Aims: This study aims to assess the cardiovascular disease (CVD) risk by QRISK2 score and conventional risk score in new-onset diabetes without a history of heart disease or stroke, to find out if patients with diabetes have similar risk of coronary artery disease (CAD) as people with established CAD and to compare the conventional and QRISK2 score for the prediction of CVD. Materials and Methods: A cross-sectional study was conducted at Bhilai over 1 year in 183 newly detected diabetic patients (89 males and 94 females) aged 40–70 years. The probable risk factors were determined by cross-tabulation of cardiometabolic parameters with the 10-year cardiovascular risk level using the QRISK2-2016 and the conventional major risk markers. Results: The mean age in males was 53.5 ± 9.7 years and in females was 54.2 ± 10.1 signifying no gender differences. Mean body mass index in the most of the individuals in both sexes were either in the pre-obese or obese range. The mean value of high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), non-HDLc, total cholesterol and HDLc (total cholesterol/HDLc) ratio was found to be higher in females than in the males. In the conventional risk group, 67.7% of individuals with new-onset diabetes were in high-risk category, 28.9% were in moderate-risk category and 3.2% in low-risk category. The QRISK2 score in new-onset diabetes was 68.8% in high-risk category, 31.1% were in moderate-risk category and none in the low-risk category. Conclusion: Risk stratification is essential for the primary prevention of CVD risks in patients with diabetes as patients with new-onset diabetes cannot be categorised as CAD risk equivalent.

Background: In 2016, an estimated 872,000 Kenyans were living with diabetes, a country average of 4%. The study objectives were (1) to describe the sociodemographic and geographic characteristics of the households with individuals diagnosed and on treatment for diabetes (2) to describe the medicines available at the household level, monthly household expenditure on medicines, location of diagnosis and treatment and the associated factors of medicines purchase location. Methods: A household survey in eight countries was conducted asking whether a household member had been diagnosed and treated for a non-communicable disease (NCD). Households with at least one member with diabetes were included in this study. Results: Out of the 142 individuals being diagnosed and treated for diabetes, 68 participants (47.9%) were prescribed single and 74 (52.1%) multiple treatments. While 54.9% of the participants were diagnosed at public hospitals, 50% of individuals purchased their medicines from a private pharmacy/chemist or private hospitals. Purchase of medicines in public facilities was associated with being less wealthy and having more than one NCD. Having medicines not available at home was reported by 26.1% of individuals, mostly because the medicines were too expensive to buy. Conclusions: Affordability of diabetes medicines remains an important barrier to access. In addition, essential medicine list restrictions to offer diabetes medicines at public primary care level limit access. Programs to increase access to NCD medicines need to consider that diagnosis and choice of treatment occurs largely in the public sector whereas medicines purchase most frequently takes place in the private sector.

Background: Hypoglycaemia is a side effect of strict diabetes control, especially in the geriatric population above sixty, who constitute approximately 100 million of the Indian population. This study was undertaken to explore the risk factors of hypoglycaemia in elderly inpatients. Materials and Methods: Fifty patients who were found to have hypoglycaemia either at admission or while admitted were enrolled. Their risk factors were compared with fifty age- and sex-matched inpatients admitted to medical wards who did not experience hypoglycaemia. Results: The duration of diabetes was significantly longer (13.4 ± 9.2 vs. 8.1 ± 5.7 years; P = 0.012) in the group which experienced hypoglycaemia. The mean glycated haemoglobin was significantly lower in the group which experienced hypoglycaemia (6.33 ± 1.12 vs. 7.61 ± 1.17; P = 0.002). Of the 50 patients who developed hypoglycaemia 28 were asymptomatic. Infection and renal failure were significantly higher in the study group. On multivariate analysis, infection was the only significant precipitating factor. Conclusion: With strict blood glucose control, elderly patients are at high risk of hypoglycaemia. The risk is higher if the patients have renal failure and infection. Diabetic therapy in elderly people should be adjusted in such a way to prevent hypoglycaemia.

Background: Dietary habits and sedentary lifestyle are major risk factors for rapidly rising incidence of type 2 diabetes. Aim: This study aims to study the association of dietary patterns with glycated haemoglobin (HbA1c) among type 2 diabetics in Karachi. Setting: Individuals attending outpatient department of Baqai Institute of Diabetology and Endocrinology (BIDE), Karachi, Pakistan. Design: Retrospective observational study. Methodology: A total of 3193 subject's data were available. Demographic, clinical parameters, food and nutrient intake were explored; patients were categorised into groups according to the adequacy of food intake. The nutrition care process at BIDE consists of getting details of 24-h diet recall. Academy of nutrition and dietetic food exchange system was used to estimate the food requirement, energy and macronutrient intakes. Statistical Analysis: Linear regression analysis was performed for establishing relationship of HbA1c. P < 0.05 was statistically significant. SPSS version 17.0 was used for the analysis. Results: Majority of the patients (89.5%) were above the age of 35 years, using oral hypoglycaemic agents (OHA) or insulin and being overweight or obese (88%). Mean HbA1c was significantly higher (P = 0.006) in cluster 1 (high cereal, vegetable and meat) as compared to cluster 2 (moderate cereal, high vegetable and moderate meat) and cluster 3 (low cereal, moderate vegetable and moderate meat). High percentage of dietary energy was found to be significant predictors of higher levels of HbA1c (P < 0.01). Females with type 2 diabetes using OHA or using OHA with Insulin following the prescribed diet pattern were associated with better glycaemic control. Conclusion: Significant association between dietary patterns and level of HbA1c was seen among type 2 diabetics. Dietary energy was found to be significant predictors of higher levels of HbA1c. Females with type 2 diabetes using OHA or using OHA with insulin following the prescribed diet pattern were associated with better glycaemic control.

Neonatal diabetes mellitus (NDM) is a monogenic form of diabetes mellitus that occurs in the first 6 months of life. It is a rare condition with a prevalence of 1 in 100,000–500,000 live births. We report a 3-month-old girl child with high blood glucose levels. She was diagnosed with diabetes mellitus during the 28^th day of life and was on treatment with insulin. She was admitted for the control of high blood glucose levels during which she was started on multiple daily insulin treatment, but the control had been poor. As the age of onset is <6 months of life, genetic analysis has been done. It revealed the presence of a heterozygous mutation p. Gly334Val (p. G334V) in KCNJ11 gene which confirmed the diagnosis of NDM. The child was successfully shifted from insulin to sulfonylureas, and the blood glucose levels are well maintained.