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Kumpatla S.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Michael C.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Viswanathan V.,Mv Hospital For Diabetes And Prof swanathan Diabetes Research Center | Viswanathan V.,Prof swanathan Diabetes Research Center
International Journal of Diabetes in Developing Countries | Year: 2015

This study was designed to evaluate the effect of yogasanas on glycaemic control, haemodynamic and lipid profile in newly diagnosed subjects with type 2 diabetes prescribed with oral hypoglycaemic agents (OHA). Three hundred and three (M:F 199:104) subjects were recruited in this prospective study and were divided into two groups. Group 1 (N = 149) were prescribed OHA alone, while group 2 subjects (N = 154) were prescribed OHA and received training individually once for regular yoga practice for 30 min daily. Baseline data on anthropometric, haemodynamic and biochemical details were collected, and subjects were asked to report for review after 3 months. All investigations were repeated after 3 months. A total of 241 subjects were available for follow-up. Diabetes treatment regimen was unchanged in both the groups during the study period. Both the groups were matched with respect to body mass index (BMI), glycaemic level, lipid profile and diet calorie consumption at baseline. BMI did not differ significantly at follow-up in both the groups. Glucose levels and HbA1c % showed greater reduction in group 2 practising yoga. Total and low-density lipoprotein (LDL) cholesterol alone improved in group 1, whereas improvement was seen in all lipid parameters in group 2. High-density lipoprotein (HDL) cholesterol was not statistically significant in both groups. Group 1 showed improvement in systolic blood pressure (P = 0.027), whereas group 2 subjects showed improvement in both systolic and diastolic blood pressures (P < 0.0001). In conclusion, regular practice of yoga along with conventional medicines could be beneficial for better control of diabetes. © 2015, Research Society for Study of Diabetes in India.

Viswanathan V.,Prof swanathan Diabetes Research Center | Rao V.N.,Prof swanathan Diabetes Research Center
International Journal of Lower Extremity Wounds | Year: 2013

The burden of diabetic foot complications, in terms of both physical and socioeconomical constraints, poses a heavy challenge both to the patient and the physician, especially in developing countries, where the number of people living with diabetes is increasing at an alarming rate compared with the developed world. In developing countries like India, there are specific causes and risk factors that increase the burden of diabetic foot infections (DFIs), for example, sociocultural risk factors such as barefoot walking, using improper footwear, poor knowledge of foot care practices, lack of adequate and timely access to podiatry services, and poor health care resources. Management of DFI in light of these limitations is quite a challenge to health care professionals. Several techniques and strategies are required to address this problem and should be combined with a multidisciplinary team effort to reduce the burgeoning epidemic of diabetic foot disease. This review is intended to address some of the major aspects of management of DFI in India. © The Author(s) 2013.

Kornfeld H.,University of Massachusetts Medical School | West K.,University of Massachusetts Medical School | Kane K.,University of Massachusetts Medical School | Kumpatla S.,Prof swanathan Diabetes Research Center | And 4 more authors.
Chest | Year: 2016

Background Previous studies reported an association of diabetes mellitus (DM) with TB susceptibility. Many studies were retrospective, had weak diagnostic criteria for DM, and did not assess other comorbidities. The Effects of Diabetes on Tuberculosis Severity (EDOTS) study is addressing these limitations with a longitudinal comparison of patients with TB who are classified as diabetic or normoglycemic according to World Health Organization criteria. We report interim findings after enrolling 159 of a planned 300 subjects. Methods A cohort study of patients with TB in South India with DM or normoglycemia defined by oral glucose tolerance test (OGTT) and fasting glucose. Glycohemoglobin (HbA1c), serum creatinine, lipids, and 25-hydroxyvitamin D were measured at enrollment. Patients were monitored monthly during TB treatment, and HbA1c measurement was repeated after 3 months. Results Of 209 eligible patients, 113 (54.1%) were classified as diabetic, 44 (21.0%) with impaired glucose tolerance, and 52 (24.9%) as normoglycemic. More patients with diabetes were detected by OGTT than by HbA1c. Diabetes was a newly received diagnosis for 37 (32.7%) in the DM group, and their median HbA1c (6.8%) was significantly lower than in those with previously diagnosed DM (HbA1c, 10.4%). Among 129 patients monitored for 3 months, HbA1c declined in all groups, with the greatest difference in patients with a newly received diagnosis of DM. Conclusions Early EDOTS study results reveal a strikingly high prevalence of glycemic disorders in South Indian patients with pulmonary TB and unexpected heterogeneity within the patient population with diabetes and TB. This glycemic control heterogeneity has implications for the TB-DM interaction and the interpretation of TB studies relying exclusively on HbA1c to define diabetic status. © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Kumpatla S.,Prof swanathan Diabetes Research Center | Aravindalochanan V.,Prof swanathan Diabetes Research Center | Rajan R.,Prof swanathan Diabetes Research Center | Viswanathan V.,Prof swanathan Diabetes Research Center | Kapur A.,World Diabetes Foundation
Diabetes Research and Clinical Practice | Year: 2013

