Premature mortality patterns among American Indians in South Dakota, 2000-2010.

Science.gov (United States)

Christensen, Mathew; Kightlinger, Lon

2013-05-01

American Indians in South Dakota have the highest mortality rates in the nation compared to other racial and ethnic groups and American Indians in other states. Cause-related and age-specific mortality patterns among American Indians in South Dakota are identified to guide prevention planning and policy efforts designed to reduce mortality within this population, in both South Dakota and other parts of the U.S. Death certificate data from South Dakota (2000-2010), on 5738 American Indians and 70,580 whites, were used to calculate age-specific mortality rates and rate ratios. These values were examined in order to identify patterns among the leading causes of death. Analyses were completed in 2011 and 2012. Within the South Dakota population, 70% of American Indians died before reaching age 70 years, compared to 25% of whites. Fatal injuries and chronic diseases were the leading causes of premature mortality. Nine leading causes of death showed consistent patterns of mortality disparity between American Indians and whites, with American Indians having significantly higher rates of mortality at lower ages. Premature mortality among American Indians in South Dakota is a serious public health problem. Unified efforts at the federal, tribal, state, and local levels are needed to reduce premature death within this population. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... Foot Care Training Tools for Diabetes Educators and Community Members Diabetes Educator Tools Diabetes Education Lesson Plan ... prevention and treatment in American Indian/Alaska Native communities. IHS Headquarters, Indian Health Service, 5600 Fishers Lane, ...

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... Program for Indians Division of Diabetes Treatment and Prevention Special Diabetes Program for Indians (SDPI) About SDPI ... Country Conference IHS Division of Diabetes Treatment and Prevention August 6-9, 2019 | Oklahoma City Conference Center | ...

Drift pumice in the Indian and South Atlantic oceans

International Nuclear Information System (INIS)

Frick, C.; Kent, L.E.

1984-01-01

Sixty-three samples of drift pumice, collected at the coasts of South Africa, East Africa, Madagascar, Mauritius, the Cocos Islands, Australia, Indonesia, Brazil, Marion Island and Bouvet Island, were investigated petrographically and geochemically with a view to establishing the possible source areas. Geochemically five distinct groups could be distinguished and some could be liked to specific eruptions in the Indian, Atlantic and Pacific oceans. Group A pumice originated from a submarine eruption off Zavodovski Island in the South Sandwich Island Group in 1962. The pumice in Group B occurs mainly on the beaches bordering the Atlantic Ocean, and was found on the west coast of South Africa, on the sea floor south-west of South Africa, and in Brazil. The source of this group is unknown, but all the evidence indicates that it must have been from the Mid-Atlantic Ridge in the South Atlantic Ocean. The Group C pumice was found in the southern Indian Ocean, probably from the Mid-Indian Ridge. The fourth group originated from a submarine eruption along the Tonga Trench in the Pacific Ocean. Group E, which is by far the most homogeneous, includes samples from Australia, the Indian Ocean islands, East and South Africa and samples of the undisputed Krakatoan origin. Specimens from the Krakatoan eruption are still the most abundant type of drift pumice that can be found

Marketplace Clinics Complementing Diabetes Care for Urban Residing American Indians.

Science.gov (United States)

Rick, Robert; Hoye, Robert E; Thron, Raymond W; Kumar, Vibha

2017-10-01

For several decades, the Minneapolis American Indian population has experienced limited health care access and threefold diabetes health disparity. As part of an urban health initiative, the marketplace clinics located in nearby CVS, Target, and Supervalu stores committed financial support, providers, certified educators, and pharmacy staff for a community-based diabetes support group. To measure the extent to which collaborating marketplace clinics and the community-based support group expanded diabetes care and provided self-management education for this largely urban Indian neighborhood. A controlled quasi-experimental study and 3-years retrospective analysis of secondary data were used to test whether the Minneapolis marketplace clinics and the community diabetes support group participants (n = 48) had improved diabetes health outcomes relative to the comparison group (n = 87). The marketplace complemented intervention group employed motivational interviewing and the patient activation measure (PAM®) in coaching diabetes self-care and behavioral modification. The federally funded comparison group received only basic self-management education. T tests and effect sizes were used to quantify the difference between the study intervention and comparison groups. Statistical significance was determined for the following outcome variables: A1C ( P < .01), body mass index ( P < .04), and PAM® ( P < .001). Includes strengths, limitations, and future study recommendations. Positive effects of marketplace clinics and community health complementation were found with regard to improved blood glucose control, weight loss, and healthful lifestyle adaptation. Primary care and community health improvements could be realized by incorporating patient activation with diabetes prevention programs for the urban Indian two-thirds majority of the United States 5 million American Indian population.

Identification of novel variants in the hepatocyte nuclear factor-1alpha gene in South Indian patients with maturity onset diabetes of young

DEFF Research Database (Denmark)

Radha, V; Ek, J; Anuradha, S

2009-01-01

. There are very few data on MODY mutations from India. OBJECTIVE: The objective was to screen coding and promoter regions of HNF1A gene for mutations in unrelated South Indian subjects in whom a clinical diagnosis of MODY was made. DESIGN: This was an observational cross-sectional study. SETTING: The study...... studies revealed reduced transcriptional activity of the HNF1A promoter for two promoter variants. We also observed cosegregation with diabetes of the Arg263His coding region mutation in eight members of one MODY family, whereas it was absent in nondiabetic subjects of this family. CONCLUSION: This study...... suggests that mutations in the HNF1A gene comprise about 9% of clinically diagnosed MODY subjects in southern India and a novel Arg263His mutation cosegregates with MODY in one family....

A diabetes self-management program designed for urban American Indians.

Science.gov (United States)

Castro, Sarah; O'Toole, Mary; Brownson, Carol; Plessel, Kimberly; Schauben, Laura

2009-10-01

Although the American Indian population has a disproportionately high rate of type 2 diabetes, little has been written about culturally sensitive self-management programs in this population. Community and clinic partners worked together to identify barriers to diabetes self-management and to provide activities and services as part of a holistic approach to diabetes self-management, called the Full Circle Diabetes Program. The program activities and services addressed 4 components of holistic health: body, spirit, mind, and emotion. Seven types of activities or services were available to help participants improve diabetes self-management; these included exercise classes, educational classes, and talking circles. Ninety-eight percent of program enrollees participated in at least 1 activity, and two-thirds participated in 2 or more activities. Program participation resulted in a significant improvement in knowledge of resources for managing diabetes. The Full Circle Diabetes Program developed and implemented culturally relevant resources and supports for diabetes self-management in an American Indian population. Lessons learned included that a holistic approach to diabetes self-management, community participation, and stakeholder partnerships are needed for a successful program.

Lifestyle Choices Fuel Epidemics of Diabetes and Cardiovascular Disease Among Asian Indians.

Science.gov (United States)

O'Keefe, Evan L; DiNicolantonio, James J; Patil, Harshal; Helzberg, John H; Lavie, Carl J

2016-01-01

Within the next 15years, India is projected to overtake China as the world's most populous nation. Due to the rapid pace of urbanization and modernization fueling population growth, in conjunction with a genetic predisposition to insulin resistance, India is suffering a rising epidemic of non-communicable diseases (NCDs), including coronary artery disease (CAD), type 2 diabetes mellitus (T2DM), and stroke. In addition to the genetic predisposition, major negative lifestyle factors are contributing to the alarming outbreak of cardiovascular disease (CVD) among the Asian Indian population; these factors include: 1) a diet high in added sugar, refined grains and other processed foods, 2) physical inactivity, 3) vitamin D deficiency (VDD), and 4) smoking/pollution. These risk factors are all highly modifiable, and steps to improve these issues should be taken urgently to avoid a worsening NCD crisis among the inhabitants of the South Asian subcontinent as well as for people with Asian Indian ethnicity worldwide. Copyright © 2015 Elsevier Inc. All rights reserved.

Diabetes Outcomes in the Indian Health System During the Era of the Special Diabetes Program for Indians and the Government Performance and Results Act

Science.gov (United States)

Wilson, Charlton; Gilliland, Susan; Cullen, Theresa; Moore, Kelly; Roubideaux, Yvette; Valdez, Lorraine; Vanderwagen, William; Acton, Kelly

2005-01-01

Objectives. We reviewed changes in blood glucose, blood pressure, and cholesterol levels among American Indians and Alaska Natives between 1995 and 2001 to estimate the quality of diabetes care in the Indian Health Service (IHS) health care delivery system. Methods. We conducted a cross-sectional analysis of data from the Indian Health Service Diabetes Care and Outcomes Audit. Results. Adjusted mean Hemoglobin A1c (HbA1c) levels (7.9% vs 8.9%) and mean diastolic blood pressure levels (76 vs 79 mm Hg) were lower in 2001 than in 1995, respectively. A similar pattern was observed for mean total cholesterol (193 vs 208 mg/dL) and triglyceride (235 vs 257 mg/dL) levels in 2001 and 1995, respectively. Conclusions. We identified changes in intermediate clinical outcomes over the period from 1995 to 2001 that may reflect the global impact of increased resource allocation and improvements in processes on the quality of diabetes care, and we describe the results that may be achieved when community, health program, and congressional initiatives focus on common goals. PMID:16051933

Latent Autoimmune Diabetes of the Adult (LADA in a Brazilian Indian

Directory of Open Access Journals (Sweden)

João Paulo Botelho Vieira Filho

Full Text Available CONTEXT: Latent autoimmune diabetes of the adult (LADA as originally described represents perhaps as many as 10 -- 20% of adult-onset patients with diabetes. DESIGN: case report. CASE REPORT: A 38-year-old Brazilian Xavante-Jê Indian with Latent Autoimmune Diabetes of the Adult (LADA is described, coming from the Sangradouro community in Poxoréu, Mato Grosso. The onset of diabetes after reaching 25 years of age, the evolution to insulin deficiency after a period of insulin-independence and the presence of auto-antibodies to glutamic acid decarboxylase (GAD characteristic of LADA were present. This patient may represent the first case of LADA in a Brazilian with full Indian heritage. Further studies are necessary to verify the prevalence of this new type of diabetes in this population that does not have Caucasoid admixture and has a particular environmental background.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... IHS Diabetes Audit Audit/SOS Login Clinician Resources Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians Division of Diabetes Treatment ...

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Medline Plus

Full Text Available ... IHS Diabetes Audit Clinician Resources Audit/SOS Login Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians Division of Diabetes Treatment ...

Associations of variants in FTO and near MC4R with obesity traits in South Asian Indians.

Science.gov (United States)

Vasan, Senthil K; Fall, Tove; Neville, Matthew J; Antonisamy, Belavendra; Fall, Caroline H; Geethanjali, Finney S; Gu, Harvest F; Raghupathy, Palany; Samuel, Prasanna; Thomas, Nihal; Brismar, Kerstin; Ingelsson, Erik; Karpe, Fredrik

2012-11-01

Recent genome-wide association studies show that loci in FTO and melanocortin 4 receptor (MC4R) associate with obesity-related traits. Outside Western populations the associations between these variants have not always been consistent and in Indians it has been suggested that FTO relates to diabetes without an obvious intermediary obesity phenotype. We investigated the association between genetic variants in FTO (rs9939609) and near MC4R (rs17782313) with obesity- and type 2 diabetes (T2DM)-related traits in a longitudinal birth cohort of 2,151 healthy individuals from the Vellore birth cohort in South India. The FTO locus displayed significant associations with several conventional obesity-related anthropometric traits. The per allele increase is about 1% for BMI, waist circumference (WC), hip circumference (HC), and waist-hip ratio. Consistent associations were observed for adipose tissue-specific measurements such as skinfold thickness reinforcing the association with obesity-related traits. Obesity associations for the MC4R locus were weak or nonsignificant but a signal for height (P work poorly in the Indian "thin-fat" phenotype.

ETHNICITY AND TYPE 2 DIABETES IN ASIAN INDIAN MIGRANTS IN AUCKLAND, NEW ZEALAND

Directory of Open Access Journals (Sweden)

Jowitt Ljiljana

2014-12-01

Full Text Available The aim of this review was to present ethnic differences in body size and body composition in Asian Indian migrants in New Zealand, associated with metabolic syndrome and type 2 diabetes, through the comparison with other ethnic groups in New Zealand. International databases including PubMed and Google scholar were consulted, as well as the websites of the World Health Organization and International Diabetes Federation. About 74 studies out of 128 publications were selected to ensure relevance to the topic of the review. Seven research projects were presented for the body size and body composition of Asian Indian migrants in New Zealand. The prevalence of type 2 diabetes of 8.6% in Asian Indians in New Zealand is still higher than in their homeland, owing to their ethnicity, genetic predisposition, sedentary lifestyle and altered nutrition, and other psychosocial factors related to migration and living conditions like stress at work and depression. For the same body mass index, in comparison with people of other ethnic groups in New Zealand Asian Indians had more total body fat, higher percent body fat, more central fat, less lean mass and appendicular skeletal muscle mass. Central obesity was associated with insulin resistance and low grade systemic inflammation. Considering the evidence that type 2 diabetes develops ten years earlier in Asian Indians than in other populations, further studies are warranted to shed some light on the still incompletely understood metabolic syndrome and “thin-fat” Indian phenotype.

Diabetes prevention in the New York City Sikh Asian Indian community: a pilot study.

Science.gov (United States)

Islam, Nadia S; Zanowiak, Jennifer M; Wyatt, Laura C; Kavathe, Rucha; Singh, Hardayal; Kwon, Simona C; Trinh-Shevrin, Chau

2014-05-19

India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.). Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs have shown the benefits of using lifestyle intervention to reduce diabetes risk, yet there have been no culturally-tailored programs for diabetes prevention in the Sikh community. Using a quasi-experimental two-arm design, 126 Sikh Asian Indians living in New York City were enrolled in a six-workshop intervention led by community health workers. A total of 108 participants completed baseline and 6-month follow-up surveys between March 2012 and October 2013. Main outcome measures included clinical variables (weight, body mass index (BMI), waist circumference, blood pressure, glucose, and cholesterol) and health behaviors (changes in physical activity, food behaviors, and diabetes knowledge). Changes were significant for the treatment group in weight, BMI, waist circumference, blood pressure, glucose, physical activity, food behaviors, and diabetes knowledge, and between group differences were significant for glucose, diabetes knowledge, portion control, and physical activity social interaction. Retention rates were high. Findings demonstrate that a diabetes prevention program in the Sikh community is acceptable, feasible, and efficacious.

Diabetes Prevention in the New York City Sikh Asian Indian Community: A Pilot Study

Directory of Open Access Journals (Sweden)

Nadia S. Islam

2014-05-01

Full Text Available India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.. Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs have shown the benefits of using lifestyle intervention to reduce diabetes risk, yet there have been no culturally-tailored programs for diabetes prevention in the Sikh community. Using a quasi-experimental two-arm design, 126 Sikh Asian Indians living in New York City were enrolled in a six-workshop intervention led by community health workers. A total of 108 participants completed baseline and 6-month follow-up surveys between March 2012 and October 2013. Main outcome measures included clinical variables (weight, body mass index (BMI, waist circumference, blood pressure, glucose, and cholesterol and health behaviors (changes in physical activity, food behaviors, and diabetes knowledge. Changes were significant for the treatment group in weight, BMI, waist circumference, blood pressure, glucose, physical activity, food behaviors, and diabetes knowledge, and between group differences were significant for glucose, diabetes knowledge, portion control, and physical activity social interaction. Retention rates were high. Findings demonstrate that a diabetes prevention program in the Sikh community is acceptable, feasible, and efficacious.

Type 2 diabetes after gestational diabetes mellitus in South Asian women in the United States.

Science.gov (United States)

Gadgil, Meghana D; Oza-Frank, Reena; Kandula, Namratha R; Kanaya, Alka M

2017-07-01

Gestational diabetes mellitus (GDM) is a major risk factor for type 2 diabetes. The incidence of both GDM and type 2 diabetes is exceedingly high in South Asian populations. However, the risk of type 2 diabetes after GDM in South Asian women in the United States is unknown. South Asians aged 40 to 84 years without known cardiovascular disease were enrolled in a community-based cohort called Mediators of Atherosclerosis in South Asians Living in America study. A history of GDM was elicited through self-report, and type 2 diabetes was ascertained by an oral glucose tolerance test. We performed a multivariable logistic regression analysis to examine the odds of type 2 diabetes after GDM history in this cross-sectional analysis. About 9.7% of women in the Mediators of Atherosclerosis in South Asians Living in America study self-reported a history of GDM, and were significantly younger, with higher mean diastolic blood pressure and self-reported weight at age 20 and 40 years than women without a history of GDM. In a model adjusted for age, weight at age 40, family history of diabetes, education, income, physical activity, caloric intake, alcohol use, and cigarette smoking, women with a history of GDM had increased odds of having type 2 diabetes compared with women without GDM (OR 3.2; 95% CI 1.3, 7.5). A history of GDM further increases the risk of type 2 diabetes in US South Asian women. Our findings underscore the importance of early postpartum screening in a population at high risk for type 2 diabetes. Copyright © 2017 John Wiley & Sons, Ltd.

South Dakota NASA Space Grant Consortium Creating Bridges in Indian Country

Science.gov (United States)

Bolman, J. R.

2004-12-01

The South Dakota Space Grant Consortium (SDSGC) was established March 1, 1991 by a NASA Capability Enhancement Grant. Since that time SDSGC has worked to provide earth and space science educational outreach to all students across South Dakota. South Dakota has nine tribes and five tribal colleges. This has presented a tremendous opportunity to develop sustainable equitable partnerships and collaborations. SDSGC believes strongly in developing programs and activities that highlight the balance of indigenous science and ways of knowing with current findings in contemporary science. This blending of science and culture creates a learning community where individuals, especially students, can gain confidence and pride in their unique skills and abilities. Universities are also witnessing the accomplishments and achievements of students who are able to experience a tribal college environment and then carry that experience to a college/university/workplace and significantly increase the learning achievement of all. The presentation will highlight current Tribal College partnerships with Sinte Gleska University and Oglala Lakota College amongst others. Programs and activities to be explained during the presentation include: Native Connections, Scientific Knowledge for Indian Learning and Leadership (SKILL), Bridges to Success Summer Research Program, Fire Ecology Summer Experience, and dual enrolled/college bridge programs. The presentation will also cover the current initiatives underway through NASA Workforce Development. These include: partnering program with the Annual He Sapa Wacipi, American Indian Space Days 2005, NASA research/internship programs and NASA Fellow Summit. An overview of recent American Indian student success will conclude the presentation. The South Dakota School of Mines and Technology has struggled over many years to develop and implement sustainable successful initiatives with Tribal Colleges and Communities. The motivating philosophy is the

Barriers and Motives to PA in South Asian Indian Immigrant Women.

Science.gov (United States)

Daniel, Manju; Abendroth, Maryann; Erlen, Judith A

2017-03-01

The high prevalence of chronic illnesses in South Asian Indian immigrant women underscores the need for identifying factors that could influence their PA. The purpose of this qualitative study was to examine the perspectives of South Asian Indian immigrant women related to barriers to and motives for lifestyle PA within the PA Framework for South Asian Indian Immigrants. Forty women participated in focus groups that were conducted in English and Hindi. Focus group questions were open-ended and semistructured. Transcribed and de-identified audiotaped sessions were coded and analyzed using Atlas.ti software. Role expectation was a core theme for barriers with four subthemes: lack of time, loss of interest, diminished social support, and environmental constraints. Self-motivation was a core theme for motives with three subthemes: optimal physical and psychological health, emphasis on external beauty, and strong social support. Future PA interventions need to target these culturally sensitive factors.

Association of diabetes and cancer mortality in American Indians: the Strong Heart Study.

Science.gov (United States)

Best, Lyle G; García-Esquinas, Esther; Yeh, Jeun-Liang; Yeh, Fawn; Zhang, Ying; Lee, Elisa T; Howard, Barbara V; Farley, John H; Welty, Thomas K; Rhoades, Dorothy A; Rhoades, Everett R; Umans, Jason G; Navas-Acien, Ana

2015-11-01

The metabolic abnormalities that accompany diabetes mellitus are associated with an increased risk of many cancers. These associations, however, have not been well studied in American Indian populations, which experience a high prevalence of diabetes. The Strong Heart Study is a population-based, prospective cohort study with extensive characterization of diabetes status. Among a total cohort of 4,419 participants who were followed for up to 20 years, 430 cancer deaths were identified. After adjusting for sex, age, education, smoking status, drinking status, and body mass index, participants with diabetes at baseline showed an increased risk of gastric (HR 4.09; 95% CI 1.42-11.79), hepatocellular (HR 2.94; 95% CI 1.17-7.40), and prostate cancer mortality (HR 3.10; 95% CI 1.22-7.94). Further adjustment for arsenic exposure showed a significantly increased risk of all-cause cancer mortality with diabetes (HR 1.27; 95% CI 1.03-1.58). Insulin resistance among participants without diabetes at baseline was associated with hepatocellular cancer mortality (HR 4.70; 95% CI 1.55-14.26). Diabetes mellitus, and/or insulin resistance among those without diabetes, is a risk factor for gastric, hepatocellular, and prostate cancer in these American Indian communities, although relatively small sample size suggests cautious interpretation. Additional research is needed to evaluate the role of diabetes and obesity on cancer incidence in American Indian communities as well as the importance of diabetes prevention and control in reducing the burden of cancer incidence and mortality in the study population.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... addition of new diabetes-related topics. New SDPI Fact Sheet Infographic! [PDF – 776 KB] See how SDPI has helped changed the course of diabetes over the past 20 years by reducing diabetes and its costly complications. Share with others today! 2017 Diabetes in Indian Country Conference Exit ...

Knowledge and awareness about diabetes mellitus and diabetic retinopathy in suburban population of a South Indian state and its practice among the patients with diabetes mellitus: A population-based study.

Science.gov (United States)

Hussain, Rameez; Rajesh, Bindu; Giridhar, Anantharaman; Gopalakrishnan, Mahesh; Sadasivan, Sanjai; James, Justin; Vijayan, Pradeep Padickal; John, Nelson

2016-04-01

Ocular complications due to diabetes mellitus (DM) were on the rise despite good literacy levels in South India. To assess the knowledge and attitude toward DM and diabetic retinopathy of the general population in a suburban town of South India. Door-to-door population survey in suburban town of South India in May 2013. A 30-point questionnaire was prepared and the data were collected and analyzed to determine statistically the knowledge, attitude, and practice (KAP) scores of the general and diabetic population and also to determine significant demographic associations. In this study, 6211 people (3528 [56.8%] women and 2683 [43.2%] men) with a mean age of 55.6 ± 11.7 years (range 21-98 years) were included. Good knowledge and positive attitude were observed in 3457 (55.6%) and 3280 (52.8%) people. Among 1538 (25.4%) people known to have DM, only 619 (40.7%) had good knowledge, 828 (53.8%) had a positive attitude, and 886 (57.6%) had good practice patterns. Although half of them followed general diabetic care, only 9.6% had undergone screening for retinopathy. Literacy showed a significant association with good KAP (P knowledge (P < 0.001). Better literacy, especially among women, is contributory to better public awareness; however, the trend for poor practice patterns needs to be radically changed with aggressive public motivation emphasizing on the necessity of retinopathy screening and periodic follow-ups.

Comparison of dietary profile of a rural south Indian population with the current dietary recommendations for prevention of non-communicable diseases (CURES 147

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Narasimhan Sowmya

2016-01-01

Interpretation & conclusions: The dietary profile of this rural south Indian population reflected unhealthy choices, with the high consumption of refined cereals in the form of polished white rice and low intake of protective foods like fruits, vegetables, n-3 poly and monounsaturated fatty acids. This could potentially contribute to the increase in prevalence of NCDs like diabetes, hypertension and cardiovascular diseases in rural areas and calls for appropriate remedial action.

Impact of gestational diabetes on the risk of diabetes following pregnancy among Chinese and South Asian women.

Science.gov (United States)

Mukerji, G; Chiu, M; Shah, B R

2012-08-01

Ethnicity and gestational diabetes mellitus (GDM) are both risk factors for the development of type 2 diabetes. However, it is uncertain whether ethnicity modifies the effect of GDM on diabetes risk. We aimed to determine the risk of diabetes following pregnancy with and without GDM for Chinese and South Asian women compared with white women. Using healthcare databases, all 1,050,108 women aged 20-49 with live births between January 1995 and June 2008 in Ontario were identified. They were followed for up to 15 years for the diagnosis of diabetes. The age-standardised prevalences of GDM were 4.1%, 7.1% and 2.9% for Chinese, South Asian and white women, respectively. The cumulative incidence of diagnosed diabetes at the median follow-up time of 7.6 years was 16.5% and 1.8% for Chinese women with and without GDM, 31.8% and 3.6% for South Asian women with and without GDM, and 25.7% and 1.8% for white women with and without GDM. The presence of GDM conferred an increase in the risk for diabetes after pregnancy of more than 13-fold in white women, but only a nine- to tenfold increase among Chinese and South Asian women. Although one-third of South Asian women with GDM were diagnosed with diabetes within 8 years postpartum, the incremental impact of GDM on diabetes risk was not as strong among Chinese and South Asian women as it was among white women.

Depression in diabetes mellitus-A comprehensive systematic review of literature from an Indian perspective.

Science.gov (United States)

Naskar, Subrata; Victor, Robin; Nath, Kamal

2017-06-01

Diabetes and depression are rapidly growing chronic health conditions that have significant negative impact upon the physical, psychological, social and occupational functioning, quality of life and often leads to socio-economic burden. Presence of both these comorbid diseases results in various short term and long term complications and increases the mortality as compared to those with depression or diabetes alone. Systematic review of the epidemiological data, risk factors and relationship between depression and glycaemic control among the Indian studies. We searched Pubmed, Pubmed Central, Google Scholar and Directory of Open Access Journal (DOAJ) databases to identify relevant Indian studies. Substantial variation in the prevalence of depression in people with diabetes was found across the 41 selected studies; according to this review the range is 2% to 84% (T1DM - 2-7%; T2DM - 8%-84%). Correlates of depression in diabetic patients are advancing age, female gender, low literacy rate, burden of being from a lower socioeconomic status, rural domicile, marriage and duration of diabetes of >2years, diabetes related complications and poor glycaemic control. Sedentary life without adequate physical activities, lack of self-care are often the factors that precipitates depression in a T2DM patient and vice versa. According to this review, among Indian population there is a significant association between depression and diabetes. Copyright © 2017 Elsevier B.V. All rights reserved.

The accuracy of polyuria, polydipsia, polyphagia, and Indian Diabetes Risk Score in adults screened for diabetes mellitus type-II

OpenAIRE

Shivshakti D Pawar; Poonam Thakur; B K Radhe; Harshal Jadhav; Vivek Behere; Vikrant Pagar

2017-01-01

Context: The World Health Organization report suggests that over 19% of the world's diabetic population currently resides in India. Unfortunately, >50% of the diabetics in India are unaware about their diabetic status. In the poor income country like India, it is essential to use cost-effective methods for screening for diabetes, and traditionally using three classical symptoms and Indian Diabetes Risk Score (IDRS) tool is helpful but, data regarding their diagnostic accuracy is very less. Ob...

Ethnic-Specific Criteria for Classification of Body Mass Index: A Perspective for Asian Indians and American Diabetes Association Position Statement.

Science.gov (United States)

Misra, Anoop

2015-09-01

Definitions for overweight and obesity are universally applied using body mass index (BMI), based on morbidity and mortality data derived from white populations. However, several studies have shown higher body fat, excess metabolic perturbations, and cardiovascular risk factors at lower value of BMI in Asian versus white populations. Definitive guidelines have been published to classify a BMI of ≥23 kg/m(2) and ≥25 kg/m(2) as overweight and obese, respectively, by the Indian Consensus Group (for Asian Indians residing in India) and a BMI of ≥23 kg/m(2) for screening for diabetes by the National Institute of Health and Care Excellence of the United Kingdom (for migrant south Asians) and, in an encouraging initiative recently (2015), by the American Diabetes Association (for all Asian ethnic groups in the United States). Overall, multiple studies, and now several guidelines, emphasize early intervention with diet and physical activity in Asian ethnic groups for prevention and management of obesity-related noncommunicable diseases. By application of these guidelines, an additional 10-15% of the population in India would be labeled as overweight/obese, and more South Asians/Asians will be diagnosed with diabetes in the United Kingdom and the United States. Additional health resources need to be allocated to deal with increasing numbers of Asians with obesity-related noncommunicable diseases, and research is needed to evolve cost-effective interventions. Finally, consensus based on data is needed so that the World Health Organization and other international agencies could take definitive steps for revision of classification of BMI for Asian populations globally.

Seasonal variation of the South Indian tropical gyre

NARCIS (Netherlands)

Aguiar-González, B.; Ponsoni, Leandro; Ridderinkhof, H.; van Aken, H.M.; de Ruijter, W.P.M.; Maas, L.R.M.

2016-01-01

Based on satellite altimeter data and global atlases of temperature, salinity, wind stress and wind-driven circulation we investigate the seasonal variation of the South Indian tropical gyre and its associated open-ocean upwelling system, known as the Seychelles–Chagos Thermocline Ridge (SCTR).

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Medline Plus

Full Text Available ... Treatment for the Prevention of Diabetes Richard Arakaki, MD Area Diabetes Consultant Phoenix Area IHS Stay Connected ... Headquarters, Indian Health Service, 5600 Fishers Lane, Rockville, MD 20857 - Find a Mail Stop Office Mail Stops ...

Journal of Genetics | Indian Academy of Sciences

Indian Academy of Sciences (India)

Lack of association of PTPN1 gene polymorphisms with type 2 diabetes in south Indians · Dhanasekaran Bodhini Venkatesan Radha Saurabh Ghosh Partha P. Majumder Viswanathan Mohan · More Details Fulltext PDF. Volume 94 Issue 1 March 2015 pp 105-113 Research Article. Comparative analyses of genetic risk ...

Prevalence of Charcot Arthropathy in Type 2 Diabetes Patients Aged over 50 Years with Severe Peripheral Neuropathy: A Retrospective Study in a Tertiary Care South Indian Hospital.

Science.gov (United States)

Salini, Dharmadas; Harish, Kumar; Minnie, Pillay; Sundaram, Karimassery R; Arun, Bal; Sandya, Chirukandath J; Mangalanandan, Thacho S; Vivek, Lakshmanan; Praveen, Valiyaparambil P

2018-01-01

Available literature on the prevalence of Charcot arthropathy (CA) represents mainly Western population. No study has been reported from India so far. Hence we attempted to study the prevalence of CA in patients with type 2 diabetes mellitus and severe peripheral neuropathy (T2DMPN), belonging to Indian population amongst whom type 2 diabetes is on the rise in alarming proportions. Medical records of 3387 patients who performed an objective vibration perception threshold test during the year 2015 were screened for T2DMPN. Out of these, 1475 T2DMPN patients above 50 years were selected and analyzed in detail for CA. CA was diagnosed based on clinical features and/or radiological investigations. The anatomical localization of the disease distribution of the affected foot was done according to Brodsky's classification. The prevalence of CA in T2DMPN patients was found to be 9.8%. The mean age of patients diagnosed with CA was 63 ± 8.36 years, and mean duration of DM for CA to develop was 18.01 ± 8.23 years. About 62.5% of the patients were male and 37.5% female. Bilateral presentation of CA was observed in 20.8% of patients. Multiple sites of the foot were affected in 48.6% of patients and belonged to type 4 classification of Brodsky. A high prevalence of CA (9.8%) was observed in the present study conducted on T2DMPN patients who presented to the endocrinology department of a tertiary care South Indian hospital. In the majority of patients, the area of foot affected belonged to type 4 classification of Brodsky.

Case management to reduce cardiovascular disease risk in American Indians and Alaska Natives with diabetes: results from the Special Diabetes Program for Indians Healthy Heart Demonstration Project.

Science.gov (United States)

Moore, Kelly; Jiang, Luohua; Manson, Spero M; Beals, Janette; Henderson, William; Pratte, Katherine; Acton, Kelly J; Roubideaux, Yvette

2014-11-01

We evaluated cardiovascular disease (CVD) risk factors in American Indians/Alaska Natives (AI/ANs) with diabetes in the Special Diabetes Program for Indians Healthy Heart (SDPI-HH) Demonstration Project. Multidisciplinary teams implemented an intensive case management intervention among 30 health care programs serving 138 tribes. The project recruited 3373 participants, with and without current CVD, between 2006 and 2009. We examined data collected at baseline and 1 year later to determine whether improvements occurred in CVD risk factors and in Framingham coronary heart disease (CHD) risk scores, aspirin use, and smoking status. A1c levels decreased an average of 0.2% (P risk scores also decreased significantly. Aspirin therapy increased significantly, and smoking decreased. Participants with more case management visits had significantly greater reductions in LDL cholesterol and A1c values. SDPI-HH successfully translated an intensive case management intervention. Creative retention strategies and an improved understanding of organizational challenges are needed for future Indian health translational efforts.

Drug addiction and diabetes: South Asian action.

Science.gov (United States)

Singh Balhara, Yatan Pal; Kalra, Sanjay

2017-06-01

Both diabetes and drug addiction are common phenomena across the world. Drug abuse impacts glycaemic control in multiple ways. It becomes imperative, therefore, to share guidance on drug deaddiction in persons with diabetes. The South Asian subcontinent is home to specific forms and patterns of drug abuse. Detailed study is needed to ensure good clinical practice regarding the same. This communication provides a simple and pragmatic framework to address this issue, while calling for concerted action on drug deaddiction in South Asia.

The Indian Ocean Experiment : Widespread air pollution from South and Southeast Asia

NARCIS (Netherlands)

Lelieveld, J; Crutzen, PJ; Ramanathan, A.; Andreae, MO; Brenninkmeijer, CAM; Campos, T; Cass, GR; Dickerson, RR; Fischer, H; de Gouw, JA; Hansel, A; Jefferson, A; Kley, D; de Laat, ATJ; Lal, S; Lawrence, MG; Lobert, JM; Mayol-Bracero, OL; Mitra, AP; Novakov, T; Oltmans, SJ; Prather, KA; Reiner, T; Rodhe, H; Scheeren, HA; Sikka, D; Williams, J

2001-01-01

The Indian Ocean Experiment (INDOEX) was an international, multiplatform field campaign to measure Long-range transport of air pollution from South and Southeast Asia toward the Indian Ocean during the dry monsoon season in January to March 1999. Surprisingly high pollution Levels were observed over

High prevalence of abnormal liver enzymes in South African patients ...

African Journals Online (AJOL)

Objective: To determine the prevalence of liver function test abnormalities in South African black and Indian adult patients with type 2 diabetes mellitus attending a tertiary diabetes clinic. iabetes clinic. Recorded data included the past medical and drug history, history of alcohol abuse, anthropometry, lipid profile and liver ...

Anthropometric analysis of the hip joint in South Indian population using computed tomography

Directory of Open Access Journals (Sweden)

Vetrivel Chezian Sengodan

2017-01-01

Conclusion: This study indicates that there are significant differences in anthropometric parameters of proximal femur among the South Indian population compared with Western population. Even within the Indian population, the anthropometric parameters vary region to region.

Intestinal helminths in lowland South American Indians: some evolutionary interpretations.

Science.gov (United States)

Confalonieri, U; Ferreira, L F; Araújo, A

1991-12-01

Data on intestinal parasite infections for South American Indians in prehistoric times as revealed by coprolite analysis are being used to support transoceanic migration routes from the Old World to the New World. These same findings on modern semi-isolated aborigines, considered persisting prehistoric patterns, are also of great importance as indicators of pre-Columbian peopling of South America. This is the case for the Lengua Indians from Paraguay, studied in the 1920s, and the Yanomami and the Salumã from Brazil, studied in the 1980s. The intestinal parasitic profile of these groups can be empirically associated with culture change, but no clear correlations with the population biology of their hosts can be made at present because of scarcity of data.

Obesity and Dyslipidemia in South Asians

Science.gov (United States)

Misra, Anoop; Shrivastava, Usha

2013-01-01

Obesity and dyslipidemia are emerging as major public health challenges in South Asian countries. The prevalence of obesity is more in urban areas than rural, and women are more affected than men. Further, obesity in childhood and adolescents is rising rapidly. Obesity in South Asians has characteristic features: high prevalence of abdominal obesity, with more intra-abdominal and truncal subcutaneous adiposity than white Caucasians. In addition, there is greater accumulation of fat at “ectopic” sites, namely the liver and skeletal muscles. All these features lead to higher magnitude of insulin resistance, and its concomitant metabolic disorders (the metabolic syndrome) including atherogenic dyslipidemia. Because of the occurrence of type 2 diabetes, dyslipidemia and other cardiovascular morbidities at a lower range of body mass index (BMI) and waist circumference (WC), it is proposed that cut-offs for both measures of obesity should be lower (BMI 23–24.9 kg/m2 for overweight and ≥25 kg/m2 for obesity, WC ≥80 cm for women and ≥90 cm for men for abdominal obesity) for South Asians, and a consensus guideline for these revised measures has been developed for Asian Indians. Increasing obesity and dyslipidemia in South Asians is primarily driven by nutrition, lifestyle and demographic transitions, increasingly faulty diets and physical inactivity, in the background of genetic predisposition. Dietary guidelines for prevention of obesity and diabetes, and physical activity guidelines for Asian Indians are now available. Intervention programs with emphasis on improving knowledge, attitude and practices regarding healthy nutrition, physical activity and stress management need to be implemented. Evidence for successful intervention program for prevention of childhood obesity and for prevention of diabetes is available for Asian Indians, and could be applied to all South Asian countries with similar cultural and lifestyle profiles. Finally, more research on

Obesity and Dyslipidemia in South Asians

Directory of Open Access Journals (Sweden)

Anoop Misra

2013-07-01

Full Text Available Obesity and dyslipidemia are emerging as major public health challenges in South Asian countries. The prevalence of obesity is more in urban areas than rural, and women are more affected than men. Further, obesity in childhood and adolescents is rising rapidly. Obesity in South Asians has characteristic features: high prevalence of abdominal obesity, with more intra-abdominal and truncal subcutaneous adiposity than white Caucasians. In addition, there is greater accumulation of fat at “ectopic” sites, namely the liver and skeletal muscles. All these features lead to higher magnitude of insulin resistance, and its concomitant metabolic disorders (the metabolic syndrome including atherogenic dyslipidemia. Because of the occurrence of type 2 diabetes, dyslipidemia and other cardiovascular morbidities at a lower range of body mass index (BMI and waist circumference (WC, it is proposed that cut-offs for both measures of obesity should be lower (BMI 23–24.9 kg/m2 for overweight and ≥25 kg/m2 for obesity, WC ≥80 cm for women and ≥90 cm for men for abdominal obesity for South Asians, and a consensus guideline for these revised measures has been developed for Asian Indians. Increasing obesity and dyslipidemia in South Asians is primarily driven by nutrition, lifestyle and demographic transitions, increasingly faulty diets and physical inactivity, in the background of genetic predisposition. Dietary guidelines for prevention of obesity and diabetes, and physical activity guidelines for Asian Indians are now available. Intervention programs with emphasis on improving knowledge, attitude and practices regarding healthy nutrition, physical activity and stress management need to be implemented. Evidence for successful intervention program for prevention of childhood obesity and for prevention of diabetes is available for Asian Indians, and could be applied to all South Asian countries with similar cultural and lifestyle profiles. Finally, more

Reframing Diabetes in American Indian Communities: A Social Determinants of Health Perspective

Science.gov (United States)

Mitchell, Felicia M.

2012-01-01

American Indians and Alaska Natives (AI/ANs) experience some of the greatest health inequities of any group within the United States. AI/ANs are diagnosed with diabetes more than twice as often as non-Hispanic white Americans. Diabetes is a chronic preventable disease often associated with individual risk factors and behaviors that indicate what…

Assessment of Diabetes Risk in an Adult Population Using Indian Diabetes Risk Score in an Urban Resettlement Colony of Delhi.

Science.gov (United States)

Acharya, Anita Shankar; Singh, Anshu; Dhiman, Balraj

2017-03-01

Diabetes mellitus is one of the non-communicable diseases which has become a major global health problem whose prevalence is increasing worldwide and is expected to reach 4.4% by 2030. The risk of diabetes escalates with increase in the number of risk factors and their duration as well. The Indian Diabetic Risk Score (IDRS) is a simple, low cost, feasible tool for mass screening programme at the community level. To assess the risk score of diabetes among the study subjects using IDRS. A cross sectional survey was conducted on adults >30 years (n=580) on both gender in an urban resettlement colony of Delhi during December 2013 to March 2015. A Semi-structured interview schedule consisting of Socio-demographic characteristics, risk factor profile and Indian Diabetes Risk Score was used. Data was entered and analyzed in SPSS. Out of 580 subjects, 31 (5.3%) study subjects were not at risk of having diabetes, rest 94.5% were at moderate or high risk of diabetes.A statistically significant association of diabetes risk with marital status(p=0.0001), education(0.005),body mass index(0.049) and systolic blood pressure was seen.(p=0.006). More than 90% of the study subjects were at risk of having diabetes, hence screening is of utmost importance so that interventions can be initiated at an early stage.

Journal of Endocrinology, Metabolism and Diabetes of South Africa ...

African Journals Online (AJOL)

Journal of Endocrinology, Metabolism and Diabetes of South Africa. ... Management of diabetic ketoacidosis · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT ... Prediabetes: a focus on the role of diabetes education in prevention of type 2 ...

South Asian women with diabetes: Psychosocial challenges and management: Consensus statement

OpenAIRE

Sarita Bajaj; Fatema Jawad; Najmul Islam; Hajera Mahtab; Jyoti Bhattarai; Dina Shrestha; Chandrika Wijeyaratne; Dimuthu T Muthukuda; Niranjala Weegoda Widanage; Than Than Aye; Moe Wint Aung; Bharti Kalra; R M Anjana; Aswathy Sreedevi; Komal Verma

2013-01-01

Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultur...

Vitamin D receptor gene polymorphisms and risk of polycystic ovary syndrome in South Indian women.

Science.gov (United States)

Siddamalla, Swapna; Reddy, Tumu Venkat; Govatati, Suresh; Erram, Nagendram; Deenadayal, Mamata; Shivaji, Sisinthy; Bhanoori, Manjula

2018-02-01

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive age women. Emerging evidence suggests that Vitamin D Receptor (VDR) might be a causal factor for characteristics associated with PCOS such as obesity and type 2 diabetes. Present study investigated association between VDR gene BsmI A/G (rs1544410), ApaI A/C (rs7975232) and TaqI T/C (rs731236) single nucleotide polymorphisms and PCOS risk in South Indian women. Genotyping of VDR gene SNPs was carried out in PCOS patients (n = 95) and controls (n = 130) by PCR-RFLP method and confirmed by sequencing analysis. Haplotype frequencies for multiple loci and the standardized disequilibrium coefficient (D') for pairwise linkage disequilibrium (LD) were assessed by Haploview software. Results showed significantly increased frequencies of BsmI G/G (p = .0197), ApaI C/C (p = .048), TaqI C/C (p = .044) genotypes and BsmI G (p = .0181), ApaI C (p = .0092), TaqI C (p = .0066) alleles in patients compared to controls. In addition, the frequency of the 'BsmI G, ApaI C, TaqI C' haplotype was also significantly elevated in patients (p = .0087). In conclusion, the VDR gene BsmI A/G ApaI A/C TaqI T/C and haplotype may constitute an inheritable risk factor for PCOS in South Indian women.

A longitudinal study of structural risk factors for obesity and diabetes among American Indian young adults, 1994-2008.

Science.gov (United States)

Marley, Tennille L; Metzger, Molly W

2015-05-07

American Indian young adults have higher rates of obesity and type 2 diabetes than the general US population. They are also more likely than the general population to have higher rates of structural risk factors for obesity and diabetes, such as poverty, frequent changes of residence, and stress. The objective of this study was to investigate possible links between these 2 sets of problems. Data from the American Indian subsample of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used to examine potential links between obesity and type 2 diabetes and structural risk factors such as neighborhood poverty, housing mobility, and stress. We used logistic regression to explore explanatory factors. American Indians in the subsample had higher rates of poor health, such as elevated hemoglobin A1c levels, self-reported high blood glucose, self-reported diabetes, and overweight or obesity. They also had higher rates of structural risk factors than non-Hispanic whites, such as residing in poorer and more transient neighborhoods and having greater levels of stress. Self-reported stress partially mediated the increased likelihood of high blood glucose or diabetes among American Indians, whereas neighborhood poverty partially mediated their increased likelihood of obesity. Neighborhood poverty and stress may partially explain the higher rates of overweight, obesity, and type 2 diabetes among American Indian young adults than among non-Hispanic white young adults. Future research should explore additional neighborhood factors such as access to grocery stores selling healthy foods, proximity and safety of playgrounds or other recreational space, and adequate housing.

Neurocysticercosos in South-Central America and the Indian Subcontinent: a comparative evaluation

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Gagandeep Singh

1997-09-01

Full Text Available Neurocysticercosis is an important public health problem in South-Central America and South Asia. A review of the differences in epidemiological and clinical attributes of cysticercosis and taeniasis in South Central America and India, respectively, is undertaken in the present communication. Intestinal taeniasis is hyperendemic in several American countries. In comparison, the prevalence of Taenia solium infestation is lower in India. The clinical manifestations in several American neurocysticercosis series comprise epilepsy, intracranial hypertension and meningeal - racemose cysticercosis, in roughly equal proportions. An overwhelming majority of the Indian subjects present with seizures. The commonest pathological substrate of the disorder in Indian patients is the solitary parenchymal degenerating cyst. The reasons for the predominance of solitary forms in India, and of multilesional forms in South Central America are discussed. The magnitude of Taenia solium infestation and the frequency of pork consumption in a given population appear to influence the quantum of cyst load in affected individuals.

Ocean transport and variability studies of the South Pacific, Southern, and Indian Oceans

Science.gov (United States)

Church, John A.; Cresswell, G. R.; Nilsson, C. S.; Mcdougall, T. J.; Coleman, R.; Rizos, C.; Penrose, J.; Hunter, J. R.; Lynch, M. J.

1991-01-01

The objectives of this study are to analyze ocean dynamics in the western South Pacific and the adjacent Southern Ocean and the eastern Indian Ocean. Specifically, our objectives for these three regions are, for the South Pacific Ocean: (1) To estimate the volume transport of the east Australian Current (EAC) along the Australian coast and in the Tasman Front, and to estimate the time variability (on seasonal and interannual time scales) of this transport. (2) To contribute to estimating the meridional heat and freshwater fluxes (and their variability) at about 30 deg S. Good estimates of the transport in the western boundary current are essential for accurate estimates of these fluxes. (3) To determine how the EAC transport (and its extension, the Tasman Front and the East Auckland Current) closes the subtropical gyre of the South Pacific and to better determine the structure at the confluence of this current and the Antarctic Circumpolar Current. (4) To examine the structure and time variability of the circulation in the western South Pacific and the adjacent Southern Ocean, particularly at the Tasman Front. For the Indian Ocean: (5) To study the seasonal interannual variations in the strength of the Leeuwin Current. (6) To monitor the Pacific-Indian Ocean throughflow and the South Equatorial and the South Java Currents between northwest Australia and Indonesia. (7) To study the processes that form the water of the permanent oceanic thermocline and, in particular, the way in which new thermocline water enters the permanent thermocline in late winter and early spring as the mixed layer restratifies. For the Southern Ocean: (8) To study the mesoscale and meridional structure of the Southern Ocean between 150 deg E and 170 deg E; in particular, to describe the Antarctic frontal system south of Tasmania and determine its interannual variability; to estimate the exchanges of heat, salt, and other properties between the Indian and Pacific Oceans; and to investigate the

Community-Specific BMI Cutoff Points for South Indian Females

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K. B. Kishore Mohan

2011-01-01

Full Text Available Objective. To analyze multiparameters related to total body composition, with specific emphasis on obesity in South Indian females, in order to derive community-specific BMI cutoff points. Patients and Methods. A total number of 87 females (of age 37.33±13.12 years from South Indian Chennai urban population participated in this clinical study. Body composition analysis and anthropometric measurements were acquired after conducting careful clinical examination. Results. BMI demonstrated high significance when normal group (21.02±1.47 kg/m2 was compared with obese group (29.31±3.95 kg/m2, <0.0001. BFM displayed high significance when normal group (14.92±4.28 kg was compared with obese group (29.94 ± 8.1 kg, <0.0001. Conclusion. Community-specific BMI cutoffs are necessary to assess obesity in different ethnic groups, and relying on WHO-based universal BMI cutoff points would be a wrong strategy.

In Search of Agency: South Indian Percussion in a Globalized India

OpenAIRE

Jones, Erica Suzanne

2017-01-01

South Indian classical (Karnatic) music and dance are essential representations of a globalized Indian identity and culture. They are emblematic of and perpetuate socio-cultural ideals of masculinity and femininity within nationalist and performance spaces. I examine the current performance space as a heritage tradition, revived and reclaimed in the 1940s-Nationalist Period. My dissertation focuses on the performance of gender within Karnatic music from a postcolonial decolonized perspective....

Diabetes guidelines and clinical practice: is there a gap? The South ...

African Journals Online (AJOL)

Objectives: The objective of this survey was to determine the therapeutic management of patients with diabetes in the South African private healthcare environment. Design: The International Diabetes Management Practices Study is an international multicentre and observational study. In this paper, the local South African ...

Psychosocial stress in South African patients with type 2 diabetes

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Samantha Ramkisson

2016-11-01

Full Text Available Objective: Diabetes mellitus is considered an emotionally and behaviourally demanding condition which adds to the stress of a patient’s daily living. There is a paucity of literature in South Africa regarding stress and diabetes. This study therefore aims to identify the areas and contributory factors of psychosocial stress in South African patients with diabetes. Method: A cross-sectional study was conducted at two public facilities and five private medical practices on the north coast of KwaZulu-Natal, South Africa. The Questionnaire on Stress in Diabetes – Revised was administered to 401 participants. Results: Eighteen percent of the sample reported having extreme psychosocial stress. Depression, physical complaints and self-medication/diet were the main areas which contributed to high psychosocial stress. Factors that also contributed to high levels of psychosocial stress were low educational level, unemployment, female gender, attending the public sector and high HbA1c levels. Conclusion: Psychosocial stress affects metabolic control in patients with diabetes, thereby increasing the risks of long-term complications.

Aldehyde dehydrogenase polymorphism in North American, South American, and Mexican Indian populations.

Science.gov (United States)

Goedde, H W; Agarwal, D P; Harada, S; Rothhammer, F; Whittaker, J O; Lisker, R

1986-01-01

While about 40% of the South American Indian populations (Atacameños, Mapuche, Shuara) were found to be deficient in aldehyde dehydrogenase isozyme I (ALDH2 or E2), preliminary investigations showed very low incidence of isozyme deficiency among North American natives (Sioux, Navajo) and Mexican Indians (mestizo). Possible implications of such trait differences on cross-cultural behavioral response to alcohol drinking are discussed. PMID:3953578

Journal of Endocrinology, Metabolism and Diabetes of South Africa ...

African Journals Online (AJOL)

Diabetes distress and related factors in South African adults with type 2 diabetes · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Samantha Ramkisson, Basil Joseph Pillay, Benn Sartorius, 35-39 ...

Predictors of low diabetes risk perception in a multi-ethnic cohort of women with gestational diabetes mellitus.

Science.gov (United States)

Mukerji, G; Kainth, S; Pendrith, C; Lowe, J; Feig, D S; Banerjee, A T; Wu, W; Lipscombe, L L

2016-10-01

To determine what proportion of women with gestational diabetes underestimate their diabetes risk and identify factors associated with low diabetes risk perception. Participants included pregnant adult women with gestational diabetes between 2009 and 2012 across seven diabetes clinics in Ontario, Canada. Data were collected through chart review and a survey that included a diabetes risk perception question. Of the 614 of 902 women (68% response rate) with gestational diabetes, 89% correctly responded that gestational diabetes increases the risk for developing diabetes. However, 47.1% of women perceived themselves to be at low risk for developing diabetes within 10 years. On multivariable analysis, BMI gestational diabetes history, absent diabetes family history and absent insulin use were appropriately associated with low diabetes risk perception. However, compared with Caucasian ethnicity, high-risk ethnicity (Aboriginal, Latin American, West Indian, South Asian, Middle Eastern, Filipino, Black, Pacific Islander) [odds ratio (OR) 2.07; 95% CI 1.30-3.31] and East and South East Asian ethnicity (OR 2.01; 1.10-3.67) were associated with low diabetes risk perception. After further adjustment for immigration, only high-risk ethnicity remained a predictor of low diabetes risk perception (OR 1.86; 1.09-3.19), whereas East and South East Asian ethnicity did not (OR 1.67; 0.86-3.22). Although the majority of women recognized gestational diabetes as a risk factor for diabetes, almost half underestimated their personal high diabetes risk despite prenatal care. Furthermore, women from high-risk ethnic groups were more likely to underestimate their risk, even after adjusting for immigration. Interventions tailored to these groups are necessary to enhance perceived diabetes risk. © 2015 Diabetes UK.

Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes

OpenAIRE

Walls, Melissa L.; Sittner, Kelley J.; Aronson, Benjamin D.; Forsberg, Angie K.; Whitbeck, Les B.; al’Absi, Mustafa

2017-01-01

American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical...

Spirits of the Air: Birds and American Indians in the South

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E. N. Anderson

2010-08-01

Full Text Available Review of Spirits of the Air: Birds and American Indians in the South. Shepard Krech III. 2009. University of Georgia Press, Athens. Pp. 245, copiously illustrated. $44.95 (hardbound. ISBN-13 978-0-8203-2815-7.

Association analysis of nine candidate gene polymorphisms in Indian patients with type 2 diabetic retinopathy

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Govindarajan Gowthaman

2010-11-01

Full Text Available Abstract Background Diabetic retinopathy (DR is classically defined as a microvasculopathy that primarily affects the small blood vessels of the inner retina as a complication of diabetes mellitus (DM.It is a multifactorial disease with a strong genetic component. The aim of this study is to investigate the association of a set of nine candidate genes with the development of diabetic retinopathy in a South Indian cohort who have type 2 diabetes mellitus (T2DM. Methods Seven candidate genes (RAGE, PEDF, AKR1B1, EPO, HTRA1, ICAM and HFE were chosen based on reported association with DR in the literature. Two more, CFH and ARMS2, were chosen based on their roles in biological pathways previously implicated in DR. Fourteen single nucleotide polymorphisms (SNPs and one dinucleotide repeat polymorphism, previously reported to show association with DR or other related diseases, were genotyped in 345 DR and 356 diabetic patients without retinopathy (DNR. The genes which showed positive association in this screening set were tested further in additional sets of 100 DR and 90 DNR additional patients from the Aravind Eye Hospital. Those which showed association in the secondary screen were subjected to a combined analysis with the 100 DR and 100 DNR subjects previously recruited and genotyped through the Sankara Nethralaya Hospital, India. Genotypes were evaluated using a combination of direct sequencing, TaqMan SNP genotyping, RFLP analysis, and SNaPshot PCR assays. Chi-square and Fisher exact tests were used to analyze the genotype and allele frequencies. Results Among the nine loci (15 polymorphisms screened, SNP rs2070600 (G82S in the RAGE gene, showed significant association with DR (allelic P = 0.016, dominant model P = 0.012, compared to DNR. SNP rs2070600 further showed significant association with DR in the confirmation cohort (P = 0.035, dominant model P = 0.032. Combining the two cohorts gave an allelic P HTRA1, rs11200638 (G>A, showed marginal

Prevalence of dyslipidemia in adult Indian diabetic patients: A cross sectional study (SOLID

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Ambrish Mithal

2014-01-01

Full Text Available Context: India leads the world with largest number of diabetic patients and is often referred to as the diabetes capital of the world. Diabetic dyslipidemia in India is one of the main cause for Coronary Artery Disease (CAD mortality. Although diabetes continues to be a major lifestyle condition in India, there is a lack of studies in India on whether dyslipidemia in Indian diabetics is being adequately controlled. Our study provides critical insights into the insights into proportion of diabetes patients achieving lipid goal in India. Aims: The primary objective of our study was to assess the control of dyslipidemia in the Indian diabetic population treated with lipid lowering drugs (LLDs, as per American Diabetes Association (ADA 2010 guidelines. Settings and Design: The study was carried out in a real world Indian clinical setting involving 178 sites. This is a multicenter, noninterventional, and cross-sectional observational study. Materials and Methods: A total of 5400 adult subjects with established type-2 diabetes mellitus (T2DM and dyslipidemia were recruited for the study. Patients in the study were on LLD at a stable dose for at least last 3 months before the designated study visit. Routine lipid profile tests were conducted for all patients. Statistical Analysis Used: Descriptive statistics was used to analyze qualitative and discrete variables. Chi-square test and t-test were conducted to assess the existence of statistically significant association between the variables. Results: A total of 5400 patients with T2DM from 178 centers across India were recruited. Out of the total population, 56.75% (N = 3065 of them were males. Primary end-point of low-density lipoprotein cholesterol (LDL-C level below ADA 2010 target was achieved in a total of 48.74% (N = 2632 patients. Gender was significantly associated with lipid levels and age was significantly (P < 0.05 correlated with all lipid levels. Control rates of other lipid parameters like

Multiple environments: South Indian children’s environmental subjectivities in formation

NARCIS (Netherlands)

de Hoop, E.

2017-01-01

This article explores the formation of South Indian children’s (11–15 years old) environmental subjectivities based on five months of qualitative fieldwork with children in their school and non-school lives. By doing so, this paper aims to widen the scope of the existing literature on children’s

Diabetes distress and related factors in South African adults with ...

African Journals Online (AJOL)

aDepartment of Behavioural Medicine, School of Nursing and Public Health, College of ... Keywords: adults, depression, diabetes-related distress, glycaemic index, South Africa ... self-care and glycaemic control.7,8 Diabetes-related distress is.

How to offer culturally relevant type 2 diabetes screening: lessons learned from the South asian diabetes prevention program.

Science.gov (United States)

van Draanen, Jenna; Shafique, Ammara; Farissi, Aziz; Wickramanayake, Dilani; Kuttaiya, Sheela; Oza, Shobha; Stephens, Neil

2014-10-01

The literature on diabetes mellitus in the South Asian population clearly states the high-risk status of this group, yet there is a lack of effective models of culturally relevant, community-based screening and education programs for such a group. The South Asian Diabetes Prevention Program (SADPP) was developed to enhance equitable access to diabetes prevention resources for the South Asian communities in Toronto by offering language-specific and culturally relevant services. The SADPP model works through 3 participant education sessions plus an additional attachment and enrolment component. The screening tool that SADPP uses to provide participants with their individual risk score at the first education session is derived from the multiculturally validated Canadian Diabetes Risk Assessment Questionnaire (CANRISK), which has been modified to reflect the distinctive characteristics of the South Asian population. After analyzing the risk scores, 32% of participants were at increased risk, 40% were at high risk, 21% were at very high risk and only 7% were found to be at low risk of diabetes development. Evaluations of the program conducted in 2010 and 2013 revealed that the program is achieving its objectives and that participants increase their knowledge and self-efficacy related to diabetes prevention after program participation. Participants reported that the presentation from the nurse and dietitian, the question-and-answer time, the healthy eating demonstration, the multiple languages of delivery and the convenient location were especially beneficial. Those working in the field are encouraged to adapt this model and to contribute to the development of culturally relevant, community-driven diabetes prevention programs. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

North-south diversity of Scolecithricidae species (Copepoda: Calanoida) in the Indian Ocean

Digital Repository Service at National Institute of Oceanography (India)

Gopalakrishnan, T.C.; Balachandran, T.

The effectiveness of north-south hydrographical barriers in restricting the distributions of Scolecithricidae species (Copepoda:Calanoida) in the euphotic zone of the Indian Ocean was studied. Twenty seven species belonging to 7 genera were...

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... selected presentation recordings. Good news: Reduction in Kidney Failure in AI/AN People Exit Disclaimer: You Are ... ihs.gov showing a dramatic decrease in kidney failure from diabetes among American Indians and Alaska Natives. ...

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... Event Calendar Indian Health Manual Key Leaders Legislation Organizational Structure Our Employees Locations Headquarters Alaska Area Albuquerque ... be a favorite to share with friends and family. Order yours today! Find Tools for Diabetes Educators! ...

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... SOS Login Clinician Resources Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians ... Prevention Program Toolkit, Program Spotlights, and more! Announcing Online Lesson Plan Outlines for Educators New or seasoned ...

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... Recruiter Newsroom Announcements Congressional Testimony Contact Us Director's Speeches Fact Sheets IHS Blog Press Releases Reports to ... DSMES Into Your Practice [PDF – 275 KB] In the Spotlight Save the Date! 2019 Diabetes in Indian ...

Metabolic syndrome in South Asians

Directory of Open Access Journals (Sweden)

Kaushik Pandit

2012-01-01

Full Text Available South Asia is home to one of the largest population of people with metabolic syndrome (MetS. The prevalence of MetS in South Asians varies according to region, extent of urbanization, lifestyle patterns, and socioeconomic/cultural factors. Recent data show that about one-third of the urban population in large cities in India has the MetS. All classical risk factors comprising the MetS are prevalent in Asian Indians residing in India. The higher risk in this ethnic population necessitated a lowering of the cut-off values of the risk factors to identify and intervene for the MetS to prevent diabetes and cardiovascular disease. Some pharmacological and nonpharmacological interventions are underway in MetS to assess the efficacy in preventing the diabetes and cardiovascular disease in this ethnic population.

Serum AGEs in black South African patients with type 2 diabetes

African Journals Online (AJOL)

T2D and 81 non-diabetic patients at Dr George Mukhari Academic Hospital in Pretoria, South Africa. Outcome ... Subjects. In total, 138 subjects with type 2 diabetes (T2D) and 81 control subjects were ..... loss of glucose tolerance associated with the diabetic state, treatment ..... fracture risk in older adults with type 2 diabetes.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... watch selected presentation recordings. Good news: Reduction in Kidney Failure in AI/AN People Exit Disclaimer: You Are ... www.ihs.gov showing a dramatic decrease in kidney failure from diabetes among American Indians and Alaska Natives. ...

Distribution of Tritium and {sup 137}CS in South Indian Ocean Waters - Implications of Water Transport Processes

Energy Technology Data Exchange (ETDEWEB)

Povinec, P. P.; Jeskovsky, M.; Sykora, I. [Comenius University, Faculty of Mathematics, Physics and Informatics, Bratislava (Slovakia); Aoyama, M. [Meteorological Research Institute, Tsukuba (Japan); Gastaud, J.; Levy, I. [International Atomic Energy Agency, Marine Environment Laboratories (Monaco); Hamajima, Y. [Kanazawa University, Low-Level Radioactivity Laboratory, Nomi (Japan); Hirose, K. [Sophia University, Faculty of Science and Technology, Tokyo (Japan); Sanchez-Cabeza, J. A. [Universitat Autonoma de Barcelona, Bellaterra (Spain)

2013-07-15

The World Ocean, and specifically the Indian Ocean, plays a significant role in the better understanding of the climate. The distribution of global fallout {sup 3}H, {sup 14}C, {sup 90}Sr, {sup 129}I and {sup 137}Cs in the seawater of the Indian Ocean, after their main injection from atmospheric nuclear weapons tests during the 1960s, have been investigated. Results obtained in the framework of the SHOTS (Southern Hemisphere Ocean Tracer Studies) project are evaluated and compared with previously published data. The enhanced {sup 3}H and {sup 137}Cs levels observed in the south Indian ocean indicate transport of water masses labelled with these radionuclides from the central Pacific Ocean via the Indonesian Seas to the Indian Ocean. The observed surface gradients and presence of several water masses in the south Indian ocean makes this ocean one of the most dynamic parts of the World ocean. (author)

Quality assurance in diabetic retinal screening in South Africa.

Science.gov (United States)

Cook, Steve; Staff, Roger T; Goatman, Keith A; Olson, John A

2014-09-03

Diabetic retinopathy (DR) is an important biomarker for microvascular disease and blindness. Digital fundus photography is a cost-effective way of screening for DR. Access to DR screening is difficult for many South Africans with diabetes. To perform external quality assurance (EQA) on graders registered in the Ophthalmological Society of South Africa DR screening programme. Graders registered on the South African (SA) Diabetic Register website were invited to participate in the study. The Scottish EQA software system was used to enable on-line grading of 100 retinal photographs. Expert National Health Service graders provided the consensus expert grading for the image set. Two hundred and sixty-one participants completed the EQA process, including nine ophthalmologists, 243 optometrists, and nine other graders. A wide range of outcomes were demonstrated, with a mean sensitivity of 0.905 (range 0.286 - 1.000) and mean specificity of 0.507 (0.000 - 0.935). The mean diagnostic odds ratio was calculated to be 12.3 (range 0.147 - 148.2). This is the first quality assurance study conducted with SA healthcare professionals. The outcomes are of interest to all stakeholders dealing with the diabetes epidemic. The disparity in grader performance indicates room for improvement. The results demonstrate a high referral rate to ophthalmology, suggesting that on average graders are performing safely, but with a high number of inappropriate referrals.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... Press Releases Reports to Congress Tribal Leader Letters Urban Leader Letters IHS Home Division of Diabetes Treatment ... Office of Tribal Self Governance - 08E05 Office of Urban Indian Health Programs - 08E65C Accessibility Budget Contact Information ...

Insights into the genetic structure and diversity of 38 South Asian Indians from deep whole-genome sequencing.

Science.gov (United States)

Wong, Lai-Ping; Lai, Jason Kuan-Han; Saw, Woei-Yuh; Ong, Rick Twee-Hee; Cheng, Anthony Youzhi; Pillai, Nisha Esakimuthu; Liu, Xuanyao; Xu, Wenting; Chen, Peng; Foo, Jia-Nee; Tan, Linda Wei-Lin; Koo, Seok-Hwee; Soong, Richie; Wenk, Markus Rene; Lim, Wei-Yen; Khor, Chiea-Chuen; Little, Peter; Chia, Kee-Seng; Teo, Yik-Ying

2014-05-01

South Asia possesses a significant amount of genetic diversity due to considerable intergroup differences in culture and language. There have been numerous reports on the genetic structure of Asian Indians, although these have mostly relied on genotyping microarrays or targeted sequencing of the mitochondria and Y chromosomes. Asian Indians in Singapore are primarily descendants of immigrants from Dravidian-language-speaking states in south India, and 38 individuals from the general population underwent deep whole-genome sequencing with a target coverage of 30X as part of the Singapore Sequencing Indian Project (SSIP). The genetic structure and diversity of these samples were compared against samples from the Singapore Sequencing Malay Project and populations in Phase 1 of the 1,000 Genomes Project (1 KGP). SSIP samples exhibited greater intra-population genetic diversity and possessed higher heterozygous-to-homozygous genotype ratio than other Asian populations. When compared against a panel of well-defined Asian Indians, the genetic makeup of the SSIP samples was closely related to South Indians. However, even though the SSIP samples clustered distinctly from the Europeans in the global population structure analysis with autosomal SNPs, eight samples were assigned to mitochondrial haplogroups that were predominantly present in Europeans and possessed higher European admixture than the remaining samples. An analysis of the relative relatedness between SSIP with two archaic hominins (Denisovan, Neanderthal) identified higher ancient admixture in East Asian populations than in SSIP. The data resource for these samples is publicly available and is expected to serve as a valuable complement to the South Asian samples in Phase 3 of 1 KGP.

Oxygen isotope records of Globigerina bulloides across a north-south transect in the south-western Indian Ocean

Digital Repository Service at National Institute of Oceanography (India)

Khare, N.; Chaturvedi, S.K.; Saraswat, R

, Washington, D.C). Lutjeharms, J.R.E., N.M. Walters and B.R. Allanson. 1985. Oceanic frontal systems and biologicalenhancement. p.11-21. In: Antarctic Nutrient Cycles and Food Webs. ed. by W.R. Siegfried et al., Springer-Verlag, NewYork. Matsumoto, K., J...: Ocean Sci. J.: 44(2); 2009; 117-123 OXYGEN ISOTOPE RECORDS OF GLOBIGERINA BULLOIDES ACROSS A NORTH-SOUTH TRANSECT IN THE SOUTH-WESTERN INDIAN OCEAN N. Khare 1* , S. K. Chaturvedi 2 and R. Saraswat 3 1. Ministry of Earth Sciences, Block...

Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: qualitative study using a multi-level theoretical approach.

Science.gov (United States)

Greenhalgh, Trisha; Clinch, Megan; Afsar, Nur; Choudhury, Yasmin; Sudra, Rita; Campbell-Richards, Desirée; Claydon, Anne; Hitman, Graham A; Hanson, Philippa; Finer, Sarah

2015-05-21

Diabetes in pregnancy is common in South Asians, especially those from low-income backgrounds, and leads to short-term morbidity and longer-term metabolic programming in mother and offspring. We sought to understand the multiple influences on behaviour (hence risks to metabolic health) of South Asian mothers and their unborn child, theorise how these influences interact and build over time, and inform the design of culturally congruent, multi-level interventions. Our sample for this qualitative study was 45 women of Bangladeshi, Indian, Sri Lankan, or Pakistani origin aged 21-45 years with a history of diabetes in pregnancy, recruited from diabetes and antenatal services in two deprived London boroughs. Overall, 17 women shared their experiences of diabetes, pregnancy, and health services in group discussions and 28 women gave individual narrative interviews, facilitated by multilingual researchers, audiotaped, translated, and transcribed. Data were analysed using the constant comparative method, drawing on sociological and narrative theories. Key storylines (over-arching narratives) recurred across all ethnic groups studied. Short-term storylines depicted the experience of diabetic pregnancy as stressful, difficult to control, and associated with negative symptoms, especially tiredness. Taking exercise and restricting diet often worsened these symptoms and conflicted with advice from relatives and peers. Many women believed that exercise in pregnancy would damage the fetus and drain the mother's strength, and that eating would be strength-giving for mother and fetus. These short-term storylines were nested within medium-term storylines about family life, especially the cultural, practical, and material constraints of the traditional South Asian wife and mother role and past experiences of illness and healthcare, and within longer-term storylines about genetic, cultural, and material heritage - including migration, acculturation, and family memories of food

Estimating the burden of disease attributable to diabetes in South Africa in 2000.

Science.gov (United States)

Bradshaw, Debbie; Norman, Rosana; Pieterse, Desiréé; Levitt, Naomi S

2007-08-01

To estimate the burden of disease attributable to diabetes by sex and age group in South Africa in 2000. The framework adopted for the most recent World Health Organization comparative risk assessment (CRA) methodology was followed. Small community studies used to derive the prevalence of diabetes by population group were weighted proportionately for a national estimate. Population-attributable fractions were calculated and applied to revised burden of disease estimates. Monte Carlo simulation-modelling techniques were used for uncertainty analysis. South Africa. Adults 30 years and older. Mortality and disability-adjusted life years (DALYs) for ischaemic heart disease (IHD), stroke, hypertensive disease and renal failure. Of South Africans aged >or= 30 years, 5.5% had diabetes which increased with age. Overall, about 14% of IHD, 10% of stroke, 12% of hypertensive disease and 12% of renal disease burden in adult males and females (30+ years) were attributable to diabetes. Diabetes was estimated to have caused 22,412 (95% uncertainty interval 20,755 - 24,872) or 4.3% (95% uncertainty interval 4.0 - 4.8%) of all deaths in South Africa in 2000. Since most of these occurred in middle or old age, the loss of healthy life years comprises a smaller proportion of the total 258,028 DALYs (95% uncertainty interval 236,856 - 290,849) in South Africa in 2000, accounting for 1.6% (95% uncertainty interval 1.5 - 1.8%) of the total burden. Diabetes is an important direct and indirect cause of burden in South Africa. Primary prevention of the disease through multi-level interventions and improved management at primary health care level are needed.

Genetic spectrum of low density lipoprotein receptor gene variations in South Indian population.

Science.gov (United States)

ArulJothi, K N; Suruthi Abirami, B; Devi, Arikketh

2018-03-01

Low density lipoprotein receptor (LDLR) is a membrane bound receptor maintaining cholesterol homeostasis along with Apolipoprotein B (APOB), Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) and other genes of lipid metabolism. Any pathogenic variation in these genes alters the function of the receptor and leads to Familial Hypercholesterolemia (FH) and other cardiovascular diseases. This study was aimed at screening the LDLR, APOB and PCSK9 genes in Hypercholesterolemic patients to define the genetic spectrum of FH in Indian population. Familial Hypercholesterolemia patients (n=78) of South Indian Tamil population with LDL cholesterol and Total cholesterol levels above 4.9mmol/l and 7.5mmol/l with family history of Myocardial infarction were involved. DNA was isolated by organic extraction method from blood samples and LDLR, APOB and PCSK9 gene exons were amplified using primers that cover exon-intron boundaries. The amplicons were screened using High Resolution Melt (HRM) Analysis and the screened samples were sequenced after purification. This study reports 20 variations in South Indian population for the first time. In this set of variations 9 are novel variations which are reported for the first time, 11 were reported in other studies also. The in silico analysis for all the variations detected in this study were done to predict the probabilistic effect in pathogenicity of FH. This study adds 9 novel variations and 11 recurrent variations to the spectrum of LDLR gene mutations in Indian population. All these variations are reported for the first time in Indian population. This spectrum of variations was different from the variations of previous Indian reports. Copyright © 2017 Elsevier B.V. All rights reserved.

Heat flow, heat generation and crustal thermal structure of the northern block of the South Indian Craton

Science.gov (United States)

Gupta, Mohan L.; Sharma, S. R.; Sundar, A.

Heat flow values and heat generation data calculated from the concentration of heat producing radioactive elements, U, Th and K in surface rocks were analyzed. The South Indian Craton according to Drury et al., can be divided into various blocks, separated by late Proterozoic shear belts. The northern block comprises Eastern and Western Dharwar Cratons of Rogers (1986), Naqvi and Rogers (1987) and a part of the South Indian granulite terrain up to a shear system occupying the Palghat-Cauvery low lands. The geothermal data analysis clearly demonstrates that the present thermal characteristics of the above two Archaean terrains of the Indian and Australian Shields are quite similar. Their crustal thermal structures are likely to be similar also.

Heat flow, heat generation and crustal thermal structure of the northern block of the South Indian Craton

Science.gov (United States)

Gupta, Mohan L.; Sharma, S. R.; Sundar, A.

1988-01-01

Heat flow values and heat generation data calculated from the concentration of heat producing radioactive elements, U, Th and K in surface rocks were analyzed. The South Indian Craton according to Drury et al., can be divided into various blocks, separated by late Proterozoic shear belts. The northern block comprises Eastern and Western Dharwar Cratons of Rogers (1986), Naqvi and Rogers (1987) and a part of the South Indian granulite terrain up to a shear system occupying the Palghat-Cauvery low lands. The geothermal data analysis clearly demonstrates that the present thermal characteristics of the above two Archaean terrains of the Indian and Australian Shields are quite similar. Their crustal thermal structures are likely to be similar also.

A systematic review of overweight, obesity, and type 2 diabetes among Asian American subgroups.

Science.gov (United States)

Staimez, Lisa R; Weber, Mary Beth; Narayan, K M Venkat; Oza-Frank, Reena

2013-07-01

This systematic review synthesizes data published between 1988 and 2009 on mean BMI and prevalence of overweight, obesity, and type 2 diabetes among Asian subgroups in the U.S. We conducted systematic searches in Pub- Med for peer-reviewed, English-language citations that reported mean BMI and percent overweight, obesity, and diabetes among South Asians/Asian Indians, Chinese, Filipinos, Koreans, and Vietnamese. We identified 647 database citations and 23 additional citations from hand-searching. After screening titles, abstracts, and full-text publications, 97 citations remained. None were published between 1988 and 1992, 28 between 1993 and 2003, and 69 between 2004 and 2009. Publications were identified for the following Asian subgroups: South Asian (n=8), Asian Indian (n=20), Chinese (n=44), Filipino (n=22), Korean (n= 8), and Vietnamese (n=3). The observed sample sizes ranged from 32 to 4245 subjects with mean ages from 24 to 78 years. Among samples of men and women, the lowest reported mean BMI was in South Asians (22.1 kg/m(2)), and the highest was in Filipinos (26.8 kg/m(2)). Estimates for overweight (12.8-46.7%) and obesity (2.1-59.0%) were variable. Among men and women, the highest rate of diabetes was reported in Asian Indians with BMI ≥ 30 kg/m(2) (32.9%, age and sex standardized). This review suggests heterogeneity among U.S. Asian populations in cardiometabolic risk factors, yet comparisons are limited due to variability in study populations, methods, and definitions used in published reports. Future efforts should adopt standardized methods to understand overweight, obesity and diabetes in this growing U.S. ethnic population.

A SYSTEMATIC REVIEW OF OVERWEIGHT, OBESITY, AND TYPE 2 DIABETES AMONG ASIAN AMERICAN SUBGROUPS

Science.gov (United States)

STAIMEZ, LISA R.; WEBER, MARY BETH; NARAYAN, K.M. VENKAT; OZA-FRANK, REENA

2015-01-01

This systematic review synthesizes data published between 1988 and 2009 on mean BMI and prevalence of overweight, obesity, and type 2 diabetes among Asian subgroups in the U.S. We conducted systematic searches in PubMed for peer-reviewed, English-language citations that reported mean BMI and percent overweight, obesity, and diabetes among South Asians/Asian Indians, Chinese, Filipinos, Koreans, and Vietnamese. We identified 647 database citations and 23 additional citations from hand-searching. After screening titles, abstracts, and full-text publications, 97 citations remained. None were published between 1988 and 1992, 28 between 1993 and 2003, and 69 between 2004 and 2009. Publications were identified for the following Asian subgroups: South Asian (n=8), Asian Indian (n=20), Chinese (n=44), Filipino (n=22), Korean (n= 8), and Vietnamese (n=3). The observed sample sizes ranged from 32 to 4245 subjects with mean ages from 24 to 78 years. Among samples of men and women, the lowest reported mean BMI was in South Asians (22.1 kg/m2), and the highest was in Filipinos (26.8 kg/m2). Estimates for overweight (12.8 - 46.7%) and obesity (2.1 – 59.0%) were variable. Among men and women, the highest rate of diabetes was reported in Asian Indians with BMI ≥ 30 kg/m2 (32.9%, age and sex standardized). This review suggests heterogeneity among U.S. Asian populations in cardiometabolic risk factors, yet comparisons are limited due to variability in study populations, methods, and definitions used in published reports. Future efforts should adopt standardized methods to understand overweight, obesity and diabetes in this growing U.S. ethnic population. PMID:23590534

Diabetes training for community health workers on an American Indian reservation.

Science.gov (United States)

Policicchio, Judith M; Dontje, Katherine

2018-01-01

To improve the knowledge and skills of community health workers (CHWs) on an American Indian (AI) Reservation related to the management of diabetes to allow CHWs, with no prior formal diabetes education to work more effectively with individuals in the community with diabetes. Training was provided in six "face-to-face" sessions with the CHWs using the Centers for Disease Control and Prevention CHW Training Resource on Heart Disease and Stroke. This is a quality improvement program guided by the Model for Improvement: Plan, Do, Study, Act and using a pre-post evaluation design. Ten AI CHWs were recruited for the training. Knowledge and attitudes, participation rates, and participant satisfaction were measured. Knowledge increased overall with largest changes in diabetes, depression and cholesterol. Diabetes attitudes were high and consistent with those found in caregivers who support patient-centered care. Participants reported learning, liking the class, and finding the materials helpful. This QI program provided by a public health nurse improved CHW's knowledge of diabetes and the management of diabetes. Next steps include formalizing the Reservation's CHW training program, expanding this training to other AI Health Service areas, and measuring the impact of CHWs in the community. © 2017 Wiley Periodicals, Inc.

Neighborhood characteristics and lifestyle intervention outcomes: Results from the Special Diabetes Program for Indians.

Science.gov (United States)

Jiang, Luohua; Chang, Jenny; Beals, Janette; Bullock, Ann; Manson, Spero M

2018-06-01

Growing evidence reveals various neighborhood conditions are associated with the risk of developing type 2 diabetes. It is unknown, however, whether the effectiveness of diabetes prevention interventions is also influenced by neighborhood characteristics. The purpose of the current study is to examine the impact of neighborhood characteristics on the outcomes of a lifestyle intervention to prevent diabetes in American Indians and Alaska Natives (AI/ANs). Year 2000 US Census Tract data were linked with those from the Special Diabetes Program for Indians Diabetes Prevention Program (SDPI-DP), an evidence-based lifestyle intervention implemented in 36 AI/AN grantee sites across the US. A total of 3394 participants started the intervention between 01/01/2006 and 07/31/2009 and were followed by 07/31/2016. In 2016-2017, data analyses were conducted to evaluate the relationships of neighborhood characteristics with intervention outcomes, controlling for individual level socioeconomic status. AI/ANs from sites located in neighborhoods with higher median household income had 38% lower risk of developing diabetes than those from sites with lower neighborhood income (adjusted hazard ratio = 0.65, 95% CI: 0.47-0.90). Further, those from sites with higher neighborhood concentrations of AI/ANs achieved less BMI reduction and physical activity increase. Meanwhile, participants from sites with higher neighborhood level of vehicle occupancy made more improvement in BMI and diet. Lifestyle intervention effectiveness was not optimal when the intervention was implemented at sites with disadvantaged neighborhood characteristics. Meaningful improvements in socioeconomic and other neighborhood disadvantages of vulnerable populations could be important in stemming the global epidemic of diabetes. Copyright © 2018 Elsevier Inc. All rights reserved.

Insights into the genetic structure and diversity of 38 South Asian Indians from deep whole-genome sequencing.

Directory of Open Access Journals (Sweden)

Lai-Ping Wong

2014-05-01

Full Text Available South Asia possesses a significant amount of genetic diversity due to considerable intergroup differences in culture and language. There have been numerous reports on the genetic structure of Asian Indians, although these have mostly relied on genotyping microarrays or targeted sequencing of the mitochondria and Y chromosomes. Asian Indians in Singapore are primarily descendants of immigrants from Dravidian-language-speaking states in south India, and 38 individuals from the general population underwent deep whole-genome sequencing with a target coverage of 30X as part of the Singapore Sequencing Indian Project (SSIP. The genetic structure and diversity of these samples were compared against samples from the Singapore Sequencing Malay Project and populations in Phase 1 of the 1,000 Genomes Project (1 KGP. SSIP samples exhibited greater intra-population genetic diversity and possessed higher heterozygous-to-homozygous genotype ratio than other Asian populations. When compared against a panel of well-defined Asian Indians, the genetic makeup of the SSIP samples was closely related to South Indians. However, even though the SSIP samples clustered distinctly from the Europeans in the global population structure analysis with autosomal SNPs, eight samples were assigned to mitochondrial haplogroups that were predominantly present in Europeans and possessed higher European admixture than the remaining samples. An analysis of the relative relatedness between SSIP with two archaic hominins (Denisovan, Neanderthal identified higher ancient admixture in East Asian populations than in SSIP. The data resource for these samples is publicly available and is expected to serve as a valuable complement to the South Asian samples in Phase 3 of 1 KGP.

South Asian women with diabetes: Psychosocial challenges and management: Consensus statement.

Science.gov (United States)

Bajaj, Sarita; Jawad, Fatema; Islam, Najmul; Mahtab, Hajera; Bhattarai, Jyoti; Shrestha, Dina; Wijeyaratne, Chandrika; Muthukuda, Dimuthu T; Widanage, Niranjala Weegoda; Aye, Than Than; Aung, Moe Wint; Kalra, Bharti; Anjana, R M; Sreedevi, Aswathy; Verma, Komal

2013-07-01

Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultural disparity, discrimination at work, disparity in marriage, restricted medical facilities are prevalent. Diabetes and depression are common in women. Increasing age, low level of education, low socioeconomic conditions, difficulties posed in finding partners, frequent divorce and family history of psychiatric illness are significant risk factors for diabetes and depression. Such patients usually have poor metabolic control, higher complication rates, increased healthcare costs, lost productivity, lower quality of life as well as increased risk of death. Preconception counseling should be incorporated in the routine diabetes clinic visit for all women of childbearing potential. Women with diabetes should have information and access to contraception. Proper family planning counseling and psychological support can help stop practices such as female foeticide and multiple pregnancies. Psychological support to patients and their families are needed to break the barrier. There is emerging evidence that women with diabetes are more prone to untoward outcomes as compared to men. Central obesity, metabolic syndrome and the polycystic ovary syndrome show ethnic specific differences in South Asian women. Optimal sexuality is an integral part of holistic health. Shortage of trained female health care professionals, lack of privacy in over-crowded health care facilities, a social taboo attached to such matters, and lack of confidence in patients contribute to the neglect of sexual issues

South Asian women with diabetes: Psychosocial challenges and management: Consensus statement

Directory of Open Access Journals (Sweden)

Sarita Bajaj

2013-01-01

Full Text Available Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultural disparity, discrimination at work, disparity in marriage, restricted medical facilities are prevalent. Diabetes and depression are common in women. Increasing age, low level of education, low socioeconomic conditions, difficulties posed in finding partners, frequent divorce and family history of psychiatric illness are significant risk factors for diabetes and depression. Such patients usually have poor metabolic control, higher complication rates, increased healthcare costs, lost productivity, lower quality of life as well as increased risk of death.Preconception counseling should be incorporated in the routine diabetes clinic visit for all women of childbearing potential. Women with diabetes should have information and access to contraception. Proper family planning counseling and psychological support can help stop practices such as female foeticide and multiple pregnancies. Psychological support to patients and their families are needed to break the barrier.There is emerging evidence that women with diabetes are more prone to untoward outcomes as compared to men. Central obesity, metabolic syndrome and the polycystic ovary syndrome show ethnic specific differences in South Asian women. Optimal sexuality is an integral part of holistic health. Shortage of trained female health care professionals, lack of privacy in over-crowded health care facilities, a social taboo attached to such matters, and lack of confidence in patients contribute to the neglect

South Asian women with diabetes: Psychosocial challenges and management: Consensus statement

Science.gov (United States)

Bajaj, Sarita; Jawad, Fatema; Islam, Najmul; Mahtab, Hajera; Bhattarai, Jyoti; Shrestha, Dina; Wijeyaratne, Chandrika; Muthukuda, Dimuthu T.; Widanage, Niranjala Weegoda; Aye, Than Than; Aung, Moe Wint; Kalra, Bharti; Anjana, R. M.; Sreedevi, Aswathy; Verma, Komal

2013-01-01

Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultural disparity, discrimination at work, disparity in marriage, restricted medical facilities are prevalent. Diabetes and depression are common in women. Increasing age, low level of education, low socioeconomic conditions, difficulties posed in finding partners, frequent divorce and family history of psychiatric illness are significant risk factors for diabetes and depression. Such patients usually have poor metabolic control, higher complication rates, increased healthcare costs, lost productivity, lower quality of life as well as increased risk of death. Preconception counseling should be incorporated in the routine diabetes clinic visit for all women of childbearing potential. Women with diabetes should have information and access to contraception. Proper family planning counseling and psychological support can help stop practices such as female foeticide and multiple pregnancies. Psychological support to patients and their families are needed to break the barrier. There is emerging evidence that women with diabetes are more prone to untoward outcomes as compared to men. Central obesity, metabolic syndrome and the polycystic ovary syndrome show ethnic specific differences in South Asian women. Optimal sexuality is an integral part of holistic health. Shortage of trained female health care professionals, lack of privacy in over-crowded health care facilities, a social taboo attached to such matters, and lack of confidence in patients contribute to the neglect of sexual issues

The South Asian genome.

Directory of Open Access Journals (Sweden)

John C Chambers

Full Text Available The genetic sequence variation of people from the Indian subcontinent who comprise one-quarter of the world's population, is not well described. We carried out whole genome sequencing of 168 South Asians, along with whole-exome sequencing of 147 South Asians to provide deeper characterisation of coding regions. We identify 12,962,155 autosomal sequence variants, including 2,946,861 new SNPs and 312,738 novel indels. This catalogue of SNPs and indels amongst South Asians provides the first comprehensive map of genetic variation in this major human population, and reveals evidence for selective pressures on genes involved in skin biology, metabolism, infection and immunity. Our results will accelerate the search for the genetic variants underlying susceptibility to disorders such as type-2 diabetes and cardiovascular disease which are highly prevalent amongst South Asians.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Science.gov (United States)

... SOS Login Clinician Resources Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians Division ... 07E57B Office of Management Services - 09E70 Office of Public Health Support - ... of Resource Access and Partnerships - 10E85C Office of Tribal Self Governance - ...

Investigation of Factors Contributing to Diabetes Risk in American Indian/Alaska Native Youth

Science.gov (United States)

Islam-Zwart, Kayleen; Cawston, Alvina

2008-01-01

This study investigated the relationship between family history, sedentary behaviors, and childhood risk for type 2 diabetes. Participants were 480 students attending schools on or near an American Indian reservation. Data were collected through survey and BMI measurement. Children who frequently watched television or played video games did not…

Evidence of a southward eddy corridor in the South-West Indian ocean

CSIR Research Space (South Africa)

Ansorge, IJ

2015-09-01

Full Text Available Mesoscale eddies and meanders have been shown to be one of the dominant sources of flow variability in the world s ocean. One example of an isolated eddy hotspot is the South-West Indian Ridge (SWIR). Several investigations have shown that the SWIR...

The management of diabetes among the rural poor in South Africa ...

African Journals Online (AJOL)

The management of diabetes among the rural poor in South Africa. ... have been found to lead to a diet that has very high carbohydrate, high in saturated fatty acids, ... to facilitate good self-management of diabetes among the rural people.

Quality assurance in diabetic retinal screening in South Africa | Cook ...

African Journals Online (AJOL)

... external quality assurance (EQA) on graders registered in the Ophthalmological Society of South Africa DR screening programme. Methods. Graders registered on the South African (SA) Diabetic Register website were invited to participate in the study. The Scottish EQA software system was used to enable on-line grading ...

Obesity, Diabetes, and Birth Outcomes Among American Indians and Alaska Natives.

Science.gov (United States)

Anderson, Kermyt G; Spicer, Paul; Peercy, Michael T

2016-12-01

Objectives To examine the relationships between prepregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), and prepregnancy body mass index, with several adverse birth outcomes: preterm delivery (PTB), low birthweight (LBW), and macrosomia, comparing American Indians and Alaska Natives (AI/AN) with other race/ethnic groups. Methods The sample includes 5,193,386 singleton US first births from 2009-2013. Logistic regression is used to calculate adjusted odds ratios controlling for calendar year, maternal age, education, marital status, Kotelchuck prenatal care index, and child's sex. Results AI/AN have higher rates of diabetes than all other groups, and higher rates of overweight and obesity than whites or Hispanics. Neither overweight nor obesity predict PTB for AI/AN, in contrast to other groups, while diabetes predicts increased odds of PTB for all groups. Being overweight predicts reduced odds of LBW for all groups, but obesity is not predictive of LBW for AI/AN. Diabetes status also does not predict LBW for AI/AN; for other groups, LBW is more likely for women with DM or GDM. Overweight, obesity, DM, and GDM all predict higher odds of macrosomia for all race/ethnic groups. Conclusions for Practice Controlling diabetes in pregnancy, as well as prepregnancy weight gain, may help decrease preterm birth and macrosomia among AI/AN.

Putting theory into practice: a case study of diabetes-related behavioral change interventions on Chicago's South Side.

Science.gov (United States)

Peek, Monica E; Ferguson, Molly J; Roberson, Tonya P; Chin, Marshall H

2014-11-01

Diabetes self-management is central to diabetes care overall, and much of self-management entails individual behavior change, particularly around dietary patterns and physical activity. Yet individual-level behavior change remains a challenge for many persons with diabetes, particularly for racial/ethnic minorities who disproportionately face barriers to diabetes-related behavioral changes. Through the South Side Diabetes Project, officially known as "Improving Diabetes Care and Outcomes on the South Side of Chicago," our team sought to improve health outcomes and reduce disparities among residents in the largely working-class African American communities that comprise Chicago's South Side. In this article, we describe several aspects of the South Side Diabetes Project that are directly linked to patient behavioral change, and discuss the theoretical frameworks we used to design and implement our programs. We also briefly discuss more downstream program elements (e.g., health systems change) that provide additional support for patient-level behavioral change. © 2014 Society for Public Health Education.

"I'm Managing My Diabetes between Two Worlds": Beliefs and Experiences of Diabetes Management in British South Asians on Holiday in the East--A Qualitative Study.

Science.gov (United States)

Patel, Neesha R; Kennedy, Anne; Blickem, Christian; Reeves, David; Chew-Graham, Carolyn

2016-01-01

Diabetes is disproportionately high among British South Asians compared to the general UK population. Whilst the migrant British South Asians group has received most attention on research related to diabetes management, little consideration has been given to impact of travel back to the East. This study aimed to explore the role of social networks and beliefs about diabetes in British South Asians, to better understand their management behaviours whilst holidaying in the East. Semistructured interviews were conducted in Greater Manchester. Forty-four participants were recruited using random and purposive sampling techniques. Interviews were analysed thematically using a constant comparison approach. Migrant British South Asians expressed a strong preference to be in a hot climate; they felt they had a healthier lifestyle in the East and often altered or abandoned their diabetes medication. Information acquisition on diabetes and availability of social networks in the East was valued. Social networks in the East are a valued source of information and support for diabetes. The lack of adherence to medication whilst abroad suggests that some migrant British South Asians have a poor understanding of diabetes. Future research needs to explore whether patients are seeking professional advice on diabetes management prior to their extended holiday.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

Medline Plus

Full Text Available ... SOS Login Clinician Resources Education Materials and Resources (Online Catalog) Contact Us Special Diabetes Program for Indians Division ... 07E57B Office of Management Services - 09E70 Office of Public Health Support - ... of Resource Access and Partnerships - 10E85C Office of Tribal Self Governance - ...

Ferritin as a Risk Factor for Glucose Intolerance amongst Men and Women Originating from the Indian Subcontinent

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Elizabeth A. Hughes

2015-01-01

Full Text Available Background. Serum ferritin predicts the onset of diabetes; however, this relationship is not clear amongst South Asians, a population susceptible to glucose intolerance and anaemia. Objective. This study tests whether ferritin levels reflect glucose tolerance in South Asians, independent of lifestyle exposures associated with Indian or British residence. Methods. We randomly sampled 227 Gujaratis in Britain (49.8 (14.4 years, 50% men and 277 contemporaries living in Gujarati villages (47.6 (11.8 years, 41% men. Both groups underwent a 75 g oral-glucose-tolerance test. We evaluated lifestyle parameters with standardised questionnaires and conducted comprehensive clinical and lab measurements. Results. Across sites, the age-adjusted prevalence of diabetes was 9.8%. Serum ferritin was higher amongst diabetics (P=0.005, irrespective of site, gender, and central obesity (P≤0.02, and was associated with fasting and postchallenge glucose, anthropometry, blood pressure, triglycerides, and nonesterified fatty acids (P<0.001. Diabetes was less in those with low ferritin (<20 mg/mL, P<0.008, and risk estimate = 0.35 (95% CI 0.15–0.81, as were blood pressure and metabolic risk factors. On multivariate analysis, diabetes was independently associated with ferritin (P=0.001 and age (P<0.001. Conclusion. Ferritin levels are positively associated with glucose intolerance in our test groups, independent of gender and Indian or UK lifestyle factors.

Journal of Endocrinology, Metabolism and Diabetes of South Africa

African Journals Online (AJOL)

JEMDSA) is published by the South African Medical Association and publishes papers related to endocrinology, metabolism and diabetes. Other websites related to this journal: http://www.jemdsa.co.za ...

Prevalence and Impact of Diabetes Mellitus Among Patients with Active Pulmonary Tuberculosis in South Korea.

Science.gov (United States)

Lee, Eun Hye; Lee, Jung Mo; Kang, Young Ae; Leem, Ah Young; Kim, Eun Young; Jung, Ji Ye; Park, Moo Suk; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Kim, Song Yee

2017-04-01

South Korea has an increasing prevalence of diabetes and a relatively high burden of tuberculosis. We aimed to determine the prevalence of diabetes in patients with active pulmonary tuberculosis (PTB) and examine the effect of diabetes on tuberculosis treatment outcomes. Data from patients ≥30 years diagnosed with and treated for PTB between January 2010 and December 2012 at Severance Hospital, a 2000-bed tertiary referral hospital in Seoul, South Korea, were analyzed and compared with data from a contemporaneous general population sample extracted from KNHANES V. Diabetes prevalence was 24.2% (252/1044) among patients with PTB and 11.6% (1700/14,655) among controls. Diabetes [odds ratios (OR) 2.56, 95% confidence interval (CI) 1.56-4.21, P Diabetes was the only factor associated with unsuccessful treatment outcomes (OR 1.67, 95% CI 1.03-2.70, P = 0.039). The prevalence of diabetes was markedly higher in patients with PTB than in a sample of the general South Korean population. Diabetes may delay sputum conversion and adversely affect treatment outcomes; detection and management of diabetes in patients with PTB is crucial.

Strategic Stability in South Asia: An Indian?s Perspective.

Energy Technology Data Exchange (ETDEWEB)

Kanwal, Gurmeet [Inst. for Defence Studies and Analyses, New Delhi (India)

2017-05-01

The security environment in South Asia has been marked by instability for several decades. The foremost causes of regional instability are the nuclear weapons-cum-missile development program of China, North Korea and Pakistan, the strident march of Islamist fundamentalism, the diabolical nexus between narcotics trafficking and terrorism, the proliferation of small arms and the instability inherent in the rule of despotic regimes. Instability on the Indian sub-continent is manifested, first and foremost, in the continuing conflict in Afghanistan, its tense relations with Iran and the Central Asian Republics (CARs); Pakistan’s struggle against the Taliban, the emerging fissiparous tendencies in Balochistan and Pakhtoonkhwa, the rise of Jihadi Islam and what some fear is Pakistan’s gradual slide towards becoming a ‘failed state’ despite some economic gains in the last five years. Also symptomatic of an unstable and uncertain security environment in the South Asian region are what some see as Sri Lanka’s inability to find a lasting solution to its internal challenges; the potential for Bangladesh’s gradual emergence as the new hub of Islamist fundamentalist terrorism and its struggle for economic upliftment to subsistence levels; the continuing negative impact of Maoist insurgency on Nepal’s fledgling democracy; the simmering discontent in Tibet and Xinjiang and what some see as a low-key uprising against China’s regime; and, the Myanmar peoples’ nascent movement for democracy. In all these countries, socio-economic development has been slow and, consequently, per capita income is alarmingly low. Transborder narcotics trafficking – the golden triangle lies to the east of South Asia and the golden crescent to its west – and the proliferation of small arms, make a potent cocktail. Ethnic tensions and fairly widespread radicalization, worsened by the advent of the vicious ideology of the Islamic state, add further to regional instability.

Excerpt from The Red Land to the South: American Indian Writers and Indigenous Mexico

Directory of Open Access Journals (Sweden)

James H. Cox

2013-09-01

Full Text Available Excerpted from James H. Cox, The Red Land to the South: American Indian Writers and Indigenous Mexico (Minneapolis: University of Minnesota Press, 2012.Reprinted with permission from University of Minnesota Press.

Psychosocial Predictors of Weight Loss among American Indian and Alaska Native Participants in a Diabetes Prevention Translational Project

Directory of Open Access Journals (Sweden)

Edward J. Dill

2016-01-01

Full Text Available The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs in a diabetes prevention translational project was investigated. Participants (n=3,135 were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components.

A genome-wide association study in American Indians implicates DNER as a susceptibility locus for type 2 diabetes.

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Hanson, Robert L; Muller, Yunhua L; Kobes, Sayuko; Guo, Tingwei; Bian, Li; Ossowski, Victoria; Wiedrich, Kim; Sutherland, Jeffrey; Wiedrich, Christopher; Mahkee, Darin; Huang, Ke; Abdussamad, Maryam; Traurig, Michael; Weil, E Jennifer; Nelson, Robert G; Bennett, Peter H; Knowler, William C; Bogardus, Clifton; Baier, Leslie J

2014-01-01

Most genetic variants associated with type 2 diabetes mellitus (T2DM) have been identified through genome-wide association studies (GWASs) in Europeans. The current study reports a GWAS for young-onset T2DM in American Indians. Participants were selected from a longitudinal study conducted in Pima Indians and included 278 cases with diabetes with onset before 25 years of age, 295 nondiabetic controls ≥45 years of age, and 267 siblings of cases or controls. Individuals were genotyped on a ∼1M single nucleotide polymorphism (SNP) array, resulting in 453,654 SNPs with minor allele frequency >0.05. SNPs were analyzed for association in cases and controls, and a family-based association test was conducted. Tag SNPs (n = 311) were selected for 499 SNPs associated with diabetes (P associated with T2DM (odds ratio = 1.29 per copy of the T allele; P = 6.6 × 10(-8), which represents genome-wide significance accounting for the number of effectively independent SNPs analyzed). Transfection studies in murine pancreatic β-cells suggested that DNER regulates expression of notch signaling pathway genes. These studies implicate DNER as a susceptibility gene for T2DM in American Indians.

Identifying postpartum intervention approaches to reduce cardiometabolic risk among American Indian women with prior gestational diabetes, Oklahoma, 2012-2013.

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Jones, Emily J; Peercy, Michael; Woods, J Cedric; Parker, Stephany P; Jackson, Teresa; Mata, Sara A; McCage, Shondra; Levkoff, Sue E; Nicklas, Jacinda M; Seely, Ellen W

2015-04-02

Innovative approaches are needed to reduce cardiometabolic risk among American Indian women with a history of gestational diabetes. We assessed beliefs of Oklahoma American Indian women about preventing type 2 diabetes and cardiovascular disease after having gestational diabetes. We also assessed barriers and facilitators to healthy lifestyle changes postpartum and intervention approaches that facilitate participation in a postpartum lifestyle program. In partnership with a tribal health system, we conducted a mixed-method study with American Indian women aged 19 to 45 years who had prior gestational diabetes, using questionnaires, focus groups, and individual interviews. Questionnaires were used to identify women's cardiometabolic risk perceptions and feasibility and acceptability of Internet or mobile phone technology for delivery of a postpartum lifestyle modification program. Focus groups and individual interviews were conducted to identify key perspectives and preferences related to a potential program. Participants were 26 women, all of whom completed surveys; 11 women participated in focus group sessions, and 15 participated in individual interviews. Most women believed they would inevitably develop diabetes, cardiovascular disease, or both; however, they were optimistic that they could delay onset with lifestyle change. Most women expressed enthusiasm for a family focused, technology-based intervention that emphasizes the importance of delaying disease onset, provides motivation, and promotes accountability while accommodating women's competing priorities. Our findings suggest that an intervention that uses the Internet, text messaging, or both and that emphasizes the benefits of delaying disease onset should be tested as a novel, culturally relevant approach to reducing rates of diabetes and cardiovascular disease in this high-risk population.

Epigenome-wide association of DNA methylation markers in peripheral blood from Indian Asians and Europeans with incident type 2 diabetes: a nested case-control study.

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Chambers, John C; Loh, Marie; Lehne, Benjamin; Drong, Alexander; Kriebel, Jennifer; Motta, Valeria; Wahl, Simone; Elliott, Hannah R; Rota, Federica; Scott, William R; Zhang, Weihua; Tan, Sian-Tsung; Campanella, Gianluca; Chadeau-Hyam, Marc; Yengo, Loic; Richmond, Rebecca C; Adamowicz-Brice, Martyna; Afzal, Uzma; Bozaoglu, Kiymet; Mok, Zuan Yu; Ng, Hong Kiat; Pattou, François; Prokisch, Holger; Rozario, Michelle Ann; Tarantini, Letizia; Abbott, James; Ala-Korpela, Mika; Albetti, Benedetta; Ammerpohl, Ole; Bertazzi, Pier Alberto; Blancher, Christine; Caiazzo, Robert; Danesh, John; Gaunt, Tom R; de Lusignan, Simon; Gieger, Christian; Illig, Thomas; Jha, Sujeet; Jones, Simon; Jowett, Jeremy; Kangas, Antti J; Kasturiratne, Anuradhani; Kato, Norihiro; Kotea, Navaratnam; Kowlessur, Sudhir; Pitkäniemi, Janne; Punjabi, Prakash; Saleheen, Danish; Schafmayer, Clemens; Soininen, Pasi; Tai, E-Shyong; Thorand, Barbara; Tuomilehto, Jaakko; Wickremasinghe, Ananda Rajitha; Kyrtopoulos, Soterios A; Aitman, Timothy J; Herder, Christian; Hampe, Jochen; Cauchi, Stéphane; Relton, Caroline L; Froguel, Philippe; Soong, Richie; Vineis, Paolo; Jarvelin, Marjo-Riitta; Scott, James; Grallert, Harald; Bollati, Valentina; Elliott, Paul; McCarthy, Mark I; Kooner, Jaspal S

2015-07-01

Indian Asians, who make up a quarter of the world's population, are at high risk of developing type 2 diabetes. We investigated whether DNA methylation is associated with future type 2 diabetes incidence in Indian Asians and whether differences in methylation patterns between Indian Asians and Europeans are associated with, and could be used to predict, differences in the magnitude of risk of developing type 2 diabetes. We did a nested case-control study of DNA methylation in Indian Asians and Europeans with incident type 2 diabetes who were identified from the 8-year follow-up of 25 372 participants in the London Life Sciences Prospective Population (LOLIPOP) study. Patients were recruited between May 1, 2002, and Sept 12, 2008. We did epigenome-wide association analysis using samples from Indian Asians with incident type 2 diabetes and age-matched and sex-matched Indian Asian controls, followed by replication testing of top-ranking signals in Europeans. For both discovery and replication, DNA methylation was measured in the baseline blood sample, which was collected before the onset of type 2 diabetes. Epigenome-wide significance was set at pdiabetes at baseline to estimate the potential contribution of DNA methylation to increased risk of future type 2 diabetes incidence among Indian Asians. 1608 (11·9%) of 13 535 Indian Asians and 306 (4·3%) of 7066 Europeans developed type 2 diabetes over a mean of 8·5 years (SD 1·8) of follow-up. The age-adjusted and sex-adjusted incidence of type 2 diabetes was 3·1 times (95% CI 2·8-3·6; pdiabetes, and baseline glycaemic measures. The mean absolute difference in methylation level between type 2 diabetes cases and controls ranged from 0·5% (SD 0·1) to 1·1% (0·2). Methylation markers at five loci were associated with future type 2 diabetes incidence; the relative risk per 1% increase in methylation was 1·09 (95% CI 1·07-1·11; p=1·3 × 10(-17)) for ABCG1, 0·94 (0·92-0·95; p=4·2 × 10(-11)) for PHOSPHO1, 0�

Overview of the Diabetes Initiative of South Carolina.

