The glomerular podocytes form a major size selective barrier for the filtration of serum proteins and reduced podocyte number is a critical event in the pathogenesis of proteinuria during diabetic nephropathy (DN). An elevated level of growth hormone (GH) is implicated as a causative factor in the development of nephropathy in patients with type 1 diabetes mellitus. We have previously shown that podocytes express GH receptor and are a target for GH action. To elucidate the molecular basis for the effects of GH on podocyte depletion, we conducted PCR-array analyses for extracellular matrix and adhesion molecules in podocytes. Our studies reveal that GH increases expression of a gene that encodes transforming growth factor-beta-induced protein (TGFBIp) expression. Similarly, microarray data retrieved from the Nephromine database revealed elevation of TGFBIp in patients with DN. Treatment with GH results in increased secretion of extracellular TGFBIp by podocytes. Both GH and TGFBIp induced apoptosis and epithelial mesenchymal transition (EMT) of podocytes. Exposure of podocytes to GH and TGFBIp resulted in increased migration of cells and altered podocyte permeability to albumin across podocyte monolayer. Administration of GH to rats induced EMT and apoptosis in the glomerular fraction of the kidney. Therefore, we conclude that the GH-dependent increase in TGFBIp in the podocyte is one of the mechanisms responsible for podocyte depletion in DN.

Background: Diabetes is one of the most common non communicable diseases globally. India is considered as the world diabetes capital. Women detected with gestational diabetes mellitus (GDM) have an increased incidence of developing diabetes; especially type 2 diabetes mellitus in the later life, and future development of obesity and diabetes in the offspring. So the aim of this study is to validate the sensitivity and specificity of diabetes in pregnancy study group of India (DIPSI) recommended 75 g oral glucose challenge test (OGCT) by comparing with carpenter and couston 100 g oral glucose tolerance test (OGTT) and to note the prevalence of gestational diabetes in antenatal population attending Kempegowda Institute of Medical Sciences (KIMS).Methods: All antenatal patients reporting to our hospital at or before 24 to 28 weeks period of gestation will be recruited for the study. Patients at random will be subjected to 75g glucose load according to DIPSI criteria and one week later to carpenter and couston 100 g OGTT. Blood glucose is estimated from venous blood using glucose oxidase and peroxidase (GOD-POD) method and patients diagnosed according to respective criteria.Results: Most of the patients were in age distribution of 20–25 years. Among 100 patients in study group 28 were diagnosed as GDM by DIPSI criteria. Among 100 patients, 12 patients were detected as GDM by carpenter and couston GTT, 19 patients had impaired glucose tolerance. The incidence of GDM in the antenatal population attending KIMS hospital between gestational ages of 24–28 weeks is 12%.Conclusions: DIPSI can be used as a diagnostic test for GDM as one step simple and easy procedure especially I low resource settings like India for improved pregnancy outcome.