BackgroundThe Metabolic syndrome (MS) consists of central obesity, glucose intolerance, hyperinsulinemia, low high density lipoproteins, high triglycerides and hypertension. Different studies have observed that MS causes microvascular complications in patients with type 2 diabetes. The aim of the study was to find out the prevalence of MS in the Indian population with type 2 diabetes mellitus in relation to gender, duration of diabetes, and to evaluate the influence of MS and its individual components on microvascular complications such as diabetic retinopathy, diabetic nephropathy and diabetic neuropathy.MethodsA population-based cross sectional survey was conducted with 1414 patients having type 2 diabetes mellitus. The International Diabetes Federation (IDF) criteria were used to identify the metabolic syndrome. Diabetic retinopathy was graded using the stereoscopic digital fundus photography. Neuropathy was assessed by measuring the vibration perception threshold through a sensitometer. Nephropathy was diagnosed by the presence of microalbuminuria in the first morning urine sample.ResultsThe age and gender adjusted prevalence of MS, using the IDF criteria, in the South Indian population was 73.3%. The prevalence was higher in women (83.3%), compared to men (65.3%). In subjects with diabetes mellitus, without and with MS, the prevalence of retinopathy was 21.3% and 16.9% (p = 0.057); prevalence of nephropathy was 20.5% and 18.0% (p = 0.296), and prevalence of neuropathy was17.2% and 19.4% (p = 0.353) respectively. Overall and in women, the clustering of MS components led to an increase in the prevalence of diabetic nephropathy. The prevalence of retinopathy and neuropathy in MS subjects, who had diabetes for < 10 years, was more in both men and women; it was more in women but not in men when the duration of diabetes varied from 11-20 years.ConclusionsThe association of MS with microangiopathies decreased with an increase in the duration of diabetes. MS behaved differently in men and women. It may need to be managed differently in the two groups.

To study the prevalence of Abnormal Sleep Patterns (ASPs), gender-wise, in subjects with type II diabetes mellitus and its influence on diabetic microangiopathies. A population-based cross-sectional survey was conducted among 1,414 patients having type II diabetes mellitus. Diabetic retinopathy was graded using stereoscopic digital fundus photography. Neuropathy was assessed by measuring vibration perception threshold using a sensitometer. Nephropathy was diagnosed by the presence of microalbuminuria in the first morning urine sample. ASPs were defined as either short (less than 5 h) or long (more than 9 h) duration of sleep with excessive daytime sleepiness. The Epworth Sleepiness Scale (ESS) score was assessed to note excessive daytime sleepiness; a score of more than 10 was considered as abnormal. The prevalence of ASPs was more in subjects with diabetes than with those without diabetes (14.8 vs. 6.6%) (P = 0.009), especially in women (15.7 vs. 5.6%) (P = 0.021). Likewise, the prevalence of short duration of sleep was higher in subjects with diabetes compared to those without diabetes (6.6 vs. 2.2%) (P = 0.040). The mean age of women subjects with diabetes, having ASPs, was higher than those without diabetes (56.4 ± 8.9 years vs. 47.2 ± 5.9 years, P = 0.033). Women subjects with ASPs had a higher risk of diabetic neuropathy on both univariate and multivariate analysis. ASPs are not only related to diabetes but can also influence the microvascular complications arising due to diabetes, particularly diabetic neuropathy. Diabetology and sleep medicine specialists need to work together to prevent the negative interactions between these two groups.

Objectives: Prevalence of diabetes mellitus is increasing globally in most developed and developing countries and Dipeptidyl peptidase-4 inhibitors (Gliptins) are recently introduced class of drugs for type 2 diabetes mellitus which shows good glycemic control. It is a prospective interventional pilot study aimed to determine the efficacy of add-on vildagliptin therapy to metformin in type 2 diabetes mellitus patients for a period of 6 months in south Indian resource limited settings. MethOds: A total of 185 patients were enrolled into the study. The study subjects were assigned into three groups based on their existing treatment (initiated within one month) i.e., group I (vildagliptin and metformin), group II (vildagliptin alone) and group III (metformin alone). They were also assessed for baseline demographic characteristics. Medication adherence was measured to ensure that patients are complies with the treatment. The clinical endpoint was estimated by using various variables like quality of life and other clinical endpoints such as RBS, PPBS after three months of specific treatment through direct interview and by referring the medical case records. Results: The results show that there is no significant difference in individual groups in terms of demographic characteristics. (P > 0.01). And all the present study subjects are found to have more than 90 % of medication adherence. We observed high level of significant improvement in group I (93.18±3.76) subjects whereas low level of improvement in group III subjects (90.4±4.13) after the relevant treatment (P = 0.003). Group I subjects are also found to have good glycaemic control (RBS, FBS and PPBS) than any other treatment groups P< 0.01). cOnclusiOns: Add on vildagliptin therapy to metformin might improve the quality of life of type 2 diabetes mellitus patients and might be useful to bring the glycemic levels under control in type 2 diabetic patients in South Indian resource limited settings.Objectives: To evaluate the accuracy of different blood glucose determination methods, and provide a theoretical basis for governments to determine the mainstream glucose detection methods. MethOds: The MEDLINE, EMBASE, EBM REVIEWS, CBM, CNKI, Wanfang, Google academic search et al were were retrieved for literatures collection, literature quality evaluation was implemented by using QUADAS criteria, meta-analysis was carried out using Stata11.0 and heterogeneity test and sensitivity analysis was implemented. Results: 20 studies were included, which contained a total of 2681 cases of patients. Meta analysis showed that values measured by the dry chemical method were significantly higher than glucose oxidase method, and no significant differences was found with the hexokinase method, no significant differences was yet found between the electrode method with enzyme method, the MD (95%CI) were 0.31 (0.09, 0.53), -0.51 (-0.14, 1.17) and -0.13, (-0.27, 0.02) respectively. Sensitivity analysis of the model, the sample source, research population, equipment and countries was carrie...