Background: The present cross sectional study was carried out on 516 subjects with type 2 diabetes from a tertiary health care hospital to identify the prevalence and predictors of cognitive impairment in diabetes. Materials and Methods: Cognitive impairment was tested using Mini Mental Scale Examination (MMSE), Trail making tests-A and B (TMT-A and TMT-B). Efficiency of these tests to diagnose cognitive impairment was analysed using reliability index (Cronbach's α = 0.82), which ruled out any internal inconsistency. Of the study participants, 174 (33.73%) met the criteria for cognitive impairment and 342 (66.27%) were having normal cognition. Out of 174, 156 diabetic subjects (89.65 percent) were not diagnosed for neurocognitive impairment prior participation. Results: Cognitive impairment was observed to be strongly associated with being a woman (P < 0.001), divorced or separated (P = 0.007), sedentary life style (P = 0.001), smoking (P < 0.001), drinking alcohol (P < 0.001), systolic blood pressure >120 mmHg (P = 0.003), triglycerides (TG) >150 mg/dl (P = 0.001), high density lipoprotein <40 mg/dl (P = 0.001), statin use (P = 0.009), waist hip ratio in both males and females (P = 0.001), glucose levels >125 mg/dl (P = 0.005) and duration of diabetes >2 years upto 10 years and more than 10 years (P = 0.001) in univariate testing. In multivariate logistic regression model, being a woman was an independent risk factor for cognitive decline, which is two fold higher (OR 2.00 95%CI 1.25-3.20, P = 0.004) than being a man. Other risk factors like glucose levels > 125 mg/dl, systolic blood pressure >120 mmHg, sedentary life style and duration of diabetes >10 years emerged as independent predictors of cognitive impairment in diabetes. Conclusion: In conclusion, the present study revealed that higher prevalence of cognitive impairment in diabetes is evident in population of Punjab, especially in women and majority of these patients remain undiagnosed for it.

The present cross sectional study was carried out on 787 type 2 diabetic subjects from tertiary health care hospitals to identify the prevalence and predictors of depression in diabetes. Depression was tested using Patient Health Questionnaire-9. Of the study participants, 199 (25.29%) met the criteria for mild to moderate depression, 252 (32.02%) were severely depressed and 336 (42.69%) were clinically non-depressed. The prevalence of depression was 65.02 % in women, which is 1.87 fold higher (p < 0.0001) than men (49.87%). Depression was observed to be strongly associated with advancing age >30 years (p < 0.05), low income (p = 0.0001), sedentary life style (p = 0.001), Plasma levels of low density lipoproteins (LDL) >100 mg/dl and triglycerides (TG) >150 mg/dl (p < 0.05), drinking alcohol (p < 0.001), statin use (p < 0.001), BMI >35-39.9 kg m(-2) (p = 0.018), WHR >0.9 cm (p < 0.0001), Glucose levels >125 mg/dl (p < 0.0001) and duration of diabetes 2-4 years (p = 0.003). In multivariate logistic regression model, risk factors such as, being a woman, duration of diabetes ≥10 years, BMI ≥30 kg m(-2), LDL >100 mg/dl, TG >150 mg/dl and sedentary life style emerged as independent predictors of depression in diabetes. In the present study, 86.4 % diabetic subjects were not diagnosed for depression prior participation. In conclusion, the present study revealed that higher prevalence of depression in diabetes was evident in population of Punjab, especially in women and majority of these patients remain undiagnosed for depression.

According to several epidemiological and clinical studies, the concentration of C-reactive protein (CRP) in blood is associated with the risk of coronary heart disease (CHD). However, these studies are limited in high incidence and prevalence area of North-West India. The present case control study investigated the contribution of three relevant CRP single nucleotide polymorphisms: -717A>G located in the promoter region (rs2794521), +1059G>C on exon2 (rs1800947) and +1444C>T in the 3' UTR (rs1130864) in 180 angiographically verified CHD cases and 175 control subjects. Minor allele frequencies (G, C and T) of rs2794521, rs1800947 and rs1130864 are observed to be 21.1, 11.7, 29.4 and 11.4, 10.0, 19.7 % in CHD cases and controls respectively. AA genotype of -717A>G and TT genotype of +1444C>T were significantly associated (P = 0.02 & 0.03 respectively) with the risk of CHD whereas, +1059G and +1444T were found to be strongly related (P = 0.023 & P = 0.008 respectively) with multivariable adjusted CRP levels. AGT Haplotype was significantly associated with the adjusted CRP levels (P < 0.05). Disease association analysis revealed that haplotype AGT influences CHD risk (OR 2.4, 95 % CI 1.23-4.84, P = 0.006) which exacerbates after correcting the confounding effects of risk variables (OR 2.5, 95 % CI 1.27-4.99, P = 0.004). With the global index of Akaike information criterion, it has been observed that the carrying each single unit of this susceptibility haplotype increases CHD risk by a value of 2.41 ± 0.439 (β ± SE) in the recessive mode.

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