1Associate Professor, Medicine, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh
2Assistant Professor, Physiology, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh
3Senior Resident, Department of Pathology, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh
4Professor, Radio Diagnosis, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh
The World Health Organization (WHO) has recently acknowledged that India has the maximum number of diabetic patients than does any given country (around 35 million). This is projected to increase to 57 million by the year 20251. India is thus the Diabetic Capital of the World Pre-diabetes is a serious matter. In fact, recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes2. The increase in the incidence of diabetes and Prediabetic, the association with cardiovascular disease and the accompanying high morbidity and mortality make glucose perturbations a serious public health issue3.
The study was undertaken to assess the prevalence of Impaired Fasting Glycaemia (IFG), Impaired Glucose Tolerance (IGT) and Diabetes Mellitus in undiagnosed high-risk patients. Characteristics of IFG patients were seen and compared with those of IGT, Diabetes mellitus and Normoglycemics. Impact of new diagnostic criteria on the number of diabetics diagnosed was also assessed 1000 high risk individuals presenting in Saraswathi institute of medical sciences with one or more of the following risk factors namely central obesity, hypertension, family history and dyslipidemia were selected and detailed history was recorded in all patients.
Mean age of the study group was 48.12 years and mean BMI was 25.3 I kg/m2 mean WHR was 0.894. Prevalence of diabetes was l 9.8% prevalence of IFG was I 0.8% prevalence of IGT was 16.6%. Normoglycemia was found in 53.01% of high-risk patients. Concordance of IFG and IGT was 33.3. WHR was significantly higher in IFG group than that found in Normoglycemics, Other Characteristics of IFG namely, BMI. Cholesterol, triglyceride and HDL-cholesterol were not found significantly different from those of normoglycemics, IGT only and diabetics. As the number of risk factors present in individual's increases, percentage detection of diabetes in them also increases, with highest detection of 76% in individuals with four risk factors. Diabetes specific micro vascular complications were present in 53.15% of diabetic patients at the time of diagnosis. Diabetic retinopathy was present in 15.6%, nephropathy in 37.5% and neuropathy in l 2.5% of newly diagnosed diabetics. 36 (8. 75%) extra diabetic patients were detected by applying recent criteria, which otherwise would have been labeled as Normoglycemia, IGT according to WHO criteria 1985.
We conclude that all high-risk patients should be screened for diabetes and this screening is more important if number of risk factors present is more. Waist hip ratio of IFG was found significantly higher than Normoglycemics. Regarding other characteristics of IFG patients, we recommend that larger study should be undertaken to draw inferences. Almost half of the type 2 diabetic patients have some evidence of micro vascular complications; so all diabetics should be screened for complications at the time of diagnosis.
IFG, IGT, BMI
