Objectives: To evaluate new diabetic control monitoring parameters insulin, ghrelin, body mass index, waist-to-hip ratio, homeostasis model assessment-insulin resistance (HOMA-IR), and HOMA-β for Type 2 diabetes mellitus (T2DM) with obesity and to compare them with the existing diabetic control markers plasma glucose and glycosylated hemoglobin (HbA1c) and to recommended these additional tests to assess complications associated with kidney, liver, cardiac, and pancreas. Methods:A total of 100 T2DM patients with obesity who attended the sugar clinic attached to Apollo Speciality Hospitals, Vanagaram and who were on standard treatment and 50 age and sex matched controls attending the routine master health check in the same hospital were enrolled for the study. Fully automated analyzers and reagents and controls were used for all assays to ensure validity of the results obtained. For insulin and ghrelin assays, established commercial kits were used and all other parameters were calculated using formulae established previously. Graphpad online calculator was used to calculate t and p values. Results:The results obtained for both controls and patients for the set of additional parameters were compared with fasting plasma glucose (FPG), post prandial plasma glucose (PPPG), and HbA1c between controls, patients and controls with patients by calculating r and p values. Highly significant correlations were obtained in all comparisons. Conclusions:Very good associations (p<0.0001) were found between FPG, PPPG, and HbA1c to each of the new parameters for controls, patients and between controls and patients. These additional parameters may be done at fixed intervals of time to evaluate kidney, liver, cardiac and pancreatic complications/dysfunction in T2DM patients with obesity.

Anion gap is an important parameter used in the interpretation of acid base disorders. This study is undertaken to update the recent understanding of the clinical usefulness of Anion gap in a selected category of patients in our Hospital. Anion Gap and 95 % confidence limits were calculated using the results for Na, Cl and HCO3 of 200 non hospitalized out patients, 300 MICU hospitalized patients, 110 neonatal hospitalized patients and 51 normal male blood donors. Standard procedure was used to collect random blood samples. Beckman coulter AU400 analyzer which employs ISE direct principle was used to measure Na / K / Cl and enzymatic method for HCO3. Appropriate assayed accuracy controls from Bio-Rad were used to validate the accuracy of the results obtained. As this study was to update the usefulness of anion gap, selection of patients with respect to inclusion or exclusion criteria were not followed. The mean + 2 SD limits obtained for blood donors were Na: 131-143, K: 3.4-4.6 Cl: 97-107, HCO3: 21-29 and AG 6-14, (all in mmol / L) all of which agree well with the normal values used in this laboratory. While AG range for blood donors was 6 to 14, for out patients it was 4 to 16, for MICU group it was 3 to 19 and for neonates 1-23 suggesting that MICU and Neonates group patients may have different types of Acid base disorders. MICU patients AG were more or less close to normal blood donors. The AG range for neonates was the widest ranging from 1 to 23. This study gives some awareness on the usefulness of AG in interpreting acid base disorders.