Science.gov (United States)

Colwell, J A; Keisler, D; Jenkins, C; Boateng, Y; Arnold, P; Lackland, D; Zheng, D; Wheeler, F C; Rosebrock, G; Smith, S H

1998-11-01

Implementation is underway for many of these programs, and there are descriptions of activities elsewhere in this symposium. The Board recognizes that in dealing with the complications of a chronic disease like diabetes, many years of intense effort will be needed before significant results may be appreciated. Progress will be monitored regularly by the Surveillance Council and SCDCP/DHEC, and modifications of the plan will be made by the Board at intervals after review of the data. We are optimistic that over the next decade, this system will make a significant impact to reduce mortality, morbidity, and costs of diabetes, and the result will be an increased quality of life for people affected by diabetes in South Carolina.

Abdominal obesity and type 2 diabetes in Asian Indians: dietary strategies including edible oils, cooking practices and sugar intake.

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Gulati, S; Misra, A

2017-07-01

Obesity and type 2 diabetes are increasing in rural and urban regions of South Asia including India. Pattern of fat deposition in abdomen, ectopic fat deposition (liver, pancreas) and also low lean mass are contributory to early-onset insulin resistance, dysmetabolic state and diabetes in Asian Indians. These metabolic perturbations are further exacerbated by changing lifestyle, diet urbanization, and mechanization. Important dietary imbalances include increasing use of oils containing high amount of trans fatty acids and saturated fats (partially hydrogenated vegetable oil, palmolein oil) use of deep frying method and reheating of oils for cooking, high intake of saturated fats, sugar and refined carbohydrates, low intake of protein, fiber and increasing intake of processed foods. Although dietary intervention trials are few; the data show that improving quality of carbohydrates (more complex carbohydrates), improving fat quality (more monounsaturated fatty acids and omega 3 polyunsaturated fatty acids) and increasing protein intake could improve blood glucose, serum insulin, lipids, inflammatory markers and hepatic fat, but more studies are needed. Finally, regulatory framework must be tightened to impose taxes on sugar-sweetened beverages, oils such as palmolein, and dietary fats and limit trans fats.

Common Polymorphisms in the Adiponectin Gene ACDC Are Not Associated With Diabetes in Pima Indians

DEFF Research Database (Denmark)

de Courten, Barbora; Hanson, Robert L; Funahashi, Tohru

2005-01-01

associated with plasma adiponectin levels, obesity, insulin resistance, and type 2 diabetes. To determine the role of genetic variation in ACDC in susceptibility to obesity and type 2 diabetes in Pima Indians, we screened the promoter, exons, and exon-intron boundaries of the gene to identify allelic...... diabetes, BMI, serum lipid levels, serum adiponectin levels, and measures of insulin sensitivity and secretion. None of the ACDC variants were associated with type 2 diabetes, BMI, or measures of insulin sensitivity or secretion. One variant, single nucleotide polymorphism (SNP)-12823, was associated...... with serum adiponectin levels (P = 0.002), but this association explained only 2% of the variance of serum adiponectin levels. Our findings suggest that these common ACDC polymorphisms do not play a major role in susceptibility to obesity or type 2 diabetes in this population....

Rajend Mesthrie. A Lexicon of South African Indian English, 1st edition

African Journals Online (AJOL)

with biryani) and the House of Deli-goats (House of Delegates). More positive contributions will emerge from politics, music, arts, culture, literature, diplo- macy and tourism. Moreover, as Mesthrie concedes, "the early history of South. African Indian English has yet to be fully uncovered" (p. xxiii). To this, one could add that a ...

Risk perception is not associated with attendance at a preventive intervention for type 2 diabetes mellitus among South Asians at risk of diabetes.

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Vlaar, Everlina M A; Nierkens, Vera; Nicolaou, Mary; Middelkoop, Barend J C; Stronks, Karien; van Valkengoed, Irene G M

2015-04-01

To evaluate the association between risk perception and attendance in a diabetes prevention programme among South Asians with a high risk for diabetes. An observational study. We measured risk perception during the baseline interview with causal beliefs, perceived susceptibility and perceived controllability. We used logistic regression to examine the relationship between risk perception and attendance. We adjusted for relevant sociodemographic factors, screening results and psychosocial factors. The Hague, the Netherlands. Five hundred and thirty-five Hindustani Surinamese (South Asians) aged 18-60 years from a lifestyle-versus-control intervention for the prevention of diabetes. In total, 68·2% attended the lifestyle or control intervention. Participants perceived lifestyle and heredity to increase the risk of diabetes and perceived increasing physical activity to decrease it. Only 44·2% of the participants perceived themselves as susceptible to diabetes and only those who perceived a family history of diabetes as a cause of diabetes appeared to be more inclined to attend. However, after adjustment for confounding, the association was not statistically significant. Risk perception was not significantly associated with attendance. The results suggest that increasing the risk perception alone in this South Asian population is unlikely to increase the attendance at a diabetes prevention programme.

Common Variants of Homocysteine Metabolism Pathway Genes and Risk of Type 2 Diabetes and Related Traits in Indians

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Ganesh Chauhan

2012-01-01

Full Text Available Hyperhomocysteinemia, a risk factor for cardiovascular disorder, obesity, and type 2 diabetes, is prevalent among Indians who are at high risk of these metabolic disorders. We evaluated association of common variants of genes involved in homocysteine metabolism or its levels with type 2 diabetes, obesity, and related traits in North Indians. We genotyped 90 variants in initial phase (2.115 subjects and replicated top signals in an independent sample set (2.085 subjects. The variant MTHFR-rs1801133 was the top signal for association with type 2 diabetes (OR=0.78 (95%  CI=0.67–0.92, P=0.003 and was also associated with 2 h postload plasma glucose (P=0.04, high-density lipoprotein cholesterol (P=0.004, and total cholesterol (P=0.01 in control subjects. These associations were neither replicated nor significant after meta-analysis. Studies involving a larger study population and different ethnic groups are required before ruling out the role of these important candidate genes in type 2 diabetes, obesity, and related traits.

Demographic details, clinical features, and nutritional characteristics of young adults with Type 1 diabetes mellitus - A South Indian tertiary center experience.

Science.gov (United States)

Joseph, Mini; Shyamasunder, Asha H; Gupta, Riddhi D; Anand, Vijayalakshmi; Thomas, Nihal

2016-01-01

Type 1 diabetes mellitus (T1DM) accounts for 5-10% of all diagnosed diabetes and the highest incidence is found in India. The main objectives were to study the demographic, clinical, and nutritional characteristics of young adults with T1DM and its effect glycosylated hemoglobin levels. This cross-sectional study was conducted among young adults with T1DM (18-45 years of age) in a tertiary hospital in South India. Data were obtained from updated medical records. The dietary data were assessed from food diaries and 24 h recall method. Anthropometry was determined. The analysis revealed that socio-economic variables did not affect the glycosylated hemoglobin levels. The mean glycosylated hemoglobin value was 8.81 ± 2.38%. Nearly, half the patients were malnourished. The overall dietary intake was inadequate. The multivariate regression model, adjusted for confounding factors such as gender, age, and body mass index, revealed that only duration of diabetes and protein intake were significant predictors of glycosylated hemoglobin status ( P diabetes management. However, there is an urgent need to educate our patients on nutrition therapy. T1DM patients need specialized advice to ensure appropriately balanced nutrition that has a significant impact on their long-term glycemic control.

A foot risk classification system to predict diabetic amputation in Pima Indians.

Science.gov (United States)

Mayfield, J A; Reiber, G E; Nelson, R G; Greene, T

1996-07-01

To quantify the contribution of various risk factors to the risk of amputation in diabetic patients and to develop a foot risk scoring system based on clinical data. A population case-control study was undertaken. Eligible subjects were 1) 25-85 years of age, 2) diabetic, 3) 50% or more Pima or Tohono O'odham Indian, 4) lived in the Gila River Indian Community, and 5) had had at least one National Institutes of Health research examination. Case patients had had an incident lower extremity amputation between 1983 and 1992; control subjects had no amputation by 1992. Medical records were reviewed to determine risk conditions and health status before the pivotal event that led to the amputation. Sixty-one people with amputations were identified and compared with 183 control subjects. Men were more likely to suffer amputation than women (odds ratio [OR] 6.5, 95% CI 2.6-15), and people with diabetic eye, renal, or cardiovascular disease were more likely to undergo amputation than those without (OR 4.6, 95% CI 1.7-12). The risk of amputation was almost equally associated with these foot risk factors: peripheral neuropathy, peripheral vascular disease, bony deformities, and a history of foot ulcers. After controlling for demographic differences and diabetes severity, the ORs for amputation with one foot risk factor was 2.1 (95% CI 1.4-3.3), with two risk factors, 4.5 (95% CI 2.9-6.9), and with three or four risk factors, 9.7 (95% CI 6.3-14.8). Male Sex, end-organ complications of eye, heart, and kidney, and poor glucose control were associated with a higher amputation rate. Peripheral neuropathy, peripheral vascular disease, deformity, and a prior ulcer were similarly equally associated with an increased risk of lower extremity amputation.

Diabetes mellitus prevalence is increasing in South Asians but is stable in Chinese living in Singapore and Mauritius.

Science.gov (United States)

Tan, Kristin H X; Barr, Elizabeth L M; Koshkina, Vira; Ma, Stefan; Kowlessur, Sudhir; Magliano, Dianna J; Söderberg, Stefan; Chia, Kee Seng; Zimmet, Paul; Lim, Wei-Yen

2017-09-01

Asia is experiencing a type 2 diabetes epidemic, but prevalence differs by ethnicity and level of socioeconomic development. Singapore and Mauritius have implemented comprehensive campaigns to address this public health problem. We compared diabetes and obesity prevalence trends among Chinese and South Asians living in Singapore and Mauritius to determine the contribution of ethnicity and economic development to diabetes. Age-specific data from serial national population-based surveys in Singapore and Mauritius between 1987 and 2010 were used to estimate age-standardized diabetes and obesity prevalence. Modified Breslow-Cox proportional hazard models were used to obtain rate ratios for diabetes risk factors. In Singapore, the age-standardized prevalence of diabetes remained stable for Chinese (men: 14% in 1992, 13% in 2010; women: 12% in 1992, 10% in 2010), but increases were observed for South Asians (men: 20% in 1992, 26% in 2010; women: 18% in 1992, 20% in 2010). There were similar patterns in Mauritius. In both countries, obesity prevalence trends were stable for Chinese women, but increased for Chinese men and South Asians. Associations between obesity and diabetes were stronger in Chinese than South Asians regardless of country. Despite different socioeconomic settings in Singapore and Mauritius, we observed rising diabetes prevalence among South Asians but stable prevalence in Chinese in both countries. This provides further evidence that ethnicity contributes to the development of diabetes, and that there should be an increased emphasis on future prevention strategies targeting South Asian populations in these countries. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Prevalence of radix entomolaris in mandibular permanent first molars: a study in a South Indian population.

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Chandra, Saurabh S; Chandra, Supriya; Shankar, Padmanabhan; Indira, Rajamani

2011-09-01

Anatomical racial variations are an acknowledged characteristic in permanent molars. Generally, mandibular first molars have 2 roots; however, the presence of a third root, radix entomolaris (RE), is a major anatomic variant among many population groups. This study evaluated the prevalence of permanent mandibular first molars featuring a distolingual root in a South Indian population. Five hundred patients of South Indian origin possessing bilateral mandibular first molars were selected. The radiographs of these patients were evaluated under optimal conditions. A total of 1000 mandibular first molars were screened and the incidence of 3-rooted mandibular first molars and the correlation between left and right side occurrence and between either gender was recorded. The prevalence of 3-rooted mandibular first molars was 18.6% of the patients examined and 13.3% of the teeth examined. There was no statistically significant difference between genders or side of occurrence (P > .05). The bilateral incidence of a symmetric distribution was 43.01%. RE is considered an Asiatic trait. The occurrence of this macrostructure in the South Indian population was 13.3%, which was lower than that of other patients of Mongoloid origin. The clinician must thoroughly examine the radiograph before initiation of endodontic therapy. Copyright © 2011 Mosby, Inc. All rights reserved.

Hypertensive disorders of pregnancy and risk of diabetes in Indian women: a cross-sectional study.

Science.gov (United States)

Agrawal, Sutapa; Fledderjohann, Jasmine

2016-08-05

Epidemiological data from high-income countries suggest that women with hypertensive disorders of pregnancy (HDP) are more likely to develop diabetes later in life. We investigated the association between pre-eclampsia and eclampsia (PE&E) during pregnancy and the risk of diabetes in Indian women. Cross-sectional study. India. Data from India's third National Family Health Survey (NFHS-3, 2005-2006), a cross-sectional survey of women aged 15-49 years, are used. Self-reported symptoms suggestive of PE&E were obtained from 39 657 women who had a live birth in the 5 years preceding the survey. The association between PE&E and self-reported diabetes status was assessed using multivariable logistic regression models adjusting for dietary intake, body mass index (BMI), tobacco smoking, alcohol drinking, frequency of TV watching, sociodemographic characteristics and geographic region. The prevalence of symptoms suggestive of PE&E in women with diabetes was 1.8% (n=207; 95% CI 1.5 to 2.0; pwomen who did not report any PE&E symptoms. In the multivariable analysis, PE&E was associated with 1.6 times (OR=1.59; 95% CI 1.31 to 1.94; pIndian women. These findings are important for a country which is already tackling the burden of young onset of diabetes in the population. However, longitudinal medical histories and a clinical measurement of diabetes are needed in this low-resource setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Pelagic communities of the South West Indian Ocean seamounts: R/V Dr Fridtjof Nansen Cruise 2009-410

Science.gov (United States)

Rogers, A. D.; Alvheim, O.; Bemanaja, E.; Benivary, D.; Boersch-Supan, P.; Bornman, T. G.; Cedras, R.; Du Plessis, N.; Gotheil, S.; Høines, A.; Kemp, K.; Kristiansen, J.; Letessier, T.; Mangar, V.; Mazungula, N.; Mørk, T.; Pinet, P.; Pollard, R.; Read, J.; Sonnekus, T.

2017-02-01

The seamounts of the southern Indian Ocean remain some of the most poorly studied globally and yet have been subject to deep-sea fishing for decades and may face new exploitation through mining of seabed massive sulphides in the future. As an attempt to redress the knowledge deficit on deep-sea benthic and pelagic communities associated mainly with the seamounts of the South West Indian Ridge two cruises were undertaken to explore the pelagic and benthic ecology in 2009 and 2011 respectively. In this volume are presented studies on pelagic ecosystems around six seamounts, five on the South West Indian Ridge, including Atlantis Bank, Sapmer Seamount, Middle of What Seamount, Melville Bank and Coral Seamount and one un-named seamount on the Madagascar Ridge. In this paper, existing knowledge on the seamounts of the southwestern Indian Ocean is presented to provide context for the studies presented in this volume. An account of the overall aims, approaches and methods used primarily on the 2009 cruise are presented including metadata associated with sampling and some of the limitations of the study. Sampling during this cruise included physical oceanographic measurements, multibeam bathymetry, biological acoustics, and net sampling of phytoplankton, macrozooplankton and micronekton/nekton. The studies that follow reveal new data on the physical oceanography of this dynamic region of the oceans, and the important influence of water masses on the pelagic ecology associated with the seamounts of the South West Indian Ridge. New information on the pelagic fauna of the region fills an important biogeographic gap for the mid- to high-latitudes of the oceans of the southern hemisphere.

Diabetes prevention among American Indians: the role of self-efficacy, risk perception, numeracy and cultural identity.

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Simonds, Vanessa W; Omidpanah, Adam; Buchwald, Dedra

2017-10-02

According to the Risk Perception Attitude (RPA) framework, classifying people according to their perceptions of disease risk and their self-efficacy beliefs allows us to predict their likelihood for engaging in preventive behaviors. Health interventions can then be targeted according to RPA group. We applied the framework to type 2 diabetes prevention behaviors among American Indians and expanded it to include culture and numeracy. Using a cross-sectional study design, we surveyed a sample of Northern Plains American Indians in a reservation community setting on self-reported perceptions of diabetes risk, objective diabetes risk, self-efficacy, engagement in healthy behaviors, knowledge of diabetes risk factors, and covariates including demographics, numeracy, and cultural identity. We used the RPA framework to classify participants into four groups based on their perceptions of risk and self-efficacy. Analyses of variance and covariance estimated inter-group differences in behaviors associated with type 2 diabetes prevention. Among 128 participants, our only finding consistent with the RPA framework was that self-efficacy and risk perception predicted knowledge about diabetes risk factors. We found limited evidence for the influence of cultural identity within the RPA framework. Overall, participants had lower numeracy skills which tended to be associated with inaccurate perceptions of higher levels of risk. The theoretical framework may benefit from inclusion of further contextual factors that influence these behaviors. Attention to numeracy skills stands out in our study as an important influence on the RPA framework, highlighting the importance of attending to numeracy when targeting and tailoring risk information to participants segmented by the RPA framework.

Dietary modifications to improve micronutrient status of Indian children and adolescents with type 1 diabetes.

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Parthasarathy, Lavanya S; Chiplonkar, Shashi A; Khadilkar, Anuradha V; Khadilkar, Vaman V

2015-01-01

Diet plays a crucial role for maintaining normal growth and development while optimizing glycemic control in children with diabetes. Dietary restrictions, in a diabetic child's diet may lead to micronutrient deficiencies. To examine dietary nutritional deficiencies of Asian Indian children with Type 1 diabetes mellitus and develop micronutrient-rich recipes suitable for them. Anthropometry, diet (3-day recall) of 70 children with diabetes (24 boys) was recorded. Daily nutrient intakes and nutrient content of recipes were estimated using CDIET version 2.0. Mean intake amongst children for energy was 79% of Indian Recommended Dietary Allowance (RDA), protein was 105% RDA, but fat intakes were high (143% RDA). Mean intakes of riboflavin, β carotene, zinc, iron were less than 50%, and thiamin and calcium were around 60% RDA suggesting a possible multiple micronutrient deficiency. Based on popularly consumed snacks, 20 healthy recipes were devised that can be incorporated in children's diet. Mean energy content of new recipes was similar to routine snacks (281±28 kcal/100 g vs 306±27 kcal/100 g cooked weight). However, the mean vitamin and mineral content of new recipes was significantly higher (pcontent (zinc, calcium and iron) and twofold increase in total vitamin content (β carotene, vitamin C, vitamin B-1, B-2, and B-3) in new recipes compared with the routine snacks. Multiple dietary micronutrient deficiencies are observed in diabetic children. Addition of newly developed recipes in their everyday diet may help to enhance micronutrient intakes without increasing their energy load.

Radiocarbon Content of Dissolved Organic Carbon in the South Indian Ocean

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Bercovici, S. K.; McNichol, A. P.; Xu, L.; Hansell, D. A.

2018-01-01

We report four profiles of the radiocarbon content of dissolved organic carbon (DOC) spanning the South Indian Ocean (SIO), ranging from the Polar Front (56°S) to the subtropics (29°S). Surface waters held mean DOC Δ14C values of -426 ± 6‰ ( 4,400 14C years) at the Polar Front and DOC Δ14C values of -252 ± 22‰ ( 2,000 14C years) in the subtropics. At depth, Circumpolar Deep Waters held DOC Δ14C values of -491 ± 13‰ ( 5,400 years), while values in Indian Deep Water were more depleted, holding DOC Δ14C values of -503 ± 8‰ ( 5,600 14C years). High-salinity North Atlantic Deep Water intruding into the deep SIO had a distinctly less depleted DOC Δ14C value of -481 ± 8‰ ( 5,100 14C years). We use multiple linear regression to assess the dynamics of DOC Δ14C values in the deep Indian Ocean, finding that their distribution is characteristic of water masses in that region.

Family communication as strategy in diabetes prevention: an observational study in families with Dutch and Surinamese South-Asian ancestry.

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van Esch, Suzanne C M; Cornel, Martina C; Geelhoed-Duijvestijn, Petronella H L M; Snoek, Frank J

2012-04-01

To explore the possibility of utilizing family communication as a diabetes prevention strategy, specifically targeting high-risk families with South-Asian ancestry in The Netherlands. In a cross-sectional study, type 2 diabetes patients from Dutch (n=311) and Surinamese South-Asian (n=157) origin filled in a questionnaire assessing socio-demographic characteristics, beliefs and concerns about familial diabetes risk, primary prevention, and diabetes-related family communication. Discussing diabetes is regarded acceptable in most families. Especially Surinamese South-Asian patients (68%) seemed motivated to convey risk messages to their relatives; they reported a higher risk perception and expressed more concern than Dutch patients. While 40% in both groups thought relatives are able to prevent developing diabetes, 46% in Dutch and 33% in Surinamese South-Asian patients were unsure. Promoting family communication appears a feasible strategy in diabetes prevention in high-risk (Surinamese South-Asian) families. Health care providers should address patients' concern and emphasize opportunities for prevention. Findings favor training of clinicians in utilizing a family approach as prevention strategy. Patients (particularly Surinamese South-Asians) are in need of professional help in the process of family risk disclosure. (Online) Educational tools should be made available at which patients can refer their relatives. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Renal outcome of type 2 diabetes in South Africa - a 12-year follow ...

African Journals Online (AJOL)

Aims. Previous studies of type 2 diabetes mellitus have indicated a benign renal outcome after long-term follow-up. The aim of this study was to determine how often renal failure due to diabetic nephropathy was a cause of death in patients with type 2 diabetes. Methods. Prospective observational study of 59 South African ...

Allele and Genotype Distributions of DNA Repair Gene Polymorphisms in South Indian Healthy Population

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Katiboina Srinivasa Rao

2014-01-01

Full Text Available Various DNA repair pathways protect the structural and chemical integrity of the human genome from environmental and endogenous threats. Polymorphisms of genes encoding the proteins involved in DNA repair have been found to be associated with cancer risk and chemotherapeutic response. In this study, we aim to establish the normative frequencies of DNA repair genes in South Indian healthy population and compare with HapMap populations. Genotyping was done on 128 healthy volunteers from South India, and the allele and genotype distributions were established. The minor allele frequency of Xeroderma pigmentosum group A ( XPA G23A, Excision repair cross-complementing 2 ( ERCC2 /Xeroderma pigmentosum group D ( XPD Lys751Gln, Xeroderma pigmentosum group G ( XPG His46His, XPG Asp1104His, and X-ray repair cross-complementing group 1 ( XRCC1 Arg399Gln polymorphisms were 49.2%, 36.3%, 48.0%, 23.0%, and 34.0% respectively. Ethnic variations were observed in the frequency distribution of these polymorphisms between the South Indians and other HapMap populations. The present work forms the groundwork for cancer association studies and biomarker identification for treatment response and prognosis.

A prevalent amino acid polymorphism at codon 98 (Ala98Val) of the hepatocyte nuclear factor-1alpha is associated with maturity-onset diabetes of the young and younger age at onset of type 2 diabetes in Asian Indians

DEFF Research Database (Denmark)

Anuradha, Shekher; Radha, Venkatesan; Deepa, Raj

2005-01-01

Among Europeans, mutations in the hepatocyte nuclear factor-1alpha (HNF1alpha) gene are associated with the most common form of maturity-onset diabetes of the young (MODY)3. In Asian Indians, type 2 diabetes occurs earlier and often overlaps with MODY, but the genetics of the latter are unknown....... The aim of this study was to estimate the prevalence of Ala98Val polymorphism of the HNF1alpha gene in different types of diabetes in Asian Indians....

Incidence of Diabetes and Prediabetes and Predictors of Progression Among Asian Indians: 10-Year Follow-up of the Chennai Urban Rural Epidemiology Study (CURES).

Science.gov (United States)

Anjana, Ranjit Mohan; Shanthi Rani, Coimbatore Subramanian; Deepa, Mohan; Pradeepa, Rajendra; Sudha, Vasudevan; Divya Nair, Haridas; Lakshmipriya, Nagarajan; Subhashini, Sivasankaran; Binu, Valsalakumari Sreekumarannair; Unnikrishnan, Ranjit; Mohan, Viswanathan

2015-08-01

There are few data on the incidence rates of diabetes and prediabetes (dysglycemia) in Asian Indians. This article presents the incidence of diabetes and prediabetes and the predictors of progression in a population-based Asian Indian cohort. Data on progression to diabetes and prediabetes from 1,376 individuals, a subset of 2,207 of the Chennai Urban Rural Epidemiology Study (CURES) cohort (phase 3) with normal glucose tolerance (NGT) or prediabetes at baseline, who were followed for a median of 9.1 years (11,629 person-years), are presented. During follow-up, 534 died and 1,077 with NGT and 299 with prediabetes at baseline were reinvestigated in a 10-year follow-up study. Diabetes and prediabetes were diagnosed based on the American Diabetes Association criteria. Incidence rates were calculated and predictors of progression to prediabetes and/or diabetes were estimated using the Cox proportional hazards model. The incidence rates of diabetes, prediabetes, and "any dysglycemia" were 22.2, 29.5, and 51.7 per 1,000 person-years, respectively. Among those with NGT, 19.4% converted to diabetes and 25.7% to prediabetes, giving an overall conversion rate to dysglycemia of 45.1%. Among those with prediabetes, 58.9% converted to diabetes. Predictors of progression to dysglycemia were advancing age, family history of diabetes, 2-h plasma glucose, glycated hemoglobin (HbA1c), low HDL cholesterol, and physical inactivity. Asian Indians have one of the highest incidence rates of diabetes, with rapid conversion from normoglycemia to dysglycemia. Public health interventions should target modifiable risk factors to slow down the diabetes epidemic in this population. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Family history of type 2 diabetes and prevalence of metabolic syndrome in adult Asian Indians.

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Das, Mithun; Pal, Susil; Ghosh, Arnab

2012-04-01

Our objective was to test the association between familial risk of type 2 diabetes mellitus (T2DM) and the prevalence of metabolic syndrome (MS) in adult Asian Indians. A total of 448 adult (>30 years) individuals (257 males and 191 females) participated in the study. Familial risk of T2DM was classified into three groups viz., 1=both parents affected; 2=parent and/or siblings affected and 3=none or no family history for T2DM. Anthropometric measures, blood pressures, fasting blood glucose and metabolic profiles were studied using standard techniques. MS was defined accordingly. The prevalence of MS phenotypes was estimated and compared among the three familial risk strata. Individuals with a history of both parents affected from diabetes had significantly higher (Pfamily history of T2DM. Significant difference was also noticed between individuals with and without MS according to the family history of diabetes (Pfamily history of T2DM. Family history of T2DM had significant effect on individuals with MS as compared to their counterparts (individuals having no family history of T2DM). It therefore seems reasonable to argue that family history of T2DM could be useful as a predictive tool for early diagnosis and prevention of MS in Asian Indian population.

U.S. Engineering Degrees for Improving South Indian Graduate Students' Marriage and Dowry Options

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Yakaboski, Tamara; Sheridan, Robyn Stout; Dade, Kristin

2014-01-01

The article examines improved marriage opportunities as an unexplored motivator for pursuing international education via U.S. graduate engineering degrees and stresses the need to centralize gender in analyzing academic mobility and international education. This interdisciplinary qualitative study explores how South Indian men and women's…

Association between Dental Health and Osteoporosis: A Study in South Indian Postmenopausal Women.

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Kapoor, Nitin; Cherian, Kripa Elizabeth; Pramanik, Binay Kumar; Govind, S; Winford, Manna Elizabeth; Shetty, Sahana; Thomas, Nihal; Paul, Thomas Vizhalil

2017-01-01

This study aims to objectively assess the dentition status in South Indian postmenopausal women and compare the dental health of osteoporotic participants with nonosteoporotic individuals. A total of 150 consecutive ambulatory South Indian postmenopausal women (>50 years of age) were assessed for their dental health using an internationally validated scoring system. Bone mineral density (BMD) was assessed using a dual-energy X-ray absorptiometry scanner. About 39% of the participants were found to have osteoporosis and 23% had osteopenia at any site. More than half of them (57%) had poor dental health, and the predominant problems were cavities (43.5%) and loss of teeth (75%). Among 112 women who had tooth loss, the mean tooth loss was 4.8. The mean tooth loss among patients with normal BMD was 1.09 ± 1.2, in osteopenia was 2.1 ± 2, and in osteoporosis was 5.4 ± 2.8 ( P women with osteoporosis had significantly higher number of tooth loss. Tooth loss may thus be used as a surrogate marker to predict osteoporosis.

Prevalence of Catalase (-21 A/T Gene Variant in South Indian (Tamil Population

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A. Lourdhu Mary

2014-01-01

Full Text Available Catalase, an endogenous antioxidant enzyme, is responsible for regulating reactive species levels. Several epidemiologic studies have suggested that single nucleotide polymorphism in catalase gene may be associated with many diseases. The genotype of CAT (-21 A/T point mutation in promoter region of catalase gene was determined by polymerase chain based restriction fragment length polymorphism analysis in the DNA of 100 healthy volunteers. The frequency of CAT (-21 A/T gene polymorphism AA, AT, and TT genotypes was found to be 7, 23, and 70 percent, respectively. The mutant “T” allele frequency was found to be 0.82 among the south Indian (Tamil population. Chi square analysis showed that the study population lies within the Hardy-Weinberg equilibrium. The wild type genotype (AA was found to be very low (7% and the mutant genotype (AT/TT was found to be more prevalent (93% among the south Indian population. This suggests that the high prevalence of mutant genotype may increase the susceptibility to oxidative stress associated diseases.

Overweight, obesity and related non-communicable diseases in Asian Indian girls and women.

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Chopra, S M; Misra, A; Gulati, S; Gupta, R

2013-07-01

The prevalence of obesity is rising globally and in India. Overweight, obesity and related diseases need to be delineated in Asian Indian women. A literature search was done using key words like 'obesity', 'Asian Indian women', 'body fat distribution', 'type 2 diabetes', 'fertility', 'polycystic ovarian disease', metabolic syndrome', 'cardiovascular disease', 'non-alcoholic fatty liver disease', 'gender', 'sex' and 'prevalence' up to September 2012 in Pubmed and Google Scholar search engines. This review highlights the Asian Indian body composition with regards to obesity and provides a collated perspective of gender-specific prevalence of the co-morbidities. Recent data show that women (range of prevalence of overweight and obesity from different studies 15-61%) have higher prevalence of overweight and obesity as compared with men (range of prevalence of overweight and obesity from different studies 12-54%) in India and that obesity is increasing in the youth. The prevalence of overweight and obesity in both men and women steeply rose in a Punjabi community from Jaipur. Importantly, prevalence of abdominal obesity has been consistently higher in women than in men. The lowest prevalence (6.0%) of type 2 diabetes mellitus in women is reported from South India (rural Andhra Pradesh; 2006) and the highest (14.0%) by the National Urban Diabetes Survey (2001). Although the clustering of cardiovascular disease risk factors was generally high, it increased further in post-menopausal women. There are a number of factors that predispose Indian women to obesity; sedentary behaviour, imbalanced diets, sequential and additive postpartum weight gain and further decrease in physical activity during this period and cultural issues. In view of these data, preventive measures should be specifically targeted to Indian women.

Foraminifera Population from South Africa Coast Line (Indian and Atlantic Oceans

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Engin Meriç

2014-11-01

Full Text Available Cape Town is the second-largest city of the Republic of South Africa. Research is conducted in 3 different stations: Maori Bay, which lies in the southwest of Cape Town, and Pyramid Rock and Partridge Points which lies in the False Bay, southeast part of Cape Town. Samples are taken from young sediments at 10.00 and 20.00 m depths, and collected by scuba-diving method. The aim of the study is to investigate the living benthic foraminifera assemblages in the Atlantic Ocean, and to compare these assemblages with the southeastern part of the Atlantic Ocean, the Arabian Sea, Indian Ocean and Western Pacific assemblages. Moreover, the aim of the study is to determine whether there are any benthic foraminifera forms reaching to the Mediterranean from Pacific Ocean, Indian Ocean or Red Sea via Suez Channel.

Vildagliptin vs sulfonylurea in Indian Muslim diabetes patients fasting during Ramadan.

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Shete, Abhijit; Shaikh, Aheson; Nayeem, K Javeed; Rodrigues, Lily; Ali, Mohamed Sheikamunadeen Sadiq; Shah, Parag; Khanna, Rajiv; Majid, Sarfaraj; Rasheed, Sabeer A; Shaikh, Shehla; Rahman, Tawfiqur

2013-12-15

To compare the use of vildagliptin and sulfonylurea with or without metformin in Indian Muslim patients with type 2 diabetes mellitus, fasting during Ramadan. This was a 4-wk, multicenter, non-interventional, open-label, observational study. Incidence of hypoglycemic events (HEs), adverse events, and changes in glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose, postprandial plasma glucose and body weight were measured pre- and post-Ramadan. Totally, 97 patients were recruited and all completed the study (vildagliptin group, n = 55; sulfonylurea group, n = 42). HEs were reported in low frequencies in both the vildagliptin and the sulfonylurea groups [0 vs 2 (4.8%) patients, respectively]. Interestingly, HbA1c reduced by -0.43% (-4.71 mmol/mol) in the vildagliptin group [8.75% (72.10 mmol/mol) to 8.32% (67.38 mmol/mol), P = 0.009] while in the sulfonylurea group there was a small increase by 0.01% [0.08 mmol/mol; 8.64% (70.92 mmol/mol) to 8.65% (71.00 mmol/mol), P = 0.958]. Higher percentage of vildagliptin-treated patients achieved HbA1c < 7.0% (< 53 mmol/mol) compared with sulfonylurea (16.4% vs 4.8%). Mean decrease in the body weight was 1.2 kg and 0.03 kg, respectively (P < 0.001). Both treatment groups were well tolerated during Ramadan. Vildagliptin is an attractive treatment option for Indian patients with type 2 diabetes mellitus who are fasting during Ramadan.

Genome-Wide DNA Methylation in Mixed Ancestry Individuals with Diabetes and Prediabetes from South Africa

Science.gov (United States)

Pheiffer, Carmen; Humphries, Stephen E.; Gamieldien, Junaid; Erasmus, Rajiv T.

2016-01-01

Aims. To conduct a genome-wide DNA methylation in individuals with type 2 diabetes, individuals with prediabetes, and control mixed ancestry individuals from South Africa. Methods. We used peripheral blood to perform genome-wide DNA methylation analysis in 3 individuals with screen detected diabetes, 3 individuals with prediabetes, and 3 individuals with normoglycaemia from the Bellville South Community, Cape Town, South Africa, who were age-, gender-, body mass index-, and duration of residency-matched. Methylated DNA immunoprecipitation (MeDIP) was performed by Arraystar Inc. (Rockville, MD, USA). Results. Hypermethylated DMRs were 1160 (81.97%) and 124 (43.20%), respectively, in individuals with diabetes and prediabetes when both were compared to subjects with normoglycaemia. Our data shows that genes related to the immune system, signal transduction, glucose transport, and pancreas development have altered DNA methylation in subjects with prediabetes and diabetes. Pathway analysis based on the functional analysis mapping of genes to KEGG pathways suggested that the linoleic acid metabolism and arachidonic acid metabolism pathways are hypomethylated in prediabetes and diabetes. Conclusions. Our study suggests that epigenetic changes are likely to be an early process that occurs before the onset of overt diabetes. Detailed analysis of DMRs that shows gradual methylation differences from control versus prediabetes to prediabetes versus diabetes in a larger sample size is required to confirm these findings. PMID:27555869

The accuracy of polyuria, polydipsia, polyphagia, and Indian Diabetes Risk Score in adults screened for diabetes mellitus type-II

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Shivshakti D Pawar

2017-01-01

Full Text Available Context: The World Health Organization report suggests that over 19% of the world's diabetic population currently resides in India. Unfortunately, >50% of the diabetics in India are unaware about their diabetic status. In the poor income country like India, it is essential to use cost-effective methods for screening for diabetes, and traditionally using three classical symptoms and Indian Diabetes Risk Score (IDRS tool is helpful but, data regarding their diagnostic accuracy is very less. Objective: (1 To assess the diagnostic accuracy of polyuria, polydipsia, polyphagia, and IDRS for detecting diabetes. Settings and Design: Six hundred and seventy-seven adult individuals> 20 years of age were screened for diabetes and assessed polyuria, polydipsia, polyphagia, and IDRS score. All were subjected for postprandial blood glucose level. Subjects and Methods: For diagnostic accuracy sensitivity, specificity, positive and negative predictive values, likelihood ratios (LRs, for positive and negative tests, and accuracy was calculated for each symptom. Similarly, by receiver operative curve (ROC curve analysis, we carried out sensitivity and specificity of IDRS. Results: There was statistically significant association between these three classical symptoms and diabetes status of individuals. When present, all these three symptoms carried 7.34% sensitivity and 98.42% specificity with positive predictive value 47.06% and NPV 84.70%, LR+4.36, LR−0.94 with accuracy of 85%. The optimum cutoff value of IDRS score was> 50, which carried sensitivity 73%, specificity 58.7%, and area under curve for ROC was 68% (P < 0.001. Conclusions: This study has shown highest specificity for these three classical symptoms in diagnosing diabetes, but these symptoms were insensitive to detect all diabetic subjects.

Assessment of cost of illness for diabetic patients in South Indian tertiary care hospital

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Leelavathi D Acharya

2016-01-01

Full Text Available Background: The impact of diabetes on health-care expenditures has been increasingly recognized. To formulate an effective health planning and resource allocation, it is important to determine economic burden. Objective: The objective of this study is to assess the cost of illness (COI for diabetic inpatients with or without complications. Methodology: The study was conducted in the medicine wards of tertiary care hospital after ethical approval by the Institutional Ethical Committee. A total of 116 each diabetic with or without complications were selected and relevant data were collected using COI questionnaire and data were analyzed using SPSS version 20. Mann–Whitney U test is used to assess the statistical significant difference in the cost of treatment of diabetes alone and with complications'. P ≤ 0.05 was considered statistically significant. Results: Total COI includes the cost of treatment, investigation, consultation fee, intervention cost, transportation, days lost due to work, and hospitalization. The median of total COI for diabetic care without any complication was Rs. 22,456.97/- per patient per annum and with complication was Rs. 30,634.45/-. Patients on dialysis had to spend 7.3 times higher, and patients with cardiac intervention had to spend 7.4 times higher than diabetic patients without any complication. Conclusion: Treatment costs were many times higher in patients with complications and with cardiac and renal interventions. Complications in diabetic patients will increase the economic burden to family and also to the society.

Efficacy of cheiloscopy in determination of sex among South indians.

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Kautilya D, Vijay; Bodkha, Pravir; Rajamohan, Naveen

2013-10-01

Human identification plays a vital role in any crime investigation. Along with the various other established methods, cheiloscopy also plays a key role in linking the criminal with the crime. The ability of a technique in differentiating the sex of a person in the field can help in screening a large number of suspects. This study evaluated the efficacy of cheiloscopy in determination of sex among South Indians. It also studied the pattern of dimorphism in the lips and lip prints of south Indians. Lip prints from 100 medical students (50 males and 50 females) were obtained and were analyzed, based on Tsuchihashi and Suzuki classification, to check for dimorphism. Lip dimensions were studied by using standard sliding calipers for dimorphism. The most common pattern of lip print among males was Type III as compared to Type I in females. The outer four portions of the lip showed statistically significant differences in males and females. Middle portion of the lip was statistically insignificant in sex determination, based on lip print patterns. Thickness of the lip was significantly larger in males as compared to that in females and this criterion could be used to establish a logistic regression for determination of sex of a person. Lips not only significantly differ among the males and females in the pattern of the lip print that they present, but they also differ in their size. These features can effectively be used to determine the sex of a person accurately.

Journal of Endocrinology, Metabolism and Diabetes of South Africa ...

African Journals Online (AJOL)

The Achievement of Glycaemic, Blood Pressure and LDL Cholesterol Targets in Patients with Type 2 Diabetes Attending a South African Tertiary Hospital Outpatient Clinic · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Y Pinchevsky, V Shukla, N Butkow, FJ Raal, ...

Glacial-interglacial vegetation dynamics in South Eastern Africa coupled to sea surface temperature variations in the Western Indian Ocean

NARCIS (Netherlands)

Dupont, L.M.; Caley, T.; Kim, J.H.; Castañeda, I.S; Malaize, B.; Giraudeau, J.

2011-01-01

Glacial-interglacial fluctuations in the vegetation of South Africa might elucidate the climate system at the edge of the tropics between the Indian and Atlantic Oceans. However, vegetation records covering a full glacial cycle have only been published from the eastern South Atlantic. We present a

Skin lightening practices: an epidemiological study of South African women of African and Indian ancestries.

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Dlova, N C; Hamed, S H; Tsoka-Gwegweni, J; Grobler, A

2015-07-01

Cutaneous adverse sequelae of skin lightening creams present with myriad skin complications and affect dermatology practice, particularly in sub-Saharan Africa where such products are widely used, with a prevalence of 25-67%. To examine the skin lightening practices of both African and Indian women living in South Africa. A cross-sectional survey was undertaken in the general outpatient departments of two regional university hospitals in Durban, South Africa. All consenting African and Indian women aged 18-70 years were recruited and asked to complete a questionnaire. Six hundred women completed the questionnaire, of whom 32·7% reported using skin lightening products. The main reasons cited were treatment of skin problems (66·7%) and skin lightening (33·3%). Products were purchased from a variety of sources. Twenty-five percent reported using sunscreen. The use of skin lightening cosmetics is common among darkly pigmented South African women, including those of both African and Indian ancestries. Despite more than 20 years of governmental regulations aimed at prohibiting both the sale of cosmetics containing mercury, hydroquinone and corticosteroids, and the advertising of any kind of skin lightener, they are far from having disappeared. The main motivations for using these products are the desire to treat skin disorders and to achieve a lighter skin colour. Television and magazine advertisements seem to influence women's choice of these products and, thus, would be efficient channels for raising public awareness about the dangers of using uncontrolled skin lighteners. © 2015 The Authors BJD © 2015 British Association of Dermatologists.

Serum chromium levels in gestational diabetes mellitus

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P G Sundararaman

2012-01-01

Full Text Available Objective: To measure serum chromium level in women with gestational diabetes mellitus (GDM from Chennai, South India. Materials and Methods: Thirty women with gestational diabetes, 60 age matched controls. Inclusion criteria: Gestational age 22-28 weeks, age group 20-35 years. Exclusion Criteria: Gestational age beyond 28 weeks, malnutrition or presence of infection. Serum chromium was measured using inductive couple plasma emission spectrometer. Results: Serum chromium levels of women with GDM, 1.59+/-0.02 ng/ml (range: 0.16-4.0 ng/ml were lower than in controls (4.58+/-0.62 ng/ml; range 0.82-5.33 ng/ml (P < 0.001. However, there were no significant differences among cases and controls when subdivided by parity. Conclusions: Women with GDM from a South Indian city had lower levels of serum chromium compared to pregnant women without GDM. Studies may be done whether chromium supplementation is useful in this group of women.

Health inequalities among urban children in India: a comparative assessment of Empowered Action Group (EAG) and South Indian states.

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Arokiasamy, P; Jain, Kshipra; Goli, Srinivas; Pradhan, Jalandhar

2013-03-01

As India rapidly urbanizes, within urban areas socioeconomic disparities are rising and health inequality among urban children is an emerging challenge. This paper assesses the relative contribution of socioeconomic factors to child health inequalities between the less developed Empowered Action Group (EAG) states and more developed South Indian states in urban India using data from the 2005-06 National Family Health Survey. Focusing on urban health from varying regional and developmental contexts, socioeconomic inequalities in child health are examined first using Concentration Indices (CIs) and then the contributions of socioeconomic factors to the CIs of health variables are derived. The results reveal, in order of importance, pronounced contributions of household economic status, parent's illiteracy and caste to urban child health inequalities in the South Indian states. In contrast, parent's illiteracy, poor economic status, being Muslim and child birth order 3 or more are major contributors to health inequalities among urban children in the EAG states. The results suggest the need to adopt different health policy interventions in accordance with the pattern of varying contributions of socioeconomic factors to child health inequalities between the more developed South Indian states and less developed EAG states.

Etiology and outcome determinants of intracerebral hemorrhage in a south Indian population, A hospital-based study

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Sunil K Narayan

2012-01-01

Full Text Available Background: There is paucity of methodologically sound published studies on intracerebral hemorrhage (ICH from India, on pub med/embase search. Aims: To explore etiology of ICH and correlate the causes, location, and size of hemorrhage to clinical outcome. Materials and Methods: A hospital-based descriptive study from South Indian eastern coastal town of Puducherry; 60 consecutive subjects aged > 12 years, predominantly of inbred Tamil population, with head CT evidence of intracerebral hemorrhage not associated with trauma and brain tumors, were recruited. Outcome at three months was measured using Glasgow Outcome scale, NIHSS and mortality. SPSS v 19 was used for statistical analysis. Results: Commonest etiological factor was hypertension, followed by bleeding diathesis, thrombolysis for myocardial infarction, and cortical vein thrombosis. Most frequent locations of hematoma were basal ganglia, thalamus, internal capsule, and cerebral and cerebellar parenchyma. Hematoma volume correlated significantly with systolic and mean arterial pressure but not with diastolic blood pressure. Poor outcome was correlated to size (P < 0.05 and intraventricular extension of hematoma (P < 0.05, and to systolic, diastolic and mean arterial pressure, but not to age, gender, smoking, alcoholism, ischemic heart disease, and blood sugar level. Among diabetic patients with ICH, the size of hematoma (P = 0.04 and severity of coma (P = 0.01 at admission were significantly worse compared to the non-diabetic, but not the outcome at three months [Glasgow outcome scale or mortality (P = 0.94 and 0.14]. Conclusions: The location of hemorrhage and correlation with outcome agreed with the patterns described for the non-white races in prior reports. Independence of outcome to diabetic status despite a more severe initial presentation may indicate importance of good care, even in high risk groups.

Diabetes in South and Central America: an update.

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Aschner, Pablo; Aguilar-Salinas, Carlos; Aguirre, Loreto; Franco, Laercio; Gagliardino, Juan Jose; de Lapertosa, Sylvia Gorban; Seclen, Segundo; Vinocour, Mary

2014-02-01

The estimated population of the South and Central America (SACA) Region is 467.6 million and 64% is in the age range of 20-79 years but the population pyramid and age distribution are changing. The average prevalence of diabetes in the Region is 8.0% and is expected to reach 9.8% by the year 2035. Prevalence is much lower in rural settings than in urban and the differences attributed to lifestyle changes may be a target for intervention. The indigenous population is a particularly vulnerable group needing special attention. On average, 24% of the adult cases with diabetes are undiagnosed but in some countries this is still as high as 50%. Health expenditure due to diabetes in the Region is around 9% of the global total. Inadequate glycemic control, defined as HbA1c >7%, is a strong predictor of chronic complications which increase resource use in the Region and less than half of the patients enrolled in diabetes care programmes are at target. Fifty percent or more of the adult population is overweight/obese and around one third of the adult population has metabolic syndrome using regional cutoffs for waist circumference. The number of people with IGT is almost equal to those with diabetes presenting an additional challenge for prevention. Children with type 1 diabetes represent only 0.2% of the total population with diabetes but the incidence may be increasing. In many places they have limited access to insulin, and even when available, it is not used appropriately. The available epidemiological data provide the background to act in developing national diabetes programmes which integrate diabetes care with cardiovascular prevention and promote diabetes prevention as well. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Perceived racial discrimination in health care, completion of standard diabetes services, and diabetes control among a sample of American Indian women.

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Gonzales, Kelly L; Lambert, William E; Fu, Rongwei; Jacob, Michelle; Harding, Anna K

2014-01-01

The purpose of this study is to examine perceived experiences of racial discrimination (perceived discrimination) in health care and its associations with completing standards of care for diabetes management and diabetes control. This cross-sectional study included 200 adult American Indian (AI) women with type 2 diabetes from 4 health care facilities located on tribal reservations in the Pacific Northwest. Participants completed a survey, and medical records were abstracted. Logistic regression was completed to assess associations. Sixty-seven percent of AI women reported discrimination during their lifetime of health care. After adjusting for patient characteristics, perceived discrimination was significantly associated with lower rates of dental exam; checks for blood pressure, creatinine, and total cholesterol; and pneumococcal vaccination. The association between perceived discrimination and total number of diabetes services completed was not statistically significant. Perceived discrimination was associated with having A1C values above target levels for diabetes control in unadjusted and adjusted models, but no association was observed for blood pressure or total cholesterol. In our sample of AI women with diabetes, two-thirds reported experiencing racial discrimination in their health care experience. Those reporting perceived discrimination completed fewer diabetes services and therefore may be at increased risk for comorbidities of diabetes. This finding supports the continued need for culturally responsive health care and programs of diabetes education to recognize perceived discrimination and its potential to impact success in self-management and services utilization. © 2014 The Author(s).

Nonassociation of homocysteine gene polymorphisms with treatment outcome in South Indian Tamil Rheumatoid Arthritis patients.

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Muralidharan, Niveditha; Gulati, Reena; Misra, Durga Prasanna; Negi, Vir S

2018-02-01

The aim of the study was to look for any association of MTR 2756A>G and MTRR 66A>G gene polymorphisms with clinical phenotype, methotrexate (MTX) treatment response, and MTX-induced adverse events in South Indian Tamil patients with rheumatoid arthritis (RA). A total of 335 patients with RA were investigated. MTR 2756A>G gene polymorphism was analyzed by PCR-RFLP, and MTRR 66A>G SNP was analyzed by TaqMan 5' nuclease assay. The allele frequencies were compared with HapMap groups. MTR 2756G allele was found to be associated with risk of developing RA. The allele frequencies of MTR 2756A>G and MTRR 66A>G SNPs in controls differed significantly when compared with HapMap groups. Neither of the SNPs influenced the MTX treatment outcome and adverse effects. Neither of the SNPs seems to be associated with MTX treatment outcome and adverse events in South Indian Tamil patients with RA.

Genetic variation in South Indian castes: evidence from Y-chromosome, mitochondrial, and autosomal polymorphisms

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Tirupati S

2008-12-01

Full Text Available Abstract Background Major population movements, social structure, and caste endogamy have influenced the genetic structure of Indian populations. An understanding of these influences is increasingly important as gene mapping and case-control studies are initiated in South Indian populations. Results We report new data on 155 individuals from four Tamil caste populations of South India and perform comparative analyses with caste populations from the neighboring state of Andhra Pradesh. Genetic differentiation among Tamil castes is low (RST = 0.96% for 45 autosomal short tandem repeat (STR markers, reflecting a largely common origin. Nonetheless, caste- and continent-specific patterns are evident. For 32 lineage-defining Y-chromosome SNPs, Tamil castes show higher affinity to Europeans than to eastern Asians, and genetic distance estimates to the Europeans are ordered by caste rank. For 32 lineage-defining mitochondrial SNPs and hypervariable sequence (HVS 1, Tamil castes have higher affinity to eastern Asians than to Europeans. For 45 autosomal STRs, upper and middle rank castes show higher affinity to Europeans than do lower rank castes from either Tamil Nadu or Andhra Pradesh. Local between-caste variation (Tamil Nadu RST = 0.96%, Andhra Pradesh RST = 0.77% exceeds the estimate of variation between these geographically separated groups (RST = 0.12%. Low, but statistically significant, correlations between caste rank distance and genetic distance are demonstrated for Tamil castes using Y-chromosome, mtDNA, and autosomal data. Conclusion Genetic data from Y-chromosome, mtDNA, and autosomal STRs are in accord with historical accounts of northwest to southeast population movements in India. The influence of ancient and historical population movements and caste social structure can be detected and replicated in South Indian caste populations from two different geographic regions.

