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Background: Diabetes mellitus refers to a group of common metabolic disorders that shares the phenotype of hyperglycemia. Complications of diabetes mellitus involve many organ systems only to play an important role in morbidity and mortality. Poor glycemic control is significantly associated with the development of macrovascular complications. Earlier studies have indicated that C-reactive protein (CRP) is an important risk factor for cardiovascular disease as evident from its higher levels in people with diabetes mellitus compared to those without. Not much is known whether CRP is related to the level of glycemic control. The purpose of this study is, to determine the relation between HbA1C, Lipid profile and CRP in individuals with type 2 diabetes mellitus.Methods: Fifty patients with T2DM reporting to Narayana Medical College and Hospital were included in the study, in whom CRP levels were estimated by using commercially available kits and correlated with HbA1C and other risk factors of coronary artery disease. Follow-up was done on 20 patients who were not on statin therapy with repeat HbA1C and CRP.Results: This study showed that both HbA1C and CRP levels had reduced significantly in follow-up patients after putting them on treatment (p<0.05). It was also found that lower the HbA1C, lower was the CRP. A positive correlation was found between HbA1C and CRP (p<0.05).Conclusions: In this study of 50 patients with T2DM, it was found that CRP is significantly correlated with HbA1C level. A positive correlation was found between serum CRP and HbA1C in the initial group and in the follow-up patients, showing that CRP levels lowers with better glycemic control and correlates with dyslipidaemia profile.

BACKGROUND: Drug utilization study analyses the prescribing patterns and justifies the rational use of drugs. Clinicians often face challenges in selecting, initiating, and individualizing appropriate drug therapy for patients. Physicians' inability to provide good management of hypertension has been identified as an important contributor to poor BP control in hypertensive patients. We assessed the prescribing trends in hypertensive patients by various physicians. METHODS: Data for study was collected from Narayana Medical College and Hospital, Nellore during a period of 10 months from outpatient departments of General Medicine, Cardiology and Nephrology. 2440 hypertensive prescriptions were analyzed. Hypertension was defined as SBP/DBP greater than 140/90 or taking medications for hypertension irrespective of etiologies. RESULTS: Both essential and secondary hypertensive prescriptions were analyzed. The mean age of the participants was 51.95± 12.68 yrs. The mean SBP of the participants was 151.98±17.75 and DBP was 93.44±10.55 mm of Hg. We found that 1663 patients were essential hypertensive and 577 were hypertensives due to chronic kidney disease. CCB was the most commonly prescribed 961(42.90%), followed by beta blockers 882(39.38%), Angiotensin receptor blockers (ARB) 646 (28.8%), Angiotensin converting enzyme inhibitors (ACEI) 420(18.75%), diuretics 231(10.3%), clonidine 119(5.3%) and prazosin 96(4.29%). 767(34.2%) were receiving monotherapy, 977(43.6%) on two drugs, 390(17.4%) on three drugs, 88(3.9%) were on four drugs and 5(0.2%) on five drug combinations. 13 (0.60%) were not using any drugs. Only 704 (31.43%) were responders. Among the prescribed drugs, 93% of drugs were prescribed by trade name and 20.64% were fixed-drug combinations. Average number of drugs prescribed was 1.91±0.84. CONCLUSIONS: It was observed that majority of drugs were prescribed by brand names on an average two drugs per prescription. CCBs were the most commonly used drugs to treat hypertension among all the age group patient population followed beta blockers ARB, ACEI, Diuretics, Clonidine and Prazosin. It was also found that there was less number of fixed dose combinations. The study suggests that there is immense scope of improvement in prescribing practices in the form of rational drug prescribing for achieving optimal blood pressure control.

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