Studies on maturity onset diabetes of the young (MODY) from S. India

We examined the following aspects of Maturity Onset Diabetes of the Young (MODY): prevalence, vascular complications, insulin secretion in offspring of MODY subjects, insulin resistance and whether MODY can be considered a distinct disease. We report a higher prevalence of MODY among Asian Indian patients. The prevalence rates of microvascular complications in MODY were found to be the same as in classical NIDDM patients. Glucose stimulated insulin and C-peptide responses were compared with non-diabetic controls. In MODY subjects, C-peptide responses were lower, whereas insulin responses were varied. Insulin secretion in offspring of MODY subjects was similarly evaluated, and abnormalities discovered even in these prediabetic subjects. Using the euglycaemic clamp technique, MODY patients were found to be more insulin resistant than classical NIDDM patients. Further lines of evidence are needed to resolve whether MODY can be considered a distinct disease

High carbohydrate high fibre diet in diabetes

This article does not have an abstract

Pancreatic beta cell function and peripheral activity of insulin in maturity onset diabetics - evaluation by mathematical applications

Evaluation of the Pancreatic beta cell function and peripheral activity of insulin in diabetics were done using recently described mathematical formulae. Diabetics in general, had decreased beta cell function as well as impaired peripheral activity of insulin. In diabetics with ideal body weight, the chief defect was diminished insuling output which was directly proportional to the severity of diabetes. In obese diabetics, the main defect was at the periphery, and except in those with severe diabetes, beta cell function was better maintained. Application of these mathematical formulae helps in a clearer understanding of the kinetics of insulin and pathogenesis of diabetes in various types of diabetics

Abnormalities in insulin response to intravenous glucose in offspring of conjugal (Type 2) diabetic parents

Glucose and insulin responses were measured during intravenous glucose tolerance test in 12 normal controls and 16 normoglycaemic adult offspring of conjugal diabetic parents. The glucose response curve and the glucose disposal rate in the offspring were not different from the normal pattern. These subjects elicited a lower first phase insulin (0-10 minutes area under the curve, p = 0.04), lower peak immunoreactive insulin response (p = 0.032) and also showed a delay in the first phase (p = 0.037) compared to control values. The second phase of insulin (11-120 minutes area) was not significantly different in the two groups. These changes could serve as early markers of diabetes in offspring of conjugal diabetic parents

Insulin antibodies in diabetic patients

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Allergy to conventional and monocomponent insulins

While allergy to conventional insulin is quite common, that to M. C. Insulin is comparatively rare. We report here a series of cases of allergy' to conventinal insulin and M.C. Insulin. The clinical features, the details of the allergy tests and management of insulin allergy are presented. In general, the allergy was most common with conventional insulins and less common with M.C. Insulin and least common with Human Insulin

Assessement of background knowledge of diabetes mellitus in diabetic patients

The background knowledge of diabetes was assessed in 230 newly registered diabetic patients by a questionnaire. Patients with positive family history knew better about role of heredity, diet as a mode of therapy and also regarding the long-term complications of diabetes. Similarly, educational status improved background knowledge. The duration of diabetes Improved the knowledge regarding the need for life-long treatment and possibility of eye complications. There was a uniform lack of answers on the role of exercise In the treatment of diabetes. The results of this study thus provides information about the areas in which stress should be given while evolving diabetes education programmes

Sub-clinical diabetic cardiomyopathy - assessment by systolic time intervals

Left ventricular performance in diabetics wit he at hypertension, ischemic Tie art disease, or clinical evidence of other heart diseases was assessed by systolic time intervals and echo-cardiography. The PEP/ LVET ratio was 3.48% higher in diabetics than in controls. There was good correlation of abnormality of PEP/LVET ratio with duration of diabetes. There was no correlation with age of patient or severity of diabetes. There was good correlation between abnormal PEP/LVET and incidence of retinopathy and nephropathy. This suggests the possibility of the presence of subclinical diabetic cardiomyopathy in these individuals

Interaction between FTO gene variants and lifestyle factors on metabolic traits in an Asian Indian population

Background Lifestyle factors such as diet and physical activity have been shown to modify the association between fat mass and obesity–associated (FTO) gene variants and metabolic traits in several populations; however, there are no gene-lifestyle interaction studies, to date, among Asian Indians living in India. In this study, we examined whether dietary factors and physical activity modified the association between two FTO single nucleotide polymorphisms (rs8050136 and rs11076023) (SNPs) and obesity traits and type 2 diabetes (T2D). Methods The study included 734 unrelated T2D and 884 normal glucose-tolerant (NGT) participants randomly selected from the urban component of the Chennai Urban Rural Epidemiology Study (CURES). Dietary intakes were assessed using a validated interviewer administered semi-quantitative food frequency questionnaire (FFQ). Physical activity was based upon the self-report. Interaction analyses were performed by including the interaction terms in the linear/logistic regression model. Results There was a significant interaction between SNP rs8050136 and carbohydrate intake (% energy) (Pinteraction = 0.04), where the ‘A’ allele carriers had 2.46 times increased risk of obesity than those with ‘CC’ genotype (P = 3.0 × 10−5) among individuals in the highest tertile of carbohydrate intake (% energy, 71 %). A significant interaction was also observed between SNP rs11076023 and dietary fibre intake (Pinteraction = 0.0008), where individuals with AA genotype who are in the 3rd tertile of dietary fibre intake had 1.62 cm lower waist circumference than those with ‘T’ allele carriers (P = 0.02). Furthermore, among those who were physically inactive, the ‘A’ allele carriers of the SNP rs8050136 had 1.89 times increased risk of obesity than those with ‘CC’ genotype (P = 4.0 × 10−5). Conclusions This is the first study to provide evidence for a gene-diet and gene-physical activity interaction on obesity and T2D in an Asian Indian population. Our findings suggest that the association between FTO SNPs and obesity might be influenced by carbohydrate and dietary fibre intake and physical inactivity. Further understanding of how FTO gene influences obesity and T2D through dietary and exercise interventions is warranted to advance the development of behavioral intervention and personalised lifestyle strategies, which could reduce the risk of metabolic diseases in this Asian Indian population