The present study was undertaken to determine the prevalence of diabetes in the rural population and to identify the major risk factors that may be the cause for increase incidence in rural population. METHODOLOGY: A study population comprising of 1022 individuals in the Malwan area of Sindhudurg district of Maharashtra, age >20 years were selected for investigation. These individuals were analyzed for their biochemical parameters by Standard Randox kits. Both fasting blood glucose and post 2-hour glucose after 75 gm of powdered glucose intake were analyzed. Baseline clinical data like height, weight and blood pressure as well as family history were recorded by the standard methods. RESULTS: The prevalence of diabetes (i.e., fasting blood glucose) as per the WHO criteria was 9.3% while it was 8.9% per ADA criteria. The prevalence according to 2-hr post-glucose blood glucose was 9.3%. The prevalence of IGT was 2.25% in subjects <50 years and 1.12% in subjects >50 years. IGT values also increase with increasing age and BMI. The accepted normal fasting and 2-hr post glucose blood glucose values are <6.1 mM/l and <7.8 mM/l. From our studies (N = 1022) we found the mean fasting glucose blood glucose was 5.31 ± 1.99 mM/l while 2 hr post glucose, blood glucose increased to 5.66 ± 4.09 mM/l. The mean fasting glucose in 95 diabetic individuals was 9.37 ± 4.43 mM/l and the 2 hrs post glucose blood glucose was 14.85 ± 8.51 mM/l, which was found to be highly significant. CONCLUSION: It was observed that the mean blood glucose in diabetic patients was 9.37 ± 4.43 mM/l with a prevalence rate of 9.3% which is highly significantly in the rural population. Compared to the general risk factors found in the urban populations we found that the increase in age and BMI could be the risk factors. Further studies focused on the genetic predisposition to diabetes need to be done.

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Stress due to neonatal illnesses like meconium aspiration, sepsis, birth asphyxia, etc. significantly elevate serum 17OHP and may lead to false positives in newborn screening for congenital adrenal hyperplasia.

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To investigate the relationship between insulin resistance and electrocardiographic changes in hypertension in the absence of confounding influences, plasma glucose and insulin responses to oral glucose were studied in 26 normotensive and 38 hypertensive subjects. Resting ECG was taken and classified into normal or abnormal using the Minnesota code. Among the 38 subjects, 16 had ECG abnormalities. All the hypertensive subjects had normal glucose tolerance. Serum insulin response of hypertensive subjects with ECG changes was 43% higher than those of hypertensive subjects without ECG changes and of normotensive subjects. The ratio AUC glucose/AUC insulin, a measure of insulin sensitivity was significantly reduced in subjects with abnormal ECG. Serum LDL cholesterol was significantly elevated and was the highest in hypertensive subjects with abnormal ECG. The ratio, Total Cholesterol/HDL Cholesterol was elevated to 5.81+/-0.47. I(125)-insulin binding to erythrocytes from 6 normotensive subjects, and 16 hypertensive subjects (8 with and 8 without ECG abnormalities) indicated 50% reduction in insulin receptor number in both the groups of hypertensive subjects compared to normotensive subjects. Multiple logistic regression analysis using mean blood pressure, serum total cholesterol, LDL cholesterol/HDL cholesterol, sex, insulin level at 60 min in OGTT, treatment, serum triglyceride, presence of family history of diabetes, CHD, hypertension and tobacco as independent variables causing ECG changes, revealed correct classification in 84% of cases. Among the variables, insulin level in OGTT contributed the most to ECG abnormalities. The data suggest that in the non obese, non diabetic Asian Indian hypertensive subjects, the presence of electrocardiographic abnormalities might be partly related to hyperinsulinemia or insulin resistance in them.