Diabetes Risk Score in Indian Population: Experience from Central India

ntroduction: Diabetes is a major health problem in the world causing significant morbidity and mortality. Currently, 77 million people in India and 463 million people are living with diabetes across the world, and this number is expected to rise to 101 million in India and 578 million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis and management. The Madras Diabetes Research Foundation (MDRF) has developed an Indian Diabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or are undiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central India and identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients or attendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, and not diagnosed with diabetes earlier were included in the study after taking proper consent and IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was 51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of <30, 30-60 and ≥60, respectively. Conclusion: Forty-five percent people of the population was at high risk of diabetes as estimated by IDRS, which  proved to be an effective and economical tool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases and start early management to reduce the morbidity and mortality

Diabetes Risk Score in Indian Population: Experience from Central India

Introduction: Diabetes is a major health problem in the world causing significant morbidity and mortality. Currently,77 million people in India and 463 million people are living with diabetes across the world, and this number is expected to rise to 101 million in India and 578 million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis and management. The Madras Diabetes Research Foundation (MDRF) has developed an Indian Diabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or are undiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central India and identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients or attendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, and not diagnosed with diabetes earlier were included in the study after taking proper consent and IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was 51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of <30, 30-60 and ≥60, respectively. Conclusion: Forty-five percent people of the population was at high risk of diabetes as estimated by IDRS, which proved to be an effective and economical tool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases and start early management to reduce the morbidity and mortality

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Failure of siblings to thrive beyond 5 years of age

We describe a family in which parents had consanguinity, being children of real sisters. They had given birth to five children. In their family, children remained healthy from birth to pre-school age and then started having symptoms around the age of 5 years and two of them succumbed to this illness. Polyglandular autoimmune syndrome Type-1 is a rare sporadic autosomal recessive disease. It is characterized by the existence of two or more endocrinal disorders. Patients may require lifelong hormone replacement therapy for survival

Diabetes Risk Score in Indian Population: Experience from Central India

Diabetes is a major health problem in the world causing significant morbidityand mortality. Currently, 77 million people in India and 463 million people are living withdiabetes across the world, and this number is expected to rise to 101 million in India and 578million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis andmanagement. The Madras Diabetes Research Foundation (MDRF) has developed an IndianDiabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or areundiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central Indiaand identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients orattendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, andnot diagnosed with diabetes earlier were included in the study after taking proper consentand IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of&lt;30, 30-60 and ≥60, respectively. Conclusion: Forty-five percent people of the population wasat high risk of diabetes as estimated by IDRS, which proved to be an effective and economicaltool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases andstart early management to reduce the morbidity and mortality

Relationship of serum thyroid stimulating hormone with body mass index in healthy adults

Objective: To investigate any possible relationship between serum thyroid stimulating hormone (TSH) with body mass index (BMI) in healthy adults. Materials and Methods: A total of 417 subjects aged 18-60 years who volunteered to get screened for thyroid illness with serum TSH have been enrolled from November 2012 to July 2013. Patients were divided into four groups based on BMI value: Underweight (BMI <18 kg/m 2 ), normal (BMI: 18-22.9 kg/m 2 ), overweight (BMI: 23-24.9 kg/m 2 ), and obese (BMI ≥25 kg/m 2 ). Result: In our study we found a significant variation (P < 0.001) in TSH with increasing BMI. As the BMI increased, mean TSH in the BMI range also increased. The individuals with higher BMI had higher TSH and this trend continued from underweight to Obese. The mean TSH of underweight group was 1.6036 mIU/L, normal weight group 2.1727 mIU/L, overweight group 2.2870 mIU/L and obese group 2.6416 mIU/L. Conclusion: In this study we found a significant relationship between serum TSH and BMI and mean TSH increased as BMI increased. Further large scale data from the population is required to confirm our findings

Invasive cranial mycosis our experiences

Fungi can cause serious cranial infections in immunocompromised and diabetic patients. Common pathogens mainly include Aspergillus and Mucor. These organisms cause tissue invasion and destruction of adjacent structures (e.g. orbit, ethmoid, sphenoid, maxillary & cavernous sinuses). Mortality and morbidity rate is high despite combined surgical, antifungal and antidiabetic treatment. We present our experience of six cases with such infection