Background: Non-dipping of nocturnal blood pressure is common in people with type 2 diabetes with hypertension and is associated with increased risk of cardiovascular and renal morbidity and mortality. This study aimed to identify the pattern of nocturnal non-dipping of BP in people with type 2 diabetes and its association with microalbuminuria. Methods: Data was examined from 100 patients with type 2 diabetes with hypertension who had undergone 24hrs ambulatory BP monitoring and it was correlated with urinary ACR, which was done in morning spot urine sample of all the patients. Results: Normal dipping was observed in 45%, non dipping in 46%, extreme dipping in 6% and 3% were reverse dippers in patients having type 2 diabetes and hypertension. It was observed that 24 hr dipping pattern of blood pressure and was strongly related to microalbuminuria (p <0.001). Non dippers were significantly older (p<0.05) with a higher prevalence of albuminuria (p<0.001) as compared to dippers. Nocturnal dipping and albuminuria was found significantly associated with glycemic control, duration of diabetes and hypertension. Conclusion: Non-dipping of nocturnal BP in people with type2 diabetes mellitus and hypertension is strongly associated with microalbuminuria.

No abstract

IntroductionCardiovascular disease (CVD) is a major health problem across the world for 30% of all deaths.

Background: Type 2 Diabetes Mellitus is an emerging pandemic with number of patients increasing rapidly in both developed and developing nations. In patients with secondary failure of type 2 diabetes after oral hypoglycaemic agents (OHAs), Insulin is the treatment, which is available in various forms with respect to viable duration of action. Basal Insulins or background insulins are used commonly either alone or with short acting insulins. NPH insulin is intermediate acting insulin given once or twice daily whereas Glargine is long acting insulin given once daily. Methods: In this study, 120 patients of type 2 diabetes mellitus already on oral hypoglycaemic agents who were not optimally controlled with combination of 2 or 3 oral hypoglycaemic agents were included after excluding patients of Type 1 diabetes, gestational diabetes and those who were newly diagnosed or already on insulin therapy. Patients were divided into 2 groups of 60 patients each. Group A were put on NPH insulin and Group B on Glargine insulin for 12 weeks. Along with parameters of diabetes and side effects were compared with special reference to early morning hypoglycaemia (at 3 am).Results: Mean reduction in fasting blood glucose was 54.42 mg/dl in Group A as compared to 66.62 mg/dl in Group B, which was statistically significant with a p value < 0.0001. Regarding hypoglycaemia it was seen in 31.67% in Group A vs. 11.67% in Group B and was significant (p=0.0078). Nocturnal hypoglycaemia was also seen to be more in Group A than Group B with values of 21.67% and 5% respectively, which was significant. There was no significant difference in daily dose requirement. Conclusion: This study showed that Insulin Glargine was better than Insulin NPH in terms of glycemic control and less side effects with respect to hypoglycemic events and nocturnal hypoglycemia with no significant difference in daily dose requirements.

Facial involvement along with paraplegia as presenting feature in acute myelogenous leukemia is rarely reported neurological presentation. IntroductionAcute myelogenous leukemia is a neoplasm of myeloid series and usually presents with signs and symptoms related to anemia, thrombocytopenia and neutropenia. CNS involvement as presenting feature is uncommon. We hereby report a case of 25 year old male who had paraplegia and facial nerve palsy as presenting feature of AML.