Language barrier and its relationship to diabetes and diabetic retinopathy

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Zheng Yingfeng

2012-09-01

Full Text Available Abstract Background Language barrier is an important determinant of health care access and health. We examined the associations of English proficiency with type-2 diabetes (T2DM and diabetic retinopathy (DR in Asian Indians living in Singapore, an urban city where English is the predominant language of communication. Methods This was a population-based, cross-sectional study. T2DM was defined as HbA1c ≥6.5%, use of diabetic medication or a physician diagnosis of diabetes. Retinal photographs were graded for the severity of DR including vision-threatening DR (VTDR. Presenting visual impairment (VI was defined as LogMAR visual acuity > 0.30 in the better-seeing eye. English proficiency at the time of interview was assessed. Results The analyses included 2,289 (72.1% English-speaking and 885 (27.9% Tamil- speaking Indians. Tamil-speaking Indians had significantly higher prevalence of T2DM (46.2 vs. 34.7%, p  Conclusions In an English dominant society, Tamil-speaking Indians are more likely to have T2DM and diabetic retinopathy. Social policies and health interventions that address language-related health disparities may help reduce the public health impact of T2DM in societies with heterogeneous populations.

Development and validation of health related quality of life questionnaire (Indian scenario) in diabetic foot ulcer patients.

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Kateel, Ramya; Augustine, Alfred J; Ullal, Sheetal; Prabhu, Shivananda; Bhat, Rahul; Adhikari, Prabha

2017-12-01

To develop and validate Health Related Quality of Life Questionnaire in Diabetic Foot Ulcer Patients (HRQLQDFU) for Indian scenario. This study was conducted in two phases. First phase was Development of HRQLQDFU which included literature search and expert interview. Second phase was validation of HRQLQDFL which included face validation, content validation and construct validation. Face validation was done by ten diabetic foot ulcer patients, ten practicing nurses and ten care givers. They were asked to read and respond to questionnaire and report any difficulty in understanding the questions. Further they were asked to add any item to the questionnaire which according to them has a significant effect on quality of life. Content validation was done by six subject experts who judged the content relevance of questionnaire with score ranging from zero to four; zero being least relevant and four being most relevant. Content validity index was calculated for each question. Questions having content validity index≥0.8 were selected for the study. Reliability was tested by calculating Cronbach's alpha. In the development phase a questionnaire containing 37 questions with six domains was developed. None of patient had difficulty in understanding questions. After content validation a new questionnaire containing 20 questions was developed. Cronbach's alpha was 0.86 which shows good reliability. The new health related quality of life questionnaire on diabetic foot ulcer patients for an Indian scenario is validated and can be a reliably measure for quality of life in diabetic foot ulcer patients. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Association analysis of 31 common polymorphisms with type 2 diabetes and its related traits in Indian sib pairs.

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Gupta, V; Vinay, D G; Rafiq, S; Kranthikumar, M V; Janipalli, C S; Giambartolomei, C; Evans, D M; Mani, K R; Sandeep, M N; Taylor, A E; Kinra, S; Sullivan, R M; Bowen, L; Timpson, N J; Smith, G D; Dudbridge, F; Prabhakaran, D; Ben-Shlomo, Y; Reddy, K S; Ebrahim, S; Chandak, G R

2012-02-01

Evaluation of the association of 31 common single nucleotide polymorphisms (SNPs) with fasting glucose, fasting insulin, HOMA-beta cell function (HOMA-β), HOMA-insulin resistance (HOMA-IR) and type 2 diabetes in the Indian population. We genotyped 3,089 sib pairs recruited in the Indian Migration Study from four cities in India (Lucknow, Nagpur, Hyderabad and Bangalore) for 31 SNPs in 24 genes previously associated with type 2 diabetes in European populations. We conducted within-sib-pair analysis for type 2 diabetes and its related quantitative traits. The risk-allele frequencies of all the SNPs were comparable with those reported in western populations. We demonstrated significant associations of CXCR4 (rs932206), CDKAL1 (rs7756992) and TCF7L2 (rs7903146, rs12255372) with fasting glucose, with β values of 0.007 (p = 0.05), 0.01 (p = 0.01), 0.007 (p = 0.05), 0.01 (p = 0.003) and 0.08 (p = 0.01), respectively. Variants in NOTCH2 (rs10923931), TCF-2 (also known as HNF1B) (rs757210), ADAM30 (rs2641348) and CDKN2A/B (rs10811661) significantly predicted fasting insulin, with β values of -0.06 (p = 0.04), 0.05 (p = 0.05), -0.08 (p = 0.01) and -0.08 (p = 0.02), respectively. For HOMA-IR, we detected associations with TCF-2, ADAM30 and CDKN2A/B, with β values of 0.05 (p = 0.04), -0.07 (p = 0.03) and -0.08 (p = 0.02), respectively. We also found significant associations of ADAM30 (β = -0.05; p = 0.01) and CDKN2A/B (β = -0.05; p = 0.03) with HOMA-β. THADA variant (rs7578597) was associated with type 2 diabetes (OR 1.5; 95% CI 1.04, 2.22; p = 0.03). We validated the association of seven established loci with intermediate traits related to type 2 diabetes in an Indian population using a design resistant to population stratification.

Immigrant Asian Indians in the U.S.: A Population at Risk for Diabetes and Cardiovascular Disease

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Misra, Ranjita

2009-01-01

Asian Indians are the third largest and fastest growing Asian subgroup in the U.S. and considered the model minority due to their high education and income level. Unlike other Asian immigrants, they are a more heterogeneous group with a genetic predisposition for diabetes and cardiovascular disease. Current national surveys are incapable of…

Diabetes mellitus: Trends in northern India

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Manish Gutch

2014-01-01

Full Text Available Diabetes mellitus is becoming a global health issue with more than 80% diabetics living in developing countries. India accounts for 62.4 million diabetics (2011. Indian Council of Medical Research India Diabetes Study (ICMR-INDIAB study showed highest weighted prevalence rate in the north India among all studied regions. Diabetes in north India has many peculiarities in all aspects from risk factors to control programmers. North Indians are becoming more prone for diabetes and dyslipidemia because rapid westernization of living style and diet due rapid migration to metropolitan cities for employment. North Indian diabetes is plagued with gender bias against females, poor quality of health services, myths, and lack of disease awareness compounded with small number of prevention and awareness programmers that too are immature to counteract the growing pandemic.

A Multiethnic Study of Pre-Diabetes and Diabetes in LMIC.

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Shen, Jia; Kondal, Dimple; Rubinstein, Adolfo; Irazola, Vilma; Gutierrez, Laura; Miranda, J Jaime; Bernabé-Ortiz, Antonio; Lazo-Porras, María; Levitt, Naomi; Steyn, Krisela; Bobrow, Kirsten; Ali, Mohammed K; Prabhakaran, Dorairaj; Tandon, Nikhil

2016-03-01

Diabetes mellitus is one of the leading causes of death and disability worldwide. Approximately three-quarters of people with diabetes live in low- and middle-income countries, and these countries are projected to experience the greatest increase in diabetes burden. We sought to compare the prevalence, awareness, treatment, and control of diabetes in 3 urban and periurban regions: the Southern Cone of Latin America and Peru, South Asia, and South Africa. In addition, we examined the relationship between diabetes and pre-diabetes with known cardiovascular and metabolic risk factors. A total of 26,680 participants (mean age, 47.7 ± 14.0 years; 45.9% male) were enrolled in 4 sites (Southern Cone of Latin America = 7,524; Peru = 3,601; South Asia = 11,907; South Africa = 1,099). Detailed demographic, anthropometric, and biochemical data were collected. Diabetes and pre-diabetes were defined as a fasting plasma glucose ≥126 mg/dl and 100 to 125 mg/dl, respectively. Diabetes control was defined as fasting plasma glucose diabetes and pre-diabetes was 14.0% (95% confidence interval [CI]: 13.2% to 14.8%) and 17.8% (95% CI: 17.0% to 18.7%) in the Southern Cone of Latin America, 9.8% (95% CI: 8.8% to 10.9%) and 17.1% (95% CI: 15.9% to 18.5%) in Peru, 19.0% (95% CI: 18.4% to 19.8%) and 24.0% (95% CI: 23.2% to 24.7%) in South Asia, and 13.8% (95% CI: 11.9% to 16.0%) and 9.9% (95% CI: 8.3% to 11.8%) in South Africa. The age- and sex-specific prevalence of diabetes and pre-diabetes for all countries increased with age (p Peru, and South Africa the prevalence of pre-diabetes rose sharply at 35 to 44 years. In South Asia, the sharpest rise in pre-diabetes prevalence occurred younger at 25 to 34 years. The prevalence of diabetes rose sharply at 45 to 54 years in the Southern Cone of Latin America, Peru, and South Africa, and at 35 to 44 years in South Asia. Diabetes and pre-diabetes prevalence increased with body mass index. South Asians had the highest prevalence of diabetes and

Influence of Tropical South Atlantic Sea Surface Temperatures on the Indian Summer monsoon in CMIP5 models

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Kucharski, Fred; Joshi, Manish K.

2017-04-01

In this study the teleconnection from the tropical south Atlantic to the Indian monsoon has been assessed in observations and in 32 models from the World Climate Research Program (WCRP) Coupled Model Intercomparison Project Phase 5 (CMIP5). All models show that the regression pattern of tropics-wide Atlantic sea surface temperature (SST) anomalies onto the tropical south Atlantic index correlates well with that in observations, even though with varying spatial standard deviations. However, only about half of the 32 models considered show the correct sign of rainfall response over India to a warm anomaly in the south tropical Atlantic, which is a reduction of rainfall. On the other hand, models generally do show large-scale responses broadly consistent with the observations, and the signal over India depends on relatively subtle changes in the response. This response to a tropical south Atlantic warm (cold) anomaly is a low-level quadrupole in streamfunction with an anticyclonic (cyclonic) anomaly over the Arabian Sea and India. This anticyclonic (cyclonic) anomaly leads to a weakening (strengthening) of the Somali jet and low-level divergence (convergence) over India, both inducing a reduction (increase) of Indian rainfall. The models which do not show the correct rainfall response over India also show a response similar to the one indicated above, but with maximum of the anticyclonic (cyclonic) response shifted to the western Pacific. The large-scale Walker circulation adjustment to the tropical south Atlantic SST anomalies is identified as one of the factors which account for the differences in the low-level streamfunction response. Models (and the observations) with the correct sign of the rainfall signal over India show the dominant upper-level convergence (divergence) as response to a warm (cold) tropical south Atlantic in the western Pacific region, whereas models with the wrong sign of the rainfall signal show it predominantly in the central-eastern Pacific

A lightning climatology of the South-West Indian Ocean

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C. Bovalo

2012-08-01

Full Text Available The World Wide Lightning Location Network (WWLLN data have been used to perform a lightning climatology in the South-West Indian Ocean (SWIO region from 2005 to 2011. Maxima of lightning activity were found in the Maritime Continent and southwest of Sri Lanka (>50 fl km⁻² yr⁻¹ but also over Madagascar and above the Great Lakes of East Africa (>10–20 fl km⁻² yr⁻¹. Lightning flashes within tropical storms and tropical cyclones represent 50 % to 100 % of the total lightning activity in some oceanic areas of the SWIO (between 10° S and 20° S.

The SWIO is characterized by a wet season (November to April and a dry season (May to October. As one could expect, lightning activity is more intense during the wet season as the Inter Tropical Convergence Zone (ITCZ is present over all the basin. Flash density is higher over land in November–December–January with values reaching 3–4 fl km⁻² yr⁻¹ over Madagascar. During the dry season, lightning activity is quite rare between 10° S and 25° S. The Mascarene anticyclone has more influence on the SWIO resulting in shallower convection. Lightning activity is concentrated over ocean, east of South Africa and Madagascar.

A statistical analysis has shown that El Niño–Southern Oscillation mainly modulates the lightning activity up to 56.8% in the SWIO. The Indian Ocean Dipole has a significant contribution since ~49% of the variability is explained by this forcing in some regions. The Madden–Julian Oscillation did not show significative impact on the lightning activity in our study.

Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes

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Melissa L. Walls

2017-09-01

Full Text Available American Indian (AI communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose–response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients.

Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes.

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Walls, Melissa L; Sittner, Kelley J; Aronson, Benjamin D; Forsberg, Angie K; Whitbeck, Les B; al'Absi, Mustafa

2017-09-16

American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose-response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients.

Genetic polymorphisms of multidrug and toxin extrusion proteins (MATE1 and MATE2 in South Indian population

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Gerard Marshall Raj

2017-02-01

Conclusion: Thus, the allele and genotype distributions of SLC47A1 and SLC47A2 gene polymorphisms were established in South Indian population and were found to be different from the frequencies of other ethnicities.

American Indian Parents’ Assessment of and Concern About Their Kindergarten Child’s Weight Status, South Dakota, 2005-2006

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Arcan, Chrisa; Hannan, Peter J.; Himes, John H.; Fulkerson, Jayne A.; Holy Rock, Bonnie; Smyth, Mary; Story, Mary

2012-01-01

Introduction Obesity is highly prevalent among American Indians, and effective prevention efforts require caregiver involvement. We examined American Indian (AI) parents' assessment of and level of concern about their kindergarten child's weight status. Methods We collected baseline data (fall of 2005 and fall of 2006) on children and their parents or caregivers for a school-based obesity prevention trial (Bright Start) on an AI reservation in South Dakota. The current study uses 413 parent-c...

Spicing up your advice for South Asian and Anglo-Australians with type 2 diabetes and CVD: Do cultural constructions of diet matter?

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Gupta, Sabrina S; Teede, Helena; Aroni, Rosalie

2018-01-01

South Asians are a growing migrant population, both globally and in Australia. This group are at higher risk for both cardiovascular disease and type 2 diabetes. The aim of this qualitative study was to compare dietary practices of South Asians, n = 41 (Indian, n = 25; Sri Lankan, n = 16) and Anglo-Australians, n = 16, with these conditions, using semi-structured in-depth interviews. Findings suggest that both groups had a high level of awareness of dietary practices necessary for optimum disease management, both prior to and post diagnosis. Bi-directional effects of migration were noted in the dietary practices of both groups suggesting hybrid diets are evident in Australia. A key barrier to implementing dietary changes highlighted by both groups of participants was a lack of specific, timely and detailed dietary advice from clinicians. Both groups expressed that advice should be repeated and reinforced throughout the course of their disease. In addition, South Asian participants wanted more culturally relevant advice. Clinicians providing dietary advice need to recognise that preferences for staple food items are resistant to change and may affect adherence. Acculturation was evident in the dietary practices of the South Asian participants. Nevertheless, many maintained traditional food practices which were tied to their cultural identity. It is recommended that clinicians consider these factors when offering advice. Copyright © 2017. Published by Elsevier Ltd.

Coronary heart disease in South Asian immigrants: synthesis of research and implications for health promotion and prevention in nursing practice.

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Mathews, Rahel; Zachariah, Rachel

2008-07-01

Although the literature reflects that Asian Indians in the United States and globally have the highest rates of morbidity and mortality because of coronary heart disease (CHD) and diabetes, few studies have described the clinical implications in the United States. Traditional risk factors dictate practice, yet these risk factors do not fully explain the rates. Central obesity, lipoprotein (a), and insulin resistance may have a strong role. The literature suggests that proactive nursing using culturally specific clinical measures are necessary to reduce risk factors for CHD and diabetes in South Asians. Additional research and prevention strategies focused on immigrant South Asians in the United States are recommended.

Nutritional profile of the morbidly obese patients attending a bariatric clinic in a South Indian tertiary care centre

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Mini Joseph

2017-09-01

Full Text Available Background: Obesity is sweeping across continents and is a major public health concern of the modern society. Aims: The main objective of this study was to study the demographic, anthropometric and dietary patterns of the morbidly obese and study region wise variation in their nutrient intake. Materials and Methods: The study was conducted on 101 morbidly obese individuals from different regions of India who attended the Bariatric clinic of a tertiary care hospital in India. Their socio-demographic details, anthropometric measurements were collected. The dietary assessment was done using a 24 hour dietary recall and a food frequency questionnaire. The study was approved by the Institutional review board and informed consent was obtained from them. Results: More than 3/4th of the patients were females and 61 per cent had Type 2 diabetes mellitus. The mean age of the male and female population was 41.3 + 15.5 years and 36.7 + 11.9 years respectively. Their mean BMI was 41kg/m2. The mean daily intake of calories was more than 2200kcal/day with a gross deficit in the intake of micronutrients. Bonferroni Test showed that there was region wise variation in dietary intake, South Indian female population had the lowest intake of the micronutrients and those from East India had the highest intake. In the male population, there was a significant regional difference in intake of Proteins (p=0.039 and Energy (p=0.024. Independent Sample T test showed that South Indian had the highest intake of Energy and proteins. Anthropometric measures showed positive relation with various macronutrient intakes. Conclusion: The obese patients require intense counselling by a dedicated team of an endocrinologist, psychiatrist, dietician, bariatric surgeon and a social worker to make achievable changes in the quality of life of the morbidly obese patients. Regional influences must be considered when counselling the patient.

Selecting SNPs informative for African, American Indian and European Ancestry: application to the Family Investigation of Nephropathy and Diabetes (FIND).

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Williams, Robert C; Elston, Robert C; Kumar, Pankaj; Knowler, William C; Abboud, Hanna E; Adler, Sharon; Bowden, Donald W; Divers, Jasmin; Freedman, Barry I; Igo, Robert P; Ipp, Eli; Iyengar, Sudha K; Kimmel, Paul L; Klag, Michael J; Kohn, Orly; Langefeld, Carl D; Leehey, David J; Nelson, Robert G; Nicholas, Susanne B; Pahl, Madeleine V; Parekh, Rulan S; Rotter, Jerome I; Schelling, Jeffrey R; Sedor, John R; Shah, Vallabh O; Smith, Michael W; Taylor, Kent D; Thameem, Farook; Thornley-Brown, Denyse; Winkler, Cheryl A; Guo, Xiuqing; Zager, Phillip; Hanson, Robert L

2016-05-04

The presence of population structure in a sample may confound the search for important genetic loci associated with disease. Our four samples in the Family Investigation of Nephropathy and Diabetes (FIND), European Americans, Mexican Americans, African Americans, and American Indians are part of a genome- wide association study in which population structure might be particularly important. We therefore decided to study in detail one component of this, individual genetic ancestry (IGA). From SNPs present on the Affymetrix 6.0 Human SNP array, we identified 3 sets of ancestry informative markers (AIMs), each maximized for the information in one the three contrasts among ancestral populations: Europeans (HAPMAP, CEU), Africans (HAPMAP, YRI and LWK), and Native Americans (full heritage Pima Indians). We estimate IGA and present an algorithm for their standard errors, compare IGA to principal components, emphasize the importance of balancing information in the ancestry informative markers (AIMs), and test the association of IGA with diabetic nephropathy in the combined sample. A fixed parental allele maximum likelihood algorithm was applied to the FIND to estimate IGA in four samples: 869 American Indians; 1385 African Americans; 1451 Mexican Americans; and 826 European Americans. When the information in the AIMs is unbalanced, the estimates are incorrect with large error. Individual genetic admixture is highly correlated with principle components for capturing population structure. It takes ~700 SNPs to reduce the average standard error of individual admixture below 0.01. When the samples are combined, the resulting population structure creates associations between IGA and diabetic nephropathy. The identified set of AIMs, which include American Indian parental allele frequencies, may be particularly useful for estimating genetic admixture in populations from the Americas. Failure to balance information in maximum likelihood, poly-ancestry models creates biased

Gestational diabetes mellitus and pregnancy outcomes among Chinese and South Asian women in Canada.

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Mukerji, Geetha; Chiu, Maria; Shah, Baiju R

2013-02-01

To determine the association between Chinese or South Asian ethnicity and adverse neonatal and maternal outcomes for women with gestational diabetes compared to the general population. A cohort study was conducted using population-based health care databases in Ontario, Canada. All 35,577 women aged 15-49 with gestational diabetes who had live births between April 2002 and March 2011 were identified. Their delivery hospitalization records and the birth records of their neonates were examined to identify adverse neonatal outcomes and adverse maternal outcomes. Compared to infants of mothers from the general population (55.5%), infants of Chinese mothers had a lower risk of an adverse outcome at delivery (42.9%, adjusted odds ratio 0.63, 95% confidence interval 0.58-0.68), whereas infants of South Asian mothers had a higher risk (58.9%, adjusted odds ratio 1.15, 95% confidence interval 1.07-1.23). Chinese women also had a lower risk of adverse maternal outcomes (32.4%, adjusted odds ratio 0.58, 95% confidence interval 0.54-0.63) compared to general population women (41.2%), whereas the risk for South Asian women was not different (39.4%, adjusted odds ratio 0.94, 95% confidence interval 0.88-1.02) from that of general population women. The risk of complications of gestational diabetes differs significantly between Chinese and South Asian patients and the general population in Ontario. Tailored interventions for gestational diabetes management may be required to improve pregnancy outcomes in high-risk ethnic groups.

Impact of classical risk factors of type 2 diabetes among Asian Indian, Chinese and Japanese populations.

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He, L; Tuomilehto, J; Qiao, Q; Söderberg, S; Daimon, M; Chambers, J; Pitkäniemi, J

2015-11-01

This review investigated the population impact of major modifiable type 2 diabetes (T2D) risk factors, with special focus on native Asian Indians, to estimate population attributable risks (PARs) and compare them with estimates from Chinese and Japanese populations. Information was obtained on risk factors in 21,041 Asian Indian, 17,774 Chinese and 17,986 Japanese populations from multiple, large, cross-sectional studies (the DECODA project) of T2D. Crude and adjusted PARs were estimated for the major T2D risk factors. Age had the highest crude and adjusted PARs among Asian Indians and Chinese in contrast to waist-hip ratio among Japanese. After adjusting for age, the PAR for body mass index (BMI) in Asian Indians (41.4% [95% CI: 37.2%; 45.4%]) was second only to triglycerides (46.4% [95% CI: 39.5%; 52.8%]) compared with 35.8% [95% CI: 29.9%; 41.4%] in Japanese and 38.4% [95% CI: 33.5%; 43.2%] in Chinese people. The PAR for BMI adjusted for age, LDL and triglycerides (39.7% [95% CI: 31.6%; 47.2%]) was higher than for any other factor in Asian Indians, and was much higher than in the Chinese (16.8% [95% CI: 3.0%; 30.9%]) and Japanese (30.4% [95% CI: 17.5%; 42.2%]) populations. This review provides estimates of the association between major risk factors and prevalences of T2D among Asian populations by examining their PARs from large population-based samples. From a public-health point of view, the importance of BMI in Asian Indians is especially highlighted in comparison to the other Asian populations. Given these results and other recent findings on the causality link between BMI and T2D, it can be postulated that obesity may be involved in the aetiology of T2D through interaction with ethnic-specific genetic factors, although ethnicity itself is not a direct risk factor for T2D as people of all ethnic backgrounds develop diabetes. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis

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Jayawardena Ranil

2012-05-01

Full Text Available Abstract Background Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported. Methods Prevalence data were obtained by searching the Medline® database with; ‘prediabetes’ and ‘diabetes mellitus’ (MeSH major topic and ‘Epidemology/EP’ (MeSH subheading. Search limits were articles in English, between 01/01/1980–31/12/2011, on human adults (≥19 years. The conjunction of the above results was narrowed down with country names. Results The most recent reported prevalence of pre-diabetes:diabetes in regional countries were; Bangladesh–4.7%:8.5% (2004–2005;Rural, India–4.6%:12.5% (2007;Rural; Maldives–3.0%:3.7% (2004;National, Nepal–19.5%:9.5% (2007;Urban, Pakistan–3.0%:7.2% (2002;Rural, Sri Lanka–11.5%:10.3% (2005–2006;National. Urban populations demonstrated a higher prevalence of diabetes. An increasing trend in prevalence of diabetes was observed in urban/rural India and rural Sri Lanka. The diabetes epidemicity index decreased with the increasing prevalence of diabetes in respective countries. A high epidemicity index was seen in Sri Lanka (2005/2006–52.8%, while for other countries, the epidemicity index was comparatively low (rural India 2007–26.9%; urban India 2002/2005–31.3%, and urban Bangladesh–33.1%. Family history, urban residency, age, higher BMI, sedentary lifestyle, hypertension and waist-hip ratio were associated with an increased risks of diabetes. Conclusion A significant epidemic of diabetes is present in the South Asian region with a rapid increase in prevalence over the last two decades. Hence there is a need for urgent preventive and curative strategies .

Diabetes Medicines

Science.gov (United States)

... Ways to Prevent Type 2 Diabetes We Have the Power to Prevent Diabetes: Tips for American Indians & Alaska ... pressure instead of using a needle to deliver the insulin. What oral ... eating and physical activity habits to manage your type 2 diabetes. You can ...

When HIV is ordinary and diabetes new: remaking suffering in a South African township.

Science.gov (United States)

Mendenhall, Emily; Norris, Shane A

2015-01-01

Escalation of non-communicable diseases (NCDs) among urban South African populations disproportionately afflicted by HIV/AIDS presents not only medical challenges but also new ways in which people understand and experience sickness. In Soweto, the psychological imprints of political violence of the Apartheid era and structural violence of HIV/AIDS have shaped social and health discourses. Yet, as NCDs increasingly become part of social and biomedical discussions in South African townships, new frames for elucidating sickness are emerging. This article employs the concept of syndemic suffering to critically examine how 27 women living with Type 2 diabetes in Soweto, a township adjacent to Johannesburg known for socio-economic mobility as well as inequality, experience and understand syndemic social and health problems. For example, women described how reconstructing families and raising grandchildren after losing children to AIDS was not only socially challenging but also affected how they ate, and how they accepted and managed their diabetes. Although previously diagnosed with diabetes, women illustrated how a myriad of social and health concerns shaped sickness. Many related diabetes treatment to shared AIDS nosologies, referring to diabetes as 'the same' or 'worse'. These narratives demonstrate how suffering weaves a social history where HIV becomes ordinary, and diabetes new.

The Paleo-Indian Entry into South America According to Mitogenomes.

Science.gov (United States)

Brandini, Stefania; Bergamaschi, Paola; Cerna, Marco Fernando; Gandini, Francesca; Bastaroli, Francesca; Bertolini, Emilie; Cereda, Cristina; Ferretti, Luca; Gómez-Carballa, Alberto; Battaglia, Vincenza; Salas, Antonio; Semino, Ornella; Achilli, Alessandro; Olivieri, Anna; Torroni, Antonio

2018-02-01

Recent and compelling archaeological evidence attests to human presence ∼14.5 ka at multiple sites in South America and a very early exploitation of extreme high-altitude Andean environments. Considering that, according to genetic evidence, human entry into North America from Beringia most likely occurred ∼16 ka, these archeological findings would imply an extremely rapid spread along the double continent. To shed light on this issue from a genetic perspective, we first completely sequenced 217 novel modern mitogenomes of Native American ancestry from the northwestern area of South America (Ecuador and Peru); we then evaluated them phylogenetically together with other available mitogenomes (430 samples, both modern and ancient) from the same geographic area and, finally, with all closely related mitogenomes from the entire double continent. We detected a large number (N = 48) of novel subhaplogroups, often branching into further subclades, belonging to two classes: those that arose in South America early after its peopling and those that instead originated in North or Central America and reached South America with the first settlers. Coalescence age estimates for these subhaplogroups provide time boundaries indicating that early Paleo-Indians probably moved from North America to the area corresponding to modern Ecuador and Peru over the short time frame of ∼1.5 ka comprised between 16.0 and 14.6 ka. © The Author 2017. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Immunohistochemical localization of CYP1A, vitellogenin and Zona radiata proteins in the liver of swordfish (Xiphias gladius L.) taken from the Mediterranean Sea, South Atlantic, South Western Indian and Central North Pacific Oceans

International Nuclear Information System (INIS)

Desantis, S.; Corriero, A.; Cirillo, F.; Deflorio, M.; Brill, R.; Griffiths, M.; Lopata, A.L.; Serna, J.M. de la; Bridges, C.R.; Kime, D.E.; De Metrio, G.

2005-01-01

Cytochrome P4501A (CYP1A) monoxygenase, vitellogenin (Vtg) and Zona radiata proteins (Zrp) are frequently used as biomarkers of fish exposure to organic contaminants. In this work, swordfish liver sections obtained from the Mediterranean Sea, the South African coasts (South Atlantic and South Western Indian Oceans) and the Central North Pacific Ocean were immunostained with antisera against CYP1A, Zrp, and Vtg. CYP1A induction was found in hepatocytes, epithelium of the biliary ductus and the endothelium of large blood vessels of fish from the Mediterranean Sea and South African waters, but not from the Pacific Ocean. Zrp and Vtg were immunolocalized in hepatocytes of male swordfish from the Mediterranean Sea and from South African waters. Plasma Dot-Blot analysis, performed in Mediterranean and Pacific specimens, revealed the presence of Zrp and Vtg in males from Mediterranean but not from Pacific. These results confirm previous findings about the potential exposure of Mediterranean swordfish to endocrine, disrupting chemicals and raise questions concerning the possible presence of xenobiotic contaminants off the Southern coasts of South Africa in both the South Atlantic and South Western Indian Oceans

Human leukocyte Antigen-B*27 allele subtype prevalence and disease association of ankylosing spondylitis among south indian population

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Vikram Haridas

2018-01-01

Conclusion: The current study indicates that a majority of South Indian AS patients are associated with HLA-B*27 alleles. In addtion we found that HLA-B*27 associated AS patients presented with more severe axial manifestations.

duration diabetes mellitus

African Journals Online (AJOL)

... group, type of diabetes, age of onset and duration of diabetes), presence of retinopathy, markers of nephropathy and biochemical variables. ... type 2 diabetes and for each ethnic group. Results. ... time of diabetes diagnosis in blacks than Indians. In the type ... countries, minority groups and disadvantaged communities in.

Genome-wide association study for type 2 diabetes in Indians identifies a new susceptibility locus at 2q21.

Science.gov (United States)

Tabassum, Rubina; Chauhan, Ganesh; Dwivedi, Om Prakash; Mahajan, Anubha; Jaiswal, Alok; Kaur, Ismeet; Bandesh, Khushdeep; Singh, Tejbir; Mathai, Benan John; Pandey, Yogesh; Chidambaram, Manickam; Sharma, Amitabh; Chavali, Sreenivas; Sengupta, Shantanu; Ramakrishnan, Lakshmi; Venkatesh, Pradeep; Aggarwal, Sanjay K; Ghosh, Saurabh; Prabhakaran, Dorairaj; Srinath, Reddy K; Saxena, Madhukar; Banerjee, Monisha; Mathur, Sandeep; Bhansali, Anil; Shah, Viral N; Madhu, Sri Venkata; Marwaha, Raman K; Basu, Analabha; Scaria, Vinod; McCarthy, Mark I; Venkatesan, Radha; Mohan, Viswanathan; Tandon, Nikhil; Bharadwaj, Dwaipayan

2013-03-01

Indians undergoing socioeconomic and lifestyle transitions will be maximally affected by epidemic of type 2 diabetes (T2D). We conducted a two-stage genome-wide association study of T2D in 12,535 Indians, a less explored but high-risk group. We identified a new type 2 diabetes-associated locus at 2q21, with the lead signal being rs6723108 (odds ratio 1.31; P = 3.32 × 10⁻⁹). Imputation analysis refined the signal to rs998451 (odds ratio 1.56; P = 6.3 × 10⁻¹²) within TMEM163 that encodes a probable vesicular transporter in nerve terminals. TMEM163 variants also showed association with decreased fasting plasma insulin and homeostatic model assessment of insulin resistance, indicating a plausible effect through impaired insulin secretion. The 2q21 region also harbors RAB3GAP1 and ACMSD; those are involved in neurologic disorders. Forty-nine of 56 previously reported signals showed consistency in direction with similar effect sizes in Indians and previous studies, and 25 of them were also associated (P < 0.05). Known loci and the newly identified 2q21 locus altogether explained 7.65% variance in the risk of T2D in Indians. Our study suggests that common susceptibility variants for T2D are largely the same across populations, but also reveals a population-specific locus and provides further insights into genetic architecture and etiology of T2D.

Global warming and South Indian monsoon rainfall-lessons from the Mid-Miocene.

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Reuter, Markus; Kern, Andrea K; Harzhauser, Mathias; Kroh, Andreas; Piller, Werner E

2013-04-01

Precipitation over India is driven by the Indian monsoon. Although changes in this atmospheric circulation are caused by the differential seasonal diabatic heating of Asia and the Indo-Pacific Ocean, it is so far unknown how global warming influences the monsoon rainfalls regionally. Herein, we present a Miocene pollen flora as the first direct proxy for monsoon over southern India during the Middle Miocene Climate Optimum. To identify climatic key parameters, such as mean annual temperature, warmest month temperature, coldest month temperature, mean annual precipitation, mean precipitation during the driest month, mean precipitation during the wettest month and mean precipitation during the warmest month the Coexistence Approach is applied. Irrespective of a ~ 3-4 °C higher global temperature during the Middle Miocene Climate Optimum, the results indicate a modern-like monsoonal precipitation pattern contrasting marine proxies which point to a strong decline of Indian monsoon in the Himalaya at this time. Therefore, the strength of monsoon rainfall in tropical India appears neither to be related to global warming nor to be linked with the atmospheric conditions over the Tibetan Plateau. For the future it implies that increased global warming does not necessarily entail changes in the South Indian monsoon rainfall.

Understanding adherence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis.

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Kumar, Kanta; Greenfield, Sheila; Raza, Karim; Gill, Paramjit; Stack, Rebecca

2016-05-26

Prevalence of diabetes and cardiovascular (CVD) disease amongst UK South Asians is higher than in the general population. Non-adherence to medicines may lead to poor clinical outcomes for South Asian patients with diabetes and CVD. To understand the decision making processes associated with taking medicines, a qualitative systematic meta-synthesis exploring medicine taking behaviours, and beliefs was undertaken. Four databases (Medline, Embase, Science Citation Index and CINAHL) were searched to identify qualitative studies of South Asian patients taking diabetic medicines. Data were thematic coded and synthesised. The following themes were identified: [1] beliefs about the need for and efficacy of medicines; [2] toxicity of medicines and polypharmacy; [3] the necessity of traditional remedies versus "western medicines"; [4] stigma and social support; and [5] communication. South Asians described cultural social stigma associated with diabetes and reported fears about drug toxicity as barriers to taking medicines. Cultural beliefs about traditional remedies and interactions with healthcare professionals also appeared to play a role in the way people made decisions about medicines. Advice should be tailored provided to South Asian patients highlighting the long term consequences of diabetes and CVD.

Depression among patients with diabetes: A community-based study in South India

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Abdullahi S Aminu

2017-01-01

Full Text Available Background: Depression is one of the more common mental health conditions found among people suffering from chronic diseases. Its presence in patients with type 2 diabetes could hinder the adherence to and effectiveness of treatment. Most studies on depression among patients with diabetes are hospital-based suggesting the need for a community-based study to assess the correlates of depression among patients with diabetes. Aim: This study aimed to estimate the prevalence and to identify the factors influencing depression among patients with type 2 diabetes in Udupi taluk situated in southern India. Subjects and Methods: This study recruited 200 patients with type 2 diabetes from both rural and urban areas. Demographic, clinical, and diabetes-related information were collected using a semi-structured questionnaire. Depression was assessed using Patient Health Questionnaire-9; a standardized questionnaire developed in the United States of America and validated in the Indian population. Results: The prevalence of depression among patients with diabetes in the community was found to be 37.5%. Most frequently, depression was mild (42, 21% in nature with severe depression (9, 4.5% seen the least. Several factors were found to be positively associated with depression including female gender, rural residence, unemployment, and the status of being unmarried. The presence of diabetic complications and other chronic diseases such as hypertension and obesity also were found to be associated with depression. Conclusion: Depression was found to be particularly high among the study population. Since depression could significantly hinder patient's adherence to treatment, there is an urgent need for early diagnosis and treatment. This calls for the integration of mental health care into the management of diabetes.

76 FR 56466 - Indian Gaming

Science.gov (United States)

2011-09-13

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an approval of the gaming compact between the Flandreau Santee Sioux Tribe and the State of South...

77 FR 43110 - Indian Gaming

Science.gov (United States)

2012-07-23

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Rosebud Sioux Tribe and the State of South Dakota. DATES...

76 FR 8375 - Indian Gaming

Science.gov (United States)

2011-02-14

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal-State Class III Gaming Compact. SUMMARY: This notice publishes an extension of the Gaming Compact between the Oglala Sioux Tribe and the State of South Dakota...

77 FR 45371 - Indian Gaming

Science.gov (United States)

2012-07-31

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Oglala Sioux Tribe and the State of South Dakota. DATES: Effective...

78 FR 15738 - Indian Gaming

Science.gov (United States)

2013-03-12

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an extension of the gaming compact between the Rosebud Sioux Tribe and the State of South Dakota...

77 FR 59641 - Indian Gaming

Science.gov (United States)

2012-09-28

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal-State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Rosebud Sioux Tribe and the State of South Dakota. DATES...

76 FR 52968 - Indian Gaming

Science.gov (United States)

2011-08-24

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Rosebud Sioux Tribe and the State of South Dakota. DATES...

76 FR 33341 - Indian Gaming

Science.gov (United States)

2011-06-08

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal--State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Rosebud Sioux Tribe and the State of South Dakota. DATES...

75 FR 55823 - Indian Gaming

Science.gov (United States)

2010-09-14

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of approved Tribal-State Class III Gaming Compact. SUMMARY: This notice publishes an extension of Gaming between the Oglala Sioux Tribe and the State of South Dakota. DATES: Effective...

78 FR 11221 - Indian Gaming

Science.gov (United States)

2013-02-15

... DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs Indian Gaming AGENCY: Bureau of Indian Affairs, Interior. ACTION: Notice of Approved Tribal-State Class III Gaming Compact. SUMMARY: This notice publishes an extension of the gaming compact between the Oglala Sioux Tribe and the State of South Dakota...

Peroxisome proliferator activated receptor gamma polymorphism Pro12Ala in polycystic ovary syndrome (PCOS of South Indian Population

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Raichel Jacob

2016-05-01

Conclusion: PPARγ2 gene Pro12Ala polymorphism was supposed to be susceptible genes in PCOS. The present study demonstrated that there is a statistical difference between the distributions of PPAR gamma Pro12Ala polymorphism in South Indian Population.

Circulating MiRNAs of 'Asian Indian Phenotype' Identified in Subjects with Impaired Glucose Tolerance and Patients with Type 2 Diabetes.

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Paramasivam Prabu

Full Text Available Several omics technologies are underway worldwide with an aim to unravel the pathophysiology of a complex phenotype such as type 2 diabetes mellitus (T2DM. While recent studies imply a clinically relevant and potential biomarker role of circulatory miRNAs in the etiology of T2DM, there is lack of data on this aspect in Indians--an ethnic population characterized to represent 'Asian Indian phenotype' known to be more prone to develop T2DM and cardiovascular disease than Europeans. We performed global serum miRNA profiling and the validation of candidate miRNAs by qRT-PCR in a cohort of subjects comprised of normal glucose tolerance (NGT, impaired glucose tolerance (IGT and patients with T2DM. Our study revealed 4 differentially expressed miRNAs (miR-128, miR-130b-3p, miR-374a-5p, miR-423-5p in subjects with IGT and T2DM patients compared to control subjects. They were positively or negatively correlated to cholesterol levels, HbA1C, HOMA-IR and fasting insulin. Interestingly, circulating level of miR-128 and miR-130b-3p were also altered in serum of diet-induced diabetic mice compared to control animals. Among the altered circulating miRNAs, miR-128 had never been described in previous studies/populations and appeared to be a 'New Lead' in Indians. It was positively correlated with cholesterol both in prediabetic subjects and in diet-induced diabetic mice, suggesting that its increased level might be associated with the development of dyslipedemia associated with T2DM. Our findings imply directionality towards biomarker potential of miRNAs in the prevention/diagnosis/treatment outcomes of diabetes.

Circulating MiRNAs of 'Asian Indian Phenotype' Identified in Subjects with Impaired Glucose Tolerance and Patients with Type 2 Diabetes.

Science.gov (United States)

Prabu, Paramasivam; Rome, Sophie; Sathishkumar, Chandrakumar; Aravind, Sankaramoorthy; Mahalingam, Balakumar; Shanthirani, Coimbatore Subramanian; Gastebois, Caroline; Villard, Audrey; Mohan, Viswanathan; Balasubramanyam, Muthuswamy

2015-01-01

Several omics technologies are underway worldwide with an aim to unravel the pathophysiology of a complex phenotype such as type 2 diabetes mellitus (T2DM). While recent studies imply a clinically relevant and potential biomarker role of circulatory miRNAs in the etiology of T2DM, there is lack of data on this aspect in Indians--an ethnic population characterized to represent 'Asian Indian phenotype' known to be more prone to develop T2DM and cardiovascular disease than Europeans. We performed global serum miRNA profiling and the validation of candidate miRNAs by qRT-PCR in a cohort of subjects comprised of normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and patients with T2DM. Our study revealed 4 differentially expressed miRNAs (miR-128, miR-130b-3p, miR-374a-5p, miR-423-5p) in subjects with IGT and T2DM patients compared to control subjects. They were positively or negatively correlated to cholesterol levels, HbA1C, HOMA-IR and fasting insulin. Interestingly, circulating level of miR-128 and miR-130b-3p were also altered in serum of diet-induced diabetic mice compared to control animals. Among the altered circulating miRNAs, miR-128 had never been described in previous studies/populations and appeared to be a 'New Lead' in Indians. It was positively correlated with cholesterol both in prediabetic subjects and in diet-induced diabetic mice, suggesting that its increased level might be associated with the development of dyslipedemia associated with T2DM. Our findings imply directionality towards biomarker potential of miRNAs in the prevention/diagnosis/treatment outcomes of diabetes.

Notes on some Indo-Pacific Pontoniinae III-IX descriptions of some new genera and species from the Western Indian Ocean and the South China Sea

NARCIS (Netherlands)

Bruce, A.J.

1967-01-01

CONTENTS Introduction................... 1 III. Anapontonia denticauda Bruce, 1966, from the western Indian Ocean . . 2 IV. Mesopontonia gorgoniophila gen. nov., sp. nov., from the South China Sea 13 V. Metapontonia fungiacola gen. nov., sp. nov., from the western Indian Ocean 23 VI. The genus

The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM among the Indian community in Chatsworth, South Africa

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Raidoo Deshandra M

2004-02-01

Full Text Available Abstract Background The purpose of this study was to determine, among the Indian community of Chatsworth, South Africa, the prevalence and utilisation patterns of complementary and alternative medicine (CAM, attitudes associated with CAM use and communication patterns of CAM users with their primary care doctors. Methods Face-to-face structured interviews were conducted in Chatsworth, a suburb of Durban in which South Africans of Indian origin predominantly reside. Participants were 200 randomly selected adult English-speaking Indian residents. Results The prevalence of CAM usage for period 2000/2001 was 38.5% (95% confidence interval 31.7% to 45.6%. Spiritual healing and herbal/natural medicines, including vitamins were the most common types of CAM used, accounting for 42.8% and 48.1% respectively of overall CAM usage. People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. The cost of CAM utilization over this 1-year period, incurred by 80.5% of users for the duration of therapy for their most troublesome condition was below R500 (approximately US$50. Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM. Greater than half (51.9% of CAM users did so either upon the advice of someone they knew, or after noticing a CAM advertisement in the local press. Seventy-nine percent of CAM users indicated that they had positive outcomes with their treatments. Fifty four percent of CAM users (excluding those using spiritual healing only failed to inform their doctors that they used CAM. The main reason given by half of this group was that informing their doctors did not seem necessary. Conclusion The prevalence of CAM in Chatsworth is similar to findings in other parts of the world. Although CAM was used to treat many different

Palmar Dermatoglyphs of South Mrican Indians

African Journals Online (AJOL)

1974-03-09

Mar 9, 1974 ... Interracial Comparisons. Indian males had a significantly higher (O,OOS>P>. 0,001) number of thenar features than had Black males, although, taken separately, the right and left hands were not significantly different. There was no such discrepancy between Indian and Coloured males, and there were no.

Traditional Indian Medicines Used for the Management of Diabetes Mellitus

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Syed Ibrahim Rizvi

2013-01-01

Full Text Available Plants have always been a source of drugs for humans since time immemorial. The Indian traditional system of medicine is replete with the use of plants for the management of diabetic conditions. According to the World Health Organization, up to 90% of population in developing countries use plants and its products as traditional medicine for primary health care. There are about 800 plants which have been reported to show antidiabetic potential. The present review is aimed at providing in-depth information about the antidiabetic potential and bioactive compounds present in Ficus religiosa, Pterocarpus marsupium, Gymnema sylvestre, Allium sativum, Eugenia jambolana, Momordica charantia, and Trigonella foenum-graecum. The review provides a starting point for future studies aimed at isolation, purification, and characterization of bioactive antidiabetic compounds present in these plants.

Trajectories of glycaemia, insulin sensitivity and insulin secretion in South Asian and white individuals before diagnosis of type 2 diabetes

DEFF Research Database (Denmark)

Hulman, Adam; Simmons, Rebecca K; Brunner, Eric J

2017-01-01

AIMS/HYPOTHESIS: South Asian individuals have reduced insulin sensitivity and increased risk of type 2 diabetes compared with white individuals. Temporal changes in glycaemic traits during middle age suggest that impaired insulin secretion is a particular feature of diabetes development among South...... Asians. We therefore aimed to examine ethnic differences in early changes in glucose metabolism prior to incident type 2 diabetes. METHODS: In a prospective British occupational cohort, subject to 5 yearly clinical examinations, we examined ethnic differences in trajectories of fasting plasma glucose...... (FPG), 2 h post-load plasma glucose (2hPG), fasting serum insulin (FSI), 2 h post-load serum insulin (2hSI), HOMA of insulin sensitivity (HOMA2-S) and secretion (HOMA2-B), and the Gutt insulin sensitivity index (ISI0,120) among 120 South Asian and 867 white participants who developed diabetes during...

Alpha-glucosidase inhibitor, acarbose, improves glycamic control and reduces body weight in type 2 diabetes: Findings on indian patients from the pooled data analysis

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Sanjay Kalra

2013-01-01

Full Text Available Alpha-glucosidase inhibitors are widely used especially in Asian countries as a treatment option for type 2 diabetes patients with high postprandial glycemia (PPG. The higher carbohydrate in the Indian diets lead to greater prandial glycemic excursion, increased glucosidase, and incretin activity in the gut and may need special therapeutic strategies to tackle these glucose peaks. This is the subgroup analysis of Indian subjects who participated in the GlucoVIP study that investigated the effectiveness and tolerability of acarbose as add-on or monotherapy in a range of patients with type 2 diabetes mellitus. A total of 1996 Indian patients were included in the effectiveness analysis. After 12.5 weeks (mean, the mean change in 2-hour PPG from baseline was −74.4 mg/dl, mean HbA1c decreased by -1.0%, and mean fasting blood glucose decreased by -37.9 mg/dl. The efficacy of acarbose was rated "very good" or "good" in 91.1% of patients, and tolerability as "very good" or "good" in 88.0% of patients. The results of this observational study suggest that acarbose was effective and well tolerated in the Indian patients with T2DM.

Shared and unique components of human population structure and genome-wide signals of positive selection in South Asia.

Science.gov (United States)

Metspalu, Mait; Romero, Irene Gallego; Yunusbayev, Bayazit; Chaubey, Gyaneshwer; Mallick, Chandana Basu; Hudjashov, Georgi; Nelis, Mari; Mägi, Reedik; Metspalu, Ene; Remm, Maido; Pitchappan, Ramasamy; Singh, Lalji; Thangaraj, Kumarasamy; Villems, Richard; Kivisild, Toomas

2011-12-09

South Asia harbors one of the highest levels genetic diversity in Eurasia, which could be interpreted as a result of its long-term large effective population size and of admixture during its complex demographic history. In contrast to Pakistani populations, populations of Indian origin have been underrepresented in previous genomic scans of positive selection and population structure. Here we report data for more than 600,000 SNP markers genotyped in 142 samples from 30 ethnic groups in India. Combining our results with other available genome-wide data, we show that Indian populations are characterized by two major ancestry components, one of which is spread at comparable frequency and haplotype diversity in populations of South and West Asia and the Caucasus. The second component is more restricted to South Asia and accounts for more than 50% of the ancestry in Indian populations. Haplotype diversity associated with these South Asian ancestry components is significantly higher than that of the components dominating the West Eurasian ancestry palette. Modeling of the observed haplotype diversities suggests that both Indian ancestry components are older than the purported Indo-Aryan invasion 3,500 YBP. Consistent with the results of pairwise genetic distances among world regions, Indians share more ancestry signals with West than with East Eurasians. However, compared to Pakistani populations, a higher proportion of their genes show regionally specific signals of high haplotype homozygosity. Among such candidates of positive selection in India are MSTN and DOK5, both of which have potential implications in lipid metabolism and the etiology of type 2 diabetes. Copyright © 2011 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Clinical, immunologic and insulin secretory characteristics of young black South African patients with diabetes: Hospital based single centre study.

Science.gov (United States)

Ekpebegh, C O; Longo-Mbenza, B

2013-03-01

To classify and characterize the clinical features of various diabetes classes among young black South Africans. Cross sectional study of 60 black patients with diabetes, all less than 30 years of age and attending Nelson Mandela Academic Hospital, Mthatha, South Africa. Diabetes was classified as Types 1A, 1B and 2 based on the anti-glutamic acid decarboxylase status and serum C-peptide response to intravenous injection of glucagon. Mean age was 19.6±4.8 years (n=60) with similar gender distribution. The mean duration of diabetes was 24.2±45.1 months. Type 1A was the class of diabetes in 55% (n=33/60) of patients. Type 1B and 2 accounted for 30% (n=18/60) and 15% (n=9/60) of patients respectively. Patients classified as Type 2 had higher waist circumference and higher prevalence of acanthosis nigricans than Types 1A and 1B groups. History of diabetes in a first degree relative and hypertension were found in similar proportions of patients with Types 1A, 1B and 2 diabetes. Five Type 1A diabetes patients had body mass index of 26.2-41kg/m(2) and this included two newly diagnosed patients with body mass index of 26.7kg/m(2) and 33.2kg/m(2). The majority of our young black South Africans with diabetes are of the Type 1A class. Acanthosis nigricans was not found in any patient with Type 1 A diabetes. A minority of Type 1 A diabetes patients were obese at initial diagnosis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The complete genome sequence of a south Indian isolate of Rice tungro spherical virus reveals evidence of genetic recombination between distinct isolates.

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Sailaja, B; Anjum, Najreen; Patil, Yogesh K; Agarwal, Surekha; Malathi, P; Krishnaveni, D; Balachandran, S M; Viraktamath, B C; Mangrauthia, Satendra K

2013-12-01

In this study, complete genome of a south Indian isolate of Rice tungro spherical virus (RTSV) from Andhra Pradesh (AP) was sequenced, and the predicted amino acid sequence was analysed. The RTSV RNA genome consists of 12,171 nt without the poly(A) tail, encoding a putative typical polyprotein of 3,470 amino acids. Furthermore, cleavage sites and sequence motifs of the polyprotein were predicted. Multiple alignment with other RTSV isolates showed a nucleotide sequence identity of 95% to east Indian isolates and 90% to Philippines isolates. A phylogenetic tree based on complete genome sequence showed that Indian isolates clustered together, while Vt6 and PhilA isolates of Philippines formed two separate clusters. Twelve recombination events were detected in RNA genome of RTSV using the Recombination Detection Program version 3. Recombination analysis suggested significant role of 5' end and central region of genome in virus evolution. Further, AP and Odisha isolates appeared as important RTSV isolates involved in diversification of this virus in India through recombination phenomenon. The new addition of complete genome of first south Indian isolate provided an opportunity to establish the molecular evolution of RTSV through recombination analysis and phylogenetic relationship.

ABCC8 R1420H Loss-of-Function Variant in a Southwest American Indian Community: Association With Increased Birth Weight and Doubled Risk of Type 2 Diabetes.

