These data are strongly in favour of the role of cardiac autonomic neuropathy in hypertension in diabetic patients. The association of the cardiac autonomic neuropathy/hypertension profile with vascular complications is consistent with a deleterious effect on vascular hemodynamics and structure, additional to the effects of hypertension.

IntroductionObesity is associated with increased occurrence of numerous diseases, including hypertension, dyslipidemia, insulin resistance, diabetes, and atherosclerosis. Blood pressure (BP), dyslipidemia, and inflammation markers and their relationships with body mass index (BMI) were determined in scholar adolescents.Material and methodsAdolescents (n = 210) (sex ratio G/B = 106/104; 11 to 16 years) were recruited in three colleges of Oran city. Anthropometric parameters were measured to classify adolescents as thin (T), normal weight (NW), overweight (OW), or obese (O). Waist circumference (WC) and BP were measured, and serum glucose, uric acid, urea, lipid parameters, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP), insulin, leptin, and adiponectin were analyzed.ResultsAdolescents were classified according to their BMI as T (15%), NW (63%), OW (13%), and O (9%). Compared to NW, increased values of WC, BP (p < 0.001), and glucose (p < 0.01) were noted in OW and O groups. Total cholesterol (TC) level was elevated in O adolescents (p < 0.01). Increased low-density lipoprotein cholesterol (LDL-C) in OW (p < 0.05) and O (p < 0.01), and reduced high-density lipoprotein cholesterol (HDL-C) concentrations were noted in both OW and O groups (p < 0.05), compared to NW. Elevated triglyceride (TG) values and TG : HDL-C ratio were observed in OW (p < 0.05) and O (p < 0.01). High values of uric acid were noted in OW and O adolescents (p < 0.01). Compared to NW, there was no significant difference in IL-1β whereas IL-6 was elevated in T (p < 0.05), OW (p < 0.01) and O (p < 0.001). Leptin, TNF-α, and CRP concentrations were significantly increased (p < 0.001), whereas adiponectin values were decreased in both OW and O groups (p < 0.01), compared to NW.ConclusionsSignificant associations were noted between WC, BP, dyslipidemia, inflammation markers, and BMI, indicating that both OW and O adolescents have a tendency to present metabolic syndrome risk factors.

Two regional risk scores for diabetes and diabetes or impaired glycaemia applicable to the Middle East and North Africa region were identified. The regional risk scores performed as well as the national risk scores derived in the same manner.

The challenge of insulin use during Ramadan could be minimized, if people with diabetes are metabolically stable and are provided with structured education for at least 2–3 months pre-Ramadan. Although, American diabetes association (ADA) recommendations 2010 and South Asian Consensus Guideline 2012 deal with management of diabetes in Ramadan and changes in insulin dosage, no specific guidance on widely prescribed low-ratio premix insulin is currently available. Hence, the working group for insulin therapy in Ramadan, after collective analysis, evaluation, and opinion from clinical practice, have formulated a practical advice to empower physicians with pre-Ramadan preparation, dose adjustment, and treatment algorithm for self-titration of low-ratio premix insulin.