24 weeks of treatment, both the groups showed improvement in HbA1c (insulin naïve: −1.4%, insulin users: −1.7%). 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.