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Proton pump inhibitors (PPI) are now one of the most widely used classes of drugs. PPIs have proven to have a very favorable safety profile and it is unusual for a patient to stop these drugs because of side effects. However, increasing numbers of patients are chronically taking PPIs for gastro esophageal reflux disease and a number of other common persistent conditions, therefore the long-term potential adverse effects are receiving increasing attention. Nowadays as PPI are the main drugs used for peptic ulcer disease and GERD ,a part from this they are also preferred in drug induced gastric irritation .In this article these studies are systematically examined, as well as the studies of the effects of chronic PPI usage on VB12 calcium , absorption which leads to neurologic disorders and osteoporosis. In general the studies in each of three areas have led to differing conclusions, but when examined systematically, a number of the studies are showing consistent results that support the conclusion that long-term adverse effects on these processes can have important clinical implications.

Proton pump inhibitors (PPI) are now one of the most widely used classes of drugs. PPIs have proven to have a very favorable safety profile and it is unusual for a patient to stop these drugs because of side effects. However, increasing numbers of patients are chronically taking PPIs for gastro esophageal reflux disease and a number of other common persistent conditions, therefore the long-term potential adverse effects are receiving increasing attention. Nowadays as PPI are the main drugs used for peptic ulcer disease and GERD ,a part from this they are also preferred in drug induced gastric irritation .In this article these studies are systematically examined, as well as the studies of the effects of chronic PPI usage on VB12 calcium , absorption which leads to neurologic disorders and osteoporosis. In general the studies in each of three areas have led to differing conclusions, but when examined systematically, a number of the studies are showing consistent results that support the conclusion that long-term adverse effects on these processes can have important clinical implications.

The aim of the study is to assess the prevalence of comorbidities and complications of type 2 diabetes mellitus among patients in a government general hospital, Ongole Andhra Pradesh. OBJECTIVES:  To estimate the prevalence of co-morbidities & complications in type 2 diabetic patients.To assess the significant relationship between the duration of diabetes and complications. METHODOLOGY: Prospective observational studies that have been conducted on 800 patients in General medicine of a tertiary care hospital among the patients who adhere to criteria were registered in the study. The data was collected by using a well-designed proforma according to the criteria, and the data was analyzed. Inclusion criteria: Diabetic patients > 18 years to <80 years are included. Exclusion criteria: Diabetic patients < 18 years to > 80 years are excluded. Patients with type 1 diabetes mellitus and gestational diabetes are excluded. RESULTS: This study revealed that out of  800 patients,co-morbid Conditions are  407 (50%) are HTN patients, 109 (13.6%) are CLD patients, 96 (12%) are pancreatitis, 83 (10.3%) are dyslipidemia patients, 77 (9.6%) are Gastritis patients and 48 (6%) are CKD patients. Complications of type 2 Diabetes are 185 (23.1%) are CVD patients, 169 (21.1%) are CVA patients, 126(15.7%) are neuropathy patients, 123 (15.3%) are retinopathy patients, 113(14.1%) are nephropathy patients, 107 (13.3%) are Diabetic foot ulcer patients and 63(7.8%) are ketoacidosis patients. Duration of diabetes less than 5 years is major in number342 (42.7%) which contributes variation in the study190 (24%) are between 6-10 years, 120 (15%) are between 11-15 years, 80 ( 10%) are between 16-20 years, 68 ( 9%) are having a duration greater than 20 years. CONCLUSION: This study mainly focused on patients having a duration of diabetes less than 5 years having complications of 0.8% patients with nephropathy, 2.1% patients with CVD, 1.8% with CVA, 1.2% with diabetic foot ulcer, 0.6% with ketoacidosis, 0.3% with retinopathy, 1% with neuropathy. Between 6-10 years of disease duration, there are 2.5% with nephropathy, 3.3% with CVD, 3% with CVA, 2.2% with diabetic foot ulcer, 0.9% with ketoacidosis, 1.8% with retinopathy, and 1.3% with neuropathy. In between 11-15 years duration with diabetes, there are 3.8%,5%,4.4%, 2.9%, 1.5%, 3.2%, and 3.5% with nephropathy, CVD, CVA, diabetic foot ulcer, ketoacidosis, retinopathy, and neuropathy respectively. As the duration of diabetes increases the occurrence of complications also rises and leads to death.