Objective:Although many studies worldwide explained the risk factors for developing Diabetic Foot Ulceration (DFU), little has been done to assess medical factors in DFU formation and link them in patients of Pakistan. This study aimed to link the DFU with different risk factors.Methods:This descriptive cross-sectional retrospective study was conducted in Diabetes Endocrine and Metabolic Centre / Post Graduate Medical Institute / Lahore General Hospital. Data of all patients presenting between July 2017 to June 2018 were analyzed for risk factors. Analysis was done on SPSS version 21.Results:Total of 3301 patient were seen during this period, out of which 2052 patient data was picked up as it was complete in respect to the information needed. Middle age, Male gender, Type 2 diabetes, and Hypertension, were insignificantly co-related. High waist circumference, Comorbidity like Neuropathy, Dyslipidemia, Greater body mass index, Poor compliance with Medication and type of medication used (combination of oral and injectable) were found statistically significant predictor for DFU. However retinopathy was not found to be a risk factor of DFU. This result was statistically significant.Conclusion:Factors like obesity, waist circumference, combination of oral along with injectable therapies, neuropathy, dyslipidemia, retinopathy and poor compliance with medication were statistically significant and can be strongly linked with diabetic foot ulcer. Middle age, Male gender, Type 2 diabetes, and Hypertension were insignificantly co-related. However, further studies are needed in larger population to support these findings.

Introduction: Ramadan is a holy month and the majority of Muslims fast in it, without considering background illnesses. SGLT-2 drugs were available for Pakistani patients recently, and this was the first year to fast in their presence.Objectives: To assess the risk of hypoglycemia in fasting diabetics using SGLT-2 drugs, comparing it with Sulphonylurea (SU) drugs. Also, a change in HbA1c and eGFR was checked. Hence, evidence was collected to recommend their use in fasting Diabetics with safety. Material and Methods: A total of 5500 patients from three different sites were included. Only 500 fulfilled the criteria of inclusion. Pregnant, lactating, advanced Chronic Kidney Disease (CKD), and those recording hypoglycemia frequently were not included. Ages between 20 to 70 years, HbA1c between 7 to 11, and patients taking SU or SGLT-2 were included. Conclusion: The eGFR was comparable in both groups post-Ramadan. HbA1c was significantly reduced in the SGLT-2 group. Bitter taste and thirst were common with the SU group. Hypoglycemia was comparable in both groups. We concluded that SGLT-2 drugs were safe during Ramadan, and caused more HbA1c reduction.

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BACKGROUND Metabolic syndrome was reported prevalence of 33.4% with the WHO, 22.6% with the NCEP-R, and 30.9% with the IDF criteria in urban population. According to literature, NCEP-R and IDF were most consistent in picking metabolic syndrome (MetS) in non insulin dependent diabetic patients. AIM This study evaluated three diagnostic criteria of metabolic syndrome with respect to their sensitivity and specificity, comparing the relation of WHO with IDF and NCEP-R, suggesting most suitable criteria for our population. MATERIAL AND METHOD It was a descriptive case-control study carried out in the Diabetes, Endocrine and Metabolic Center, Lahore General Hospital, Lahore (DEMC, LGH) between November 2011 to November 2013. Total 3300 subjects were selected and. interviewed for demographics, everyday features (diet, exercise, smoking, alcohol consumption). Laboratory analysis were used to develop biochemical parameters. .Anthropometric measurements were carried out. Data was analysed using SPSS version 23. Chi-square was used for comparison of proportions. Kappa statistic was used to test degree of agreement between them. RESULTS The incidence of MetS in type2 diabetic patients according to WHO criteria was highest, followed by IDF and NCEP-R.  IDF and NCEP-R had better specificity. Positive Predictive Value (PPV) was high for NCEP-R and Negative Predictive Value (NPV) for IDF. Kappa showed both were in agreement, with IDF criteria better. CONCLUSION WHO criteria was most sensitive in picking diagnosis of MetS. IDF was second in sensitivity and NCEP-R was most specific. There is need to improve awareness, in view of the alarming number of patients.

Objectives: Ramadan comes every year, in which Muslims fast for a month according to lunar calendar, which is shorter in duration, and hence can result in Ramadan rotating in different seasons in the same country. Having diabetes, demands a change in life style during fasting, with regular exercise and change in diet patterns. International Diabetes Federation (IDF) has formulated Diabetes and Ramadan (DAR) guidelines, which provide guidance. Assess the knowledge of Healthcare workers before workshop, and to compare afterwards. Study Design: Experimental Study. Setting: Medical Unit-III, Diabetes Endocrine and Metobilc Center Lahore General Hospital, Lahore. Period: 2 years, 2019 and 2020. Material & Methods: This study was carried out on the participants of workshop. A pretest was given to participants. Questions assessed the knowledge on Complications, Risk Stratification, Diet and Exercise, when to break their fast and adjustment in the dosage of different medications used by diabetics. A 90 minute interactive workshop was carried out. Participants were encouraged to question and get justifications for better understanding. Afterwards, a posttest was carried out. Data was assessed using SPSS, and a simple t-test was applied. Results: There was gross improvement in retention of knowledge in all areas. It was also statistically significant when t-test was applied. Conclusion: Interactive workshop pattern improves the retention of knowledge among participants. It was a better way to deliver knowledge, than conventional lecture.