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Background: Diabetes Mellitus is an important health problem affecting major population worldwide. It is characterized by absolute or relative deficiency in insulin secretion and/or insulin action associated with chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. The prevalence of type II diabetes mellitus for all age groups worldwide was estimated to be 2.8% in 2000 and likely to increase to 4.4% in 2030. The number of people with diabetes is projected to rise from 285 million adults in 2010 to 439 million adults in 2030. In India, it is estimated that presently 31.7 million individuals are affected by this deadly disease, which are likely to increase to 79.4 million by the year 2030. Diabetes patients with nephropathy have higher prevalence of thyroid disorder than type 2 DM without nephropathy which may have an influence on diabetic management. Diabetic women are frequently affected than men and hypothyroidism is more common than thyrotoxicosis. Methods: In our study 100 patients with type 2 DM attending Guru Nanak Dev hospital attached to GMC Amritsar were recruited. These patients were divided into two groups of 50 patients each. Group 1 consisted of patients of type 2 DM without nephropathy and group 2 consisted of patients of type 2 DM with nephropathy. Results: Out of 100 patients thyroid dysfunction was more prevalent in diabetic nephropathy group as compared to diabetic without nephropathy group. P-value for thyroid dysfunction in diabetic nephropathy was statistically significant. In our study we found a statistically significant correlation between TSH and serum insulin levels in patients with diabetic and diabetic nephropathy. Higher prevalence of thyroid dysfunction like low T3 syndrome and subclinical hypothyroidism was found in women as compared to men. Conclusion: Routine assessment of thyroid hormone level in addition to other biochemical parameters in the early stage of diabetes and diabetes nephropathy will help in the management of those patients who are difficult to manage.

Background: Olfactory dysfunctions albeit commonly studied in research study are rarely tested in clinical practice and commonly overlooked in elderly. With ageing, rate of decline in olfactory and cognitive functions increases. Diabetic patients are more prone to develop these olfactory and cognitive dysfunctions. Elderly diabetic patients with olfactory dysfunction were found to have increased incidence of cognitive impairment as compared to patients without olfactory dysfunction. So olfactory function testing can be used as screening tool to detect cognitive impairment at earliest and can halt the progression of cognitive impairment by appropriate measures. Methods: A cross-sectional study done on 200 elderly diabetic patients. Olfactory dysfunctions were detected by open essence test and cognitive testing was done with MMSE. Patients with psychosis, apparent dementia, any nasal disease were excluded. Results: Out of 200 patients total number of patients with MMSE <23, 24-26 and >26 were 19, 51 and 150 with average Open Essence (OE) score 6.05±, 6.74±0.92 and 8.5±0.54 respectively indicating that patients with lower OE score were found to have lower MMSE score. Conclusion: With ageing, olfactory as well as cognitive dysfunction increases. Diabetes accelerates these processes substantially. Olfactory dysfunction precedes the development of cognitive impairment. So elderly patients with diabetes should be screened for olfactory functions so that proper measures could be taken to decrease the incidence or severity of cognitive dysfunction.