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Baier, Leslie J; Muller, Yunhua Li; Remedi, Maria Sara; Traurig, Michael; Piaggi, Paolo; Wiessner, Gregory; Huang, Ke; Stacy, Alyssa; Kobes, Sayuko; Krakoff, Jonathan; Bennett, Peter H; Nelson, Robert G; Knowler, William C; Hanson, Robert L; Nichols, Colin G; Bogardus, Clifton

2015-12-01

Missense variants in KCNJ11 and ABCC8, which encode the KIR6.2 and SUR1 subunits of the β-cell KATP channel, have previously been implicated in type 2 diabetes, neonatal diabetes, and hyperinsulinemic hypoglycemia of infancy (HHI). To determine whether variation in these genes affects risk for type 2 diabetes or increased birth weight as a consequence of fetal hyperinsulinemia in Pima Indians, missense and common noncoding variants were analyzed in individuals living in the Gila River Indian Community. A R1420H variant in SUR1 (ABCC8) was identified in 3.3% of the population (N = 7,710). R1420H carriers had higher mean birth weights and a twofold increased risk for type 2 diabetes with a 7-year earlier onset age despite being leaner than noncarriers. One individual homozygous for R1420H was identified; retrospective review of his medical records was consistent with HHI and a diagnosis of diabetes at age 3.5 years. In vitro studies showed that the R1420H substitution decreases KATP channel activity. Identification of this loss-of-function variant in ABCC8 with a carrier frequency of 3.3% affects clinical care as homozygous inheritance and potential HHI will occur in 1/3,600 births in this American Indian population. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Clinical characteristics of non-insulin-dependent diabetes mellitus among southwestern American Indian youths.

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Coddington, D A; Hisnanick, J J

2001-03-01

The clinical characteristics and presentation of non-insulin-dependent diabetes mellitus (NIDDM) among 22 youths, aged less than 20 years, of an American Indian tribe Tohono O'odham Nation in the southwestern United States were studied. Ten males and 12 females (7-20 years old) were identified with a 13.7-year mean age of onset of diabetes. Over 80% (18/22) of the patients were obese at diagnosis having a body mass index greater than the 95th percentile for their age and sex, and there was a strong family history of NIDDM; eight patients were born to mothers who had gestational diabetes, and 19 patients had at least one parent with NIDDM. At the time of diagnosis, plasma glucose levels ranged from 10.3 mmol/L to 33 mmol/L, with nearly 60% (13/22) of the patients having a glucose reading greater than 16.8 mmol/L. C-peptide levels were done on 10 patients, and these were in the normal to elevated range. Clinical management of the 22 patients varied. To control hyperglycaemia and symptoms, such as nocturia and polyuria, 14 patients were on oral hypoglycaemic medication, and five were on insulin therapy. Compliance with dietary management was very difficult for these patients as evidenced by the fact that only three patients were on dietary control for their diabetes. The cases described in this series demonstrate NIDDM in childhood and illustrate the importance of accurate classification of diabetes during childhood, particularly in children from populations at high risk for NIDDM.

Eruption age of permanent mandibular first molars and central incisors in the south Indian population

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Gupta Rakhi

2007-01-01

Full Text Available Objective: The existing eruption schedules for permanent and deciduous dentition are based on studies in the Western population. Since Indians differ from Westerners racially, genetically, and environmentally, these studies fail to provide relevant guidance on the eruption schedule in the Indian population. This study aims at determining the eruption pattern of permanent mandibular molars and central incisors in the south Indian population. Materials and Methods: 10,156 apparently healthy Indian children in the age-group of 6-9 years were examined with mouth mirror and probe under adequate illumination for the status of the eruption of the permanent mandibular first molar and permanent mandibular central incisor. Pearson′s Chi-square test with Yates′ continuity correction was used to calculate the P -value for comparison of proportion between girls and boys. The values obtained in our study were compared with the standard values. The Z-test with continuity correction was used to calculate the P -value. Results: As per our study, the permanent mandibular first molars and central incisors erupted one to two years later compared to the values reported in Westerners. The earlier eruption of the permanent mandibular first molars compared to the permanent mandibular central incisors, as well as the earlier eruption of both the teeth in girls compared to boys, were in accordance with the existing literature. Conclusion: The eruption age reported by us may form a standard reference for eruption age in Indians.

Knowledge and screening of head and neck cancer among American Indians in South Dakota.

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Dwojak, Sunshine; Deschler, Daniel; Sargent, Michele; Emerick, Kevin; Guadagnolo, B Ashleigh; Petereit, Daniel

2015-06-01

We established the level of awareness of risk factors and early symptoms of head and neck cancer among American Indians in South Dakota and determined whether head and neck cancer screening detected clinical findings in this population. We used the European About Face survey. We added questions about human papillomavirus, a risk factor for head and neck cancer, and demographics. Surveys were administered at 2 public events in 2011. Participants could partake in a head and neck cancer screening at the time of survey administration. Of the 205 American Indians who completed the survey, 114 participated in the screening. Mean head and neck cancer knowledge scores were 26 out of 44. Level of education was the only factor that predicted higher head and neck cancer knowledge (b = 0.90; P = .01). Nine (8%) people had positive head and neck cancer screening examination results. All abnormal clinical findings were in current or past smokers (P = .06). There are gaps in American Indian knowledge of head and neck cancer risk factors and symptoms. Community-based head and neck cancer screening in this population is feasible and may be a way to identify early abnormal clinical findings in smokers.

Population Growth and Sprawl on the Pine Ridge Indian Reservation, South Dakota

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Campbell, R. L.

2006-05-01

The most important impact on global land cover is human use and development. With the recent population growth occurring on the reservations in South Dakota, especially Pine Ridge Indian Reservation, the towns and agricultural areas of the reservation are undergoing a change. Although urban sprawl certainly is not a consideration on the reservations, the population explosion currently underway has seen a subsequent increase in rural sprawl. In this case, rural sprawl is defined as exponential population growth and geographic expansion of remote reservation communities. Using satellite imagery and software to render these images is a cost effective way to investigate this growth. Also, using remotely sensed data and a GIS (geographic information system) package can address different issues that concern people and communities in and around the Pine Ridge area. The objective of my project is to observe land use change on the Pine Ridge Indian reservation using Geographic Information Systems such as; ARCGis 9, ENVI, and Multispec, along with Landsat 4, 5, and 7 imagery over the past 20 years.

Evaluation of arch width variations among different skeletal patterns in South Indian population.

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Prasad, Mandava; Kannampallil, Senny Thomas; Talapaneni, Ashok Kumar; George, Suja Ani; Shetty, Sharath Kumar

2013-01-01

Anterior cranial base can be taken as a reference line (SN) to determine the steepness of mandibular plane. Subjects with high mandibular plane angle tend to have a long face and one with low MP-SN angle has a shorter face. This study was done to investigate if dental arch widths correlated with vertical facial types and if there are any differences in arch widths between untreated male and female adults in South Indian population. Lateral cephalogram and dental casts were obtained from 180 untreated South Indian adults (90 males and 90 females) above 18 year old with no cross bite, minimal crowding and spacing. The angle between the anterior cranial base and the mandibular plane was measured on lateral cephalogram of each patient. Dental casts were used to obtain comprehensive dental measurements including maxillary and mandibular inter canine, inter premolar and inter molar widths, as well as amount of crowding or spacing. The results showed that male arch widths were significantly larger than those of females (P population. The results obtained in our study when compared with studies done in other population groups showed that there is difference in inter arch widths according to ethnicity and race. It was concluded that the dental arch width is associated with gender, race and vertical facial morphology. Thus using individualized arch wires according to each patient's pre treatment arch form and width is suggested during orthodontic treatment.

Natural radionuclides in the South Indian foods and their annual dose

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Shanthi, G.; Thampi Thanka Kumaran, J.; Gnana Raj, G. Allan; Maniyan, C.G

2010-01-01

The study was carried out to evaluate the radioactivity concentration in the food crops grown in high-level natural radioactive area (HLNRA) in south west India. Food samples collected were analysed by means of a gamma spectroscopy and estimated annual dietary intakes of the radioisotopes 226 Ra, 228 Ra, 228 Th and 40 K. The annual intake of the food stuffs was estimated on the basis of their average annual consumption. Calculations were also made to determine the effective dose to an individual consuming such diets. The intakes of these radionuclides were calculated using the concentrations in south Indian foods and daily consumption rates of these foods. Daily intakes of these radionuclides were as follows: 226 Ra, 0.001-1.87; 228 Ra, 0.0023-1.26, 228 Th, 0.01-14.09 40 K, 0.46-49.39 Bq/day. The daily internal dose resulting from ingestion of radionuclides in food was 4.92 μSv/day and the annual dose was 1.79 mSv/yr. The radionuclides with highest consumption is 40 K.

Vulnerability of teleosts caught by the pelagic tuna longline fleets in South Atlantic and Western Indian Oceans

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Lucena-Frédou, Flávia; Kell, Laurie; Frédou, Thierry; Gaertner, Daniel; Potier, Michel; Bach, Pascal; Travassos, Paulo; Hazin, Fábio; Ménard, Frédéric

2017-06-01

Productivity and Susceptibility Analysis (PSA) is a methodology for evaluating the vulnerability of a stock based on its biological productivity and susceptibility to fishing. In this study, we evaluated the vulnerability of 60 stocks of tuna, billfishes and other teleosts caught by the tuna longline fleets operating in the South Atlantic and Indian Ocean using a semi-quantitative PSA. We (a) evaluated the vulnerability of the species in the study areas; (b) compared the vulnerability of target and non-target species and oceans; (c) analyzed the sensitivity of data entry; and (d) compared the results of the PSA to other fully quantitative assessment methods. Istiophoridae exhibited the highest scores for vulnerability. The top 10 species at risk were: Atlantic Istiophorus albicans; Indian Ocean Istiompax indica; Atlantic Makaira nigricans and Thunnus alalunga; Indian Ocean Xiphias gladius; Atlantic T. albacares, Gempylus serpens, Ranzania laevis and X. gladius; and Indian Ocean T. alalunga. All species considered at high risk were targeted or were commercialized bycatch, except for the Atlantic G. serpens and R. laevis which were discarded, and may be considered as a false positive. Those species and others at high risk should be prioritized for further assessment and/or data collection. Most species at moderate risk were bycatch species kept for sale. Conversely, species classified at low risk were mostly discarded. Overall, species at high risk were overfished and/or subjected to overfishing. Moreover, all species considered to be within extinction risk (Critically Endangered, Endangered and Vulnerable) were in the high-risk category. The good concordance between approaches corroborates the results of our analysis. PSA is not a replacement for traditional stock assessments, where a stock is assessed at regular intervals to provide management advice. It is of importance, however, where there is uncertainty about catches and life history parameters, since it can

The oral disposition index is a strong predictor of incident diabetes in Asian Indian prediabetic men.

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Ram, Jagannathan; Snehalatha, Chamukuttan; Selvam, Sundaram; Nanditha, Arun; Shetty, Ananth Samith; Godsland, Ian F; Johnston, Desmond G; Ramachandran, Ambady

2015-08-01

In this analysis, we sought to examine the prospective association of the disposition index (DIo) derived from oral glucose tolerance test with incident diabetes in Asian Indian men with impaired glucose tolerance (IGT). These post hoc analyses used data from a 2-year prospective study in primary prevention of diabetes using lifestyle intervention among 517 men with IGT. All the participants received standard lifestyle advice at baseline. The surrogate insulin sensitivity and insulin secretion measures were tested for their hyperbolic relationship. Predictive associations of various surrogate measures with incident diabetes were determined using receiver operating characteristic curves. The combination of total area under the curve of insulin-to-glucose ratio (AUCinsulin/glucose) and Matsuda's insulin sensitivity index was the best equation to depict DIo [β: -0.954 (95 % CI -1.015 to -0.893)] compared to other measures tested in this cohort. There was an inverse association between change in DIo at the final follow-up and development of incident diabetes. Among the surrogate insulin measures studied, DIo [AUC (0.717 (95 % CI 0.675-0.756))] as a composite measure was superior than other surrogate indices. Among the surrogate indices studied, DIo was the best measure associated with incident diabetes.

Evaluation of gestational diabetes mellitus risk in South Indian women based on MTHFR (C677T and FVL (G1691A mutations

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Imran Ali Khan

2015-05-01

Full Text Available We aimed to scrutinize the extent to which single amino acid substitutions in the MTHFR and FVL genes affect the risk of GDM in pregnant women of South Indian descendant. This case-control study was implemented once the ethical approval has been obtained. Overall 237 women were recruited in this study: 137 had been diagnosed with GDM and the remaining 100 women were used as normal controls or non-GDM. The diagnosis of GDM was confirmed with biochemical analysis i.e., GCT and OGTT tests. Five milliliters of peripheral blood was collected and used for biochemical and molecular analyses. DNA was isolated and genotyping for MTHFR (C677T and FVL (G1691A mutations was performed using PCR-RFLP. FVL (G1691A locus was not polymorphic in the investigated sample. There was no significant difference in the allele and genotype frequencies of C677T polymorphism between GDM and non-GDM women (p=0.8892

Glacial-interglacial vegetation dynamics in South Eastern Africa coupled to sea surface temperature variations in the Western Indian Ocean

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L. M. Dupont

2011-11-01

Full Text Available Glacial-interglacial fluctuations in the vegetation of South Africa might elucidate the climate system at the edge of the tropics between the Indian and Atlantic Oceans. However, vegetation records covering a full glacial cycle have only been published from the eastern South Atlantic. We present a pollen record of the marine core MD96-2048 retrieved by the Marion Dufresne from the Indian Ocean ∼120 km south of the Limpopo River mouth. The sedimentation at the site is slow and continuous. The upper 6 m (spanning the past 342 Ka have been analysed for pollen and spores at millennial resolution. The terrestrial pollen assemblages indicate that during interglacials, the vegetation of eastern South Africa and southern Mozambique largely consisted of evergreen and deciduous forests. During glacials open mountainous scrubland dominated. Montane forest with Podocarpus extended during humid periods was favoured by strong local insolation. Correlation with the sea surface temperature record of the same core indicates that the extension of mountainous scrubland primarily depends on sea surface temperatures of the Agulhas Current. Our record corroborates terrestrial evidence of the extension of open mountainous scrubland (including fynbos-like species of the high-altitude Grassland biome for the last glacial as well as for other glacial periods of the past 300 Ka.

Accuracy of Demirjian′s 8 teeth method for age prediction in South Indian children: A comparative study

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Rezwana Begum Mohammed

2015-01-01

Full Text Available Introduction: Demirjian′s method of tooth development is most commonly used to assess age in individuals with emerging teeth. However, its application on numerous populations has resulted in wide variations in age estimates and consequent suggestions for the method′s adaptation to the local sample. Original Demirjian′s method utilized seven mandibular teeth, to which recently third molar is added so that the method can be applied on a wider age group. Furthermore, the revised method developed regression formulas for assessing age. In Indians, as these formulas resulted in underestimation, India-specific regression formulas were developed recently. The purpose of this cross-sectional study was to evaluate the accuracy and applicability of original regression formulas (Chaillet and Demirjian 2004 and India-specific regression formulas (Acharya 2010 using Demirjian′s 8 teeth method in South Indian children of age groups 9-20 years. Methods: The present study consisted of 660 randomly selected subjects (330 males and 330 females were in the aged ranging from 9 to 20 years divided into 11 groups according to their age. Demirjian′s 8 teeth method was used for staging of teeth. Results: Demirjian′s method underestimated the dental age (DA by 1.66 years for boys and 1.55 years for girls and 1.61 years in total. Acharya′s method over estimated DA by 0.21 years for boys and 0.85 years for girls and 0.53 years in total. The absolute accuracy was better for Acharya′s method compared with Demirjian method. Conclusion: This study concluded that both the Demirjian and Indian regression formulas were reliable in assessing age making Demirjian′s 8 teeth method applicable for South Indians.

Comparative studies on Indian traditional nanomedicine Yashadha Bhasma and zinc oxide nanoparticles for anti-diabetic activity

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Durgalakshmi, D.; Ajay Rakkesh, R.; Bhargavi Ram, T.; Balakumar, S.

2017-07-01

Diabetes mellitus is the most common endocrine disorder due to carbohydrate metabolism. Also, zinc and its supplements have been used in Indian traditional medicines for treating urinary tract infections. In this work, an attempt has been made to compare the properties of ‘Yashadha Bhasma’ a traditional ayurvedic ZnO supplement for diabetic treatment with the laboratory-synthesized ZnO nanoparticles. The nano-sized ZnO particles are synthesized using co-precipitation method and calcined at 400 °C for further purification. Confirmation of ZnO and presence of Ca and K elements additional to Zn in Yashadha Bhasma is confirmed from XPS. The morphology of ZnO is found to be spherical with average diameter of 15 nm. TEM results show that ZnO rods of Yashadha Bhasma are porous and non-uniform. Glucose degradation studies revealed good performance with ZnO nanoparticles with 80% degradation occurring within 15 min itself. Antibacterial studies also performed well establishing efficacy of ZnO nanoparticles against both gram-positive and gram-negative bacterial strains, thereby establishing suitable material for treating diabetes mellitus and also curing bacterial wound infections arising due to diabetes mellitus.

Studies on insulin secretion and insulin resistance in non-insulin-dependent diabetes in young Indians

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Naidoo, C.

1986-01-01

Patients with Non-insulin-dependent diabetes mellitus (NIDDM) have defects in insulin secretion and insulin action. In the discrete genetic syndrome of NIDDY (non-insulin-dependent diabetes in the young), the situation is less clear and these aspects is the subject of this thesis. This study included Indian pasients with three generation transmission of NIDDM via one parent. The insulin and C-peptide responses to oral and intravenous glucose in patients with NIDDY were studied. The insulin and glucose responses to non-glucose secretogogues glucagon, tolbutamide and arginine, in NIDDY were also investigated. The following aspects with regard to insulin resistance in NIDDY were examined: glucose and free fatty acid response to intravenous insulin administration, insulin binding to circulating erythrocytes and monocytes, 125 I-insulin binding to the solubilized erythrocyte membrane receptor and 125 I-insulin binding to fibroblasts in culture

Studies on insulin secretion and insulin resistance in non-insulin-dependent diabetes in young Indians

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Naidoo, C

1986-01-01

Patients with Non-insulin-dependent diabetes mellitus (NIDDM) have defects in insulin secretion and insulin action. In the discrete genetic syndrome of NIDDY (non-insulin-dependent diabetes in the young), the situation is less clear and these aspects is the subject of this thesis. This study included Indian pasients with three generation transmission of NIDDM via one parent. The insulin and C-peptide responses to oral and intravenous glucose in patients with NIDDY were studied. The insulin and glucose responses to non-glucose secretogogues glucagon, tolbutamide and arginine, in NIDDY were also investigated. The following aspects with regard to insulin resistance in NIDDY were examined: glucose and free fatty acid response to intravenous insulin administration, insulin binding to circulating erythrocytes and monocytes, /sup 125/I-insulin binding to the solubilized erythrocyte membrane receptor and /sup 125/I-insulin binding to fibroblasts in culture.

Effect of severe obesity in childhood and adolescence on risk of type 2 diabetes in youth and early adulthood in an American Indian population.

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Tanamas, Stephanie K; Reddy, Sanil P; Chambers, Melissa A; Clark, Elena J; Dunnigan, Diana L; Hanson, Robert L; Nelson, Robert G; Knowler, William C; Sinha, Madhumita

2017-12-28

The risk of early-onset type 2 diabetes associated with the severity of obesity in youth is not well understood. This study aims to determine metabolic alterations and type 2 diabetes risk among American Indian children who are obese or severely obese. Incidence rates of diabetes before 20 years (youth-onset) and 45 years were computed in 2728 children who were from 5 to Obesity was defined as age-sex-adjusted body mass index (BMI) ≥95th percentile, and its severity was quantified as the percentage of the 95th percentile (%BMI p95 ). In the younger cohort, 0.9% of those non-obese and 2.9% of those with 100% to obese and 9.8% of those with 100% to youth-onset diabetes was 3.8 and 4.9/1000 person-years in the child and adolescent cohorts, respectively, and before the age of 45 was 12.3 and 16.8/1000 person-years, respectively. Incidence rates of youth-onset diabetes in those with the most severe obesity (≥140%BMI p95 ) were 2.3 to 5.1 times as high as in those with the least severe obesity (100 to obesity in an American Indian population is a major driver of type 2 diabetes developing in adolescents and young adults. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

An exploration of culture, diabetes, and nursing in the South Asian community: a metasynthesis of qualitative studies.

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Fleming, Elizabeth; Gillibrand, Warren

2009-04-01

South Asian people are often perceived as a homogenous group whose culture is prescriptive and constraining. A metasynthesis of how culture influences diabetes self-management in the context of a South Asian population was undertaken. Theory explication was used to deconstruct and reconceptualize the findings of the studies. Eleven publications reported themes of health beliefs, individuality, context, and shared experiences. The results indicate that culture does not influence diabetes self-management in a rigid and prescriptive way; instead, individuals negotiate and interpret culture in a shifting and diverse context. An individualized approach to delivering culturally appropriate nursing care should be taken.

Nutritional Intake in Low Body Mass Index (BMI Males with Type 1 Diabetes and Fibrocalcific Pancreatic Diabetes: What are the Unmet Needs? A Cross-Sectional Study from a South Indian Tertiary Care Hospital

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Mini Joseph

2017-10-01

Full Text Available Introduction: There is paucity of data on the nutritional intake in low Body Mass Index (BMI Asian Indians with diabetes. Aim: To study the difference in the nutrient intake pattern in low-BMI Type 1 Diabetes Mellitus (T1DM and Fibrocalcific Pancreatic Diabetes (FCPD patients. Materials and Methods: This cross-sectional study consisted of T1DM (n=40 and FCPD (n=20 male patients with similar BMI. Nutritional data was collected using the 24 hour recall method and food diaries. Fasting blood samples were analysed for lipid profile, serum creatinine, glycosylated haemoglobin, albumin, calcium and vitamin D. Stool samples were analysed for pancreatic elastase. Percentage analysis, Independent sample t-test and Pearson coefficient correlation were used to analyse the data. A p-value<0.05 was considered as statistically significant. Results: The FCPD patients, on biochemical analysis, had significantly lower vitamin D levels compared to the T1DM group (p=0.035. However, haemoglobin, triglycerides, low density lipoproteins, creatinine, albumin and calcium were similar between the groups. In the nutrient data, FCPD patients had a significant higher intake of fat (p=0.039, fibre (p<0.001, calcium (p=0.047, phosphorous (p=0.035, and niacin (p=0.001 and calories from fat (p=0.047. The T1DM group had a significantly higher intake of thiamine (p=0.047 and carbohydrates (p=0.014. Conclusion: T1DM and FCPD groups have similar dietary pattern deficit in fibre, calories, macronutrients and micronutrients. Malabsorption and poor glycaemic control in FCPD patients can be attributed to a higher dietary fat intake. A balanced diet can ensure better glycaemic control.

Nutritional factors associated with antenatal depressive symptoms in the early stage of pregnancy among urban South Indian women.

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Lukose, Ammu; Ramthal, Asha; Thomas, Tinku; Bosch, Ronald; Kurpad, Anura V; Duggan, Christopher; Srinivasan, Krishnamachari

2014-01-01

Many women of reproductive age from developing countries have poor nutritional status, and the prevalence of depression during pregnancy is high. The objective of the present study was to assess the prevalence of antenatal depressive symptoms in early pregnancy, and to identify the demographic and nutritional factors associated with these symptoms in a sample of urban South Indian pregnant women. This cross-sectional study was the baseline assessment of a prospective randomized controlled trial of vitamin B12 supplementation in urban pregnant south Indian women between the ages of 18 and 40 years ( www.clinicaltrials.gov : NCT00641862). 365 women in their first trimester of pregnancy were screened for depressive symptoms at an urban clinic in Karnataka, South India, using the Kessler Psychological Distress Scale (K-10). Nutritional, clinical and biochemical factors were also assessed. Mean (SD) age of the cohort was 22.6 (3.7) years and mean (SD) BMI was 20.4 (3.3) kg/m(2). 121 (33 %) of the women in the 1st trimester had symptoms consistent with depression (K-10 score >6). In multivariate log binomial regression analysis, presence of antenatal depressive symptoms in the first trimester were positively associated with vomiting, prevalence ratio (PR) = 1.54 (95 % CI 1.10, 2.16) and negatively with anemia, PR = 0.67 (95 % CI 0.47, 0.96). Nutrient intakes, serum vitamin B12, methylmalonic acid, homocysteine and red cell folate levels were not associated with measures of depression. Antenatal depressive symptoms in early pregnancy are highly prevalent in urban Indian women and are more common in women with vomiting and without anemia. In this cross-sectional data, blood concentrations of vitamin B12 and folate were not associated with depressive symptoms. The relationship between nutritional status and depressive symptoms may require larger and longitudinal studies.

Association of systemic risk factors with the severity of retinal hard exudates in a north Indian population with type 2 diabetes

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Sachdev N

2010-01-01

Full Text Available Background: The various risk factors for diabetic retinopathy and its spectrum are still poorly understood in the Indian population. Aims: To study the association of various systemic risk factors with retinal hard exudates in type 2 diabetic north Indian patients and to measure the incidence of dyslipidemia in them. Settings and Design: A tertiary-hospital-based cross-sectional study. Materials and Methods: An observational case-study which included 180 type 2 diabetic patients (180 eyes of nonproliferative diabetic retinopathy (NPDR with clinically significant macular edema (CSME. In these patients the retinal hard exudates were graded on a central 500 fundus picture using modified Airlie House classification and divided into three groups of absent or minimal hard exudates (Group 1, hard exudates present (Group 2 and prominent hard exudates (Group 3. Their association with various risk factors, namely the age of onset of diabetes and its duration, gender, insulin therapy, and various systemic parameters like hypertension, blood hemoglobin, glycosylated hemoglobin, serum (s. creatinine levels, 24-h proteinuria and complete lipid profile including total s. cholesterol, low-density lipoprotein cholesterol (LDL, high-density lipoprotein cholesterol (HDL, very low-density lipoprotein cholesterol (VLDL and s. triglyceride (TG was studied. The incidence of dyslipidemia was also calculated among these groups of patients. Statistical Analysis: ANOVA test, linear regression analysis and Spearman′s correlation test. Results: On univariate analysis, the retinal hard exudates were significantly associated with s. creatinine (P=0.016, systolic blood pressure (P=0.014, s. cholesterol (P < 0.001, s. LDL (P=0.008 and s. TG (P=0.013 levels. While on linear regression analysis, s. cholesterol (P < 0.001 and s. LDL cholesterol (P=0.028 were found to be independent risk factors affecting the density of retinal hard exudates. On Spearman′s correlation test, the

Perceptions and Concerns Regarding Diabetes Mellitus During Pregnancy Among American Indian Women.

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Carson, L D; Henderson, J Neil; King, Kama; Kleszynski, Keith; Thompson, David M; Mayer, Patricia

2014-12-01

Diabetes among American Indian (AI) people is a. condition that creates excessive morbidity and mortality and is a significant health disparity. This research delineated culturally constructed models of diabetes mellitus (DM) among 97 pregnant women in 2 large AI Nations to Oklahoma. Analysis of data revealed intense anxiety, fear, and dread related to DM during pregnancy. The sample was stratified by DM status: (a) absence of DM ( n = 66), (b) DM prior to pregnancy ( n = 4), and (c) gestational ( n = 27). Structured and semistructured interviews elicited patient culturally based explanatory models (EMs) of etiology, course, and treatment. The research incorporated an integrated phenomenologic and ethnographic approach and yielded both quantitative and qualitative data. General findings comprised the following main categories of patients' concerns regarding DM as an illness: (a) care-seeking behaviors, (b) medical management, (c) adherence and self-management, (d) complications, and (e) the conceptual sense of DM as a "severe" and feared condition. Many findings varied according to acculturation status, but all included significant fear and anxiety surrounding (a) the health and well-being of the unborn child, (b) the use of insulin injections, (c) blindness, (d) amputation, and (e) death, but with (f) a paradoxically lowered anxiety level about diabetes severity overall, while at the same time expressing extreme dread of specific outcomes. The latter finding is considered consistent with the presence of chronic conditions that can usually be managed, yet still having risk if severe.

Prevalence of cataract surgery and visual outcomes in Indian immigrants in Singapore: the Singapore Indian eye study.

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Gupta, Preeti; Zheng, Yingfeng; Ting, Tay Wan; Lamoureux, Ecosse L; Cheng, Ching-Yu; Wong, Tien-Yin

2013-01-01

To determine the prevalence of cataract surgery and factors associated with post-surgical visual outcomes in migrant Indians living in Singapore. We conducted a population-based study in 3,400 Indian immigrants residing in Singapore-the Singapore Indian Eye Study (SINDI). All participants underwent comprehensive medical eye examination and a standardized interview. Post-operative visual impairment (VI) was defined as best-corrected or presenting visual acuity (BCVA or PVA) of 20/60 or worse. The age- and gender-standardized prevalence of cataract surgery was 9.7% (95% confidence interval [CI]: 8.9%, 10.7%) in Singapore resident Indians. Post-operative VI defined by BCVA occurred in 10.9% eyes (87/795). The main causes of post-operative VI were diabetic retinopathy (20.7%), posterior capsular opacification (18.4%), and age-related macular degeneration (12.6%). Undercorrected refractive error doubled the prevalence of post-operative VI when PVA was used. The rate of cataract surgery is about 10% in Indian residents in Singapore. Socioeconomic variables and migration had no significant impact on the prevalence of cataract surgery. Diabetic retinopathy was a major cause of post-operative VI in migrant Indians living in Singapore. Uncorrected postoperative refractive error remains an efficient way to improve vision.

Improvement in diet habits, independent of physical activity helps to reduce incident diabetes among prediabetic Asian Indian men.

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Ram, Jagannathan; Selvam, Sundaram; Snehalatha, Chamukuttan; Nanditha, Arun; Simon, Mary; Shetty, Ananth Samith; Godsland, Ian F; Johnston, Desmond G; Ramachandran, Ambady

2014-12-01

To assess the beneficial effects of the components of lifestyle intervention in reducing incidence of diabetes in Asian Indian men with impaired glucose tolerance (IGT) in India. This analysis was based on a 2 year prospective, randomized controlled primary prevention trial in a cohort of Asian Indian men with IGT (n=537) (Clinical Trial No: NCT00819455). Intervention and control groups were given standard care advice at baseline. Additionally, the intervention group received frequent, mobile phone based text message reminders on healthy lifestyle principles. Dietary intake and physical activity habits were recorded by validated questionnaires. The lifestyle goals were: reductions in consumption of carbohydrates, oil, portion size and body mass index of at least 1 unit (1 kg/m(2)) from baseline and maintenance of good physical activity. The association between diabetes and lifestyle goals achieved was assessed using multiple logistic regression analyses. Changes in insulin sensitivity (Matsuda's insulin sensitivity index) and oral disposition index during the follow-up were assessed. At the end of the study, 123 (23.8%) participants developed diabetes. The mean lifestyle score was higher in the intervention group compared with control (2.59 ± 1.13 vs. 2.28 ± 1.17; P=0.002). Among the 5 lifestyle variables, significant improvements in the 3 dietary goal were seen with intervention. Concomitant improvement in insulin sensitivity and oral disposition index was noted. Higher lifestyle score was associated with lower risk of developing diabetes (odds ratio: 0.54 [95% CI: 0.44-0.70]; P<0.0001). Beneficial effects of intervention were associated with increased compliance to lifestyle goals. The plausible mechanism is through improvement in insulin sensitivity and beta cell preservation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Natural radionuclides in the South Indian foods and their annual dose

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Shanthi, G., E-mail: shanthidickson@gmail.co [Department of Physics, Women' s Christian College, Nagercoil 629001, Tamil Nadu (India); Thampi Thanka Kumaran, J. [Department of Physics, NM Christian College, Marthandam 629165, Tamil Nadu (India); Gnana Raj, G. Allan [Department of Chemistry and Research Centre, Scott Christian College, Nagercoil 629003, Tamil Nadu (India); Maniyan, C.G [Health Physics Unit, Indian Rare Earths, Manavalakurichi 629252, Tamil Nadu (India)

2010-07-21

The study was carried out to evaluate the radioactivity concentration in the food crops grown in high-level natural radioactive area (HLNRA) in south west India. Food samples collected were analysed by means of a gamma spectroscopy and estimated annual dietary intakes of the radioisotopes {sup 226}Ra, {sup 228}Ra, {sup 228}Th and {sup 40}K. The annual intake of the food stuffs was estimated on the basis of their average annual consumption. Calculations were also made to determine the effective dose to an individual consuming such diets. The intakes of these radionuclides were calculated using the concentrations in south Indian foods and daily consumption rates of these foods. Daily intakes of these radionuclides were as follows: {sup 226}Ra, 0.001-1.87; {sup 228}Ra, 0.0023-1.26, {sup 228}Th, 0.01-14.09 {sup 40}K, 0.46-49.39 Bq/day. The daily internal dose resulting from ingestion of radionuclides in food was 4.92 {mu}Sv/day and the annual dose was 1.79 mSv/yr. The radionuclides with highest consumption is {sup 40}K.

Community reintegration in rehabilitated South Indian persons with spinal cord injury.

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Samuelkamaleshkumar, Selvaraj; Radhika, Somasundaram; Cherian, Binu; Elango, Aarumugam; Winrose, Windsor; Suhany, Baby T; Prakash, M Henry

2010-07-01

To explore community reintegration in rehabilitated South Indian persons with spinal cord injury (SCI) and to compare the level of community reintegration based on demographic variables. Survey. Rehabilitation center of a tertiary care university teaching hospital. Community-dwelling persons with SCI (N=104). Not applicable. Craig Handicap Assessment and Reporting Technique (CHART). The mean scores for each CHART domain were physical independence 98+/-5, social Integration 96+/-11, cognitive independence 92+/-17, occupation 70+/-34, mobility 65+/-18, and economic self sufficiency 53+/-40. Demographic variables showed no statistically significant difference with any of the CHART domains except for age and mobility, level of education, and social integration. Persons with SCI in rural South India who have completed comprehensive, mostly self-financed, rehabilitation with an emphasis on achieving functional ambulation, family support, and self-employment and who attend a regular annual follow-up show a high level of community reintegration in physical independence, social integration, and cognitive independence. CHART scores in the domains of occupation, mobility, and economic self-sufficiency showed lower levels of community reintegration. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Illness beliefs and the sociocultural context of diabetes self-management in British South Asians: a mixed methods study.

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Patel, Neesha R; Chew-Graham, Carolyn; Bundy, Christine; Kennedy, Anne; Blickem, Christian; Reeves, David

2015-05-10

British South Asians have a higher incidence of diabetes and poorer health outcomes compared to the general UK population. Beliefs about diabetes are known to play an important role in self-management, yet little is known about the sociocultural context in shaping beliefs. This study aimed to explore the influence of sociocultural context on illness beliefs and diabetes self-management in British South Asians. A mixed methods approach was used. 67 participants recruited using random and purposive sampling, completed a questionnaire measuring illness beliefs, fatalism, health outcomes and demographics; 37 participants completed a social network survey interview and semi-structured interviews. Results were analysed using SPSS and thematic analysis. Quantitative data found certain social network characteristics (emotional and illness work) were related to perceived concern, emotional distress and health outcomes (p work remained a significant predictor of perceived concern and emotional distress related to diabetes (p culturally appropriate interventions to modify beliefs and support self-management in this population.

Understanding adherence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis

OpenAIRE

Kumar, Kanta; Greenfield, Sheila; Raza, Karim; Gill, Paramjit; Stack, Rebecca

2016-01-01

Background: Prevalence of diabetes and cardiovascular (CVD) disease amongst UK South Asians is higher than in\\ud the general population. Non-adherence to medicines may lead to poor clinical outcomes for South Asian patients\\ud with diabetes and CVD. To understand the decision making processes associated with taking medicines, a qualitative systematic meta-synthesis exploring medicine taking behaviours, and beliefs was undertaken.\\ud \\ud Methods: Four databases (Medline, Embase, Science Citati...

Challenges in Type 1 diabetes management in South East Asia: Descriptive situational assessment

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Jothydev Kesavadev

2014-01-01

Full Text Available Treatment of type 1 diabetes is a challenging issue in South East Asia. Unlike in the developed countries, patients have to procure insulin, glucometer strips and other treatment facilities from their own pockets. Coupled with poor resources are the difficulties with diagnosis, insulin initiation, insulin storage, marital and emotional challenges. Being a disease affecting only a minority of people, it is largely ignored by the governments and policy makers. Comprehensive diagnostic, treatment and team based educational facilities are available only in the speciality diabetes centers in the private sector whereas majority of the subjects with type 1 diabetes are from a poor socio-economic background. Unlike in the Western world, being known as a diabetes patient is a social sigma and poses huge emotional burden living with the disease and getting married. Even with best of the resources, long-term treatment of type 1 diabetes still remains a huge challenge across the globe. In this review, authors from India, Pakistan, Nepal, Sri Lanka, Myanmar and Bangladesh detail the country-specific challenges and discuss the possible solutions.

Challenges in Type 1 diabetes management in South East Asia: Descriptive situational assessment.

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Kesavadev, Jothydev; Sadikot, Shaukat M; Saboo, Banshi; Shrestha, Dina; Jawad, Fatema; Azad, Kishwar; Wijesuriya, Mahendra Arunashanthi; Latt, Tint Swe; Kalra, Sanjay

2014-09-01

Treatment of type 1 diabetes is a challenging issue in South East Asia. Unlike in the developed countries, patients have to procure insulin, glucometer strips and other treatment facilities from their own pockets. Coupled with poor resources are the difficulties with diagnosis, insulin initiation, insulin storage, marital and emotional challenges. Being a disease affecting only a minority of people, it is largely ignored by the governments and policy makers. Comprehensive diagnostic, treatment and team based educational facilities are available only in the speciality diabetes centers in the private sector whereas majority of the subjects with type 1 diabetes are from a poor socio-economic background. Unlike in the Western world, being known as a diabetes patient is a social sigma and poses huge emotional burden living with the disease and getting married. Even with best of the resources, long-term treatment of type 1 diabetes still remains a huge challenge across the globe. In this review, authors from India, Pakistan, Nepal, Sri Lanka, Myanmar and Bangladesh detail the country-specific challenges and discuss the possible solutions.

Temperature Data From AUSTRALIA STAR and Other Platforms From Indian Ocean and South Pacific Ocean From 19860929 to 19890106 (NODC Accession 8900196)

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National Oceanic and Atmospheric Administration, Department of Commerce — Temperature data from Australia Star and other ships from Indian Ocean and South Pacific Ocean from September 29, 1986 to January 6, 1989. The data were collected by...

Angiotensin-converting enzyme gene insertion/deletion polymorphism studies in Asian Indian pregnant women biochemically identifies gestational diabetes mellitus.

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Khan, Imran A; Jahan, Parveen; Hasan, Qurratulain; Rao, Pragna

2014-12-01

Gestational diabetes mellitus (GDM) is defined as glucose intolerance first recognized during pregnancy. Insertion/deletion (I/D) polymorphism of a 287 bp Alu repetitive sequence in intron 16 of the angiotensin-converting enzyme (ACE) gene has been widely investigated in Asian Indian populations with different ethnic origins. The present study examined possible association between I/D polymorphism of the ACE gene and GDM in Asian Indian pregnant women. A total of 200 pregnant women (100 GDM and 100 non-GDM) were recruited in this study and I/D polymorphism of a 287 bp Alu1 element inside intron 16 of the ACE gene was examined by polymerase chain reaction (PCR)-based gel electrophoresis. The distribution of the variants like II, ID, and DD genotypes of ACE gene showed differences between normal GDM versus non-GDM subjects, and the frequency of the ID+ DD Vs II genotype was significant (p=0.0002) in the GDM group. ACE gene polymorphism was associated with GDM in Asian Indian pregnant women. © The Author(s) 2013.

Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages.

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Mercy Manyema

Full Text Available Type 2 diabetes poses an increasing public health burden in South Africa (SA with obesity as the main driver of the epidemic. Consumption of sugar sweetened beverages (SSBs is linked to weight gain and reducing SSB consumption may significantly impact the prevalence of obesity and related diseases. We estimated the effect of a 20% SSB tax on the burden of diabetes in SA.We constructed a life table-based model in Microsoft Excel (2010. Consumption data from the 2012 SA National Health and Nutrition Examination Survey, previously published own- and cross-price elasticities of SSBs and energy balance equations were used to estimate changes in daily energy intake and its projected impact on BMI arising from increased SSB prices. Diabetes relative risk and prevalent years lived with disability estimates from the Global Burden of Disease Study and modelled disease epidemiology estimates from a previous study were used to estimate the effect of the BMI changes on diabetes burden. Diabetes cost estimates were obtained from the South African Council for Medical Schemes. Over 20 years, a 20% SSB tax could reduce diabetes incident cases by 106 000 in women (95% uncertainty interval (UI 70 000-142 000 and by 54 000 in men (95% UI: 33 000-80 000; and prevalence in all adults by 4.0% (95% UI: 2.7%-5.3%. Cumulatively over twenty years, approximately 21 000 (95% UI: 14 000-29 000 adult T2DM-related deaths, 374 000 DALYs attributed to T2DM (95% UI: 299 000-463 000 and over ZAR10 billion T2DM healthcare costs (95% UI: ZAR6.8-14.0 billion equivalent to USD860 million (95% UI: USD570 million-USD1.2 billion may be averted.Fiscal policy on SSBs has the potential to mitigate the diabetes epidemic in South Africa and contribute to the National Department of Health goals stated in the National NCD strategic plan.

Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages.

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Manyema, Mercy; Veerman, J Lennert; Chola, Lumbwe; Tugendhaft, Aviva; Labadarios, Demetre; Hofman, Karen

2015-01-01

Type 2 diabetes poses an increasing public health burden in South Africa (SA) with obesity as the main driver of the epidemic. Consumption of sugar sweetened beverages (SSBs) is linked to weight gain and reducing SSB consumption may significantly impact the prevalence of obesity and related diseases. We estimated the effect of a 20% SSB tax on the burden of diabetes in SA. We constructed a life table-based model in Microsoft Excel (2010). Consumption data from the 2012 SA National Health and Nutrition Examination Survey, previously published own- and cross-price elasticities of SSBs and energy balance equations were used to estimate changes in daily energy intake and its projected impact on BMI arising from increased SSB prices. Diabetes relative risk and prevalent years lived with disability estimates from the Global Burden of Disease Study and modelled disease epidemiology estimates from a previous study were used to estimate the effect of the BMI changes on diabetes burden. Diabetes cost estimates were obtained from the South African Council for Medical Schemes. Over 20 years, a 20% SSB tax could reduce diabetes incident cases by 106 000 in women (95% uncertainty interval (UI) 70 000-142 000) and by 54 000 in men (95% UI: 33 000-80 000); and prevalence in all adults by 4.0% (95% UI: 2.7%-5.3%). Cumulatively over twenty years, approximately 21 000 (95% UI: 14 000-29 000) adult T2DM-related deaths, 374 000 DALYs attributed to T2DM (95% UI: 299 000-463 000) and over ZAR10 billion T2DM healthcare costs (95% UI: ZAR6.8-14.0 billion) equivalent to USD860 million (95% UI: USD570 million-USD1.2 billion) may be averted. Fiscal policy on SSBs has the potential to mitigate the diabetes epidemic in South Africa and contribute to the National Department of Health goals stated in the National NCD strategic plan.

PATTERNS OF INTERNET USE AND THEIR IMPLICATIONS IN INDIAN MEDICAL STUDENTS: A STUDY FROM A SOUTH INDIAN MEDICAL COLLEGE

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Ravi Kishore

2016-05-01

Full Text Available BACKGROUND Internet has become a platform for recent advances, innovative learning methods and self-assessment. Medical students spend significant time using Internet for academic and non-academic purposes. There is a dearth of clear evidence regarding patterns of internet use among Indian Medical students. An internet usage patterns study in First Year Medical students would help identify the necessity to train students in Internet access in the initial phase of Medical course. AIM To assess the Internet usage patterns in First Year Indian Medical Students. MATERIALS AND METHODS A cross-sectional study in which 132 students studying in First Year undergraduate medical course at MVJ Medical College and Research Hospital, Bangalore, a cosmopolitan city in South India, participated. Data related to internet use was captured using a pretested questionnaire. Statistical analysis was performed using Microsoft Excel version 2007. RESULTS 70% of students used internet for academic and non-academic purposes. Slow internet speed (31% and lack of time (23% were most common amongst impediments to internet use. Majority of students (57% used internet for greater than 7 hours per week. Understanding a topic better (62% seems to be most important motive for academic use of internet. 36% of students did not use any academic website. CONCLUSIONS First Year Indian Medical students spent significant amounts of time using internet for multiple purposes. There is a lack of awareness regarding academic websites and online animations among significant portion of students. Students in our study may be guided appropriately by Internet training sessions at the beginning of the Medical course to enable the best use of internet for academic purpose.

Long-term efficacy of liraglutide in Indian patients with Type 2 diabetes in a real-world setting

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Parjeet Kaur

2016-01-01

Full Text Available Background: Long-term efficacy of liraglutide, a glucagon-like peptide-1 analog, on body weight and glycemic control has not been studied in Indian Type 2 diabetes mellitus (T2DM subjects. Aim: To evaluate the effect of liraglutide on glycemic control and body weight for 1 year in Indian T2DM patients. Methods: Liraglutide was prescribed to 96 obese patients with T2DM and followed up for 1 year. Clinical parameters were measured at baseline and 3, 6, 9, and 12 months. Dosage of liraglutide and other medications was adjusted according to clinical judgment. Results: 1 year data were available for 74 patients. Mean age was 50.9 ± 9.6 years. Mean duration of diabetes was 11.6 ± 6.3 years. Glycosylated hemoglobin (HbA1c significantly decreased from 8.9 ± 1.3% at baseline to 7.4 ± 1.2% at 1 year. Body weight significantly declined from 98.9 ± 16.0 kg at baseline to 93.8 ± 15.0 kg at 1 year. After an initial decline, subset of patients had an increase in mean HbA1c (n = 30/74 and mean body weight (n = 33/74 after 6 months of liraglutide initiation. Baseline HbA1c and baseline body weight were positively associated with a reduction of HbA1c and body weight at 1 year, respectively. No major side effects occurred. Conclusion: Liraglutide treatment resulted in a significant and sustained reduction in HbA1c and body weight over 1 year in Indian T2DM patients. Magnitude of reduction of HbA1c and body weight at 1 year was positively associated with baseline HbA1c and baseline weight, respectively.

Morphology of Sigmoid Colon in South Indian Population: A Cadaveric Study.

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Michael, Stelin Agnes; Rabi, Suganthy

2015-08-01

Sigmoid volvulus is a common etiological factor in acute large bowel obstruction. The increased length of sigmoid colon is attributed as one of the causes of sigmoid volvulus. The aim of this study was to find the morphology of sigmoid colon in South Indian population using cadavers. The present study was performed with 31 cadavers used for teaching purpose. The sigmoid colon was classified into classical, long-narrow and long- broad types by their disposition in the abdominal cavity. The sigmoid loop's relation to pelvic brim was also observed and grouped as pelvic and suprapelvic in position. The length of sigmoid colon along the mesenteric and antimesenteric border, height and width of sigmoid mesocolon in relation to the pelvic brim and the root of mesentery were measured in the study. The study showed that the majority of the sigmoid colons fell into the classical type (47.6%). The sigmoid colon in pelvic position was significantly more prevalent. The mean length of sigmoid colon was 15.2 ± 4.4cm and 19.2 ± 6cm considering the pelvic brim and root of mesentery as reference points of measurement respectively. The mean length along antimesenteric border was 22.3 ± 7.9cm and 25 ± 8.7cm along the same reference points. The mean length of mesocolon height was 6.5 ± 3cm with reference to pelvic brim and 7.3 ± 3cm with reference to root of Sigmoid mesocolon respectively. The mean width of mesocolon was 7.4 ± 3cm (pelvic brim) and 8 ± 2cm (root of Sigmoid mesocolon) There was a positive correlation of sigmoid colon length with the height of the mesocolon. The gender analysis showed that males had statistically significant longer sigmoid colon and mesocolon. This study documents that the South Indian population has a more classical type of sigmoid colon and that the anatomical dimensions of sigmoid colon and its mesocolon is significantly longer in males.

Insulin secretion and action in North Indian women during pregnancy.

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Arora, G P; Almgren, P; Thaman, R G; Pal, A; Groop, L; Vaag, A; Prasad, R B; Brøns, C

2017-10-01

The relative roles(s) of impaired insulin secretion vs. insulin resistance in the development of gestational diabetes mellitus depend upon multiple risk factors and diagnostic criteria. Here, we explored their relative contribution to gestational diabetes as defined by the WHO 1999 (GDM1999) and adapted WHO 2013 (GDM2013) criteria, excluding the 1-h glucose value, in a high-risk Indian population from Punjab. Insulin secretion (HOMA2-B) and insulin action (HOMA2-IR) were assessed in 4665 Indian women with or without gestational diabetes defined by the GDM1999 or adapted GDM2013 criteria. Gestational diabetes defined using both criteria was associated with decreased insulin secretion compared with pregnant women with normal glucose tolerance. Women with gestational diabetes defined by the adapted GDM2013, but not GDM1999 criteria, were more insulin resistant than pregnant women with normal glucose tolerance, and furthermore displayed lower insulin secretion than GDM1999 women. Urban habitat, illiteracy, high age and low BMI were independently associated with reduced insulin secretion, whereas Sikh religion, increasing age and BMI, as well as a family history of diabetes were independently associated with increased insulin resistance. Gestational diabetes risk factors influence insulin secretion and action in North Indian women in a differential manner. Gestational diabetes classified using the adapted GDM2013 compared with GDM1999 criteria is associated with more severe impairments of insulin secretion and action. © 2017 Diabetes UK.

Bone mineral density and factors influencing it in Asian Indian population with type 2 diabetes mellitus

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Sadishkumar Kamalanathan

2014-01-01

Full Text Available Objective: To assess bone mineral density (BMD in type 2 diabetes mellitus (T2DM patients and its relation, if any, to clinical, hormonal and metabolic factors. Materials and Methods: A prospective evaluation of 194 T2DM patients (97 men and 97 women was carried out. BMD was done with dual energy X-ray absorptiometry (DXA at the lumbar spine and total hip. Physical activity, nutritional intake and sunlight exposure were calculated. Biochemical and hormonal tests included serum 25 hydroxy vitamin D [25(OH D], parathyroid hormone, estrogen, testosterone and urinary calcium-creatinine ratio. Glycosylated hemoglobin and complete lipid profiles were done in patients with diabetes. Five hundred and seventy one non-diabetic controls (262 males and 309 females were evaluated for BMD alone. Results: BMD was normal (Z score > -2 in 156 (80.5% and low (Z score ≤ -2 in 38 (19.5% patients in the diabetes study group. BMD in the diabetes group was significantly higher than the control group in both sexes at the hip and spine. The difference was no longer significant on analysis of a BMI matched control subgroup. Weight and BMI showed significant correlation to BMD. Duration of T2DM, degree of glycemic control, use of drugs like statins and thiazolidinediones, 25(OH D levels, calcium intake, sunlight exposure and physical activity did not significantly affect BMD in this cohort of individuals with diabetes. Conclusions: Bone mineral density of Asian Indian T2DM subjects was similar to that of healthy volunteers in this study.

Association between type 2 diabetes mellitus and disability: What is the contribution of diabetes risk factors and diabetes complications?

