Clinical profile of lean body weight type 2 diabetes mellitus patients in comparison with normal weight and obese type 2 diabetes mellitus patients

Shavana, S M (2011) Clinical profile of lean body weight type 2 diabetes mellitus patients in comparison with normal weight and obese type 2 diabetes mellitus patients. Masters thesis, K.A.P. Viswanatham Government Medical College, Tiruchirappalli.

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Abstract

INTRODUCTION : Diabetes Mellitus is a group of metabolic disorders characterized by a deficiency of insulin secretion and / or insulin effect, which causes hyperglycemia, disturbances of carbohydrate, fat and protein metabolism and a constellation of chronic complications. Diabetes is and will remain a threat to global health .World wide diabetes probably affects 150 million people and its prevalence is predicted to double by 2015. The incidence of diabetes is showing an alarming rise in developing countries, particularly in India3. 60-80% of the diabetics in developed countries are obese. Whereas in India we find that clinical profile of diabetics is different1. Most of the patients attending our diabetic clinic are not obese as defined by existing parameters such as BMI. It is interesting to note that most patients fall in normal weight group and some even lean group. Obesity in type 2 diabetes is less common in Indian population compared to western population1,4. So, it is worth studying the clinical profile of lean type 2 diabetes, by comparing with normal and obese population with type 2 diabetes. AIM OF THE STUDY : 1. To Study and compare the clinical profile of Lean Body weight Type 2 Diabetes Mellitus patients with obese and Normal weight Type 2 DM patients, by age, sex, family history and Anthropometry. 2. To compare the "presenting complications" of the lean with normal weight / obese type 2 Diabetes patients. 3. To compare the Biochemical profile of the lean type 2 Diabetes with that of normal and obese type 2 DM. MATERIALS AND METHODS : Type of the study : Cross sectional. Period of study : January 2010 – September 2010. Place of study : Annal Gandhi Memorial Government Hospital, Trichy. No.of Patients : 100. Materials : Type 2 Diabetes Mellitus patients. The hundred patients were divided into three groups based on BMI. Body Mass Index (BMI). Group A: BMI < 18.5 Kg/m2 (Lean Body Weight Type 2DM), Group B: BMI, between 18.5 and 24.9 Kg/m2 (Normal Weight Type 2 DM), Group C: BMI > 30Kg/m2 (Obese Type 2 DM). A careful detailed history were taken from each person, i.e. Age of onset, duration, any positive family history, dietary pattern, presenting complaints – at the time of diagnosis etc. Detailed examination was done for all the hundred patients to find out various complications, if any. Biochemically, Blood glucose (Both fasting and post prandial), Blood urea, Serum Creatinine, Lipid profile were analysed in all the three groups. Selection of cases: Cases included in the study were selected as per the records available with them. Duration of disease, Body Mass Index, Waist Hip Ratio, current Blood Glucose, Urea, Serum Creatinine and Lipid profile were taken into consideration. Exclusion Criteria for cases: 1. Presence of history of pulmonary tuberculosis. 2. Presence of other chronic illnesses that could affect body weight like chronic liver disease and chronic kidney disease. 3. Type 2 Diabetes patients with Age of onset less than 30 years. 4. History wise, particularly in lean patients those who were normal or obese at the time of presentation, but lost body weight significantly after the detection of type2 Diabetes mellitus. 5. Patients with history of Cancer /HIV. 6. Over weight patients with BMI between 25-30. Selection of Controls Control cases were normal weight as well as obese patients with Type 2 Diabetes Mellitus. RESULTS : "Diabetes Mellitus" is an age old affliction of man and is the most common metabolic disorder all over the world. The incidence of Diabetes is showing alarming rise in developing countries, particularly. In India. India3 is known as the Diabetic capital of the world. Most of the diabetics in developed countries are obese. However in India we have a significant number of diabetics who are either normal weight or even under weight4. Even though obesity is considered as part of Syndrome X in the pathogenesis of type 2 diabetes, in our study, out of 100 patients only32 patients were obese. Our study included hundred patients. Among 100 patients, 48 are males and 52 are females. In our study majority of patients, that is 49 patients (49%) belong to normal weight, 32 patients (32%) belong to obese and 19 patients (19%) belong to lean body weight. CONCLUSION : a. Majority of type 2 diabetes patients in our population are having normal weight (49%) and lean body weight contributes to 19% b. Lean diabetics have more severe hyperglycemia and poor metabolic control. They are more prone for microvascular complications like neuropathy and retinopathy. c. Early treatment with insulin in lean type 2 diabetics is mandatory to achieve good glycemic control and to prevent future complications.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Clinical profile ; lean body weight ; type 2 diabetes mellitus patients ; comparison ; normal weight ; obese type 2 diabetes mellitus patients.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 13 Feb 2018 15:45
Last Modified: 13 Feb 2018 15:45
URI: http://repository-tnmgrmu.ac.in/id/eprint/5687

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