Awareness of gestational diabetes mellitus among antenatal women in a primary health center in South India

Background: Gestational diabetes mellitus (GDM) is a perfect window of opportunity for the prevention of DM in two generations, and its incidence is increasing in our country. Awareness of the condition among antenatal women will translate into prevention and early diagnosis of the disease. This study was done to determine the awareness of GDM among all the antenatal women who attend a Primary Health Center (PHC) for antenatal care. Materials and Methods: A pretested questionnaire consisting of details on background characteristics, 12 questions focusing on Type 2 DM and GDM, and a question on the source of knowledge was administered to all women attending the antenatal clinic. Their responses were scored and the women were graded as having good, fair, or poor knowledge about GDM. Results: One hundred and twenty antenatal women participated in the study. Mean age of the women was 23.8 years (SD: 2.94). Overall, 17.5% women had good knowledge, 56.7% had fair knowledge, and 25.8% women had poor knowledge about GDM. The major sources of awareness of GDM were reported to be television/radio, neighbors/friends, and family members. Discussion: Only a small proportion of rural antenatal women had good knowledge about GDM. The awareness that untreated GDM may pose a risk to the unborn child was high among the study women. Health care workers have to play a greater role in bringing about awareness about GDM among antenatal women

National health programs in the field of endocrinology and metabolism - Miles to go

The endocrine and metabolic diseases of childhood obesity, diabetes mellitus, hypertension, iodine deficiency disorders, vitamin D deficiency, and osteoporosis are major public health problems. Different programs including National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke address these problems although some are yet to be addressed. National surveys have shown high prevalence of these disorders and their risk factors. Most of the programs aim at awareness raising, lifestyle modification, (primary prevention) and screening (secondary prevention) for the disease conditions as these are proven to be cost-effective compared to late diagnosis and treatment of various complications. Urgent concerted full scale implementation of these programs with good coordination under the umbrella of National Rural Health Mission is the need of the moment. The referral system needs strengthening as are the secondary and tertiary levels of health care. Due attention is to be given for implementation of these programs in the urban areas, as the prevalence of these conditions is almost equal or even higher among urban poor people where primary and secondary prevention measures are scarcely available and treatment costs are sky-high

Knowledge of hypoglycemia and its associated factors among type 2 diabetes mellitus patients in a Tertiary Care Hospital in South India

Introduction: Hypoglycemia being the rate limiting complication in the attainment of strict glycemic control in diabetes management, in this study, we intended to study the knowledge of its symptoms, target blood levels during treatment and ways of prevention among type 2 diabetes patients attending Outpatient Department (OPD) of a medical college hospital. Materials and Methods: Every fifth patient attending the OPD during the 4 months between March and June 2013 was interviewed using a questionnaire. Results: The study included 366 type 2 diabetic patients, of which 76.5% were females. The target fasting and postprandial blood glucose levels while on treatment was known to 135 (36.9%) and 126 (34.4%) patients, respectively. The common symptoms of hypoglycemia known to the study subjects were dizziness (81.4%), weakness (73.8%), and drowsiness (72.1%). Overall, 242 (66.1%) diabetic patients had good knowledge on hypoglycemia (knowledge of at least three symptoms of hypoglycemia together with at least one precipitating factor and at least one remedial measure). Higher age, illiteracy, low socioeconomic status were associated with poor knowledge whereas treatment with insulin along with oral hypoglycemic agents was associated with good knowledge on hypoglycemia. Sex and duration of disease were not associated with knowledge on hypoglycemia. Conclusion: Although the knowledge on symptoms of hypoglycemia, precipitating factors, remedial measures are high in this study, the target blood levels, complications were known to just a third of them. There is a knowledge gap on important aspects of hypoglycemia among type 2 diabetic patients

Reported hypoglycemia in Type 2 diabetes mellitus patients: Prevalence and practices-a hospital-based study

Introduction: Hypoglycemia tops the list of hurdles in preventing tight glycemic control in diabetic patients. It is even considered as a cardiovascular risk factor. However, it continues to be a neglected complication with very limited epidemiological data in our country. Aim: To study the self-reported prevalence of hypoglycemia among type 2 diabetic patients and the practices adopted by them during and after the episodes to manage and avert future occurrences. Materials and Methods: It is a questionnaire-based cross-sectional study done using systematic random sampling selecting every 5th patient attending the diabetic Out-Patient (OP) in a tertiary medical college hospital. Results: There were 366 participants with median age of 60 years. Around 96% reported any one symptom of hypoglycemia, but 78% had eaten following the episode and got relieved of the symptoms. Weakness (76.2%) and dizziness (74%) were the most common symptoms reported by the patients. A quarter of them reported having severe attacks requiring somebody's assistance. Most patients resorted to timely meals (85%) to avert future attacks. Patients who took insulin along with oral hypoglycemic agents (OHAs) were at a higher risk (OR = 2.3) for hypoglycemia compared to patients taking only OHAs (P < 0.01). Conclusion: The reported prevalence of hypoglycemia among type 2 diabetes patients is quite high. This finding reiterates the importance of enquiring and educating every diabetic patient about hypoglycemic episodes during every health visit