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Tabesh, Maryam; Shaw, Jonathan E; Zimmet, Paul Z; Söderberg, Stefan; Koye, Digsu N; Kowlessur, Sudhir; Timol, Maryam; Joonas, Noorjehan; Sorefan, Ameena; Gayan, Praneel; Alberti, K George M M; Tuomilehto, Jaakko; Magliano, Dianna J

2018-03-06

The aim of this study was to evaluate the association between type 2 diabetes and disability in Mauritius and to assess the extent to which the effect of diabetes is explained by diabetes risk factors and concomitant complications. Data from a national survey in the multiethnic nation of Mauritius, which comprises South Asians and African Creoles, were analyzed. Disability was measured using the Katz activities of daily living questionnaire in participants aged >50 years. Among 3692 participants, 487 (13.2%) had some level of disability. Diabetes was associated with significantly higher risk of disability (odds ratio [OR] 1.67; 95% confidence interval [CI] 1.34-2.08). After adjusting for demographic, behavioral, and metabolic factors, as well as comorbidities, disability was significantly associated with diabetes among African Creoles (OR 2.03; 95% CI 1.16-3.56), but not South Asians (OR 1.27; 95% CI 0.98-1.66). Obesity explained much of the association between diabetes and disability (excess percentage of risk: 26.3% in South Asians and 12.1% in African Creoles). Obesity, history of cardiovascular disease (CVD), asthma-like symptoms, and depression together explained 46.5% and 29.0% of the excess risk in South Asians and African Creoles, respectively. Diabetes is associated with a 67% increased risk of disability. Diabetes risk factors and comorbidities explain more of the association between diabetes and disability among South Asians than Africans. Obesity and history of CVD explained the largest percentage of the relationship between diabetes and disability, indicating that weight and CVD management may be helpful in controlling disability related to diabetes. © 2018 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Population pharmacokinetic modeling of glibenclamide in poorly controlled South African type 2 diabetic subjects

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Rambiritch V

2016-07-01

Full Text Available Virendra Rambiritch,1 Poobalan Naidoo,2 Breminand Maharaj,1 Goonaseelan Pillai3 1University of KwaZulu-Natal, Durban, 2Department of Internal Medicine, RK Khan Regional Hospital, Chatsworth, South Africa; 3Novartis Pharma AG, Basel, Switzerland Aim: The aim of this study was to describe the pharmacokinetics (PK of glibenclamide in poorly controlled South African type 2 diabetic subjects using noncompartmental and model-based methods. Methods: A total of 24 subjects with type 2 diabetes were administered increasing doses (0 mg/d, 2.5 mg/d, 5 mg/d, 10 mg/d, and 20 mg/d of glibenclamide daily at 2-week intervals. Plasma glibenclamide, glucose, and insulin determinations were performed. Blood sampling times were 0 minute, 30 minutes, 60 minutes, 90 minutes, and 120 minutes (post breakfast sampling and 240 minutes, 270 minutes, 300 minutes, 330 minutes, 360 minutes, and 420 minutes (post lunch sampling on days 14, 28, 42, 56, and 70 for doses of 0 mg, 2.5 mg, 5.0 mg, 10 mg, and 20 mg, respectively. Blood sampling was performed after the steady state was reached.  A total of 24 individuals in the data set contributed to a total of 841 observation records. The PK was analyzed using noncompartmental analysis methods, which were implemented in WinNonLin®, and population PK analysis using NONMEM®. Glibenclamide concentration data were log transformed prior to fitting. Results: A two-compartmental disposition model was selected after evaluating one-, two-, and three-compartmental models to describe the time course of glibenclamide plasma concentration data. The one-compartment model adequately described the data; however, the two-compartment model provided a better fit. The three-compartment model failed to achieve successful convergence. A more complex model, to account for enterohepatic recirculation that was observed in the data, was unsuccessful. Conclusion: In South African diabetic subjects, glibenclamide demonstrates linear PK and was best

Impacts of urbanisation on the lifestyle and on the prevalence of diabetes in native Asian Indian population.

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Ramachandran, A; Snehalatha, C; Latha, E; Manoharan, M; Vijay, V

1999-06-01

Recent studies from the Asian subcontinent show an increasing prevalence of diabetes. This increase has been attributed to factors related to lifestyle changes related to modernisation. A periurban rural population resembling the rural in their occupation, but with access to certain urban facilities was chosen for this study. The aim of the study was to assess the impact of modernisation on the rising prevalence of diabetes in the native Indians. A total of 1637 adults aged 20 years and above (749 men and 888 women) were tested for diabetes and impaired glucose tolerance (IGT) by 2 h post-glucose challenge. Demographic, anthropometric, dietary and occupational details, were recorded. Dietary habits were similar in all categories of socio-economic strata. In the present study group, the age standardised prevalence of Type 2 diabetes was 5.9%, which was intermediate to that in the urban (11.6%) and rural (2.4%) populations. The prevalence data of the latter two population were available from previous surveys. Prevalence of impaired glucose tolerance (IGT) was high (6.9%) and similar in all three population samples. In the periurban population, a large percentage of subjects were doing only routine household work and had a sedentary life-style. After correcting for the age and BMI, sedentary work and occupation had a significant association with diabetes, suggesting that sedentary lifestyle may be an important determinant for the higher prevalence of diabetes in an urbanising population.

Studies of genetic variability of the hepatocyte nuclear factor-1α gene in an Indian maturity-onset diabetes of the young family.

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Yang, Jing; Jiang, Feng; Guo, Hui; Soniya, Thadimacca; Yan, Chun-Xia; Tian, Zhu-Fang; Shi, Bing-Yin

2016-01-01

Maturity-onset diabetes of the young (MODY), one of the specific types of diabetes mellitus, is a monogenetic disorder characterized by an autosomal dominant (AD) inheritance and β-cell dysfunction. To study an Indian family with clinical diagnosis of MODY and detect the genetic mutations in the aspect of molecular mechanism, seven blood samples were obtained from the diabetic patients of this pedigree and genomic DNA was extracted from peripheral leukocytes. The exon1, exon2 and exon4 of hepatocyte nuclear factor-1α (HNF-1α) gene were amplified by polymerase chain reaction. Then the products were sequenced and compared with standard sequences on gene bank. As a result, two mutations were detected in exon1. That was CTC → CTG (Leu → Leu) in codon17 and ATC → CTC (Ile → Leu) in codon27. I27L was speculated to have a close relationship with the glycometabolism and the pathogenesis of diabetes mellitus together with the putative novel mutation existed in this Indian pedigree. Meanwhile, one mutation of GGG → GGC (Gly → Gly) in codon288 of exon4 was detected in the proband. No mutations were found in exon2 but a G → T base substitution in the intron4 region among all seven samples was detected. It may have some potential effects on the onset of diabetes in this family, but we do not have any evidence right now. Although it requires further investigation on the function of mutations found in the intron region, our research may provide some clue for this issue and it deserves more attention.

Complex genetic origin of Indian populations and its implications

Indian Academy of Sciences (India)

2012-10-15

Oct 15, 2012 ... statistical analyses, we predicted that the present-day. Indian populations .... of type 2 diabetes only amongst Indians (Metspalu et al. 2011). Our other ... A new variety of spondyloepi(meta)physeal dysplasia of the autosomal ...

Distribution of Oxycephalidae (Hyperiidea-Amphipoda) in the Indian Ocean- A statistical study

Digital Repository Service at National Institute of Oceanography (India)

Nair, K.K.C.; Jayalakshmy, K.V.

Statistical analysis of oxycephalids on coexistence of the species showed two clusters of high affinity in the Arabian Sea, four in the Bay of Bengal, one in the South East Indian Ocean and three in the South West Indian Ocean. Species occurring...

A Home-Based Educational Intervention Improves Patient Activation Measures and Diabetes Health Indicators among Zuni Indians.

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Vallabh O Shah

Full Text Available One in three people will be diagnosed with diabetes by 2050, and the proportion will likely be higher among Native Americans. Diabetes control is currently suboptimal in underserved populations despite a plethora of new therapies. Patient empowerment is a key determinant of diabetes control, but such empowerment can be difficult to achieve due to resource limitation and cultural, language and health literacy barriers. We describe a home-based educational intervention using Community Health Representatives (CHRs, leading to improvement in Patient Activation Measures scores and clinical indicators of diabetes control.Sixty participants with type 2 diabetes (T2D completed a baseline evaluation including physical exam, Point of Care (POC testing, and the Patient Activation Measure (PAM survey. Participants then underwent a one hour group didactic session led by Community Health Representatives (CHRs who subsequently carried out monthly home-based educational interventions to encourage healthy lifestyles, including diet, exercise, and alcohol and cigarette avoidance until follow up at 6 months, when clinical phenotyping and the PAM survey were repeated.PAM scores were increased by at least one level in 35 (58% participants, while 24 participants who started at higher baseline score did not change. Six months after intervention, mean levels of A1C decreased by 0.7 ± 1.2%; fasting blood glucose decreased by 24.0 ± 38.0 mg/dl; BMI decreased by 1.5 ± 2.1 kg/m2; total cholesterol decreased by 12.0 ± 28.0 mg/dl; and triglycerides decreased by 52.0 ± 71.0 mg/dl. All of these changes were statistically significant (p < 0.05.This six month, CHR led and community-oriented educational intervention helps inform standards of practice for the management of diabetes, engages diabetic populations in their own care, and reduces health disparities for the underserved population of Zuni Indians.ClinicalTrials.gov NCT02339311.

Islet immunity and beta cell reserve of indigenous Black South Africans with ketoacidosis at initial diagnosis of diabetes.

Science.gov (United States)

Ekpebegh, Chukwuma; Longo-Mbenza, Benjamin; Blanco-Blanco, Ernesto

2013-01-01

Islet immunity and beta cell reserve status were utilized to classify persons with ketoacidosis as the initial manifestation of diabetes. The clinical features of the various diabetes classes were also characterized. Prospective cross sectional study. Nelson Mandela Academic Hospital, Mthatha, Eastern Cape Province, South Africa. Indigenous Black South Africans with ketoacidosis as the initial manifestation of diabetes. Islet immunity and beta cell reserve were respectively assessed using serum anti-glutamic acid decarboxylase 65 (GAD) antibody and serum C-peptide after 1 mg of intravenous glucagon. Serum anti-GAD 65 antibody > or = 5 units/L and or = 0.5 ng/mL and < 0.5 ng/mL, respectively. The proportions of patients with A+beta-, A+beta+, A-beta- and A-beta+ and their clinical characteristics were determined. Of the 38 males and 33 females who participated in the study, patients were categorized in various classes: A-beta+, 46.5% (n=33/ 71); A-beta-, 26.8% (n=19/71); A+beta-, 22.5% (n=16/71); and A+beta+, 4.2% (n=3/71). The ages of the various classes were: 41.8 +/- 13.8 years for A-beta+ (n=33); 36.5 +/- 14.6 years for A-beta- (n=19); and 20.6 +/- 7.1 years for the combination of A+beta- with A+beta+ (n=19) (P<.0001, P<.0001 for the combination of A+beta- and A+beta+ vs A-beta+, P=.001 for the combination of A+beta- and A+beta+ vs A-beta-and P=.2 for A-beta- vs A-beta+. The clinical features of type 2 diabetes were most prevalent in A-beta+ class while the A+beta- and A+beta+ groups had the clinical profile of type 1A diabetes. Most of the indigenous Black South African patients with ketoacidosis as the initial manifestation of diabetes had islet immunity, beta cell reserve status and clinical profiles of type 2 diabetes.

A study on the evolution of Indian Ocean triple junction and the process of deformation in the Central Indian Basin

Digital Repository Service at National Institute of Oceanography (India)

Murthy, K.S.R.; Rao, T.C.S.

It is generally presumed that the intraplate deformation in the Central Indian Basin (CIB) is a direct consequence of spreading across the South East Indian Ridge and the resistance to shortening at the continental collision between India...

in a Family of South Indian Descent

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Muthiah Subramanian

2015-01-01

Full Text Available Inherited channelopathies are a heterogeneous group of disorders resulting from dysfunction of ion channels in cellular membranes. They may manifest as diseases affecting skeletal muscle contraction, the conduction system of the heart, nervous system function, and vision syndromes. We describe a family of South Indian descent with hypokalemic periodic paralysis in which four members also have idiopathic generalized epilepsy. Hypokalemic periodic paralysis is a genetically heterogeneous channelopathy that has been linked to mutations in genes encoding three ion channels CACNIAS, SCN4A, and KCNJ2 predominantly. Although data on specific gene in idiopathic generalized epilepsy is relatively scarce, mutations of voltage gated sodium channel subunit genes (CACNB4 and nonsense mutations in voltage gated calcium channels (CACNA1A have been linked to idiopathic generalized epilepsy in two families. We speculate that gene mutations altering the ability of the beta subunit to interact with the alpha subunit of the CaV1.1 channel and mutations in the pore-forming potassium channel subunit may be possible explanations for the combined manifestation of both diseases. Functional analysis of voltage gated calcium channel and other ion channels mutations may provide additional support and insight for the causal role of these mutations. The understanding of mutations in ion-channel genes will lead to improved diagnosis and treatment of such inherited channelopathies.

Development of a situation-specific theory for explaining health-related quality of life among older South Korean adults with type 2 diabetes.

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Chang, Sun Ju; Im, Eun-Ok

2014-01-01

The purpose of the study was to develop a situation-specific theory for explaining health-related quality of life (QOL) among older South Korean adults with type 2 diabetes. To develop a situation-specific theory, three sources were considered: (a) the conceptual model of health promotion and QOL for people with chronic and disabling conditions (an existing theory related to the QOL in patients with chronic diseases); (b) a literature review using multiple databases including Cumulative Index for Nursing and Allied Health Literature (CINAHL), PubMed, PsycINFO, and two Korean databases; and (c) findings from our structural equation modeling study on health-related QOL in older South Korean adults with type 2 diabetes. The proposed situation-specific theory is constructed with six major concepts including barriers, resources, perceptual factors, psychosocial factors, health-promoting behaviors, and health-related QOL. The theory also provides the interrelationships among concepts. Health care providers and nurses could incorporate the proposed situation-specific theory into development of diabetes education programs for improving health-related QOL in older South Korean adults with type 2 diabetes.

Cultural negotiations in health and illness: The experience of adult onset diabetes among Gujarati South Asians in England.

OpenAIRE

Keval, Harshad C.

2008-01-01

Diabetes has become a global health problem, with both physical and psycho-social impacts on people's lives. The South Asian communities in the UK have been identified as 'high risk' groups with high rates of type 2 (non-insulin dependent) diabetes. This thesis explores the experiences of type 2 diabetes among a group of Hindu Gujaratis in several locations in England. Purposive and snowball sampling was used to recruit participants and a grounded theory framework was utilised to generate and...

Prevalence of primary glaucoma in an urban South Indian population

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Jacob Aby

1998-01-01

Full Text Available Glaucoma is fast emerging as a major cause of blindness in India. In order to estimate the prevalence of primary open angle glaucoma (POAG and primary angle closure glaucoma (PACG in an urban South Indian population, we examined 972 individuals aged 30-60 years, chosen using a cluster sampling technique from 12 census blocks of Vellore town. They underwent a complete ocular examination, including applanation tonometry and gonioscopy, at the Medical College Hospital. Characteristic field defects on automated perimetry was a diagnostic requisite for POAG. Prevalence (95% CI of POAG, PACG, and ocular hypertension were 4.1 (0.08-8.1, 43.2 (30.14-56.3, and 30.8 (19.8-41.9 per 1,000, respectively. All the PACG cases detected were of the chronic type. Hitherto unavailable community-based information on primary glaucoma in our study population indicates that PACG is about five times as common as POAG.

Dietary and physical activity strategies to prevent type 2 diabetes in South Asian adults: protocol for a systematic review

NARCIS (Netherlands)

Muilwijk, Mirthe; Stronks, Karien; Qureshi, Samera Azeem; Beune, Erik; Celis-Morales, Carlos; Gill, Jason; Sheikh, Aziz; Jenum, Anne Karen; van Valkengoed, Irene G. M.

2017-01-01

Introduction Type 2 diabetes (T2D) is a major health concern among populations of South Asian ethnicity. Although dietary and physical activity interventions may reduce the risk of T2D, the effectiveness has been moderate among South Asians. This might (in part) be because this subgroup follows

Replication of type 2 diabetes candidate genes variations in three geographically unrelated Indian population groups.

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Ali, Shafat; Chopra, Rupali; Manvati, Siddharth; Singh, Yoginder Pal; Kaul, Nabodita; Behura, Anita; Mahajan, Ankit; Sehajpal, Prabodh; Gupta, Subash; Dhar, Manoj K; Chainy, Gagan B N; Bhanwer, Amarjit S; Sharma, Swarkar; Bamezai, Rameshwar N K

2013-01-01

Type 2 diabetes (T2D) is a syndrome of multiple metabolic disorders and is genetically heterogeneous. India comprises one of the largest global populations with highest number of reported type 2 diabetes cases. However, limited information about T2D associated loci is available for Indian populations. It is, therefore, pertinent to evaluate the previously associated candidates as well as identify novel genetic variations in Indian populations to understand the extent of genetic heterogeneity. We chose to do a cost effective high-throughput mass-array genotyping and studied the candidate gene variations associated with T2D in literature. In this case-control candidate genes association study, 91 SNPs from 55 candidate genes have been analyzed in three geographically independent population groups from India. We report the genetic variants in five candidate genes: TCF7L2, HHEX, ENPP1, IDE and FTO, are significantly associated (after Bonferroni correction, ppopulation. Interestingly, SNP rs7903146 of the TCF7L2 gene passed the genome wide significance threshold (combined P value = 2.05E-08) in the studied populations. We also observed the association of rs7903146 with blood glucose (fasting and postprandial) levels, supporting the role of TCF7L2 gene in blood glucose homeostasis. Further, we noted that the moderate risk provided by the independently associated loci in combined population with Odds Ratio (OR)<1.38 increased to OR = 2.44, (95%CI = 1.67-3.59) when the risk providing genotypes of TCF7L2, HHEX, ENPP1 and FTO genes were combined, suggesting the importance of gene-gene interactions evaluation in complex disorders like T2D.

Concepts and treatment for diabetes among traditional and faith healers in the northern province, South Africa.

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Peltzer, K; Khoza, L B; Lekhuleni, M E; Madu, S N; Cherian, V I; Cherian, L

2001-05-01

The purpose of the study was to assess the concepts and treatment modalities for diabetes among traditional and faith healers in the Northern Province in South Africa. The sample consisted of 50 traditional healers (13 females and 37 males) and 50 faith healers (12 females and 38 males). They were interviewed on local terminology, clinical manifestations, causes, curability, and treatment for diabetes, help-seeking behaviour of diabetes patients, and the healers' sources of information about diabetes. Results indicate that all healers were familiar with "diabetes", however, not all of them had seen patients suffering from diabetes. The perceived causes of diabetes by both traditional and faith healers could be divided into (1) diet (especially too much of sugar), (2) heredity, (3) supernatural, and (4) psychological causes. Most traditional healers (92%) and faith healers (90%) indicated that diabetes is curable. Treatments used by the healers in this study included the use of prayer, diet, and herbs. The authors conclude that the concepts and treatment modalities for diabetes among traditional and faith healers should be taken note of by health workers while developing health education programmes in the Province.

Seizure-related hospital admissions, readmissions and costs: Comparisons with asthma and diabetes in South Australia.

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Bellon, Michelle L; Barton, Christopher; McCaffrey, Nikki; Parker, Denise; Hutchinson, Claire

2017-08-01

Seizures are listed as an Ambulatory Care Sensitive Condition (ACSC), where, in some cases, hospitalisation may be avoided with appropriate preventative and early management in primary care. We examined the frequencies, trends and financial costs of first and subsequent seizure-related hospital admissions in the adult and paediatric populations, with comparisons to bronchitis/asthma and diabetes admissions in South Australia between 2012 and 2014. De-identified hospital separation data from five major public hospitals in metropolitan South Australia were analysed to determine the number of children and adults admitted for the following Australian Refined Diagnosis Related Groups: seizure related conditions; bronchitis/asthma; and diabetes. Additional data included length of hospital stay and type of admission. Demographic data were analysed to identify whether social determinants influence admission, and a macro costing approach was then applied to calculate the financial costs to the Health Care System. The rate of total seizure hospitalizations was 649 per 100,000; lower than bronchitis/asthma (751/100,000), yet higher than diabetes (500/100,000). The highest proportions of subsequent separations were recorded by children with seizures regardless of complexity (47% +CSCC; 17% -CSCC) compared with asthma (11% +CSCC; 14% -CSCC) or diabetes (14% +CSCC; 13% -CSCC), and by adults with seizures with catastrophic or severe complications/comorbidity (25%), compared with diabetes (22%) or asthma (14%). The mean cost per separation in both children and adults was highest for diabetes (AU$4438/$7656), followed by seizures (AU$2408/$5691) and asthma (AU$2084/$3295). Following the lead of well-developed and resourced health promotion initiatives in asthma and diabetes, appropriate primary care, community education and seizure management services (including seizure clinics) should be targeted in an effort to reduce seizure related hospitalisations which may be avoidable

Association between grip strength and diabetes prevalence in black, South-Asian, and white European ethnic groups: a cross-sectional analysis of 418 656 participants in the UK Biobank study.

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Ntuk, U E; Celis-Morales, C A; Mackay, D F; Sattar, N; Pell, J P; Gill, J M R

2017-08-01

To quantify the extent to which ethnic differences in muscular strength might account for the substantially higher prevalence of diabetes in black and South-Asian compared with white European adults. This cross-sectional study used baseline data from the UK Biobank study on 418 656 white European, black and South-Asian participants, aged 40-69 years, who had complete data on diabetes status and hand-grip strength. Associations between hand-grip strength and diabetes were assessed using logistic regression and were adjusted for potential confounding factors. Lower grip strength was associated with higher prevalence of diabetes, independent of confounding factors, across all ethnicities in both men and women. Diabetes prevalence was approximately three- to fourfold higher in South-Asian and two- to threefold higher in black participants compared with white European participants across all levels of grip strength, but grip strength in South-Asian men and women was ~ 5-6 kg lower than in the other ethnic groups. Thus, the attributable risk for diabetes associated with low grip strength was substantially higher in South-Asian participants (3.9 and 4.2 cases per 100 men and women, respectively) than in white participants (2.0 and 0.6 cases per 100 men and women, respectively). Attributable risk associated with low grip strength was also high in black men (4.3 cases) but not in black women (0.4 cases). Low strength is associated with a disproportionately large number of diabetes cases in South-Asian men and women and in black men. Trials are needed to determine whether interventions to improve strength in these groups could help reduce ethnic inequalities in diabetes prevalence. © 2017 Diabetes UK.

A profile of Latinos with poorly controlled diabetes in South Florida

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Sonjia Kenya

2015-04-01

Full Text Available Introduction: Latinos are the largest minority group in the United States and diabetes or pre-diabetes affects more than 70% of Latinos aged 45 years and older. Miami-Dade County is home to one of the highest populations of diverse Latinos. In this descriptive manuscript, we present baseline characteristics of participants enrolled in the Miami Healthy Heart Initiative (MHHI. This was a study conducted to determine the effects of a community health worker (CHW intervention among Latinos with poorly controlled diabetes in South Florida. Methods: We recruited 300 diverse Latino adults with suboptimal diabetes outcomes (HbA1c≥8 into MHHI. This randomized control trial examined the impact of a 1-year CHW-led intervention on glycemic control, blood pressure, and cholesterol levels. At baseline, physiologic measures, including HbA1c, LDL, blood pressure, and BMI, were assessed. Data on socio-demographic characteristics and additional determinants of health such as depression status, provider communication, diet, exercise, cigarette smoking, readiness to change diabetes management behaviors (stages of change, and confidence in ability to improve diabetes self-care (self-efficacy were collected. Results: Participants came from 20 different countries, with Cuban Americans representing 38% of the sample. Most had lived in the US for more than 10 years, had completed at least 12 years of school, and had high levels of health literacy, yet 48% had very low acculturation. Nearly 80% had poor self-efficacy, 80% met the criteria for depression, and 83% were not adherent to their medications. More than half the population was not at their target for blood pressure, 50% were above the recommended LDL goal, and most were obese. Conclusion: In a diverse population of Latinos with poorly controlled diabetes in Miami, we found high rates of depression, obesity, medication non-adherence, poor self-efficacy, and provider communication. These may contribute to poor

Rationale and design of South Asian Birth Cohort (START: a Canada-India collaborative study

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Anand Sonia S

2013-01-01

Full Text Available Abstract Background People who originate from the Indian subcontinent (South Asians suffer among the highest rates of type 2 diabetes in the world. Prior evidence suggests that metabolic risk factors develop early in life and are influenced by maternal and paternal behaviors, the intrauterine environment, and genetic factors. The South Asian Birth Cohort Study (START will investigate the environmental and genetic basis of adiposity among 750 South Asian offspring recruited from highly divergent environments, namely, rural and urban India and urban Canada. Methods Detailed information on health behaviors including diet and physical activity, and blood samples for metabolic parameters and DNA are collected from pregnant women of South Asian ancestry who are free of significant chronic disease. They also undergo a provocative test to diagnose impaired glucose tolerance and gestational diabetes. At delivery, cord blood and newborn anthropometric indices (i.e. birth weight, length, head circumference and skin fold thickness are collected. The mother and growing offspring are followed prospectively and information on the growth trajectory, adiposity and health behaviors will be collected annually up to age 3 years. Our aim is to recruit a minimum of 750 mother-infant pairs equally divided between three divergent environments: rural India, urban India, and Canada. Summary The START cohort will increase our understanding of the environmental and genetic determinants of adiposity and related metabolic abnormalities among South Asians living in India and Canada.

Immigration and dietary patterns in South Asian Canadians at risk for diabetes.

Science.gov (United States)

Kandola, Kirandeep; Sandhu, Supna; Tang, Tricia

To examine the relationship between immigration and dietary patterns among South Asian adults at risk for diabetes and living in Canada. We recruited 428 South Asian adults affiliated with Sikh and Hindu temples in Metro Vancouver. Of the total sample, 422 completed self-report surveys including demographic background information, and two brief food screeners (fruit/vegetable/fiber intake and fat intake). Food screeners were culturally tailored to include traditional foods consumed in the South Asian community. Multiple linear regressions examined the relationship between diet and immigration. All models were adjusted for age, sex, marital status, education, income, and employment. Participants reported low levels of meat, fruit and vegetable consumption. Intake of whole milk products, traditional South Asian desserts and snacks were relatively high in comparison to other fat-containing food items. Specific trends in diet were seen in relation to time following immigration with the longer duration of years living in Canada the greater consumption of fruit/vegetable/fiber, non-starchy vegetables, total fat and meat reported; and lower intake of whole milk. Acculturation appears to influence some dietary patterns in our sample of South Asian Canadian adults. These findings should be considered when designing culturally tailored lifestyle modification interventions for this community. Copyright © 2016 Elsevier Inc. All rights reserved.

Physician education programme improves quality of diabetes care

African Journals Online (AJOL)

diabetes have been compiled and circulated to health care workers, but ... studied and attempted to improve the quality of diabetes care in primary care ..... project indicators in the Indian Health Service primary care setting. Diabetes Care ...

HTLV-I infection in the South West Indian Ocean islands, particularly in La Réunion and the Seychelles.

Science.gov (United States)

Aubry, P; Bovet, P; Vitrac, D; Schooneman, F; Hollanda, J; Malvy, D; Gaüzère, B-A

2013-10-01

Data on HTLV-I are scarce in several Southwest Indian Ocean islands except for La Réunion and The Seychelles. The two cases of HTLV-I have been confirmed by Western-Blot in La Réunion, among blood donors. In Seychelles (87 400 inhabitants in 2012), where blood donors and some other cases are screened, HTLV-I was confirmed with a line immune assay in 43 persons and at least 10-20 patients are known to have tropical spastic paraparesia or adult T-cell lymphoma associated with HTLV-I. In the south-west Indian Ocean, a possibly important other issue may be co-infection of HTLV-1 with the Strongyloides stercoralis roundworm, which is endemic in all countries of the region and which can sometimes lead to severe symptomatic infestation.

Prevalencia de diabetes mellitus e hiperlipidemias en indígenas otomíes Prevalence of diabetes mellitus and hyperlipemias in Otomi indians

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Claudia Alvarado-Osuna

2001-10-01

Full Text Available Objetivo. Determinar prevalencia y factores de riesgo de la diabetes mellitus (DM e hiperlipidemias en un grupo de indígenas otomíes de Querétaro. Material y métodos. Entre 1996 y 1997, en muestreo de conveniencia se trabajó con 91 indígenas, de 15 a 77 años de edad, de las comunidades de Yosphí y El Rincón, del estado de Querétaro, México. Se tomaron muestras sanguíneas en ayuno y se determinó la concentración de glucosa, colesterol y triglicéridos. Se realizó análisis estadístico para comparación entre sexos y grupos de edad. Resultados. La prevalencia de DM fue 4.4%, la de hipercolesterolemia 7.2%, y la de hipertrigliceridemia (HTG 26%. Las concentraciones promedio de glucosa (81.0±24.4 mg/dl y triglicéridos (157.4±88.9 mg/dl se incrementaron significativamente con la edad (p=0.0279 y phttp://www.insp.mx/salud/index.htmlObjective. To determine prevalence and risk factors for diabetes mellitus (DM and hyperlipidemias in a population of Otomi Indians. Material and methods. A cross-sectional study was conducted between 1996 and 1997, in a convenience sample of 91 Otomi Indians, aged 15 to 77 years, in the comunities of Yosphi and El Rincon, Queretaro, Mexico. Fasting blood samples were obtained to measure glucose, cholesterol and triglyceride levels. Results. DM was found in 4.4% of subjects; hypercholesterolemia in 7.6%; and hypertriglyceridemia (HTG in 26%. Mean concentrations of glucose --(81.0±24.4 mg/dl and triglycerides (157.4±88.9 mg/dl increased significantly with age, p=0.0279 and phttp://www.insp.mx/salud/index.html

Phylogeny and colonization history of Pringlea antiscorbutica (Brassicaceae), an emblematic endemic from the South Indian Ocean Province.

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Bartish, Igor V; Aïnouche, Abdelkader; Jia, Dongrui; Bergstrom, Dana; Chown, Steven L; Winkworth, Richard C; Hennion, Françoise

2012-11-01

The origins and evolution of sub-Antarctic island floras are not well understood. In particular there is uncertainty about the ages of the contemporary floras and the ultimate origins of the lineages they contain. Pringlea R. Br. (Brassicaceae) is a monotypic genus endemic to four sub-Antarctic island groups in the southern Indian Ocean. Here we used sequences from both the chloroplast and nuclear genomes to examine the phylogenetic position of this enigmatic genus. Our analyses confirm that Pringlea falls within the tribe Thelypodieae and provide a preliminary view of its relationships within the group. Divergence time estimates and ancestral area reconstructions imply Pringlea diverged from a South American ancestor ~5 Myr ago. It remains unclear whether the ancestor of Pringlea dispersed directly to the South Indian Ocean Province (SIOP) or used Antarctica as a stepping-stone; what is clear, however, is that following arrival in the SIOP several additional long-distance dispersal events must be inferred to explain the current distribution of this species. Our analyses also suggest that although Pringlea is likely to have inherited cold tolerance from its closest relatives, the distinctive morphology of this species evolved only after it split from the South American lineage. More generally, our results lend support to the hypothesis that angiosperms persisted on the sub-Antarctic islands throughout the Pliocene and Pleistocene. Taken together with evidence from other sub-Antarctic island plant groups, they suggest the extant flora of sub-Antarctic is likely to have been assembled over a broad time period and from lineages with distinctive biogeographic histories. Copyright © 2012 Elsevier Inc. All rights reserved.

A case-control analysis of common variants in GIP with type 2 diabetes and related biochemical parameters in a South Indian population

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Kumar Harish

2010-07-01

Full Text Available Abstract Background Glucose-dependent insulinotropic polypeptide (GIP is one of the incretins, which plays a crucial role in the secretion of insulin upon food stimulus and in the regulation of postprandial glucose level. It also exerts an effect on the synthesis and secretion of lipoprotein lipase, from adipocytes, important for lipid metabolism. The aim of our study was to do a case-control association analysis of common variants in GIP in association with type 2 diabetes and related biochemical parameters. Method A total of 2000 subjects which includes 1000 (584M/416F cases with type 2 diabetes and 1000 (470M/530F normoglycemic control subjects belonging to Dravidian ethnicity from South India were recruited to assess the effect of single nucleotide polymorphisms (SNPs in GIP (rs2291725, rs2291726, rs937301 on type 2 diabetes in a case-control manner. The SNPs were genotyped by using tetra primer amplification refractory mutation system-PCR (ARMS PCR. For statistical analysis, our study population was divided into sub-groups based on gender (male and female. Association analysis was carried out using chi-squared test and the comparison of biochemical parameters among the three genotypes were performed using analysis of covariance (ANCOVA. Result Initial analysis revealed that, out of the total three SNPs selected for the present study, two SNPs namely rs2291726 and rs937301 were in complete linkage disequilibrium (LD with each other. Therefore, only two SNPs, rs2291725 and rs2291726, were genotyped for the association studies. No significant difference in the allele frequency and genotype distribution of any of the SNPs in GIP were observed between cases and controls (P > 0.05. Analysis of biochemical parameters among the three genotypes showed a significant association of total cholesterol (P = 0.042 and low density lipoprotein (LDL with the G allele of the SNP rs2291726 in GIP (P = 0.004, but this was observed only in the case of female

Critical success factors of Indian Entrepreneurs

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Alex Antonites

2013-12-01

Full Text Available This research seeks to explore the critical success factors that influence the success of Indian small business owners in the largest metropolitan area in South Africa. To achieve this, the objective of the study was to confirm whether there are significant differences between a successful and less successful group of business owners in terms of general management skills, personal characteristics, and entrepreneurial orientation and financing of the business. Through analysing secondary evidence and empirical results it was possible to facilitate a better understanding of how Indian entrepreneurs operating in small and medium enterprises sustain success, thus contributing to the body of knowledge relating to entrepreneurship development in the domain of entrepreneurship. From the literature it became clear that cultural dimensions have an impact on the entrepreneurial process. The arrival of Indians in South Africa has contributed to a unique Indian culture. The characteristics that describe ethnic entrepreneurs and success factors attributed to their success are described. Small and medium enterprises (SMEs are crucial for the development of any country as they offer benefits of economic growth and employment generation. The success factors to sustain SMEs are also described. The findings of the study indicate that there are no significant differences between the comparable groups in relation to management skills and finance factors. There are, however, significant differences relating to personal factors, such as the level of education, family support and experience. Finally, an important learning is that the Indian entrepreneurs in this study are similar to ethnic entrepreneurs reviewed in literature. The study was conducted in Tshwane, the largest metropolitan area in South Africa, and amongst the largest in the world. Keywords: Culture, ethnic entrepreneurship, Indian entrepreneurship, critical success factors, small and medium enterprises

Association of MTHFR and PPARγ2 gene polymorphisms in relation to type 2 diabetes mellitus cases among north Indian population.

Science.gov (United States)

Raza, Syed Tasleem; Abbas, Shania; Ahmed, Faisal; Fatima, Jalees; Zaidi, Zeashan Haider; Mahdi, Farzana

2012-12-15

Type 2 diabetes mellitus is a multifactorial and polygenic disease, which is considered as a major life threatening problem all over the world. There has been a worldwide effort in the identification of susceptibility genes for type 2 diabetes mellitus and its complications. At present, adequate data is not available dealing with MTHFR (rs1801133) and PPARγ2 (rs1801282) gene polymorphisms and its association with type 2 diabetes mellitus cases among north Indian populations. Thus, we conceived the need for further studies to investigate MTHFR and PPARγ2 gene polymorphisms and their susceptibility to type 2 diabetes mellitus in north Indian population. In this study, a total 175 subjects including 87 type 2 diabetes mellitus cases and 88 controls were enrolled. MTHFR and PPARγ2 gene polymorphisms in the cases and controls were evaluated by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). The MTHFR gene CC, CT, TT genotype frequencies obtained were 40%, 43%, and 17% in type 2 diabetes mellitus cases and 56%, 29%, and 15% in healthy controls respectively. The OR for CC was 0.54 (95%CI 0.29-0.98, P=0.041, χ(2)=4.18, power=0.98), for CT 1.76 (95%CI 0.94-3.30, P=0.07, χ(2)=3.2, power=0.96), and for TT 1.2 (95%CI 0.53-2.70, P=0.66, χ(2)=0.198, power=0.76). The PPARγ2 gene GG CG, CC genotype frequencies obtained were 28%, 41%, and 31% in cases and 40%, 39%, and 21% in healthy controls respectively. OR for GG was 0.58 (95%CI 0.30-1.09, P=0.08, χ(2)=2.9, power=0.96), for CG 1.12 (95%CI 0.61-2.05, P=0.71, χ(2)=0.137, power=0.778), and for CC 1.63 (95%CI 0.82-3.23, P=0.156, χ(2)=2.01, power=0.92). It might be recommended that MTHFR CC genotype seems to be a good marker for the early identification of population at risk of type 2 diabetes mellitus. While we have detected significant difference in allelic frequencies of PPARγ2 C (Proline) and G (Alanine), but at genotypic level significant difference was not detected in this case

Traditional and western medicine: cultural beliefs and practices of South African Indian Muslims with regard to stroke.

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Bham, Zaheerah; Ross, Eleanor

2005-01-01

To investigate the beliefs of caregivers and traditional healers within the South African Indian Muslim community regarding the etiology and treatment of stroke and the persons likely to be consulted in this regard. A descriptive case study design was employed which incorporated two groups and was located within a qualitative paradigm. Data were collected within the homes of caregivers and the consulting rooms of traditional healers. Ten caregivers of persons who had sustained strokes and 10 traditional healers were interviewed. Individual interviews were held with participants. Responses to semi-structured interview schedules were analyzed using thematic content analysis and descriptive statistics. For both groups, religion and faith in God played a pertinent role in beliefs regarding etiology of illnesses such as stroke. Caregivers used a combination of traditional and Western medicine approaches. For traditional healers, treatment was based on the premise of restoring the balance between hot and cold in the body, which had been placed in disequilibrium by the stroke. Participants expressed disillusionment with referrals to Western healthcare professionals whose treatment was often regarded as culturally inappropriate. They also emphasized the integral role played by family members in the treatment of illness and disease. Results have implications for: culturally sensitive management of stroke patients in the South African Indian Muslim community; collaboration between Western and traditional healers; involvement of families in the remediation process; and further research.

Role of Endothelial Nitric Oxide Synthase Gene Polymorphisms in Predicting Aneurysmal Subarachnoid Hemorrhage in South Indian Patients

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Linda Koshy

2008-01-01

Full Text Available Endothelial nitric oxide synthase (eNOS gene polymorphisms have been implicated as predisposing genetic factors that can predict aneurysmal subarachnoid hemorrhage (aSAH, but with controversial results from different populations. Using a case-control study design, we tested the hypothesis whether variants in eNOS gene can increase risk of aSAH among South Indian patients, either independently, or by interacting with other risk factors of the disease. We enrolled 122 patients, along with 224 ethnically matched controls. We screened the intron-4 27-bp VNTR, the promoter T-786C and the exon-7 G894T SNPs in the eNOS gene. We found marked interethnic differences in the genotype distribution of eNOS variants when comparing the South Indian population with the reported frequencies from Caucasian and Japanese populations. Genotype distributions in control and patient populations were found to be in Hardy-Weinberg equilibrium. In patients, the allele, genotype and estimated haplotype frequencies did not differ significantly from the controls. Multiple logistic regression indicated hypertension and smoking as risk factors for the disease, however the risk alleles did not have any interaction with these risk factors. Although the eNOS polymorphisms were not found to be a likely risk factor for aSAH, the role of factors such as ethnicity, gender, smoking and hypertension should be evaluated cautiously to understand the genotype to phenotype conversion.

Association of American Indian cultural identity with physical activity.

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Duncan, Glen E; McDougall, Casey L; Dansie, Elizabeth; Garroutte, Eva; Buchwald, Dedra; Henderson, Jeffrey A

2014-01-01

Cultural factors are associated with health behaviors among American Indians. Accordingly, the objective of our study was to investigate whether cultural identity, defined as the primary language spoken at home, is associated with: 1) higher total physical activity levels, and 2) levels of leisure-time physical activity recommended for health benefits in a diverse sample of American Indians. Cross-sectional analysis of 5,207 American Indian adults 18 to 82 years. Participants resided on the Oglala Sioux (n=2,025) and Cheyenne River Sioux (n=1,528) reservations in South Dakota, and the Gila River Indian Community (n=1,654) in Arizona. Bicultural participants in South Dakota, but not Arizona, reported significantly higher total physical activity compared to the English-only group (Pcultures with which they identify are recommended.

Influence of tumour suppressor gene (TP53, BRCA1 and BRCA2) polymorphisms on polycystic ovary syndrome in South Indian women.

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Siddamalla, Swapna; Reddy, Tumu Venkat; Govatati, Suresh; Guruvaiah, Praveen; Deenadayal, Mamata; Shivaji, Sisinthy; Bhanoori, Manjula

2018-05-24

Polycystic Ovary Syndrome (PCOS) is a heterogeneous multifactorial endocrine metabolic disorder. In addition to hyperandrogenism, acne, hirsutism, obesity, oligoanovulation and infertility, insulin resistance is also a common feature in women of PCOS. Tumor suppressor genes (TSGs) perform essential function in the maintenance of genomic stability and regulatory pathways influencing the activity of several replication and transcription factors. The main aim of this study was to investigate the association of Single Nucleotide Polymorphisms of TP53, BRCA1and BRCA2 genes with the susceptibility to PCOS in South Indian women. Present study investigated association between TP53 gene (rs1042522 G/C), BRCA1 (rs71361504 -/GTT, rs3092986 T/C) and BRCA2 (rs206118 A/G) and, SNPs and PCOS risk. Genotyping of TSGs was carried out on DNA from PCOS patients (n = 110) and controls (n = 130) of South Indian origin by polymerase chain reaction (PCR) and confirmed by sequencing analysis. The genotype frequency and allele distributions of cases and controls were analyzed using Fisher's exact test. Haplotype frequencies for multiple loci and the standardized disequilibrium coefficient (D') for pair wise linkage disequilibrium (LD) were assessed by Haploview Software. Significant increase in frequencies ofTP53 (rs1042522 G/C), BRCA1 (rs71361504 -/GTT, rs3092986 T/C) genotypes and alleles in patients compared to controls. In addition, the frequency of the C/T (P = 0.002) and A/C (P = 0.012) haplotype was also significantly elevated in patients. But BRCA2 (rs206118 A/G) did not show significant association with PCOS. The TP53 and BRCA1 may constitute an inheritable risk factor for PCOS in South Indian women. Copyright © 2018 Elsevier B.V. All rights reserved.

Psychological trauma symptoms and Type 2 diabetes prevalence, glucose control, and treatment modality among American Indians in the Strong Heart Family Study.

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Jacob, Michelle M; Gonzales, Kelly L; Calhoun, Darren; Beals, Janette; Muller, Clemma Jacobsen; Goldberg, Jack; Nelson, Lonnie; Welty, Thomas K; Howard, Barbara V

2013-01-01

The aims of this paper are to examine the relationship between psychological trauma symptoms and Type 2 diabetes prevalence, glucose control, and treatment modality among 3776 American Indians in Phase V of the Strong Heart Family Study. This cross-sectional analysis measured psychological trauma symptoms using the National Anxiety Disorder Screening Day instrument, diabetes by American Diabetes Association criteria, and treatment modality by four categories: no medication, oral medication only, insulin only, or both oral medication and insulin. We used binary logistic regression to evaluate the association between psychological trauma symptoms and diabetes prevalence. We used ordinary least squares regression to evaluate the association between psychological trauma symptoms and glucose control. We used binary logistic regression to model the association of psychological trauma symptoms with treatment modality. Neither diabetes prevalence (22%-31%; p=0.19) nor control (8.0-8.6; p=0.25) varied significantly by psychological trauma symptoms categories. However, diabetes treatment modality was associated with psychological trauma symptoms categories, as people with greater burden used either no medication, or both oral and insulin medications (odds ratio=3.1, ppsychological trauma symptoms suggests future research investigate patient and provider treatment decision making. © 2013.

Association between diabetic nephrology and other diabetic microvascularand macrovascular complications

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Chandy, A.; John, M.; Pawar, B.; Isaac, R.

2008-01-01

Diabetic nephropathy is found to be significantly associated withdiabetic retinopathy and coronary artery disease. Few studies have also shownan association between diabetic nephropathy and neuropathy and peripheralvascular disease. A cross sectional study was done among consecutive type 2diabetics presenting to Christian Medical College and Hospital, Ludhiana fromJune 2004 to may 2005. Patients were subjected to the clinical and laboratoryinvestigations 174 patients were studied over a period of one year. Diabeticnephropathy was found to be associated with proliferative diabeticretinopathy, neuropathy and cardiovascular disease by univariate analysis. Inmultivariate analysis, diabetic nephropathy was again sufficiently associatedwith proliferative diabetic retinopathy and coronary artery disease. Weconclude that close association between diabetic nephropathy and other microand macrovascular complications exists in our Indian patients also. (author)

Circulating MiRNAs of ‘Asian Indian Phenotype’ Identified in Subjects with Impaired Glucose Tolerance and Patients with Type 2 Diabetes

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Prabu, Paramasivam; Rome, Sophie; Sathishkumar, Chandrakumar; Aravind, Sankaramoorthy; Mahalingam, Balakumar; Shanthirani, Coimbatore Subramanian; Gastebois, Caroline; Villard, Audrey; Mohan, Viswanathan; Balasubramanyam, Muthuswamy

2015-01-01

Several omics technologies are underway worldwide with an aim to unravel the pathophysiology of a complex phenotype such as type 2 diabetes mellitus (T2DM). While recent studies imply a clinically relevant and potential biomarker role of circulatory miRNAs in the etiology of T2DM, there is lack of data on this aspect in Indians—an ethnic population characterized to represent ‘Asian Indian phenotype’ known to be more prone to develop T2DM and cardiovascular disease than Europeans. We performed global serum miRNA profiling and the validation of candidate miRNAs by qRT-PCR in a cohort of subjects comprised of normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and patients with T2DM. Our study revealed 4 differentially expressed miRNAs (miR-128, miR-130b-3p, miR-374a-5p, miR-423-5p) in subjects with IGT and T2DM patients compared to control subjects. They were positively or negatively correlated to cholesterol levels, HbA1C, HOMA-IR and fasting insulin. Interestingly, circulating level of miR-128 and miR-130b-3p were also altered in serum of diet-induced diabetic mice compared to control animals. Among the altered circulating miRNAs, miR-128 had never been described in previous studies/populations and appeared to be a ‘New Lead’ in Indians. It was positively correlated with cholesterol both in prediabetic subjects and in diet-induced diabetic mice, suggesting that its increased level might be associated with the development of dyslipedemia associated with T2DM. Our findings imply directionality towards biomarker potential of miRNAs in the prevention/diagnosis/treatment outcomes of diabetes. PMID:26020947

California Wellness Study: American Indians and Obesity

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Hodge, Felicia Schanche; Kotkin-Jaszi, Suzanne T.

2011-01-01

This paper identifies the prevalence and predictors of obesity among California’s American Indian adults. A cross-sectional study was conducted at 13 rural sites. Indian healthcare clinics served as the sampling frame and were selected because of their proximity and access to the target population. Four-hundred and fifty adult American Indians participated; 74 percent were female and 26 percent were male. The average age was 40, ranging from 18–74. Measures included socio-demographics, general health, BMI, type 2 diabetes, exercise and dietary habits. Eighty-two percent were overweight, obese or morbidly obese. Chi-square tests revealed three variables significantly associated with BMI categories: having type 2 diabetes, female gender and poor general health status. A logistic regression model for obese/morbidly obese (BMI > 30) versus overweight/normal (BMI < 30) persons found gender and diabetes status as significant predictors, while general health status showed trend. Females had 1.59 greater odds of being obese than males (p=0.04). Those that do not have diabetes are less likely to be obese (p=0.02). Those that do not have good general health were 2.5 times more likely to be obese than those that have good general health (p=0.06). Overall goodness of fit was significant (p=0.0009). It is important to identify individuals and population who are normal/overweight, obese/morbidly obese so support and interventions can be planned and implemented. PMID:21625381

Replication of type 2 diabetes candidate genes variations in three geographically unrelated Indian population groups.

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Shafat Ali

Full Text Available Type 2 diabetes (T2D is a syndrome of multiple metabolic disorders and is genetically heterogeneous. India comprises one of the largest global populations with highest number of reported type 2 diabetes cases. However, limited information about T2D associated loci is available for Indian populations. It is, therefore, pertinent to evaluate the previously associated candidates as well as identify novel genetic variations in Indian populations to understand the extent of genetic heterogeneity. We chose to do a cost effective high-throughput mass-array genotyping and studied the candidate gene variations associated with T2D in literature. In this case-control candidate genes association study, 91 SNPs from 55 candidate genes have been analyzed in three geographically independent population groups from India. We report the genetic variants in five candidate genes: TCF7L2, HHEX, ENPP1, IDE and FTO, are significantly associated (after Bonferroni correction, p<5.5E-04 with T2D susceptibility in combined population. Interestingly, SNP rs7903146 of the TCF7L2 gene passed the genome wide significance threshold (combined P value = 2.05E-08 in the studied populations. We also observed the association of rs7903146 with blood glucose (fasting and postprandial levels, supporting the role of TCF7L2 gene in blood glucose homeostasis. Further, we noted that the moderate risk provided by the independently associated loci in combined population with Odds Ratio (OR<1.38 increased to OR = 2.44, (95%CI = 1.67-3.59 when the risk providing genotypes of TCF7L2, HHEX, ENPP1 and FTO genes were combined, suggesting the importance of gene-gene interactions evaluation in complex disorders like T2D.

Diabetes care and outcomes for American Indians and Alaska natives in commercial integrated delivery systems: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) Study.

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Schmittdiel, Julie A; Steiner, John F; Adams, Alyce S; Dyer, Wendy; Beals, Janette; Henderson, William G; Desai, Jay; Morales, Leo S; Nichols, Gregory A; Lawrence, Jean M; Waitzfelder, Beth; Butler, Melissa G; Pathak, Ram D; Hamman, Richard F; Manson, Spero M

2014-01-01

To compare cardiovascular disease risk factor testing rates and intermediate outcomes of care between American Indian/Alaska Native (AI/AN) patients with diabetes and non-Hispanic Caucasians enrolled in nine commercial integrated delivery systems in the USA. We used modified Poisson regression models to compare the annual testing rates and risk factor control levels for glycated haemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), and systolic blood pressure (SBP); number of unique diabetes drug classes; insulin use; and oral diabetes drug medication adherence between insured AI/AN and non-Hispanic white adults with diabetes aged ≥18 in 2011. 5831 AI/AN patients (1.8% of the cohort) met inclusion criteria. After adjusting for age, gender, comorbidities, insulin use, and geocoded socioeconomic status, AI/AN patients had similar rates of annual HbA1c, LDL-C, and SBP testing, and LDL-C and SBP control, compared with non-Hispanic Caucasians. However, AI/AN patients were significantly more likely to have HbA1c >9% (>74.9 mmol/mol; RR=1.47, 95% CI 1.38 to 1.58), and significantly less likely to adhere to their oral diabetes medications (RR=0.90, 95% CI 0.88 to 0.93) compared with non-Hispanic Caucasians. AI/AN patients in commercial integrated delivery systems have similar blood pressure and cholesterol testing and control, but significantly lower rates of HbA1c control and diabetes medication adherence, compared with non-Hispanic Caucasians. As more AI/ANs move to urban and suburban settings, clinicians and health plans should focus on addressing disparities in diabetes care and outcomes in this population.

Type 2 diabetes management: Patient knowledge and health care team perceptions, South Africa

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Nombeko Mshunqane

2012-10-01

Full Text Available Background: South African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus. There is minimal research information on interactions between what patients know about their disease and what health professionals perceive thatpatients should know to control their disease well.Objectives: This study determined the knowledge that patients with type 2 diabetes have about the management of their disease, as well as the perceptions of the health care team about the services given to patients.Method: Qualitative data were collected using two focus groups and in-depth interviews. Patient focus group (n = 10 explored patients’ knowledge about management of type 2 diabetes. Patients were recruited from Dr George Mukhari Hospital outpatients’ diabetes clinic. Professional focus group (n = 8 explored the health care team’s experiences, barriers and facilitators in managing the disease. Professional focus group participants were recruited because of their expertise in chronic disease management, working in the community (public health or working directly with patients with type 2 diabetes. Five health care professionals were interviewed using the same guide of questions as for the focus group.Results: Participants identified type 2 diabetes as a chronic disease that needs behaviour change for good control. Five major themes were identified: patients’ knowledge; education programmes; behaviour change; support; and a patient-centred approach.Conclusion: Management of type 2 diabetes may be enhanced by reinforcing patients’ knowledge, encouraging behaviour change whilst taking into consideration patients’ backgrounds. The health care team needs to utilise a patient-centred approach.

Radiographic Abnormalities in the Feet of Diabetic Patients with Neuropathy and Foot Ulceration.

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Viswanathan, Vijay; Kumpatla, Satyavani; Rao, V Narayan

2014-11-01

People with diabetic neuropathy are frequently prone to several bone and joint abnormalities. Simple radiographic findings have been proven to be quite useful in the detection of such abnormalities, which might be helpful not only for early diagnosis but also in following the course of diabetes through stages of reconstruction of the ulcerated foot.The present study was designed to identify the common foot abnormalities in south Indian diabetic subjects with and without neuropathy using radiographic imaging. About 150 (M:F 94:56) subjects with type 2 diabetes were categorised into three groups: Group I (50 diabetic patients), Group II (50 patients with neuropathy), and Group III (50 diabetic patients with both neuropathy and foot ulceration). Demographic details, duration of diabetes and HbA1c values were recorded. Vibration perception threshold was measured for assessment of neuropathy. Bone and joint abnormalities in the feet and legs of the study subjects were identified using standardised dorsi-plantar and lateral weight-bearing radiographs. Radiographic findings of the study subjects revealed that those with both neuropathy and foot ulceration and a longer duration of diabetes had more number of bone and joint abnormalities. Subjects with neuropathy alone also showed presence of several abnormalities, including periosteal reaction, osteopenia, and Charcot changes. The present findings highlight the impact of neuropathy and duration of diabetes on the development of foot abnormalities in subjects with diabetes. Using radiographic imaging can help in early identification of abnormalities and better management of the diabetic foot.

