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Effect of the pro and anti-inflammatory cytokines like (TNF-α, IL-6, CRP) has been reported in insulin signaling pathways, cross-linking and ultimately developing insulin resistance in β-cells of pancreas which further risks to T2DM. Stability among these Pro and anti-inflammatory cytokines is necessary to make β-cells immune to any infection which may lead to T2DM. →What this article adds: Our experimental findings provide evidence that the pattern and variation of these cytokines (TNF-α, IL-6, CRP, and WBC) are important in the pathogenesis of T2DM. The significant correlation of these inflammatory mediators in T2DM cases with glycemic profile and insulin sensitivity leads to the pathogenesis of diseases in this ethnic population. These findings confirms that TNF-α, IL-6, plays a positive role in the pathogenesis of T2DM in this ethnic population of Kashmir and can act as an early prediction biomarkers.

The marked improvement in overall iodine nutrition in Kashmir Valley- one and a half decades after implementation of salt iodization should encourage healthcare providers to make tangible efforts for implementation of iodization programmes in areas with iodine deficiency.

Background:Fibrocalculous pancreatic diabetes (FCPD) is a secondary form of diabetes, described from several tropical countries, including India. We described the existence of this entity in the subtropical region-the Kashmir valley of the Indian subcontinent and compared the clinical characteristics of these patients with type 2 diabetes mellitus (T2DM) patients.Aim:The present study aimed to compare the clinical characteristics of patients with FCPD and those with T2DM to identify the characteristics distinctive of FCPD.Materials and Methods:A total of 124 patients with FCPD were compared with 124 patients with T2DM matched for age and duration of diabetes. Biochemical parameters and microvascular and macrovascular complications were assessed in all patients. Multivariate regression analyses were performed to study the determinants of microvascular complications in both groups.Results:FCPD patients had significantly lower serum cholesterol, serum triglyceride, and serum calcium levels but higher glycosylated hemoglobin levels compared to T2DM patients. FCPD participants were significantly leaner. The prevalence of retinopathy, neuropathy, and nephropathy was similar between the two. Five T2DM patients had documented cardiovascular disease compared to one in FCPD patients (P < 0.05). Multiple logistic regression analysis revealed glycosylated hemoglobin and duration of diabetes to be significantly associated with retinopathy and nephropathy in T2DM. Among FCPD patients, glycosylated hemoglobin showed a strong association with retinopathy as well as nephropathy. BMI showed a significant negative association with nephropathy in FCPD patients. Age and age at onset showed a strong association with neuropathy in FCPD patients while the duration of diabetes showed the association with neuropathy (P = 0.015) in T2DM.Conclusion:There are several differences in the phenotype, biochemical parameters, and prevalence of diabetic complications between patients with FCPD and T2DM.

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