Aim: The methods used for diagnosis of diabetes have limitations particularly in situations associated with stress hyperglycemia. Aim of this study was to evaluate the performance of A1c and fasting plasma glucose (FPG) tests for screening newly diagnosed diabetes (NDD) defined by OGTT among tuberculosis (TB) cases in India. Methods: A total of 983 subjects aged ≥18 years with TB were selected from 7 TB units - 4 urban, 2 rural and 1 semi-urban areas of Tamil Nadu, India, during August 2010-March 2011. Screening for diabetes was carried out by 2-h 75g OGTT. Classification of glucose intolerance status was based on WHO criteria. HbA1c was measured by high performance liquid chromatography using Bio-Rad turbo machine. HbA1c≥47.5mmol/mol was used for diagnosis of diabetes. FPG was estimated by glucose-oxidase method. Known cases of subjects with diabetes were excluded and final analysis was done using data of 779 individuals. The performance of A1c and FPG tests was evaluated against the results of OGTT using receiver operating characteristic curve analysis. Results: Prevalence of NDD was 10.8%. The areas under the curve (AUC) were 0.754 [95% confidence interval (CI) 0.68-0.83] (p<0.001) for A1c and 0.662 (95% CI 0.58-0.74) for FPG (p<0.001) in NDD subjects. The HbA1c cut-off point of ≥47.5mmol/mol gave a sensitivity of 59.1% and specificity of 91.7%, and the respective values were 34.8% and 97.5% for FPG in subjects with NDD. Conclusion: HbA1c performed better than FPG as a screening tool for newly diagnosed diabetes among subjects with TB. © 2013 Elsevier Ireland Ltd.

Kumpatla S.,Prof swanathan Diabetes Research Center | Karuppiah K.,Apollo Hospitals | Immaneni S.,Apollo Hospitals | Muthukumaran P.,Prof swanathan Diabetes Research Center | And 3 more authors.
Indian Journal of Medical Research | Year: 2014

Background & objectives: The association between adiponectin and risk of cardiovascular disease is well known. The aim of the present study was to evaluate adiponectin and certain inflammatory markers and to determine the correlations between them in angiographically proven coronary artery disease (CAD) in subjects with and without diabetes. Methods: A total of 180 subjects who underwent coronary angiography for symptoms suggestive of CAD were categorised into groups based on their diabetes and/or CAD status: group1 (non-diabetic non-CAD); group2 (non-diabetic CAD); group3 (diabetic non-CAD) and group4 (diabetic CAD). Adiponectin, tumour necrosis factor a (TNF-α) and soluble form of E-selectin (sE-selectin) were estimated using quantitative sandwich enzyme immunoassay and high sensitive C-reactive protein (hsCRP) by particle enhanced immunoturbidimetric method. Results: Adiponectin levels were significantly lower in subjects with either diabetes or CAD and were much lower in subjects who had both. hsCRP was elevated in CAD and diabetes but did not differ significantly between groups. sE-selectin and TNF-α levels were elevated in CAD. Adiponectin negatively correlated with age, glucose, sE-selectin, total and LDL cholesterol. hsCRP correlated with BMI, sE-selectin and urea. sE-selectin correlated with BMI, triglycerides and VLDL cholesterol, whereas TNF-α correlated with fasting plasma glucose. In the logistic regression analysis, adiponectin had a significant inverse association with CAD. sE-selectin and TNF-α also showed significant independent association with CAD. Interpretation & conclusions: Adiponectin and other inflammatory markers such as sE-selectin and TNF-α showed a significant association with CAD. Hence, early assessment of such markers can help to identify high risk patients, and to reduce the inflammatory component of diabetes and CAD.

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