Background and Aims Vaccinations are now open to all adults in India. However, spread of COVID19 infection continues unabated. We aimed to ascertain number of breakthrough infections after vaccinations in a chronic care, diabetes-centric healthcare facility. Methods We received rigorously maintained data of vaccinations, health status, symptoms of COVID19 & RT-PCR testing of all staff (doctors, nurses, paramedical workers, other staff) in our health care facility from January 16, 2021 till date. Results Out of 123 employees, 110 were vaccinated (Covaxin, 28, Covishield, 85). Second dose was completed in 107 (94.7%) and first dose in 6 persons (5.3%). Breakthrough infections occurred in 18 persons (15.9%), 17 of them had incurred it after the second dose. Except one (required hospitalization), all (94.5%) had mild COVID19 disease. Conclusions High prevalence of mild breakthrough infection is seen in our health care facility. Research in breakthrough infections in India should be extended to other institutions and community to obtain larger data.

Lockdown due to the Coronavirus disease 2019 (COVID 19) pandemic may cause weight gain and enhance the risk of type 2 diabetes mellitus (T2DM). We aimed to determine this risk in apparently nondiabetic individuals. Material methods: Baseline demographic and clinical data from 100 apparently non-diabetic household members (related or unrelated) of patients with type 2 diabetes mellitus were collected until 49 days of lockdown and analyzed using the XL-STAT statistical software. A two-pronged analytical strategy was employed. First, the metabolic risk profile related to age, sex, weight, family history, and exercise pattern was analyzed. This was followed by an assessment of the risk of developing type 2 diabetes using an established risk assessment engine. Results: There was a trend towards weight gain seen in 40% of the cohort, with 16% of the population experiencing a 2.1e5 kg weight increment. When all the risk parameters were analyzed together using the ADA risk engine, there was an increase in the ADA diabetes risk score in 7% of the population, with 6.66% in the high-risk group. There was a further increase in weight among 3% of the population who were already obese at baseline. Conclusion: We show an increased risk of T2MD consequent to weight gain during 49 days of lockdown in India.

Background and aims It is not known if new onset diabetes during Coronavirus-19 disease (COVID-19; NOD COVID) is phenotypically or biochemically different than new onset diabetes before COVID-19 (NOD). Methods All adults diagnosed with new onset diabetes from during the time of COVID-19 were compared with new onset diabetes prior to COVID-19, from two tertiary care hospitals in Chennai and Delhi. RTPCR test for SARS-CoV-2 virus was done as appropriate, and COVID-19 antibody test was done in all other NOD COVID patients. Result A total of 555 patients with new onset diabetes were included in the study (282 NOD and 273 NOD COVID patients). Patients with NOD COVID had higher fasting and post prandial blood glucose and glycated hemoglobin vs. NOD patients. Both the groups had high average body mass index; ∼28 kg/m2. Interestingly, fasting C-peptide levels were significantly higher in the NOD COVID group vs. NOD group. There was no difference in C-peptide or glycemic parameters between the COVID-19 antibody positive and negative NOD COVID cases. Conclusion Individuals who were diagnosed with diabetes during COVID-19 epidemic (NOD COVID) do not significantly differ from those diagnosed before COVID-19 in symptomatology, phenotype, and C-peptide levels but they had more severe glycemia.

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Background and Objective Excess hepatic and pancreatic fat may contribute to hyperglycemia. The objective of this study was to examine the effect of dapagliflozin (SGLT-2 inhibitor) on anthropometric profile, liver, and pancreatic fat in patients with type 2 diabetes mellitus (T2DM). Research Design and Methods This is an observational interventional paired study design without a control group. Patients (n, 30) were given dapagliflozin 10mg/day (on top of stable dose of metformin and/or sulphonylureas) for a period of 120 days. Changes in anthropometry (circumferences and skinfold thickness), surrogate markers of insulin resistance, body composition, liver, and pancreatic fat (as were measured by MRI-derived proton density fat fraction) were evaluated. Result After 120 days of treatment with dapagliflozin, a significant reduction in weight, body mass index (BMI), body fat, circumferences, and all skinfold thickness was seen. A significant reduction in blood glucose, hemoglobin A1c, hepatic transaminases, fasting insulin, homeostatic model assessment –insulin resistance (HOMA-IR), and postprandial C-peptide was noted while HOMA-beta, post parandial insulin sensitivity and fasting adiponectin were significantly increased. There was no change in lean body mass. Compared to baseline there was a significant decrease in mean liver fat fraction (from15.2 to 10.1%, p <0.0001) and mean pancreatic fat fraction (from 7.5 to 5.99%, p <0.0083). Reduction in liver fat was significant after adjustment for change in body weight. Conclusion Dapagliflozin, after 120 days of use, reduced pancreatic and liver fat and increased insulin sensitivity in Asian Indian patients with T2DM.

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