Hypertension and Diabetes Mellitus: A Preliminary South African Health Promotion Activity Using Service-Learning Principles.

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Srinivas, Sunitha C; Paphitis, Sharli Anne

2016-06-01

A marked increase in the chronic non-communicable diseases such as hypertension and diabetes mellitus in the South African population is in concert with global trends. A health promotion activity carried out by pharmacy students for school learners during the Sasol National Festival of Science and Technology (SciFest) in South Africa was used as a service-learning opportunity. Pilot tested quizzes on hypertension and diabetes were used to determine the level of knowledge of attendees before and after taking the computer based quiz. Posters, information leaflets and interactive models on these two conditions were also used to reach out to the larger population. Of the 203 participants for the hypertension quiz, 169 completed both the pre- and post-intervention quizzes. Similarly, 86 of the 104 participants for the diabetes quiz, completed both the pre- and post-intervention quizzes. The results show that the post-intervention quiz resulted in a significant increase in the scores from 78.2 to 85.6 % in the case of Hypertension while a marginal increase from 94.2 to 95.5 % was obtained in the case of diabetes. The knowledge of the SciFest attendees with regard to both conditions is above average and improved further after the educational intervention. Health promotion activities which include interactive educational methods and culturally appropriate materials carried out by pharmacy students during service-learning courses are important for improving the awareness on the prevention of these chronic health conditions. Heath promotion service-learning courses can assist in addressing the health care gaps which arise because of a lack of co-ordinated efforts between NGO's and local Government to address the prevention and management of non-communicable diseases such as hypertension and diabetes mellitus.

Diabetes in South African older adults: prevalence and impact on quality of life and functional disability - as assessed using SAGE Wave 1 data.

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Werfalli, Mahmoud; Kassanjee, Reshma; Kalula, Sebastiana; Kowal, Paul; Phaswana-Mafuya, Nancy; Levitt, Naomi S

2018-01-01

Diabetes is a chronic disease with severe late complications. It is known to impact the quality of life and cause disability, which may affect an individual's capacity to manage and maintain longer-term health and well-being. To examine the prevalence of self-report diabetes, and association between diabetes and each of health-related quality of life and disability amongst South Africa's older adults. To study both the direct relationship between diabetes and these two measures, as well as moderation effects, i.e. whether associations between other factors and these measures of well-being differed between individuals with diabetes and those without. Secondary analyses of data on participants aged 50 years and older from the Study on global AGEing and adult health (SAGE) in South Africa Wave 1 (2007-2008) were conducted. Prevalence of self-reported diabetes was assessed. Multivariable regressions describe the relationships between each of quality of life (WHOQoL) and disability (WHODAS), and diabetes, while controlling for selected socio-demographic characteristics, health risk behaviours and co-morbid conditions. In the regression models, we also investigated whether diabetes moderates the relationships between these additional factors and WHOQoL/WHODAS. Self-reported diabetes prevalence was 9.2% (95% CI: 7.8,10.9) and increased with age. Having diabetes was associated with poorer WHOQoL scores (additive effect: -4.2; 95% CI: -9.2,0.9; p-value disability (multiplicative effect: 2.1; 95% CI: 1.5,2.9; p-value disability were both related to not being in a relationship, lower education, less wealth, lower physical activity and a larger number of chronic conditions. Diabetes is associated with lower quality of life and greater disability amongst older South Africans. Attention needs to be given to enhancing the capacity of health systems to meet the changing needs of ageing populations with diabetes in SA as well as facilitating social support networks in communities.

Serum Lipoprotein (a Levels in Black South African Type 2 Diabetes Mellitus Patients

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Jim Joseph

2016-01-01

Full Text Available Lipoprotein (a (Lp(a which is a low-density lipoprotein-like particle containing apo(a is considered as an emergent cardiovascular risk factor. Type 2 diabetes mellitus (T2DM is associated with a two- to threefold increase in the risk of cardiovascular disease (CVD. The aim of this study was to investigate the levels of Lp(a in Black South African T2DM patients and its association with other metabolic factors. 67 T2DM patients and 48 healthy control participants were recruited for the cross-sectional study. The Lp(a level was determined by ELISA and the result was analyzed using SPSS. The Lp(a level in diabetics was found to be significantly increased (P=0.001 when compared to the normal healthy group. In the diabetic group, the Lp(a levels correlated significantly with the duration of diabetes (P=0.008 and oxidized LDL (ox-LDL levels (P=0.03 and decreased total antioxidant capacity (P=0.001. The third tertile of Lp(a was significantly correlated with increased ox-LDL, C-reactive protein, and triglycerides and decreased total antioxidant capacity.

Ethnic variation in the prevalence of visual impairment in people attending diabetic retinopathy screening in the United Kingdom (DRIVE UK).

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Sivaprasad, Sobha; Gupta, Bhaskar; Gulliford, Martin C; Dodhia, Hiten; Mann, Samantha; Nagi, Dinesh; Evans, Jennifer

2012-01-01

To provide estimates of visual impairment in people with diabetes attending screening in a multi-ethnic population in England (United Kingdom). The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK) Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People on the diabetes register in West Yorkshire and South East London who were screened, treated or monitored between April 2008 to July 2009 (London) or August 2009 (West Yorkshire) were included in the study. Data on age, gender, ethnic group, visual acuity and diabetic retinopathy were collected. Ethnic group was defined according to the 2011 census classification. The two main ethnic minority groups represented here are Blacks ("Black/African/Caribbean/Black British") and South Asians ("Asians originating from the Indian subcontinent"). We examined the prevalence of visual impairment in the better eye using three cut-off points (a) loss of vision sufficient for driving (approximately ethnic groups to the age-structure of the white population. Data on visual acuity and were available on 50,331 individuals 3.4% of people diagnosed with diabetes and attending screening were visually impaired (95% confidence intervals (CI) 3.2% to 3.5%) and 0.39% severely visually impaired (0.33% to 0.44%). Blacks and South Asians had a higher prevalence of visual impairment (directly age standardised prevalence 4.6%, 95% CI 4.0% to 5.1% and 6.9%, 95% CI 5.8% to 8.0% respectively) compared to white people (3.3%, 95% CI 3.1% to 3.5%). Visual loss was also more prevalent with increasing age, type 1 diabetes and in people living in Yorkshire. Visual impairment remains an important public health problem in people with diabetes, and is more prevalent in the minority ethnic groups in the UK.

Diabetes self-management education in South Auckland, New Zealand, 2007-2008.

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Silva, Martha; Clinton, Janet; Appleton, Sarah; Flanagan, Pat

2011-03-01

Self-management education programs seek to help patients realize that they are their own principal caregivers and that health care professionals are consultants who support them in this role. The aim of this study was to evaluate a diabetes self-management education program implemented as part of a district-wide approach in South Auckland, New Zealand, which has some of the highest prevalence rates for diabetes and is one of the most ethnically diverse and deprived regions of New Zealand. Self-management attitudes and behaviors were monitored with the use of questionnaires before and after program implementation. Clinical outcomes such as hemoglobin A1c, body mass index, and blood pressure were also tracked before the program began and 3 months after the program ended. Participant focus groups and facilitator interviews were conducted to explore perceptions of the program. Participants showed improvement in attitudes toward their own ability to manage their diabetes; in diet, physical activity, and foot care; and in hemoglobin A1c levels 3 months after the end of participation. Participants also reduced their sense of isolation when dealing with their diabetes. However, catering to the needs of a multiethnic community is extremely resource-intensive because of the need to provide adequate language and cultural interpretation. Self-management education can work in multiethnic, high-needs communities in New Zealand. Programs must ensure they enable the appropriate mechanisms and have appropriate resources to support the community's needs.

Access to Digital Communication Technology and Perceptions of Telemedicine for Patient Education among American Indian Patients with Diabetes.

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Mathieson, Kathleen; Leafman, Joan S; Horton, Mark B

2017-01-01

Health care access for medically underserved patients managing chronic conditions is challenging. While telemedicine can support patient education and engagement, the "digital divide" may be particularly problematic among the medically underserved. This study evaluated physical access to digital devices, use of e-mail and social media tools, and perceptions of telemedicine among American Indian (AI) patients with diabetes mellitus (DM). Survey data were collected from AI patients with DM during teleophthalmology exams. Eighty-eight percent of patients had access to digital device(s), 70% used e-mail, and 56% used social media. Younger age and greater education were positively associated with e-mail and social media use (p < .05). Most (60%) considered telemedicine an excellent medium for health-related patient education. American Indian patients with DM had access enabling patient education via telemedicine. Future work should examine patient technology preferences and effectiveness of technology-based education in improving outcomes among medically underserved populations.

Pathogenesis of type 2 diabetes and cardiovascular disease in South Asians : effects of dietary interventions on metabolism and cardiovascular function

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Bakker, Leontine Erica Henriëtte

2015-01-01

People of South Asian origin have an increased risk of developing type 2 diabetes (T2D) and cardiovascular disease (CVD) compared to people of Western European descent. Not only is the prevalence of these diseases higher in South Asians, they also occur at a younger age and lower BMI, and have a

Prevalence of human papilloma virus with risk of cervical cancer among south Indian women: A genotypic study with meta-analysis and molecular dynamics of HPV E6 oncoprotein.

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Akram Husain, R S; Rajakeerthana, R; Sreevalsan, Anoop; Prema Jayaprasad, P; Ahmed, Shiek S S J; Ramakrishnan, V

2018-04-23

Cervical cancer (CC) is a major fatal health problem in women with high mortality worldwide. Human Papilloma Virus (HPV) is considered as one of the causative factors for CC. The HPV prevalence and their genotype distribution among women population are essential to evaluate the deteriorating impact of HPV. A cross-sectional study was performed involving 212 participants to identify the prevalence of high-risk HPV genotypes in south India using PCR and DNA Sequencing. The results obtained from cross-sectional study were used to conduct a meta-analysis of the previous published studies on HPV prevalence and genotype distribution across six geographical regions (North, Northeast, East, Central, West, and South) of India. Additionally, molecular simulation was performed using GROMACS software to determine the structural differences of E6 oncoprotein in HPV-16 and 18 genotypes, characterized from Indian subjects. Among the study participants, the HPV prevalence was found to be 81.70% in CC, 71.42% in HSIL and 61.30% in LSIL. The meta-analysis showed a high prevalence of HPV-16 in CC across the entire six regions. Of which, South and North India were found to have high HPV prevalence among Indian regions. Further, simulation of E6 oncoprotein revealed structural differences between HPV-16 and 18 which may be associated with their oncogenic nature. The HPV-16 and 18 were noticed to be highly prevalent in Indian women. Health awareness and vaccination programs are regularly needed to protect Indian women community. Copyright © 2018 Elsevier B.V. All rights reserved.

Diabetes care may be improved with Steno Quality Assurance Tool--a self-assessment tool in diabetes management

DEFF Research Database (Denmark)

Bjerre-Christensen, Ulla; Nielsen, Annemette Anker; Binder, Christian

2014-01-01

AIM: To evaluate if improvements in the quality of diabetes care in Indian clinics can be obtained by simple self-surveillance PC-based software. METHOD: Nineteen Indian diabetes clinics were introduced to the principles of quality assurance (QA), and to a software program, the Steno Quality...... patients (baseline) and 4440 (follow-up). The average examination frequency per clinic of the following indicators increased significantly: lipid examination (72-87%) (p=0.007), foot examination (80-94%) (p=0.02), HbA1c investigation (59-77%) (p=0.006), and urine albumin excretion investigation (72-87%) (p.......002). CONCLUSION: Quality of diabetes care can be improved by applying SQAT, a QA self-surveillance software that enables documentation of changes in process and outcome indicators....

A Comparative Analysis of Indian Gaming in the United States

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Ackerman, William V.; Bunch, Rick L.

2012-01-01

Previous research on Indian gaming in South Dakota discovered very restrictive and unfavorable tribal-state compacts that appear to border on economic racism. This article expands this previous research by exploring the influence of tribal-state Indian gaming compacts for the Indian casinos located in the contiguous United States. The purpose is…

Cost-effectiveness of interventions to control cardiovascular diseases and diabetes mellitus in South Asia: a systematic review

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Singh, Kavita; Chandrasekaran, Ambalam M; Bhaumik, Soumyadeep; Chattopadhyay, Kaushik; Gamage, Anuji Upekshika; Silva, Padmal De; Roy, Ambuj; Prabhakaran, Dorairaj; Tandon, Nikhil

2018-01-01

Objectives More than 80% of cardiovascular diseases (CVD) and diabetes mellitus (DM) burden now lies in low and middle-income countries. Hence, there is an urgent need to identify and implement the most cost-effective interventions, particularly in the resource-constraint South Asian settings. Thus, we aimed to systematically review the cost-effectiveness of individual-level, group-level and population-level interventions to control CVD and DM in South Asia. Methods We searched 14 electronic databases up to August 2016. The search strategy consisted of terms related to ‘economic evaluation’, ‘CVD’, ‘DM’ and ‘South Asia’. Per protocol two reviewers assessed the eligibility and methodological quality of studies using standard checklists, and extracted incremental cost-effectiveness ratios of interventions. Results Of the 2949 identified studies, 42 met full inclusion criteria. Critical appraisal of studies revealed 15 excellent, 18 good and 9 poor quality studies. Most studies were from India (n=37), followed by Bangladesh (n=3), Pakistan (n=2) and Bhutan (n=1). The economic evaluations were based on observational studies (n=9), randomised trials (n=12) and decision models (n=21). Together, these studies evaluated 301 policy or clinical interventions or combination of both. We found a large number of interventions were cost-effective aimed at primordial prevention (tobacco taxation, salt reduction legislation, food labelling and food advertising regulation), and primary and secondary prevention (multidrug therapy for CVD in high-risk group, lifestyle modification and metformin treatment for diabetes prevention, and screening for diabetes complications every 2–5 years). Significant heterogeneity in analytical framework and outcome measures used in these studies restricted meta-analysis and direct ranking of the interventions by their degree of cost-effectiveness. Conclusions The cost-effectiveness evidence for CVD and DM interventions in South Asia

[Knowledge of the general population about hypertension and diabetes mellitus in South Kivu, Democratic Republic of Congo].

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Katchunga, P B; Malanda, B; Mweze, M C; Dupont, B; M'Buyamba-Kabangu, J R; Kashongwe, Z; Kabinda, J M; Buysschaert, M

2012-04-01

In the Democratic Republic of Congo (DRC), a country in a post-conflict period, high priority cannot be given to non-communicable diseases other than to emergencies. This certainly involves inadequacy in raising awareness for prevention of these diseases. To evaluate the level of knowledge of the Congolese general population on hypertension and diabetes mellitus. Responses to a questionnaire from 3% of the general population aged 15 and older in the city of Bukavu and two rural areas: Hombo and Walungu (South Kivu, eastern DRC), recruited after stratification by ward in the city of Bukavu and a group of prone villages were expected. The questions focused on identification, testing, causes, complications and treatment of hypertension and diabetes mellitus. Of the 7770 respondents, screening for hypertension and diabetes mellitus affected only 14.9% and 7.3% of subjects respectively. Knowledge of these two conditions was generally low in the general population, although better in the subgroups of patients and those with higher socioeconomic level (Pknowledge (Pknowledge about hypertension and diabetes mellitus and their testing in South Kivu is low. It is imperative that the Congolese government includes non-communicable diseases in its priorities of the millennium. Similarly, the WHO should actively contribute to screening for them in low-income countries. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages

OpenAIRE

Manyema, Mercy; Veerman, J. Lennert; Chola, Lumbwe; Tugendhaft, Aviva; Labadarios, Demetre; Hofman, Karen

2015-01-01

Introduction Type 2 diabetes poses an increasing public health burden in South Africa (SA) with obesity as the main driver of the epidemic. Consumption of sugar sweetened beverages (SSBs) is linked to weight gain and reducing SSB consumption may significantly impact the prevalence of obesity and related diseases. We estimated the effect of a 20% SSB tax on the burden of diabetes in SA. Methods and Findings We constructed a life table-based model in Microsoft Excel (2010). Consumption data fro...

Diversity of palatal rugae patterns and their reliability in sex discrimination in a South Indian population

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Sai Madhavi Nallamilli

2015-01-01

Full Text Available Introduction and Aims: Array of palatal rugae in the realm of forensic odontology has been constantly explored owing to their individual uniqueness and resistance to postmortem procedures, while their scope in sex determination and racial profiling remains understated. In this context, the present study aimed to record the diversity of palatal rugae patterns in a South Indian population. Materials and Methods: A descriptive cross-sectional study was conducted among people who reported to the outpatient department of a dental institution. Sample comprised a total of 200 subjects divided into two groups of 100 each, based upon gender. Impressions of anterior maxilla were made of all the study subjects and casts obtained subsequently. Outline of palatal rugae pattern was traced on these models and the data computed. Z test and unpaired t-test were used for statistical analysis and the probability value calculated. In addition, logistic regression analysis was performed to estimate the accuracy of sex allocation. Results: The shape of rugae exhibited highly significant sex difference in the curved type, which was found to be higher in males, and in the wavy type which was higher in females, enabling sex differentiation using palatal rugae patterns. Logistic regression analysis predicted high power of sex allocation for males rather than females in the study population. Conclusion: This study highlighted the uniqueness and greater sex discrimination potential of curved shape of palatal rugae in categorizing males of South Indian population, substantiating their use in the identification of deceased, by relating the antemortem and postmortem dental records.

Cytotoxic, Antimitotic, and Antiproliferation Studies on Rasam: A South Indian Traditional Functional Food.

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Devarajan, Agilandeswari; Mohan Maruga Raja, M K

2017-10-01

Rasam is a traditional South Indian food, prepared using tamarind juice as a base, with a variety of spices. Rasam , with all its ingredients medicinally claimed for various ailments, is a functional food. Systematic consumption of traditional functional food provides an excellent preventive measure to ward off many diseases. To study rasam for cytotoxic, antimitotic, and antiproliferation potential beyond its culinary and nutritional effect. Brine shrimp lethality assay, onion root tip inhibition assay, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay in Calu-6, HeLa, MCF-7 cell lines for four stage-wise samples in the preparation of rasam (RS1, RS2, RS3, and RS4) were studied. RS4, the end product of rasam showed high lethality with an LC 50 value of 38.7 μL/mL. It showed maximum antimitotic activity in a dose-dependent manner compared to other samples with an IC 50 value of 189.86 μL/mL. RS4 also showed an IC 50 value of 350.22 and 410.15 μL/mL in MCF-7 and Calu-6 cell lines, respectively. From this study, we suggest that rasam is a classic example of traditional functional food and it can treat breast and lung cancer on chronic use. Rasam , a South Indian traditional functional food, showed high lethality (LC 50 = 38.7 mL/mL) against brine shrimps Rasam also showed potential antimitotic activity (IC 50 = 189.86 mL/mL) by inhibiting the onion root tips Rasam showed an IC 50 value of 350.22 and 410.15 mL/mL against MCF-7 and Calu-6 cell lines respectively Rasam , when consumed on daily dietary basis, can treat breast and lung cancer. Abbreviations used: SS 316: Stainless Steel 316 grade; MTT: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide; DMEM: Dulbecco's modified Eagle medium; FBS: Fetal bovine serum media; TPVG: Trypsin phosphate versene glucose; EDTA: Ethylene diamine tetra acetic acid; PBS: Phosphate buffered saline; DMSO: Dimethyl sulfoxide.

Barriers to diabetes awareness and self-help are influenced by people's demographics: perspectives of South Asians with type 2 diabetes.

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Pardhan, Shahina; Nakafero, Georgina; Raman, Rajiv; Sapkota, Raju

2018-03-26

To determine whether barriers to diabetes awareness and self-help differ in South Asian participants of different demographic characteristics (age, gender, and literacy) with type 2 diabetes living in the United Kingdom. Six focus group discussions (FGDs) were carried out in patients who were categorized according to age (30-60 years, ≥60 years), gender (male, female) and literacy status (literate, illiterate). Data were analysed following the iterative process of thematic analysis techniques. Barriers were demographic-specific. The illiterate groups reported language as the major barrier to improved diabetes awareness and self-help. The literate groups reported that information provided by healthcare providers was general, and not specific to their diet/culture. Major barriers to adherence to the recommended diet for diabetes included: insufficient knowledge/awareness about nutritional content of food (all groups); lack of self-will to resist eating sweets, especially during weddings/festivals (literate older groups/literate younger females/illiterate older males); difficulty cooking separate meals for diabetic and non-diabetic family members (illiterate/literate older females). Other barriers to seeking advice/help ranged from not wanting to disclose their diabetes as it may affect employment/work (literate groups) to fear of being singled out at social gatherings (illiterate groups). General lack of motivation to exercise was reported by all groups. Time constraints and not knowing what/how to exercise was reported by literate younger groups whilst the illiterate older groups reported to not having suitable exercising facilities at local communities. Different barriers were also reported when accessing healthcare; language barriers (illiterate groups), restricted access to doctors' appointments/difficulty attending specific appointment slots offered by General Practitioners (literate females). Different barriers exist to improved awareness about diabetes and

Delayed follow-up in patients with diabetic retinopathy in South India: Social factors and impact on disease progression

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Natrajan Vengadesan

2017-01-01

Full Text Available Purpose: To identify social factors associated with delayed follow-up in South Indian patients with diabetic retinopathy (DR and to study DR progression during the delayed follow-up period. Materials and Methods: In this cross-sectional study, 500 consecutive patients with DR returning after greater than twice the advised follow-up period were identified from a tertiary referral center in South India. A previously validated 19-item questionnaire was administered to study patients to assess causes for the follow-up delay. Patient demographics, DR status, and treatment plan were recorded at the study visit and the visit immediately before the delay. The eye with the most severe disease was included in the analysis. Results: Complete data were available for 491 (98.2% patients. Among these, 248 (50.5% cited “my eyes were okay at the time,” 201 (41.0% cited “no attender to accompany me,” and 190 (38.6% cited “financial cost” as causes of the follow-up delay. Those with vision-threatening DR (VTDR, n = 233 predominantly reported “financial cost” (47% vs. 32%, P= 0.001, whereas those with non-VTDR more frequently reported “my eyes were okay at the time” (58% vs. 42%, P= 0.001. Evidence of disease progression from non-VTDR to VTDR was seen in 67 (26% patients. Almost 1/3rd (29% of patients who were previously advised regular examination required additional intervention. Conclusion: Many patient-level factors affect poor compliance with follow-up in DR, and these factors vary by disease severity. Targeting these barriers to care through patient education and clinic procedures may promote timely follow-up and better outcomes in these patients.

Spatial Epidemiology of Alcohol- and Drug-Related Health Problems Among Northern Plains American Indians: Nebraska and South Dakota, 2007 to 2012.

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Ponicki, William R; Henderson, Jeffrey A; Gaidus, Andrew; Gruenewald, Paul J; Lee, Juliet P; Moore, Roland S; Davids, Sharice; Tilsen, Nick

2018-03-01

Despite high abstinence rates, American Indians experience elevated rates of many alcohol and other drug problems. American Indians also predominantly reside in poor and rural areas, which may explain some observed health disparities. We investigated whether geographic areas including reservations or large American Indian populations exhibited greater incidence of alcohol- and drug-related hospitalizations. We obtained inpatient hospitalization records for 2 Northern Plain states (Nebraska and South Dakota) for the years 2007 to 2012. We constructed zip code counts for 10 categories of hospitalization with diagnoses or injury causation commonly associated with alcohol or drug use. We related these to community sociodemographic characteristics using Bayesian Poisson space-time regression models and examined associations with and without controls for whether each zip code was located within an American Indian reservation. Controlling for other demographic and economic characteristics, zip codes with greater percentage of American Indians exhibited greater incidence for all 10 substance abuse-related health outcomes (9 of 10 well supported); zip code areas within American Indian reservations had greater incidence of self-inflicted injury and drug dependence and abuse, and reduced incidence of alcohol cirrhosis and prescription opioid poisoning. However, the analyses generally demonstrated no well-supported differences in incidence associated with local residence percentages of American Indian versus African American. In our analyses, ethnicity or heredity alone did not account for alcohol- and drug-related hospitalizations among Native populations. Aspects of social, economic, and political dimensions of Native lives must be considered in the etiology of alcohol- and drug-related problems for rural-dwelling indigenous peoples. Copyright © 2018 by the Research Society on Alcoholism.

Mortality as a function of obesity and diabetes mellitus.

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Pettitt, D J; Lisse, J R; Knowler, W C; Bennett, P H

1982-03-01

Mortality according to body mass index (weight/height2) was studied in 2197 Pima Indians aged 15-74 years, as part of the longitudinal study of diabetes begun in 1965 in the Gila River Indian Community of Arizona. The Pima Indians are a population with a high prevalence of obesity, and they have the highest known incidence of type II (non-insulin dependent) diabetes mellitus. Among males, mortality was greatest in those with a body mass index of at least 40 kg/m2, but obesity had little effect on mortality at body mass indices below 40 kg/m2. Age-specific death rates in women were not consistently related to obesity, although mortality in subjects with diabetes was higher than in those without. In men, diabetes had little effect on mortality. In this study, as in several other mortality studies, the lowest mortality rates were experienced by people with body weights well above those recommended as "desirable" by the Society of Actuaries in 1959. Thus, the applicability of the "desirable" weight standards in common use is questioned.

Traditional Indian customs surrounding birth A review | Chalmers ...

African Journals Online (AJOL)

Since 1960, only a few studies have been made of traditional custOIns surrounding birth in Indian culture. Very few of these have described customs followed by Indians in South Africa. A review of these publications is presented here. Customs described include religious, social and psychological aspects of behaviour in ...

Tobacco Use and Cardiovascular Disease among American Indians: The Strong Heart Study

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Thomas K. Welty

2010-10-01

Full Text Available Tobacco use among American Indians has a long and complicated history ranging from its utilization in spiritual ceremonies to its importance as an economic factor for survival. Despite this cultural tradition and long history, there are few studies of the health effects of tobacco in this population. The Strong Heart Study is a prospective observational study of cardiovascular disease (CVD in 13 American Indian tribes in Arizona, Oklahoma, and North and South Dakota with 4,549 participants. Baseline examinations were followed by two examinations at regular intervals and 16 years of morbidity and mortality follow-up. Hazard ratios (HRs for non-fatal CVD for current smokers vs. non-smokers after adjusting for other risk factors were significant in women (HR = 1.94, 95% CI 1.54 to 2.45 and men (HR = 1.59, 95% CI 1.16 to 2.18. Hazard ratios for fatal CVD for current smokers vs. non-smokers after adjusting for other risk factors were significant in women (HR = 1.64, 95% CI 1.04 to 2.58, but not in men. Individuals who smoked and who were diagnosed with diabetes mellitus, hypertension or renal insufficiency were more likely to quit smoking than those without these conditions. On average, American Indians smoke fewer cigarettes per day than other racial/ethnic groups; nevertheless, the ill effects of habitual tobacco use are evident in this population.

Economic Burden of Diabetes in Urban Indians

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Chandra, Pablo; Gogate, Bageshri; Gogate, Parikshit; Thite, Nilesh; Mutha, Abhay; Walimbe, Amit

2014-01-01

Purpose : To find out the average economic burden of medical care on a patient with diabetes in Pune, India Methods : A semi-open ended questionnaire followed by interview was conducted with patients attending diabetes and ophthalmic out-patient departments. They were asked regarding the duration of diabetes, methods undertaken for blood sugar control and the amount they spend on consultations, laboratory tests, medicines and procedures if any within past year. Expenditure was classified as d...

Analysis of SLC16A11 Variants in 12,811 American Indians: Genotype-Obesity Interaction for Type 2 Diabetes and an Association With RNASEK Expression

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Traurig, Michael; Hanson, Robert L.; Marinelarena, Alejandra; Kobes, Sayuko; Piaggi, Paolo; Cole, Shelley; Curran, Joanne E.; Blangero, John; Göring, Harald; Kumar, Satish; Nelson, Robert G.; Howard, Barbara V.; Knowler, William C.; Baier, Leslie J.

2016-01-01

Genetic variants in SLC16A11 were recently reported to be associated with type 2 diabetes in Mexican and other Latin American populations. The diabetes risk haplotype had a frequency of 50% in Native Americans from Mexico but was rare in Europeans and Africans. In the current study, we analyzed SLC16A11 in 12,811 North American Indians and found that the diabetes risk haplotype, tagged by the rs75493593 A allele, was nominally associated with type 2 diabetes (P = 0.001, odds ratio 1.11). However, there was a strong interaction with BMI (P = 5.1 × 10−7) such that the diabetes association was stronger in leaner individuals. rs75493593 was also strongly associated with BMI in individuals with type 2 diabetes (P = 3.4 × 10−15) but not in individuals without diabetes (P = 0.77). Longitudinal analyses suggest that this is due, in part, to an association of the A allele with greater weight loss following diabetes onset (P = 0.02). Analyses of global gene expression data from adipose tissue, skeletal muscle, and whole blood provide evidence that rs75493593 is associated with expression of the nearby RNASEK gene, suggesting that RNASEK expression may mediate the effect of genotype on diabetes. PMID:26487785

Medicinal perceptions of vegetables traditionally consumed by South-Asian migrants living in Bradford, Northern England.

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Pieroni, Andrea; Houlihan, Laura; Ansari, Nafeesa; Hussain, Bushra; Aslam, Saiqa

2007-08-15

Dietary habits change rapidly amongst migrant communities in Western countries, and these changes can cause major concerns for public-health policymakers because they frequently lead to increases in diet-related diseases like diabetes. Such is the case in most South-Asian communities in the UK. In this study, we carried out an ethnobiological survey of the vegetables traditionally consumed among the Indian and Pakistani communities of Bradford, in Western Yorkshire, UK. Our purpose was to analyse in depth details of the traditional culinary use of vegetables within these households, and to assess the health perceptions of them. Semi-structured interviews with a total of 150 South-Asian women were carried out. Twenty-five vegetables were recorded, as well as their traditional culinary use and their frequency of use. We found that a few of these vegetables, particularly those presenting bitter or aromatic tastes, were perceived to have remarkable medicinal value particularly against diabetes. Our study also found important generational differences in the women's knowledge of the culinary processes related to these foods, confirming that the consumption of traditional vegetables is inextricably embedded in cultural heritage and the representation of identity among migrants. Our findings may offer evidence of a link between the choice of food and the foods' perceived medicinal value among South-Asian migrants. It may also provide important information for health care professionals when designing strategies for improving health care counteracting type 2 diabetes. We strongly believe such strategies should take into account socio-cultural components and emic health beliefs, as well as patients' views of traditional dietary ingredients.

Journal of Genetics | Indian Academy of Sciences

Indian Academy of Sciences (India)

Cytotaxonomical analysis of Momordica L. (Cucurbitaceae) species of Indian ..... putative kinase 1 gene associated with the increase risk of type 2 diabetes in northern ... genetic polymorphisms involved in cancer cachexia: a systematic review.

Outward Bound with Ayyappan: Work, Masculinity, and Self-Respect in a South Indian Pilgrimage Festival

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Elizabeth (Liz Wilson

2016-06-01

Full Text Available The annual pilgrimage festival dedicated to the god Ayyappan has become immensely popular in the past sixty years. As many as fifty million pilgrims participate each year. This paper draws on interviews of pilgrims conducted in South India in 2012–2013. My fieldwork suggests that the increasing popularity of the event relates to the contemporary South Indian work environment, an environment in which traditional gender roles are being reshaped by the challenges posed by migration for work opportunities. Interviews of English-speaking pilgrims show that their interpretations of the pilgrimage festival highlight the complexities of manhood in a time of rapidly changing work roles for men and women. Specifically, my fieldwork demonstrates that pilgrims perceive Ayyappan as a source of aid for those who struggle to succeed as financial providers and heads of the family unit. Pilgrims anxious about the loss of traditional models of masculinity amidst rapid change find solace in the blessings the god Ayyappan yields.

Tumour necrosis factor alpha and interleukin 10 gene ...

Indian Academy of Sciences (India)

2011-08-19

Aug 19, 2011 ... 1Bhagwan Mahavir Medical Research Centre, Hyderabad 500 004, India. 2Institute of ... diagnosis and ischemic stroke cases were differentiated ... Diabetes Mellitus 2009). ..... South Indian patients with type 2 diabetes.

Benefits & risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians – A population with the highest risk of premature coronary artery disease & diabetes

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Enas, Enas A.; Kuruvila, Arun; Khanna, Pravien; Pitchumoni, C.S.; Mohan, Viswanathan

2013-01-01

Several reviews and meta-analyses have demonstrated the incontrovertible benefits of statin therapy in patients with cardiovascular disease (CVD). But the role for statins in primary prevention remained unclear. The updated 2013 Cochrane review has put to rest all lingering doubts about the overwhelming benefits of long-term statin therapy in primary prevention by conclusively demonstrating highly significant reductions in all-cause mortality, major adverse cardiovascular events (MACE) and the need for coronary artery revascularization procedures (CARPs). More importantly, these benefits of statin therapy are similar at all levels of CVD risk, including subjects at low (statins is also highly effective in delaying and avoiding expensive CARPs such as angioplasties, stents, and bypass surgeries. There is no evidence of any serious harm or threat to life caused by statin therapy, though several adverse effects that affect the quality of life, especially diabetes mellitus (DM) have been reported. Asian Indians have the highest risk of premature coronary artery disease (CAD) and diabetes. When compared with Whites, Asian Indians have double the risk of CAD and triple the risk of DM, when adjusted for traditional risk factors for these diseases. Available evidence supports the use of statin therapy for primary prevention in Asian Indians at a younger age and with lower targets for low-density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein (non-HDL-C), than those currently recommended for Americans and Europeans. Early and aggressive statin therapy offers the greatest potential for reducing the continuing epidemic of CAD among Indians. PMID:24434254

Type 2 diabetes: identifying high risk Asian American subgroups in a clinical population.

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Wang, Elsie J; Wong, Eric C; Dixit, Anjali A; Fortmann, Stephen P; Linde, Randolph B; Palaniappan, Latha P

2011-08-01

We compared the prevalence and treatment of type 2 diabetes across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) and Non-Hispanic Whites (NHWs) in a Northern California healthcare system. A three-year, cross-sectional sample of patient electronic health records was accessed to compare diabetes prevalence in 21,816 Asian and 73,728 NHWs aged 35+ years. Diabetes was classified through ICD-9 codes, abnormal laboratory values, or use of oral anti-diabetic medication. Multivariate adjusted prevalence rates for each Asian subgroup, and adjusted odds ratios (OR) relative to NHWs, were compared. Age-adjusted prevalence ranged from 5.8% to 18.2% (women) and 8.1 to 25.3% (men). Age-adjusted ORs of Asian subgroups ranged 1.11-3.94 (women) and 1.14-4.56 (men). The odds of diabetes were significantly higher in Asian Indians (women OR 3.44, men OR 3.54) and Filipinos (women OR 3.94, men OR 4.56), compared to NHWs. Results for Asian Indians and Filipinos were similar with age-and-BMI adjustment. Treatment rates across subgroups were 59.7-82.0% (women) and 62.9-79.4% (men). Heterogeneity exists in the prevalence of diabetes across Asian subgroups, independent of obesity prevalence. Asian Indian and Filipino subgroups had particularly high prevalence of diabetes when compared to NHWs. Future studies should explore these clinically important differences among Asian subgroups. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Clinical characteristics, angiographic profile and in hospital mortality in acute coronary syndrome patients in south indian population

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Rajni Sharma

2014-01-01

Full Text Available Aims: The aim was to study the clinical profile, risk factors prevalence, angiographic distribution, and severity of coronary artery stenosis in acute coronary syndrome (ACS patients of South Indian population. Materials and Methods: A total of 1562 patients of ACS were analyzed for various risk factors, angiographic pattern and severity of coronary heart disease, complications and in hospital mortality at Sri Jayadeva Institute of Cardiovascular Research and Sciences, Bengaluru, Karnataka, India. Results: Mean age of presentation was 54.71 ± 19.90 years. Majority were male 1242 (79.5% and rest were females. Most patients had ST elevation myocardial infarction (STEMI 995 (63.7% followed by unstable angina (UA 390 (25% and non-STEMI (NSTEMI 177 (11.3%. Risk factors; smoking was present in 770 (49.3%, hypertension in 628 (40.2%, diabetes in 578 (37%, and obesity in (29.64% patients. Angiography was done in 1443 (92.38% patients. left anterior descending was most commonly involved, left main (LM coronary artery was least common with near similar frequency of right coronary artery and left circumflex involvement among all three groups of ACS patients. Single-vessel disease was present in 168 (45.28% UA, 94 (56.29% NSTEMI and 468 (51.71% STEMI patients. Double-vessel disease was present in 67 (18.08% UA, 25 (14.97% NSTEMI and 172 (19.01% STEMI patients. Triple vessel disease was present in 28 (7.55% UA, 16 (9.58% NSTEMI, 72 (7.95% STEMI patients. LM disease was present in 12 (3.23% UA, 2 (1.19% NSTEMI and 9 (0.99% STEMI patients. Complications; ventricular septal rupture occurred in 3 (0.2%, free wall rupture in 2 (0.1%, cardiogenic shock in 45 (2.9%, severe mitral regurgitation in 3 (0.2%, complete heart block in 11 (0.7% patients. Total 124 (7.9% patients died in hospital after 2.1 ± 1.85 days of admission. Conclusion: STEMI was most common presentation. ACS occurred a decade earlier in comparison to Western population. Smoking was most prevalent

Understanding Cultural Influences on Dietary Habits in Asian, Middle Eastern, and Latino Patients with Type 2 Diabetes: A Review of Current Literature and Future Directions.

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Mora, Natalie; Golden, Sherita Hill

2017-10-23

This review focuses on evaluating and identifying gaps in the current literature regarding culturally specific dietary influences for patients with type 2 diabetes. As this topic has previously been examined in African American populations, we chose to focus on four other distinct populations (Hispanic, Middle Eastern, Western Pacific, South Asian). Given the rapid increase in global rates of type 2 diabetes and high rates of diabetes among certain ethnic groups, it is important to understand how culturally adapted strategies in diabetes management have been described in different regions and populations. The specific role of nutrition in controlling diabetes is tied to cultural habits and customs. Variation in cultural practices, including diet, create unique environments in which patients with diabetes must navigate. The role of family, particularly among Hispanics, is crucial to cultural adaptations of diabetes management. Incorporating alternative medicine, namely observed in Chinese and Indian populations, also guided diabetes care strategies. Language barriers, health literacy, and acculturation were all unique factors affecting cultural approaches to diabetes management in these four populations. Understanding such cultural determinants is crucial to addressing diabetes disparities and improving outcomes.

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

... particularly in the Indian region, which suggests that the tropical Pacific SST forcing is not sufficient to represent ENSO-induced teleconnection patterns over South Asia. Therefore, SST forcing over the tropical Indian Ocean together with air–sea coupling is alsorequired for better representation of ENSO-induced changes ...

Interannual variability of the tropical Indian Ocean mixed layer depth

Digital Repository Service at National Institute of Oceanography (India)

Keerthi, M.G.; Lengaigne, M.; Vialard, J.; Montegut, C.deB.; Muraleedharan, P.M.

, shoaling the MLD (Masson et al. 2002, Qu and Meyers 2005, Du et al. 2005). The seasonal cycle in the southern tropical Indian Ocean has been less 3 investigated. Seasonal shoaling and deepening of the mixed layer in the south-western Tropical Indian...

Risk factors for choledocholithiasis in a south Indian population: a case-control study.

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Chandran, Alexander Palapatti; Sivarajan, Ramya Ramakrishnan; Srinivas, Melpakkam; Srinivasan, Vijaya; Venkataraman, Jayanthi

2013-11-01

To identify risk factors for common bile duct (CBD) stones in a south Indian population. Demographic characteristics and diet details were obtained from patients with isolated CBD stones (Gp I) and those with combined CBD and gallstones (Gp II) and age- and sex-matched controls. The risk factors were compared between the two groups. The demographic characteristics were similar between the two groups and matched controls. The significant risk factors for Gp I were infrequent consumption of green vegetable (odds ratio (OR), 2.3; p 3 times per week) of spices (OR, 2.8; p oil (p oil intake (251 + 105 vs. 292 + 89 mL; p CBD stones in both groups were associated with reduced intake of sugar and green vegetables. Our findings need to be validated in larger studies.

Effects of 16 genetic variants on fasting glucose and type 2 diabetes in South Asians: ADCY5 and GLIS3 variants may predispose to type 2 diabetes.

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Simon D Rees

Full Text Available BACKGROUND: The Meta-Analysis of Glucose and Insulin related traits Consortium (MAGIC recently identified 16 loci robustly associated with fasting glucose, some of which were also associated with type 2 diabetes. The purpose of our study was to explore the role of these variants in South Asian populations of Punjabi ancestry, originating predominantly from the District of Mirpur, Pakistan. METHODOLOGY/PRINCIPAL FINDINGS: Sixteen single nucleotide polymorphisms (SNPs were genotyped in 1678 subjects with type 2 diabetes and 1584 normoglycaemic controls from two Punjabi populations; one resident in the UK and one indigenous to the District of Mirpur. In the normoglycaemic controls investigated for fasting glucose associations, 12 of 16 SNPs displayed β values with the same direction of effect as that seen in European studies, although only the SLC30A8 rs11558471 SNP was nominally associated with fasting glucose (β = 0.063 [95% CI: 0.013, 0.113] p = 0.015. Of interest, the MTNR1B rs10830963 SNP displayed a negative β value for fasting glucose in our study; this effect size was significantly lower than that seen in Europeans (p = 1.29×10(-4. In addition to previously reported type 2 diabetes risk variants in TCF7L2 and SLC30A8, SNPs in ADCY5 (rs11708067 and GLIS3 (rs7034200 displayed evidence for association with type 2 diabetes, with odds ratios of 1.23 (95% CI: 1.09, 1.39; p = 9.1×10(-4 and 1.16 (95% CI: 1.05, 1.29; p = 3.49×10(-3 respectively. CONCLUSIONS/SIGNIFICANCE: Although only the SLC30A8 rs11558471 SNP was nominally associated with fasting glucose in our study, the finding that 12 out of 16 SNPs displayed a direction of effect consistent with European studies suggests that a number of these variants may contribute to fasting glucose variation in individuals of South Asian ancestry. We also provide evidence for the first time in South Asians that alleles of SNPs in GLIS3 and ADCY5 may confer risk of type 2 diabetes.

Morphometric study of tensor of vastus intermedius in South Indian population.

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Veeramani, Raveendranath; Gnanasekaran, Dhivyalakshmi

2017-03-01

Tensor of vastus intermedius is a newly discovered muscle located between vastus lateralis and vastus intermedius. The purpose of this study was to investigate the detailed morphology of tensor of vastus intermedius, specifically to provide data pertaining to the attachments, innervations, variation in the types and its morphometry in South Indian population. The tensor of vastus intermedius was studied in thirty six cadaveric lower limbs using macrodissection techniques. The origin of the muscle was from upper part of intertrochanteric line and anterior part of greater trochanter of femur inserted to medial aspect of upper border of patella. The muscle was classified into four types based on the origin and also the aponeurosis course with independent type (type 1) being common. The mean and standard deviation of the length of tensor of vastus intermedius and aponeurosis were 145.40±37.55 mm and 193.55±42.32 mm, respectively. The results of the study suggest that tensor of vastus intermedius is variable and the information provided regarding the attachments, types and quantitative data will contribute to the existing knowledge of the muscle.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

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Full Text Available ... site content U.S. Department of Health and Human Services Indian Health Service The Federal Health Program for American Indians and ... Indian/Alaska Native communities. IHS Headquarters, Indian Health Service, 5600 Fishers Lane, Rockville, MD 20857 - Find a ...

Prevalence of specific learning disabilities among primary school children in a South Indian city.

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Mogasale, Vijayalaxmi V; Patil, Vishwanath D; Patil, Nanasaheb M; Mogasale, Vittal

2012-03-01

To measure the prevalence of specific learning disabilities (SpLDs) such as dyslexia, dysgraphia and dyscalculia among primary school children in a South Indian city. A cross-sectional multi-staged stratified randomized cluster sampling study was conducted among children aged 8-11 years from third and fourth standard. A six level screening approach that commenced with identification of scholastic backwardness followed by stepwise exclusion of impaired vision and hearing, chronic medical conditions and subnormal intelligence was carried out among these children. In the final step, the remaining children were subjected to specific tests for reading, comprehension, writing and mathematical calculation. The prevalence of specific learning disabilities was 15.17% in sampled children, whereas 12.5%, 11.2% and 10.5% had dysgraphia, dyslexia and dyscalculia respectively. This study suggests that the prevalence of SpLDs is at the higher side of previous estimations in India. The study is unique due to its large geographically representative design and identification of the problem using simplified screening approach and tools, which minimizes the number and time of specialist requirement and spares the expensive investigation. This approach and tools are suitable for field situations and resource scarce settings. Based on the authors' experience, they express the need for more prevalence studies, remedial education and policy interventions to manage SpLDs at main stream educational system to improve the school performance in Indian children.

Total body fat, proinflammatory cytokines and insulin resistance in Indian subjects. Highlights and achievements

International Nuclear Information System (INIS)

Yajnik, C.S.

2002-01-01

Urban and migrant Indians are experiencing a rapidly escalating epidemic of diabetes and CHD. This may be related to high body fat percentage in Indians and its central distribution which have been shown to be detrimental for metabolism

Population and genomic lessons from genetic analysis of two Indian populations.

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Juyal, Garima; Mondal, Mayukh; Luisi, Pierre; Laayouni, Hafid; Sood, Ajit; Midha, Vandana; Heutink, Peter; Bertranpetit, Jaume; Thelma, B K; Casals, Ferran

2014-10-01

Indian demographic history includes special features such as founder effects, interpopulation segregation, complex social structure with a caste system and elevated frequency of consanguineous marriages. It also presents a higher frequency for some rare mendelian disorders and in the last two decades increased prevalence of some complex disorders. Despite the fact that India represents about one-sixth of the human population, deep genetic studies from this terrain have been scarce. In this study, we analyzed high-density genotyping and whole-exome sequencing data of a North and a South Indian population. Indian populations show higher differentiation levels than those reported between populations of other continents. In this work, we have analyzed its consequences, by specifically assessing the transferability of genetic markers from or to Indian populations. We show that there is limited genetic marker portability from available genetic resources such as HapMap or the 1,000 Genomes Project to Indian populations, which also present an excess of private rare variants. Conversely, tagSNPs show a high level of portability between the two Indian populations, in contrast to the common belief that North and South Indian populations are genetically very different. By estimating kinship from mates and consanguinity in our data from trios, we also describe different patterns of assortative mating and inbreeding in the two populations, in agreement with distinct mating preferences and social structures. In addition, this analysis has allowed us to describe genomic regions under recent adaptive selection, indicating differential adaptive histories for North and South Indian populations. Our findings highlight the importance of considering demography for design and analysis of genetic studies, as well as the need for extending human genetic variation catalogs to new populations and particularly to those with particular demographic histories.

Ectodermal Dysplasia: Report and Analysis of Eleven South Indian Patients with Review of Literature

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Renuka Ammanagi

2010-01-01

Full Text Available Ectodermal dysplasia represents a rare syndrome affecting two or more ectodermally derived structures. The condition is thought to occur in approximately 1 in every 100,000 live births. It affects men more frequently and severely, while women being the carriers and heterozygote usually show minor defects. There are more than 150 different variants of ectodermal dysplasia (ED reported in the literature. Most commonly encountered among them is hypohidrotic ED which frequently exhibits the most severe dental anomalies like hypodontia or anodontia along with hypohidrosis and hypotrichosis. Here we make an attempt to collectively report and discuss eleven South Indian patients who reported to our department during the year 1998 to 2004. An added emphasis is laid on family history of consanguineous marriage among the parents of these patients.

Towards understanding the low prevalence of Helicobacter pylori in Malays: genetic variants among Helicobacter pylori-negative ethnic Malays in the north-eastern region of Peninsular Malaysia and Han Chinese and South Indians.

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Maran, Sathiya; Lee, Yeong Yeh; Xu, Shu Hua; Raj, Mahendra Sundramoorthy; Abdul Majid, Noorizan; Choo, Keng Ee; Zilfalil, Bin Alwi; Graham, David Y

2013-04-01

To identify gene polymorphisms that differ between Malays, Han Chinese and South Indians, and to identify candidate genes for the investigation of their role in protecting Malays from Helicobacter pylori (H. pylori) infection. Malay participants born and residing in Kelantan with a documented absence of H. pylori infection were studied. Venous blood was used for genotyping using the Affymetrix 50K Xba I kit. CEL files from 141 Han Chinese and 76 South Indians were analyzed to compare their allele frequency with that of the Malays using fixation index (FST ) calculation. The single nucleotide polymorphisms (SNPs) with the highest allele frequency (outliers) were then examined for their functional characteristics using F-SNP software and the Entrez Gene database. In all, 37 Malays were enrolled in the study; of whom 7 were excluded for low genotyping call rates. The average FST estimated from the genome-wide data were 0.038 (Malays in Kelantan vs the South Indians), 0.015 (Malays in Kelantan vs Han Chinese) and 0.066 (Han Chinese vs South Indians), respectively. The outlier gene variants present in Malays with functional characteristics were C7orf10 (FST  0.29988), TSTD2 (FST  0.43278), SMG7 (FST  0.29877) and XPA (FST  0.43393 and 0.43644). Genetic variants possibly related to protection against H. pylori infection in ethnic Malays from the north-eastern region of Peninsular Malaysia were identified for testing in subsequent trials among infected and uninfected Malays. © 2012 The Authors. Journal of Digestive Diseases © 2012 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

When's dinner? Does timing of dinner affect the cardiometabolic risk profiles of South-Asian Canadians at risk for diabetes.

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Sandhu, S K; Tang, T S

2017-04-01

To explore the relationship between the time dinner is consumed (dinnertime or timing of dinner) and cardiometabolic risk factors among South-Asian Canadians at risk for diabetes. We recruited 432 South-Asian adults affiliated with Sikh and Hindu Temples in Metro Vancouver. Participants deemed to be at risk of diabetes underwent a clinical and behavioural assessment. Dinnertime was measured via self-report. Clinical endpoints included HbA 1c , apolipoprotein, blood pressure, weight, BMI and waist circumference. The mean age of participants was 65 years and 59% were male. Dinnertime was categorized into three groups: early (before 18:00 h); average (18:00 to 20:00 h); and late (later than 20:00 h). Among the participants, 19% (n = 79), 44% (n = 187) and 37% (n = 157) reported early, average and late dinnertimes, respectively. Significant differences were found for dinnertime groups and years of residence in Canada, gender and employment. Compared with the early dinnertime group, the late dinnertime group lived in Canada for a shorter duration, comprised a higher proportion of males (66 vs 48%; P = 0.01) and were currently employed (37 vs 22%; P = 0.02). With regard to clinical endpoints, compared with the early dinnertime group, the late dinnertime group had lower systolic blood pressure (135.9 vs 131.7 mmHg; P = 0.03). After controlling for demographic characteristics, this difference was diminished. No significant differences were found between dinnertime and HbA 1c , apolipoprotein, diastolic blood pressure, weight, BMI and waist circumference. Findings suggest that, among this sample of South-Asian Canadians at risk of Type 2 diabetes, there was no association between timing of the evening meal and cardiometabolic profiles. © 2016 Diabetes UK.

Diabetes Awareness and Body Size Perceptions of Cree Schoolchildren

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Willows, Noreen D.; Marshall, Dru; Raine, Kim; Ridley, Denise C.

2009-01-01

Native American Indians and First Nations are predisposed to obesity and diabetes. A study was done to understand Cree schoolchildren's diabetes awareness and body size perceptions in two communities that had diabetes awareness-raising activities in the Province of Quebec, Canada. Children (N = 203) in grades 4-6 were classified into weight…

Assessment of two versions of regional climate model in simulating the Indian Summer Monsoon over South Asia CORDEX domain

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Pattnayak, K. C.; Panda, S. K.; Saraswat, Vaishali; Dash, S. K.

