Background: Diabetes is the most common non-communicable disease known today. This study was conducted to assess the clinical profile and complications in patients with type 2 diabetes mellitus.Methods: A prospective study was carried out between April 2017 to April 2018 in patients attending a tertiary care hospital in Chennai. Patients with type 2 diabetes of age 25-80 years, minimum of 5 years duration were enrolled.Results: Out of 66 patients, 23(34.8%) were males whereas 43 (65.2%) were females.  Mean age in this study population was 55.36 years with a standard deviation of 11.362. In present study, the mean fasting blood sugar level was 196.12±77.180, mean postprandial blood sugar level was 303.26±115.385 and the mean HbA1C levels was 10.95±2.369. 77.3% were on oral hypoglycaemic agents, 13.6% on insulin and 9.1% on combined therapy with oral hypoglycemic agents and insulin. The complications associated with diabetes found in present study were microvascular complications which include peripheral neuropathy 41(62.1%), retinopathy 31(46.96%), nephropathy 28 (42.42%). Peripheral neuropathy was found to be most commonly associated. Macrovascular complications include cardiovascular disease in 12.12% (n=8) and cerebrovascular disease in 4.54% (n=3). Autonomic neuropathy was found in 69.69% (n=46).Conclusions: The complications of DM are commonly seen in patients with poor glycaemic control. Among microvascular complications, peripheral neuropathy was most commonly seen. Autonomic neuropathy usually goes unnoticed and asymptomatic in most of the individuals. Increasing levels of HbA1c was found to be significantly correlated with neuropathy.

Henoch-Schonlein purpura (HSP) is a common leukocytoclastic vasculitis seen in children. However, it is uncommon in adults. HSP is characterized by the classic tetrad of non-thrombocytopenic palpable purpura, arthritis or arthralgias, gastrointestinal, and renal involvement. We report a rare case of adult onset HSP with multi-organ involvement. Early recognition of multi-organ involvement is very important, especially in adults.

The autonomic nervous system (ANS) innervates the entire neuraxis and influences the functions of all organs. This study was undertaken for evaluating the autonomic dysfunction in diabetic patients using clinical autonomic tests and neuro- electrophysiology. A prospective study was carried out in 66 patients with type II diabetes mellitus in a tertiary care hospital for one year. Systemic examination, necessary investigations, nerve conduction study and clinical testing for the autonomic nervous system were done. The results were noted and analyzed. 65.2% were females, whereas 34.8% were males. Mean duration of diabetes was found to be 9.06 years (SD 4.121). 80.3% population was known to have type 2 diabetes for 5-10 years duration, 13.6% had diabetes for 10-15 years, and only 3.5% had diabetes for more than 15 years. Mean FBS was found to be 196.12(mg/dl) ±77.180 SD and mean PPBS was 303.26(mg/dl) ± 115.385 SD. Mean HbA1c levels were 10.95 ± 2.36 SD. 33.3% showed early parasympathetic involvement for cardiac autonomic neuropathy, 9% had definite parasympathetic involvement, and only 6% had both parasympathetic and sympathetic involvement. 62.12% showed abnormal responses in nerve conduction study, of which 48.78% had autonomic dysfunction. The main factor responsible for the development and progression of autonomic dysfunction is poor glycaemic status. If contributing factors can be detected, early identification of cardiac autonomic neuropathy (CAN) and appropriate management would halt its progression. Aggressive glycaemic monitoring and treatment shall bring down the progression and prolong the time interval in showing abnormal responses in autonomic function testing.

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