Next Generation sequencing as a tool in gut microbiota to discriminate between wellness and obese

Around 13% of the world’s adult population are obese and its incidence has doubled in past 3 decades [1]. This study aims to discern the differences in gut microbial composition among healthy and obese individuals. A cross sectional study was conducted in a tertiary care centre. Human faecal and blood samples from healthy (n= 5) and obese (n=10) were collected after obtaining IEC and informed consent. Ultra-sonogram abdomen was also done to detect fatty liver changes. DNA was extracted using Qiagen DNA stool mini kit (Qiagen, Germany) and PCR was performed using Qiagen multiplex PCR master mix and fusion primers. Metagenomics analysis was performed using Ion torrent (PGM). The sequencing reads were in FASTA format and were clustered and reported as operational taxonomic units [2]. Statistical Analysis: Chi square test of significance and student ‘t’ test was done using Quick Calcs, version 5 (Graph Pad Software Inc., La Jolly, CA, USA).Gut microbial composition among healthy lean participants (BMI 18-23) had predominantly gram positive bacteria like Ruminococcus, Bifidobacterium, Peanibacillus. Similarly, gram positive bacteria such as Bifidobacterium, Dialister, Clostridales were predominant in mild risk obese (BMI 30-35) whereas gram negative bacteria like Enterobacter, Vibrio and Escherichia were higher among moderate to severe risk obese participants (BMI &gt;35). A clear shift of gram positive to gram negative bacteria was observed among study groups. Analysis by phyla showed a five-fold reduction in counts of Firmicutes in mild obese to moderate and severe obese and in contrast Proteobacteria doubled in moderate and severe obese category. The mean fasting blood sugar (FBS) was higher among obese (101.9 + 10.9) in contrast to healthy participants (89.6 + 7.1) with a statistical significance (P=0.04). Fatty liver was significantly higher among obese, n=10 (100%) when compared to healthy participants, n=1 (20%) (P=0.007). Gram negative bacteria is predominant in moderate to severe obese and from this it is evident that lipopolysaccharides found in GNB could be well associated with severe obesity and related consequences. Faecal transplant could possibly be used as an intervention among severe obese and other related metabolic disorders to revert to a lean phenotype

A community-based study of postpartum depression in rural Southern India

Background: Depression is the most common complication postpartum affecting 10%–15% of women, contributing greatly to maternal mortality and morbidity, but the care availed is very low among the women who suffer. Objective: The aim is to study the prevalence of postpartum depression among recently delivered women in a rural population and the health care utilization pattern for the condition among women. Methodology: This was conducted as a population-based cross-sectional study in a rural population served by primary health center. All women in the study area who had a pregnancy outcome during the past 6 months and have completed 42 days since their last delivery were included in the study. The data on postpartum depression were collected using the Edinburgh Postnatal Depression Scale (EPDS). Results: There were 365 postpartum women in the study area who participated in the study. Mean age of the study participants was 24.5 years. The deliveries were Institutional in 97.8% of women. The prevalence of depression among the study women (an EPDS score of 10 and above) was 11%. Among women with depression, a history of depression before the last delivery was given by 42.5% of women. Only 7.5% of women had sought some form of health care for their problem. Conclusion: The study shows that the prevalence of depression among postpartum women is quite high and the health seeking for depression is very low. Health professionals and workers have to be trained to raise awareness, detect, and treat depression among postpartum women promptly

Does a nutrition education programme change the knowledge and practice of healthy diets among high school adolescents in Chennai, India?

Background: Nutrition education is used as a way of promoting lifelong healthy eating practices among school adolescents. There is limited published information on the impact of nutrition education programmes in India. Objectives: To assess the knowledge and practices of high school students with respect to healthy diets before and after a nutrition education programme. Design: Pre- and post-intervention questionnaire survey. Setting: Two private schools in Chennai city. Method: This study was conducted among adolescents studying in standard VIII and IX in two private schools in Chennai city. Nutrition education as lectures and interactive discussions were given to students one hour every week for a period of 10 weeks. Information on knowledge and attitude on healthy eating and dietary practices was collected before and after the nutrition education intervention using a questionnaire. Differences in knowledge, attitude and practice of students on healthy diet were measured using the X2 test with the level of significance p&lt;0.05. Results: A total of 181 students were involved in the study (response rate 92%). Following the nutrition education programme, satisfactory dietary knowledge significantly improved from 37% to 67% ( p&lt;0.001). Similarly, students showing a positive attitude towards healthy diet increased from 18% to 40% ( p&lt;0.001). The proportion of students taking soft drinks reduced from 20% to 10% ( p&lt;0.01) and ingestion of fast food items through fast food restaurants reduced significantly. Conclusions: This short-term nutrition education programme brought significant improvements in dietary knowledge and reductions in soft drinks and fast foods consumption. </jats:sec