CORRELATION OF GLYCOSYLATED HEMOGLOBIN LEVELS WITH FASTING AND POSTPRANDIAL GLUCOSE IN SOUTH INDIAN TYPE 2 DIABETIC PATIENTS

Objective: To assess the correlation of glycosylated hemoglobin levels with fasting and postprandial glucose in South Indian type 2 diabetic patients.Methods: This retrospective observational study was carried out as per the protocol approved by the institutional ethics committee (IEC) and case records of patients (≥ 40 y old) diagnosed with type 2 diabetes mellitus (T2DM) and complications, that fasting blood sugar (FBS), postprandial blood sugar (PPBS) and HbA1c measured during previous follow-ups were included in the study. Statistical analyses were carried out using SPSS Ver.20 and p ≤ 0.05 were considered statistically significant. Results: Based on the study criteria, 633 case profiles were selected and enrolled in the study. Most of the patients were males 488 (77.1%) and the mean age of patients was 59.7 y (SD=9.6). The mean fasting glucose and postprandial glucose were 9.42 mmol/l (SD=4.2), 13.39 mmol/l (SD=5.2) respectively. Patients were suffering from different type of diabetes complications, and most of them had poor glycemic control as the mean HbA1c was found to be 8.7 % (SD=2.2). The FBS and PPBS were plotted against HbA1c values showed moderate correlation and the sensitivity, specificity, positive predictive value and negative predictive value of postprandial glucose level was better than the fasting blood glucose level.Conclusion: This present study showed that there is the significant correlation between PPBS and HbA1c values. Since PPBS is performed routinely, its interpretation in terms of long term glycemic control will help clinicians to tailor their therapeutic strategies

STUDY ON PRESCRIBING PATTERN OF ANTI-DIABETIC DRUGS AMONG TYPE 2 DIABETES PATIENTS WITH COMPLICATION IN SOUTH INDIAN TEACHING HOSPITAL

ABSTRACTObjective: To evaluate the drug utilization pattern of anti-diabetic agents with respect to glycosylated hemoglobin A1c (HbA1c) level in a Type 2diabetes patient with complication.Methods: This retrospective observational study was conducted as per the protocol approved by the Institutional Ethics Committee. The patientsdiagnosed with Type 2 diabetes mellitus with complication were identified, and those who had measured HbA1c level during previous follow upswere included in the study. All demographic, drug prescriptions, and clinical data of patients were collected and documented in a suitably designedcase report form. Descriptive analyses were performed using Statistical Package for the Social Sciences Version 20.Results: Based on the study criteria, 644 patients were selected and enrolled for the study. The majority of study subjects 494 (76.7%) were male and415 (64.4%) were belonged to the age group 45-64 years. 252 (39.1%) of the patient, had normal weight followed by 234 (36.3%) were overweight,and 142 (22.1%) patients were obese. The prescription pattern showed the majority of patients 509 (79%) patients had 1-2 anti-diabetic medicationfollowed 133 (20.7%) patient prescribed with 3-4 anti-diabetic drug. An insulin was prescribed in 507 (63.4%) patients and among oral anti-diabeticdrugs, metformin 283 (43.9%), glimepiride 140 (21.7%), and voglibose 88 (13.7%) was most commonly prescribed.Conclusion: Among all the anti-diabetic drugs, the insulin was highly preferred over oral hypoglycemic agents (OHAs) to control the glycemic level,and metformin accounted for the most commonly prescribed OHAs. In the second generation of sulfonylureas class, glimepiride and glipizide weremost prescribed.Keywords: Anti-diabetic agents, Diabetes mellitus, Prescription pattern

Polyserositis: An Extremely Rare Life-Threatening Manifestation of Pheochromocytoma

The pericardium is an uncommon site for manifestation of pheochromocytoma. Herein, the case of a 57-year-old man with cardiac tamponade is presented. Pericardiocentesis was performed, and the vital signs were stabilized afterwards. An abdominal computed tomography (CT) scan illustrated a nonhomogeneous right adrenal mass suspicious of pheochromocytoma, planned for right adrenalectomy. He recovered well after surgery, and his subsequent follow-ups did not reveal any complications

Rhabdomyolysis plus Hypocalcemia and Diabetic Ketoacidosis as Concurrent Rare COVID-19 Manifestations

Background. Common manifestations of coronavirus disease 2019 (COVID-19) from its initial official introduction are mostly related to the respiratory system. However, other rarer presentations are reported nowadays. Case Presentations. We reported three cases of COVID-19-infected patients with rhabdomyolysis as well as two other rarer simultaneous signs, including hypocalcemia (Case 1) and diabetic ketoacidosis (DKA) (Case 2). Conclusion. Despite the fact that rhabdomyolysis is an infrequent manifestation of COVID-19, high clinical suspicion is required for proper diagnosis and management of this disease as well as other concurrent rarer presentations, including hypocalcemia and DKA for the prevention of further complications