2018-04-01

This study assess the performance of two versions of Regional Climate Model (RegCM) in simulating the Indian summer monsoon over South Asia for the period 1998 to 2003 with an aim of conducting future climate change simulations. Two sets of experiments were carried out with two different versions of RegCM (viz. RegCM4.2 and RegCM4.3) with the lateral boundary forcings provided from European Center for Medium Range Weather Forecast Reanalysis (ERA-interim) at 50 km horizontal resolution. The major updates in RegCM4.3 in comparison to the older version RegCM4.2 are the inclusion of measured solar irradiance in place of hardcoded solar constant and additional layers in the stratosphere. The analysis shows that the Indian summer monsoon rainfall, moisture flux and surface net downward shortwave flux are better represented in RegCM4.3 than that in the RegCM4.2 simulations. Excessive moisture flux in the RegCM4.2 simulation over the northern Arabian Sea and Peninsular India resulted in an overestimation of rainfall over the Western Ghats, Peninsular region as a result of which the all India rainfall has been overestimated. RegCM4.3 has performed well over India as a whole as well as its four rainfall homogenous zones in reproducing the mean monsoon rainfall and inter-annual variation of rainfall. Further, the monsoon onset, low-level Somali Jet and the upper level tropical easterly jet are better represented in the RegCM4.3 than RegCM4.2. Thus, RegCM4.3 has performed better in simulating the mean summer monsoon circulation over the South Asia. Hence, RegCM4.3 may be used to study the future climate change over the South Asia.

Foot Kinetics and Kinematics Profile in Type 2 Diabetes Mellitus with Peripheral Neuropathy: A Hospital Based Study from South India.

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Hazari, Animesh; Maiya, Arun G; N, Shivashankara K

2018-02-01

A kinetic change in thefoot like altered plantar pressure is the most common etiological risk factor for causing foot ulcers among people with diabetes mellitus. Kinematic alterations in joint angle and spatiotemporal parameters of the gait have also been frequently observed in participants with diabetes peripheral neuropathy. Diabetes peripheral neuropathy is the most common long-term standing complication of type 2 diabetes mellitus. It leads to various micro and macrovascular related complication of the foot. There is a gap in theliteraturefor biomechanical evaluation and assessment in type 2 diabetes mellitus with peripheral neuropathy in Indian population. The aim of the study was to assess and determine the biomechanical changes including kinetics and kinematics of foot among diabetic peripheral neuropathy. The cross-sectional study was conducted at Diabetic Foot Clinic, Kasturba Hospital, Manipal University, Manipal, Karnataka, India. A total of 120 participants with type 2 diabetes mellitus and peripheral neuropathywere recruited under the purposive sampling method. Participants with any active ulceration or amputation were excluded from the study. The mean age, height, weight, body mass index, duration of diabetes was 57±14 year, 164±11cm, 61±18kg, 24± 3, 12±7 year respectively. There were significant changes in overall biomechanical profile along with clinical manifestations of diabetes peripheral neuropathy.The regression analysis showed statistical significance for dynamic maximum plantar pressure at forefoot with age, weight, height, duration of diabetes, body mass index, knee & ankle joint angle at toe-off phase of gait cycle,pinprick sensation and ankle reflex (R=.71,R =.55, F (12, 108)=521.9 kPa, p=.002) Conclusions: From the present study, we conclude that people with type 2 diabetes mellitus and peripheral neuropathy have significant changes in their foot kinetics and kinematicsparameters. Therefore, they could be at higher risk of foot

Ethnic variation in the prevalence of visual impairment in people attending diabetic retinopathy screening in the United Kingdom (DRIVE UK.

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Sobha Sivaprasad

Full Text Available To provide estimates of visual impairment in people with diabetes attending screening in a multi-ethnic population in England (United Kingdom.The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People on the diabetes register in West Yorkshire and South East London who were screened, treated or monitored between April 2008 to July 2009 (London or August 2009 (West Yorkshire were included in the study. Data on age, gender, ethnic group, visual acuity and diabetic retinopathy were collected. Ethnic group was defined according to the 2011 census classification. The two main ethnic minority groups represented here are Blacks ("Black/African/Caribbean/Black British" and South Asians ("Asians originating from the Indian subcontinent". We examined the prevalence of visual impairment in the better eye using three cut-off points (a loss of vision sufficient for driving (approximately <6/9 (b visual impairment (<6/12 and (c severe visual impairment (<6/60, standardising the prevalence of visual impairment in the minority ethnic groups to the age-structure of the white population.Data on visual acuity and were available on 50,331 individuals 3.4% of people diagnosed with diabetes and attending screening were visually impaired (95% confidence intervals (CI 3.2% to 3.5% and 0.39% severely visually impaired (0.33% to 0.44%. Blacks and South Asians had a higher prevalence of visual impairment (directly age standardised prevalence 4.6%, 95% CI 4.0% to 5.1% and 6.9%, 95% CI 5.8% to 8.0% respectively compared to white people (3.3%, 95% CI 3.1% to 3.5%. Visual loss was also more prevalent with increasing age, type 1 diabetes and in people living in Yorkshire.Visual impairment remains an important public health problem in people with diabetes, and is more prevalent in the minority ethnic groups in the UK.

Neutrophil-lymphocyte ratio is a novel reliable predictor of nephropathy, retinopathy, and coronary artery disease in Indians with type-2 diabetes

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Sachin Chittawar

2017-01-01

Full Text Available Background and Aims: Neutrophil-lymphocyte ratio (NLR has been suggested to be a predictor of coronary artery disease (CAD, and end-organ damage in type-2 diabetes mellitus (T2DM. Similar data are lacking from Indians with T2DM. Hence, this study aimed to evaluate the role of NLR as a predictor of microvascular complications and CAD in T2DM. Subjects and Methods: Consecutive T2DM patients attending the outpatient services of 2 different hospitals, who gave consent, underwent clinical, anthropometric evaluation, and evaluation for the occurrence of retinopathy, nephropathy, neuropathy, and CAD. Results: A total of 298 patients were screened of which 265 patients' data were analyzed. Occurrence of hypertension, neuropathy, nephropathy, retinopathy, and CAD was 12.8%, 18.5%, 41.5%, 62.3%, and 3.8%, respectively. Patients in higher NLR quartiles had significantly higher diabetes duration, occurrence of nephropathy, albuminuria, retinopathy, CAD and lpwer glomerular filtration rate. Patients with more microvascular complications had significantly longer diabetes duration, blood pressure, NLR, creatinine, and urine albumin excretion. Binary logistic regression revealed NLR followed by body mass index were best predictors of microvascular complications. NLR had areas under the receiver operating characteristic curve (AUC of 0.888 (95% CI: 0.848–0.929; P < 0.001, 0.708 (95% CI: 0.646–0.771; P < 0.001, and 0.768 (95% CI: 0.599–938; P = 0.004 in predicting albuminuria, retinopathy, and CAD, respectively. NLR of 2.00 had sensitivity and specificity of 86.4% and 69% in predicting albuminuria; sensitivity and specificity of 64.2% and 63% in predicting retinopathy; sensitivity and specificity of 80% and 47.1% in predicting CAD. Conclusion: NLR is inexpensive, easy to use, reliable predictor of nephropathy, retinopathy, and CAD in Indian T2DM.

Constraints faced by urban poor in managing diabetes care: patients’ perspectives from South India

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Upendra Bhojani

2013-10-01

Full Text Available Background: Four out of five adults with diabetes live in low- and middle-income countries (LMIC. India has the second highest number of diabetes patients in the world. Despite a huge burden, diabetes care remains suboptimal. While patients (and families play an important role in managing chronic conditions, there is a dearth of studies in LMIC and virtually none in India capturing perspectives and experiences of patients in regard to diabetes care. Objective: The objective of this study was to better understand constraints faced by patients from urban slums in managing care for type 2 diabetes in India. Design: We conducted in-depth interviews, using a phenomenological approach, with 16 type 2- diabetes patients from a poor urban neighbourhood in South India. These patients were selected with the help of four community health workers (CHWs and were interviewed by two trained researchers exploring patients’ experiences of living with and seeking care for diabetes. The sampling followed the principle of saturation. Data were initially coded using the NVivo software. Emerging themes were periodically discussed among the researchers and were refined over time through an iterative process using a mind-mapping tool. Results: Despite an abundance of healthcare facilities in the vicinity, diabetes patients faced several constraints in accessing healthcare such as financial hardship, negative attitudes and inadequate communication by healthcare providers and a fragmented healthcare service system offering inadequate care. Strongly defined gender-based family roles disadvantaged women by restricting their mobility and autonomy to access healthcare. The prevailing nuclear family structure and inter-generational conflicts limited support and care for elderly adults. Conclusions: There is a need to strengthen primary care services with a special focus on improving the availability and integration of health services for diabetes at the community level

Polymorphic Alu Insertion/Deletion in Different Caste and Tribal Populations from South India.

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Chinniah, Rathika; Vijayan, Murali; Thirunavukkarasu, Manikandan; Mani, Dhivakar; Raju, Kamaraj; Ravi, Padma Malini; Sivanadham, Ramgopal; C, Kandeepan; N, Mahalakshmi; Karuppiah, Balakrishnan

2016-01-01

Seven human-specific Alu markers were studied in 574 unrelated individuals from 10 endogamous groups and 2 hill tribes of Tamil Nadu and Kerala states. DNA was isolated, amplified by PCR-SSP, and subjected to agarose gel electrophoresis, and genotypes were assigned for various Alu loci. Average heterozygosity among caste populations was in the range of 0.292-0.468. Among tribes, the average heterozygosity was higher for Paliyan (0.3759) than for Kani (0.2915). Frequency differences were prominent in all loci studied except Alu CD4. For Alu CD4, the frequency was 0.0363 in Yadavas, a traditional pastoral and herd maintaining population, and 0.2439 in Narikuravars, a nomadic gypsy population. The overall genetic difference (Gst) of 12 populations (castes and tribes) studied was 3.6%, which corresponds to the Gst values of 3.6% recorded earlier for Western Asian populations. Thus, our study confirms the genetic similarities between West Asian populations and South Indian castes and tribes and supported the large scale coastal migrations from Africa into India through West Asia. However, the average genetic difference (Gst) of Kani and Paliyan tribes with other South Indian tribes studied earlier was 8.3%. The average Gst of combined South and North Indian Tribes (CSNIT) was 9.5%. Neighbor joining tree constructed showed close proximity of Kani and Paliyan tribal groups to the other two South Indian tribes, Toda and Irula of Nilgiri hills studied earlier. Further, the analysis revealed the affinities among populations and confirmed the presence of North and South India specific lineages. Our findings have documented the highly diverse (micro differentiated) nature of South Indian tribes, predominantly due to isolation, than the endogamous population groups of South India. Thus, our study firmly established the genetic relationship of South Indian castes and tribes and supported the proposed large scale ancestral migrations from Africa, particularly into South India

40 CFR 147.2051 - EPA-administered program-Indian lands.

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2010-07-01

... Carolina § 147.2051 EPA-administered program—Indian lands. (a) Contents. The UIC program for all classes of... these requirements. (b) Effective date. The effective date of the UIC program for Indian lands in South Carolina is November 25, 1988. [53 FR 43090, Oct. 25, 1988, as amended at 56 FR 9419, Mar. 6, 1991] ...

Analysis of SLC16A11 Variants in 12,811 American Indians: Genotype-Obesity Interaction for Type 2 Diabetes and an Association With RNASEK Expression.

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Traurig, Michael; Hanson, Robert L; Marinelarena, Alejandra; Kobes, Sayuko; Piaggi, Paolo; Cole, Shelley; Curran, Joanne E; Blangero, John; Göring, Harald; Kumar, Satish; Nelson, Robert G; Howard, Barbara V; Knowler, William C; Baier, Leslie J; Bogardus, Clifton

2016-02-01

Genetic variants in SLC16A11 were recently reported to be associated with type 2 diabetes in Mexican and other Latin American populations. The diabetes risk haplotype had a frequency of 50% in Native Americans from Mexico but was rare in Europeans and Africans. In the current study, we analyzed SLC16A11 in 12,811 North American Indians and found that the diabetes risk haplotype, tagged by the rs75493593 A allele, was nominally associated with type 2 diabetes (P = 0.001, odds ratio 1.11). However, there was a strong interaction with BMI (P = 5.1 × 10(-7)) such that the diabetes association was stronger in leaner individuals. rs75493593 was also strongly associated with BMI in individuals with type 2 diabetes (P = 3.4 × 10(-15)) but not in individuals without diabetes (P = 0.77). Longitudinal analyses suggest that this is due, in part, to an association of the A allele with greater weight loss following diabetes onset (P = 0.02). Analyses of global gene expression data from adipose tissue, skeletal muscle, and whole blood provide evidence that rs75493593 is associated with expression of the nearby RNASEK gene, suggesting that RNASEK expression may mediate the effect of genotype on diabetes. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Resonance – Journal of Science Education | Indian Academy of ...

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education; Volume 15; Issue 4. A Visit to the South Pole - Adventures of the First Indian to Winter-Over the South Pole and Explore Antarctica. Parmjit Singh Sehra. Reflections Volume 15 Issue 4 April 2010 pp 384-391 ...

Diabetes prevalence and its risk factors in rural area of Tamil Nadu

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Gupta Sanjay

2010-01-01

Full Text Available Objectives: To estimate the usefulness of the Indian diabetes risk score for detecting undiagnosed diabetes in the rural area of Tamil Nadu. Materials and Methods: The present study was conducted in the field practice area of rural health centers (Chunampett and Annechikuppam, Tamil Nadu, covering a population of 35000 from February to March 2008 by using a predesigned and pretested protocol to find out the prevalence and the risk of diabetes mellitus in general population by using Indian diabetes risk score. Results: 1936 respondents comprising 1167 (60.27% females and 769 (39.73% males were studied. Majority 1203 (62.50% were Hindus. 1220 (63.% had studied up to higher secondary. 1200 (62% belonged to lower and lower-middle socio-economic class. A large number of the subjects 948 (50% were below 35 years of age. Most of the respondents 1411 (73% indulged in mild to moderate physical activity. 1715 (87.91% had no family history of diabetes mellitus. 750 (39.64% individuals were in the overweight category (>25 BMI. Out of these overweight persons, 64% had high diabetic risk score. It is observed that chances of high diabetic score increase with the increase in BMI. Prevalence of diabetes in studied population was 5.99%; out of these, 56% known cases of diabetes mellitus had high (>60 IDRS. Co-relation between BMI and IDRS shows that, if BMI increases from less than 18.50 to more than 30, chances of high risk for developing diabetes mellitus also significantly increase. Conclusion: This study estimates the usefulness of simplified Indian diabetes risk score for identifying undiagnosed high risk diabetic subjects in India. This simplified diabetes risk score has categorized the risk factors based on their severity. Use of the IDRS can make mass screening for undiagnosed diabetes in India more cost effective.

Design of a Randomized Controlled Trial of a Web-Based Intervention to Reduce Cardiovascular Disease Risk Factors among Remote Reservation-Dwelling American Indian Adults with Type 2 Diabetes

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Henderson, Jeffrey A.; Chubak, Jessica; O'Connell, Joan; Ramos, Maria C.; Jensen, Julie; Jobe, Jared B.

2012-01-01

We describe a randomized controlled trial, the Lakota Oyate Wicozani Pi Kte (LOWPK) trial, which was designed to determine whether a Web-based diabetes and nutritional intervention can improve risk factors related to cardiovascular disease (CVD) among a group of remote reservation-dwelling adult American Indian men and women with type 2 diabetes…

Diabetes mellitus in Zambia and the Western Cape province of South Africa: Prevalence, risk factors, diagnosis and management.

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Bailey, Sarah Lou; Ayles, Helen; Beyers, Nulda; Godfrey-Faussett, Peter; Muyoyeta, Monde; du Toit, Elizabeth; Yudkin, John S; Floyd, Sian

2016-08-01

To determine the prevalence of and risk factors for diabetes mellitus and examine its diagnosis and management in the study communities. This is a population-based cross-sectional study among adults in 24 communities from Zambia and the Western Cape (WC) province of South Africa. Diabetes is defined as a random blood glucose concentration (RBG)⩾11.1mmol/L, or RBGdiabetes diagnosis. For individuals with a prior diagnosis of diabetes, RBGprevalence of diabetes was 3.5% and 7.2% respectively. The highest risk groups identified were those of older age and those with obesity. Of those identified to have diabetes, 34.5% in Zambia and 12.7% in WC were previously unaware of their diagnosis. Among Zambian participants with diabetes, this proportion was lower among individuals with better education or with higher household socio-economic position. Of all those with previously diagnosed diabetes, 66.0% in Zambia and 59.4% in WC were not on any diabetes treatment, and 34.4% in Zambia and 32.7% in WC had a RBG concentration beyond the recommended level, ⩾7.8mmol/L. The diabetes risk factor profile for our study communities is similar to that seen in high-income populations. A high proportion of individuals with diabetes are not on diabetes treatment and of those on treatment a high proportion have high glycaemic concentrations. Such data may assist in healthcare planning to ensure timely diagnosis and management of diabetes. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Rajella paucispinosa n. sp., a new deep-water skate (Elasmobranchii, Rajidae) from the western Indian Ocean off South Mozambique, and a revised generic diagnosis.

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Weigmann, Simon; Stehmann, Matthias F W; Thiel, Ralf

2014-08-08

A new species of the widely in temperate and tropical latitudes distributed skate genus Rajella is described based on an almost adult male specimen from the western Indian Ocean off South Mozambique. The holotype of R. paucispinosa n. sp. was caught during cruise 17 of RV 'Vityaz' along the deep western Indian Ocean in 1988/89. It is the northernmost record of a Rajella specimen in the western Indian Ocean. The new species is the 18th valid species of the genus and the fifth species in the western Indian Ocean. It differs from its congeners in the small maximal total length of about 50 cm and only few thorns on the dorsal surface. The new species has only two thorns on each orbit, one nuchal thorn, one right scapular thorn (left one not detectable, abraded), and one median row of tail thorns. Other species of Rajella typically have half rings of thorns on orbital rims, a triangle of thorns on nape-shoulder region, and at least three rows of tail thorns. Another conspicuous feature of the new species is the almost completely white dorsal and ventral coloration. 

Diabetes Health, Residence & Metabolism in Asians: the DHRMA study, research into foods from the Indian subcontinent - a blinded, randomised, placebo controlled trial

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Patel Jeetesh V

2011-12-01

Full Text Available Abstract Background Coronary heart disease (CHD is highly prevalent amongst the South Asian communities in Britain. The reasons for this excess CHD risk are multifactorial, but in part relate to a susceptibility to diabetes mellitus - where the aberrant metabolism of non-esterified fatty acids (NEFA and glucose are likely to underpin vascular disease in this population. Dietary intervention is an important and first line approach to manage increased CHD risk. However, there is limited information on the impact of the South Asian diet on CHD risk. Methods/Design The Diabetes Health, Residence & Metabolism in Asians (DHRMA study is a blinded, randomised, placebo controlled trial that analyses the efficacy of reduced glycaemic index (GI staples of the South Asian diet, in relation to cardio-metabolic risk factors that are commonly perturbed amongst South Asian populations - primarily glucose, fatty acid and lipoprotein metabolism and central adiposity. Using a 10-week dietary intervention study, 50 healthy South Asians will be randomised to receive either a DHRMA (reduced GI supply of chapatti (bread, stone ground, high protein wheat flour and white basmati rice (high bran, unpolished or commercially available (leading brand versions chapatti wheat flour and basmati rice. Volunteers will be asked to complete a 75g oral glucose tolerance test at baseline and at 10-weeks follow-up, where blood metabolites and hormones, blood pressure and anthropometry will also be assessed in a standardised manner. Discussion It is anticipated that the information collected from this study help develop healthy diet options specific (but not exclusive for South Asian ethnic communities. Trial registration Current Controlled Trials ISRCTN02839188

United States interests in South Asia

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2009-12-11

Gulf of Malacca in the 10 Bhupinder Singh , ―The Indian Ocean and regional Security‖ (Punjab: B.C...Qaida in Afghanistan. Swati Parashar of the South Asian Analysis Group says that, US led anti terrorist operations cannot exclude South Asia...23 Swati Parashar, ―The U.S and South Asia: From Tactical Security Relationship Towards a Strategic Partnership,‖ 2006, http

Risk factors for mortality in a south Indian population on generic antiretroviral therapy.

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Rupali, Priscilla; Mannam, Sam; Bella, Annie; John, Lydia; Rajkumar, S; Clarence, Peace; Pulimood, Susanne A; Samuel, Prasanna; Karthik, Rajiv; Abraham, Ooriapadickal Cherian; Mathai, Dilip

2012-12-01

Antiretroviral treatment (ART) programs from low-income countries utilizing standardized ART regimens, simplified approaches to clinical decision making and basic lab monitoring have reported high mortality rates. We determined the risk factors for mortality among HIV-infected adults following the initiation of ART from a single center in south India. ART-naive HIV-infected south Indian adults attending the Infectious Diseases clinic in a 2000-bed academic medical center in south India who were initiated on ART (generic, fixed-dose combinations) as per the national guidelines were followed up. Cases (32 patients who died) were compared with age and sex matched controls. Eight-hundred and twenty-two patients were started on ART from January 1, 2000 to December 31, 2008. The cumulative mortality was 6.8% (56/822). Among the cases mean age was 44 years, 18% were women and mean CD4 counts was 107 cells/microl. Among the controls mean age was 41 years, 18% were women and mean CD4 counts were 113 cells/microl. Stavudine based ART was predominant 62.5% in the cases vs 37.5% in the controls, followed by zidovudine based therapy in 31.2% of cases and 43.7% in the controls. Tenofovir based therapy was used in 6.2% of cases vs 18.7% in the controls. The commonest causes of death were drug toxicity 19%, advanced Acquired Immunodeficiency Syndrome (AIDS) in 37%, Immune Reconstitution Inflammatory Syndrome (IRIS) in 16%, non AIDS related deaths in 22% and malignancies 6%. In a univariate analysis, absolute lymphocyte count ART (p=0.001) were significantly associated with mortality. The mortality among our patients was comparable to that reported from other low-income countries. Earlier initiation of ART may reduce the high mortality rates observed.

Risk factors of diabetes in North Indians with metabolic syndrome.

Science.gov (United States)

Pratyush, Daliparthy D; Tiwari, Shalbha; Singh, Saurabh; Singh, Surya K

2016-01-01

Metabolic syndrome progresses to diabetes and determinants of this progression like hyperinsulinemia, hypertriglyceridemia and genetic factors have been speculative. The present study was aimed at quantifying the insulin resistance and influence of family history of diabetes in subjects with metabolic syndrome developing prediabetes and diabetes. Consecutive subjects attending the endocrine clinic were evaluated for metabolic syndrome as per definition of International Diabetes Federation, 2005. The family history of diabetes in their first degree relatives was ascertained and Homeostasis model assessment of Insulin resistance (HOMA-IR), Homeostasis model assessment for beta cell function (HOMA-B) and Quantitative insulin sensitivity check index (QUICKI) were calculated in 163 subjects enrolled. HOMA-IR was higher (pmetabolic syndrome+prediabetes or diabetes compared to metabolic syndrome with normal glucose tolerance. HOMA-B was lower and prevalence of prediabetes and diabetes was higher in metabolic syndrome subjects with family history of diabetes than in those without such family history (pmetabolic syndrome having prediabetes and diabetes had more severe insulin resistance than those with metabolic syndrome only. Beta cell dysfunction was remarkable and prevalence of prediabetes was high in metabolic syndrome subjects with family history of diabetes. Both the severity of the insulin resistance and family history of diabetes are therefore proposed to be determinants of diminished Beta cell function leading to diabetes in metabolic syndrome. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Sadhana | Indian Academy of Sciences

Indian Academy of Sciences (India)

Telugu language is one of the most widely spoken south Indian languages. In the proposed Telugu speech recognition system, errors obtained from decoder are analysed to improve the performance of the speech recognition system. Static pronunciation dictionary plays a key role in the speech recognition accuracy.

Significant association of the dupA gene of Helicobacter pylori with duodenal ulcer development in a South-east Indian population

OpenAIRE

Alam, Jawed; Maiti, Sankar; Ghosh, Prachetash; De, Ronita; Chowdhury, Abhijit; Das, Suryasnata; Macaden, Ragini; Devarbhavi, Harshad; Ramamurthy, T.; Mukhopadhyay, Asish K.

2012-01-01

A novel virulence factor, duodenal ulcer-promoting gene A (dupA), in Helicobacter pylori has been found to be associated with disease in certain populations but not in others. This study analysed a South-east Indian population as part of the debate about the relevance of dupA for the prediction of clinical outcomes. A total of 140 H. pylori strains isolated from duodenal ulcer (DU) (n=83) and non-ulcer dyspepsia (NUD) patients (n=57) were screened by PCR and dot-blot hybridization to determin...

Nutritional status of the Indian population

Indian Academy of Sciences (India)

In addition, the Indian population is passing through a nutritional transition and is expected to witness higher prevalences of adult non-communicable diseases such as diabetes, hypertension and coronary heart disease according to the theory of `fetal origin of adult disease'. Clearly, there is a need for examining several ...

Incidence of diabetes and its mortality according to body mass index in South Koreans aged 40–79 years

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Jung HH

2017-12-01

Full Text Available Hae Hyuk Jung, Ji In Park, Jin Seon Jeong Department of Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Gangwon-do, South Korea Purpose: The purpose of this study was to assess diabetes incidence and all-cause mortality according to baseline body mass index (BMI and to compare relative risks of mortality associated with incident diabetes across various BMI classes in a cohort of South Korean adults.Patients and methods: Based on data from the National Health Insurance database of Korean individuals aged 40–79 years without preexisting diabetes, we calculated BMI at the baseline health examination. We estimated the relative risk of mortality associated with incident diabetes using time-dependent Cox models and considering the time of diabetes diagnosis.Results: We noted 29,307 incident diabetes cases and 22,940 deaths during an 8-year follow-up of the initial cohort (n=436,692 and 73,756 incident diabetes cases and 57,556 deaths during a 10-year follow-up of the replication cohort (n=850,282. Regarding all-cause mortality, time-dependent Cox models revealed statistically significant interactions between diabetes status and baseline BMI class (P=0.018 and P<0.001 in the initial and replication cohorts, respectively. In separately conducted analyses for each BMI class, diabetes-associated relative risks for BMI values of 16.0–18.4, 18.5–22.9, 23.0–24.9, 25.0–29.9, and 30.0–34.9 kg/m2 were 1.50 (95% confidence interval [CI], 1.09–2.07, 1.39 (95% CI, 1.26–1.54, 1.20 (95% CI, 1.08–1.35, 1.18 (95% CI, 1.07–1.30, and 0.97 (95% CI, 0.74–1.28 in the initial cohort, and 1.44 (95% CI, 1.18–1.74, 1.33 (95% CI, 1.26–1.41, 1.24 (95% CI, 1.16–1.31, 1.11 (95% CI, 1.05–1.17, and 0.99 (95% CI, 0.85–1.16 in the replication cohort. The increasing trend of relative risk with decreasing BMI persisted mostly among subgroups stratified according to age or sex and smoking status

Actinic keratosis and diabetes complications: A nationwide population-based study in South Korea (2009-2015).

Science.gov (United States)

Lee, YoungBok; Lee, JiHyun; Choi, JinYoung; Yu, DongSoo; Han, KyungDo; Park, Yong-Gyu

2017-11-29

As the associations between actinic keratosis (AK) and diabetes complications in patients with diabetes mellitus (DM) have never been investigated, this study aimed to evaluate any such associations in patients with DM. This retrospective cohort study analyzed clinical data for DM patients aged>40 years who had undergone the health examination recommended by the South Korea National Health Insurance Program between 2009 and 2012 (n=2,056,580). All of these patients were classified according to the presence of diabetic retinopathy (DR), end-stage renal disease (ESRD) and history of DVD; myocardial infarction, stroke, transient ischaemic attacks. Newly diagnosed AK was identified using claims data from baseline to the date of diagnosis or 31 December 2015, whichever came first. Of the 2,056,580 patients with DM, 6404 (0.31%) developed AK. Those patients in the DR, ESRD and CVD groups were more likely to be diagnosed with AK (PAK were significantly higher in the DR, ESRD and CVD groups: HR (95% CI): 1.29 (1.21-1.39), HR: 4.24 (3.28-5.47) and HR: 1.22 (1.13-1.31), respectively. This study has revealed that the incidence of AK is higher in diabetes patients with ocular, renal and cardiovascular complications. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Complete genome sequencing and evolutionary analysis of Indian isolates of Dengue virus type 2

Energy Technology Data Exchange (ETDEWEB)

Dash, Paban Kumar, E-mail: pabandash@rediffmail.com; Sharma, Shashi; Soni, Manisha; Agarwal, Ankita; Parida, Manmohan; Rao, P.V.Lakshmana

2013-07-05

Highlights: •Complete genome of Indian DENV-2 was deciphered for the first time in this study. •The recent Indian DENV-2 revealed presence of many unique amino acid residues. •Genotype shift (American to Cosmopolitan) characterizes evolution of DENV-2 in India. •Circulation of a unique clade of DENV-2 in South Asia was identified. -- Abstract: Dengue is the most important arboviral infection of global public health significance. It is now endemic in most parts of the South East Asia including India. Though Dengue virus type 2 (DENV-2) is predominantly associated with major outbreaks in India, complete genome information of Indian DENV-2 is not available. In this study, the full-length genome of five DENV-2 isolates (four from 2001 to 2011 and one from 1960), from different parts of India was determined. The complete genome of the Indian DENV-2 was found to be 10,670 bases long with an open reading frame coding for 3391 amino acids. The recent Indian DENV-2 (2001–2011) revealed a nucleotide sequence identity of around 90% and 97% with an older Indian DENV-2 (1960) and closely related Sri Lankan and Chinese DENV-2 respectively. Presence of unique amino acid residues and non-conservative substitutions in critical amino acid residues of major structural and non-structural proteins was observed in recent Indian DENV-2. Selection pressure analysis revealed positive selection in few amino acid sites of the genes encoding for structural and non-structural proteins. The molecular phylogenetic analysis based on comparison of both complete coding region and envelope protein gene with globally diverse DENV-2 viruses classified the recent Indian isolates into a unique South Asian clade within Cosmopolitan genotype. A shift of genotype from American to Cosmopolitan in 1970s characterized the evolution of DENV-2 in India. Present study is the first report on complete genome characterization of emerging DENV-2 isolates from India and highlights the circulation of a

Complete genome sequencing and evolutionary analysis of Indian isolates of Dengue virus type 2

International Nuclear Information System (INIS)

Dash, Paban Kumar; Sharma, Shashi; Soni, Manisha; Agarwal, Ankita; Parida, Manmohan; Rao, P.V.Lakshmana

2013-01-01

Highlights: •Complete genome of Indian DENV-2 was deciphered for the first time in this study. •The recent Indian DENV-2 revealed presence of many unique amino acid residues. •Genotype shift (American to Cosmopolitan) characterizes evolution of DENV-2 in India. •Circulation of a unique clade of DENV-2 in South Asia was identified. -- Abstract: Dengue is the most important arboviral infection of global public health significance. It is now endemic in most parts of the South East Asia including India. Though Dengue virus type 2 (DENV-2) is predominantly associated with major outbreaks in India, complete genome information of Indian DENV-2 is not available. In this study, the full-length genome of five DENV-2 isolates (four from 2001 to 2011 and one from 1960), from different parts of India was determined. The complete genome of the Indian DENV-2 was found to be 10,670 bases long with an open reading frame coding for 3391 amino acids. The recent Indian DENV-2 (2001–2011) revealed a nucleotide sequence identity of around 90% and 97% with an older Indian DENV-2 (1960) and closely related Sri Lankan and Chinese DENV-2 respectively. Presence of unique amino acid residues and non-conservative substitutions in critical amino acid residues of major structural and non-structural proteins was observed in recent Indian DENV-2. Selection pressure analysis revealed positive selection in few amino acid sites of the genes encoding for structural and non-structural proteins. The molecular phylogenetic analysis based on comparison of both complete coding region and envelope protein gene with globally diverse DENV-2 viruses classified the recent Indian isolates into a unique South Asian clade within Cosmopolitan genotype. A shift of genotype from American to Cosmopolitan in 1970s characterized the evolution of DENV-2 in India. Present study is the first report on complete genome characterization of emerging DENV-2 isolates from India and highlights the circulation of a

Place of sulfonylureas in the management of type 2 diabetes mellitus in South Asia: A consensus statement

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Sanjay Kalra

2015-01-01

Full Text Available Since their introduction in clinical practice in the 1950′s, Sulfonylureas (SUs have remained the main-stay of pharmacotherapy in the management of type 2 diabetes. Despite their well-established benefits, their place in therapy is inappropriately being overshadowed by newer therapies. Many of the clinical issues associated with the use of SUs are agent-specific, and do not pertain to the class as such. Modern SUs (glimepiride, gliclazide MR are backed by a large body of evidence, experience, and most importantly, outcome data, which supports their role in managing patients with diabetes. Person-centred care, i.e., careful choice of SU, appropriate dosage, timing of administration, and adequate patient counseling, will ensure that deserving patients are not deprived of the advantages of this well-established class of anti-diabetic agents. Considering their efficacy, safety, pleiotropic benefits, and low cost of therapy, SUs should be considered as recommended therapy for the treatment of diabetes in South Asia. This initiative by SAFES aims to encourage rational, safe and smart prescription of SUs, and includes appropriate medication counseling.

Demographic, medical and visual aspects of Dia- betic Retinopathy (DR and Diabetic Macular Edema (DME in South African diabetic patients*

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Anusha Y. Sukha

2009-12-01

interactions (p = 0.01 and emotional re-action to vision loss (p = 0.018 was reported in subjects with DME. Conclusion: This study has identified possible demographic, medical and visual risk factors of DR and DME in South African diabetic patients.

Is cardiovascular risk reduction therapy effective in South Asian, Chinese and other patients with diabetes? A population-based cohort study from Canada.

Science.gov (United States)

Ke, Calvin H; Morgan, Steve; Smolina, Kate; Gasevic, Danijela; Qian, Hong; Khan, Nadia A

2017-08-31

Guidelines recommend ACE inhibitors (ACEi), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs) and diuretics in all patients with diabetes mellitus. However, the effectiveness of these agents in South Asian and Chinese populations is unknown. We sought to determine whether ACEi, ARB, CCB and diuretics are associated with reduced mortality in South Asian, Chinese and other patients with diabetes. Population-based cohort study using administrative health databases. Province of British Columbia, Canada (2006-2013). Patients aged ≥35 years with incident diabetes. Primary outcome was all-cause mortality for each medication class compared with untreated patients within each ethnicity. Treatment effect was assessed using inverse probability of treatment weighted Cox proportional hazards models. Medication adherence effect on mortality was also evaluated. 208 870 patients (13 755 South Asian, 22 871 Chinese, 172 244 other Canadian) were included. ACEi reduced mortality in other patients (HR=0.88, 0.84-0.91), but power was insufficient to evaluate for benefit in Chinese and South Asian patients. ARB and diuretics reduced mortality in Chinese (ARB HR=0.64, 0.50-0.82; diuretics HR=0.77, 0.62-0.96) and other patients (ARB HR=0.69, 0.64-0.74; diuretics HR=0.66, 0.63-0.69) compared with untreated patients. No mortality benefit was observed among South Asians for any drug class or for CCB among all ethnicities. Higher medication adherence was associated with lower mortality for other patients only (HR=0.79, 0.72-0.86). Effectiveness of cardiovascular risk reduction therapy on mortality varies considerably by ethnicity. Further study is needed to evaluate the mortality benefit of antihypertensive agents in South Asians. Inclusion of these ethnic groups in future clinical trials is essential to examine for differential responses. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

Family Food Choices: A Guide to Weight and Diabetes Control.

Science.gov (United States)

Indian Health Service (PHS/HSA), Rockville, MD.

Written for American Indians who have diabetes, this folder explains diabetes and outlines a weight control program and diet. The folder discusses the five things diabetics can do to help control their disease: lose weight, watch the amount and kind of fat eaten, eat more food with fiber, avoid sugar, and avoid alcohol. Charts for foods containing…

Polycystic ovary syndrome, blood group & diet: A correlative study in South Indian females

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Rahul Pal, Pratik Kumar Chatterjee, Poulomi Chatterjee, Vinodini NA, PrasannaMithra, Sourjya Banerjee, Suman VB2, Sheila R. Pai

2014-07-01

Full Text Available Aim: To find out the co-relation between polycystic ovary syndrome (PCOS with blood group & diet in South Indian females, between the age-group of (20-30 years. Objectives: Correlative analysis of ABO & Rh system, dietary habits & alcohol consumption with PCOS. Materials & Methods: 100 patients between (20-30 years, diagnosed with PCOS were selected. A standard PCOS questionnaire was given. Blood group & dietary status data were collected. Patients were grouped according to ABO & Rh system considering their diet & alcohol intake (p≤0.05 significant. Result: Our data revealed that the highest risk of PCOS was observed in females with blood group ‘O’ positive followed by ‘B’ positive who were on mixed diet & used to consume alcohol. Our study also suggests that Rh negative individuals didn’t show any association with PCOS. Conclusion: The results of our study suggest that ‘O’ positive females, are more prone to PCOS. Though the relative frequency of B positive individuals are more in India, females with blood group O positive are more susceptible to PCOS, contributing factors being mixed diet & alcohol intake. So, early screening of ‘O’ positive &‘B’ positive females of reproductive age-group in South-India, could be used as a measure for timely diagnosis of PCOS, better management &also prevention of complications. However, further research should be done to investigate the multifaceted mechanisms triggering these effects.

Single-nucleotide polymorphisms in peroxisome proliferator ...

Indian Academy of Sciences (India)

However, association of these polymorphisms with the metabolic syndrome and its individual components has not been well investigated in the Indian population. The Indian population harbours the maximum number of diabetics in the world who are thus more susceptible to metabolic disorders. We screened a South ...

Ethnic differences in diabetes prevalence and ICT use.

Science.gov (United States)

Umeh, Kanayo; Mackay, Michael; Le-Brun, Stephanie Davis

Uptake of information and communication technology (ICT) by individuals with diabetes can assist nursing care delivery, and improve patient outcomes. However, it is unclear how such uptake relates to ethnic differences in diabetes risk. To assess the moderating effects of ICT uptake on South Asian excess diabetes prevalence over a specific elapsed timeframe, accounting for selected environmental, socio-economic, and behavioural risk factors. Archived data from a UK Office for National Statistics household survey 2006-2011 (120 621 partly non-orthogonal participant records) were analysed using hierarchical binary logistic regression analyses. ICT uptake qualified ethnic differences in diabetes prevalence. Non-smoking diabetes cases living in terraced housing with a home computer were more likely to be South Asian than Caucasian. By contrast, such cases were more likely to be Caucasian if a computer was unavailable (OR: 0.61; CI: 0.43-0.86; P=0.005). Furthermore, diabetes cases from low-income, mobile-dependent homes were probably South Asian (OR: 0.05; CI: 0.00-0.50; P=0.012). Home computing was linked to better tobacco control among South Asians with diabetes living in terraced properties. Mobile phone dependence was pronounced in those that received income support. Implications for nursing care are considered.

Association of tinnitus and hearing loss in otological disorders: a decade-long epidemiological study in a South Indian population

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Santoshi Kumari Manche

Full Text Available Abstract Introduction: Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern. Tinnitus is often associated with different forms of hearing loss of varying severity. Objective: The present study aimed to identify the association of tinnitus with hearing loss in various otological disorders of a South Indian population. Methods: A total of 3255 subjects referred to the MAA ENT Hospital, Hyderabad, from 2004 to 2014, affected with various otological diseases have been included in the present cross-sectional study. Diagnosis of the diseases was confirmed by an ear, nose, and throat (ENT specialist using detailed medical and clinical examination. Statistical analysis was performed using the χ 2 test and binary logistic regression. Results: Tinnitus was observed in 29.3% (956 of the total study subjects that showed an increased prevalence in greater than 40 years of age. There was a significant increase in risk of tinnitus with middle (OR = 1.79, 95% CI = 1.02-3.16 and inner (OR = 3.00, 95% CI = 1.65-5.45 inner ear diseases. It was noted that 96.9% (n = 927 of the tinnitus subjects was associated with hearing loss. Otitis media (60.9%, presbycusis (16.6% and otosclerosis (14.3% are the very common otological disorders leading to tinnitus. Tinnitus was significantly associated with higher degree of hearing loss in chronic suppurative otitis media (CSOM subjects. Conclusion: The present study could identify the most prevalent otological risk factors leading to development of tinnitus with hearing loss in a South Indian population.

Experiences and Perceptions of Physical Activity Among South Asian and Anglo-Australians With Type 2 Diabetes or Cardiovascular Disease: Implications for Clinical Practice.

Science.gov (United States)

Gupta, Sabrina S; Aroni, Rosalie; Teede, Helena

2017-02-01

Research indicates that there are worryingly low levels of physical activity among South Asians compared with Anglo-Australians with type 2 diabetes and/or cardiovascular disease (CVD). We compared perceptions, barriers, and enablers of physical activity in these groups. We used a qualitative design, conducting in-depth, semistructured iterative interviews in Victoria with 57 South Asian and Anglo-Australian participants with either type 2 diabetes or CVD. While both groups exhibited knowledge of the value of physical activity in health maintenance and disease management, they wished for more specific and culturally tailored advice from clinicians about the type, duration, and intensity of physical activity required. Physical activity identities were tied to ethnic identities, with members of each group aspiring to meet the norms of their culture regarding engagement with physical activity as specific exercise or as incidental exercise. Individual personal exercise was deemed important by Anglo-Australians whereas South Asians preferred family-based physical activity.

Indian Ocean and Indian summer monsoon: relationships without ENSO in ocean-atmosphere coupled simulations

Science.gov (United States)

Crétat, Julien; Terray, Pascal; Masson, Sébastien; Sooraj, K. P.; Roxy, Mathew Koll

2017-08-01

The relationship between the Indian Ocean and the Indian summer monsoon (ISM) and their respective influence over the Indo-Western North Pacific (WNP) region are examined in the absence of El Niño Southern Oscillation (ENSO) in two partially decoupled global experiments. ENSO is removed by nudging the tropical Pacific simulated sea surface temperature (SST) toward SST climatology from either observations or a fully coupled control run. The control reasonably captures the observed relationships between ENSO, ISM and the Indian Ocean Dipole (IOD). Despite weaker amplitude, IODs do exist in the absence of ENSO and are triggered by a boreal spring ocean-atmosphere coupled mode over the South-East Indian Ocean similar to that found in the presence of ENSO. These pure IODs significantly affect the tropical Indian Ocean throughout boreal summer, inducing a significant modulation of both the local Walker and Hadley cells. This meridional circulation is masked in the presence of ENSO. However, these pure IODs do not significantly influence the Indian subcontinent rainfall despite overestimated SST variability in the eastern equatorial Indian Ocean compared to observations. On the other hand, they promote a late summer cross-equatorial quadrupole rainfall pattern linking the tropical Indian Ocean with the WNP, inducing important zonal shifts of the Walker circulation despite the absence of ENSO. Surprisingly, the interannual ISM rainfall variability is barely modified and the Indian Ocean does not force the monsoon circulation when ENSO is removed. On the contrary, the monsoon circulation significantly forces the Arabian Sea and Bay of Bengal SSTs, while its connection with the western tropical Indian Ocean is clearly driven by ENSO in our numerical framework. Convection and diabatic heating associated with above-normal ISM induce a strong response over the WNP, even in the absence of ENSO, favoring moisture convergence over India.

Genome-Wide Association and Trans-ethnic Meta-Analysis for Advanced Diabetic Kidney Disease: Family Investigation of Nephropathy and Diabetes (FIND.

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Sudha K Iyengar

2015-08-01

Full Text Available Diabetic kidney disease (DKD is the most common etiology of chronic kidney disease (CKD in the industrialized world and accounts for much of the excess mortality in patients with diabetes mellitus. Approximately 45% of U.S. patients with incident end-stage kidney disease (ESKD have DKD. Independent of glycemic control, DKD aggregates in families and has higher incidence rates in African, Mexican, and American Indian ancestral groups relative to European populations. The Family Investigation of Nephropathy and Diabetes (FIND performed a genome-wide association study (GWAS contrasting 6,197 unrelated individuals with advanced DKD with healthy and diabetic individuals lacking nephropathy of European American, African American, Mexican American, or American Indian ancestry. A large-scale replication and trans-ethnic meta-analysis included 7,539 additional European American, African American and American Indian DKD cases and non-nephropathy controls. Within ethnic group meta-analysis of discovery GWAS and replication set results identified genome-wide significant evidence for association between DKD and rs12523822 on chromosome 6q25.2 in American Indians (P = 5.74x10-9. The strongest signal of association in the trans-ethnic meta-analysis was with a SNP in strong linkage disequilibrium with rs12523822 (rs955333; P = 1.31x10-8, with directionally consistent results across ethnic groups. These 6q25.2 SNPs are located between the SCAF8 and CNKSR3 genes, a region with DKD relevant changes in gene expression and an eQTL with IPCEF1, a gene co-translated with CNKSR3. Several other SNPs demonstrated suggestive evidence of association with DKD, within and across populations. These data identify a novel DKD susceptibility locus with consistent directions of effect across diverse ancestral groups and provide insight into the genetic architecture of DKD.

Genome-Wide Association and Trans-ethnic Meta-Analysis for Advanced Diabetic Kidney Disease: Family Investigation of Nephropathy and Diabetes (FIND).

Science.gov (United States)

Iyengar, Sudha K; Sedor, John R; Freedman, Barry I; Kao, W H Linda; Kretzler, Matthias; Keller, Benjamin J; Abboud, Hanna E; Adler, Sharon G; Best, Lyle G; Bowden, Donald W; Burlock, Allison; Chen, Yii-Der Ida; Cole, Shelley A; Comeau, Mary E; Curtis, Jeffrey M; Divers, Jasmin; Drechsler, Christiane; Duggirala, Ravi; Elston, Robert C; Guo, Xiuqing; Huang, Huateng; Hoffmann, Michael Marcus; Howard, Barbara V; Ipp, Eli; Kimmel, Paul L; Klag, Michael J; Knowler, William C; Kohn, Orly F; Leak, Tennille S; Leehey, David J; Li, Man; Malhotra, Alka; März, Winfried; Nair, Viji; Nelson, Robert G; Nicholas, Susanne B; O'Brien, Stephen J; Pahl, Madeleine V; Parekh, Rulan S; Pezzolesi, Marcus G; Rasooly, Rebekah S; Rotimi, Charles N; Rotter, Jerome I; Schelling, Jeffrey R; Seldin, Michael F; Shah, Vallabh O; Smiles, Adam M; Smith, Michael W; Taylor, Kent D; Thameem, Farook; Thornley-Brown, Denyse P; Truitt, Barbara J; Wanner, Christoph; Weil, E Jennifer; Winkler, Cheryl A; Zager, Philip G; Igo, Robert P; Hanson, Robert L; Langefeld, Carl D

2015-08-01

Diabetic kidney disease (DKD) is the most common etiology of chronic kidney disease (CKD) in the industrialized world and accounts for much of the excess mortality in patients with diabetes mellitus. Approximately 45% of U.S. patients with incident end-stage kidney disease (ESKD) have DKD. Independent of glycemic control, DKD aggregates in families and has higher incidence rates in African, Mexican, and American Indian ancestral groups relative to European populations. The Family Investigation of Nephropathy and Diabetes (FIND) performed a genome-wide association study (GWAS) contrasting 6,197 unrelated individuals with advanced DKD with healthy and diabetic individuals lacking nephropathy of European American, African American, Mexican American, or American Indian ancestry. A large-scale replication and trans-ethnic meta-analysis included 7,539 additional European American, African American and American Indian DKD cases and non-nephropathy controls. Within ethnic group meta-analysis of discovery GWAS and replication set results identified genome-wide significant evidence for association between DKD and rs12523822 on chromosome 6q25.2 in American Indians (P = 5.74x10-9). The strongest signal of association in the trans-ethnic meta-analysis was with a SNP in strong linkage disequilibrium with rs12523822 (rs955333; P = 1.31x10-8), with directionally consistent results across ethnic groups. These 6q25.2 SNPs are located between the SCAF8 and CNKSR3 genes, a region with DKD relevant changes in gene expression and an eQTL with IPCEF1, a gene co-translated with CNKSR3. Several other SNPs demonstrated suggestive evidence of association with DKD, within and across populations. These data identify a novel DKD susceptibility locus with consistent directions of effect across diverse ancestral groups and provide insight into the genetic architecture of DKD.

Retort process modelling for Indian traditional foods.

Science.gov (United States)

Gokhale, S V; Lele, S S

2014-11-01

Indian traditional staple and snack food is typically a heterogeneous recipe that incorporates varieties of vegetables, lentils and other ingredients. Modelling the retorting process of multilayer pouch packed Indian food was achieved using lumped-parameter approach. A unified model is proposed to estimate cold point temperature. Initial process conditions, retort temperature and % solid content were the significantly affecting independent variables. A model was developed using combination of vegetable solids and water, which was then validated using four traditional Indian vegetarian products: Pulav (steamed rice with vegetables), Sambar (south Indian style curry containing mixed vegetables and lentils), Gajar Halawa (carrot based sweet product) and Upama (wheat based snack product). The predicted and experimental values of temperature profile matched with ±10 % error which is a good match considering the food was a multi component system. Thus the model will be useful as a tool to reduce number of trials required to optimize retorting of various Indian traditional vegetarian foods.

Microvascular complications in South African patients with long ...

African Journals Online (AJOL)

The prevalence of complications and the clinical and biochemical parameters were evaluated for type 1 and type 2 diabetes and for each ethnic group. Results. Of the 219 patients, 47 had type 1 DM (36 blacks, 11 Indians) and 172 were classilied a type 2 DM (96 blacks, 76 Indians). The mean age of onset of DM was later ...

Age-related proximal femur bone mineral loss in South Indian women: a dual energy X-ray absorptiometry study.

Science.gov (United States)

Anburajan, M; Rethinasabapathi, C; Korath, M P; Ponnappa, B G; Kumar, K S; Panicker, T M; Govindan, A; Jagadeesan, G N

2001-04-01

i) To collect normative data for proximal femur bone mineral density (BMD) in South Indian women using dual energy X-ray absorptiometry (DXA) and ii) to study the rate and significance of hip bone mineral loss with advancing age in this population. Forty five women, whose age ranged from 16 to 84 years were studied. This sample was drawn randomly from general medical practice at KJ Hospital, Chennai, South India during November, 1997 to April, 1998. Of these 45 cases, 21 were pre-menopausal (mean +/- SD age = 30.9+/-8.8 years) and 24 post-menopausal (mean +/- SD age = 62.1+/-11.0 years). Subjects with secondary bone diseases were excluded. Also excluded were those taking any drugs known to affect calcium metabolism e.g., thiazide diuretics, oestrogen and calcium. Subjects were divided into seven decadal age groups from 15-24 years to 75-84 years. BMD of the right proximal femur was evaluated using a QDR-1000 DXA bone densitometer (Hologic Inc., Waltham, Massachusetts, USA). Data analysis was done with SPSS/PC statistical software package. Linear regression analysis showed significant (p India women have been evaluated and it may prove useful for diagnosing osteoporosis in the women of South India.

Changing food habits in a South Indian Hindu Brahmin community: a case of transitioning gender roles and family dynamics.

Science.gov (United States)

Mahadevan, Meena; Blair, Dorothy; Raines, Emily Rose

2014-01-01

This study was conducted to explore the perceptions of 20 South Indian Hindu Brahmin women on the factors influencing their food habits upon immigrating to America. The competing demands of juggling a new career and managing their family's nutritional needs at the same time, all without the support of extended family members, played an important role in steering these women away from cooking traditional healthy meals, and resorting to fast foods instead. Intervention strategies should be directed toward improving the barriers to eating healthy that were specifically identified within the confines of shifting gender roles and limited family support networks.

Economic burden of diabetes in urban indians.

Science.gov (United States)

Chandra, Pablo; Gogate, Bageshri; Gogate, Parikshit; Thite, Nilesh; Mutha, Abhay; Walimbe, Amit

2014-01-01

To find out the average economic burden of medical care on a patient with diabetes in Pune, India. A semi-open ended questionnaire followed by interview was conducted with patients attending diabetes and ophthalmic out-patient departments. They were asked regarding the duration of diabetes, methods undertaken for blood sugar control and the amount they spend on consultations, laboratory tests, medicines and procedures if any within past year. Expenditure was classified as direct cost (cost of medicines, doctor's fees, investigations, lasers and surgery) and indirect cost (travel, diet control, health classes and loss of wages). Data was collected regarding the socioeconomic status according to Kuppaswamy classification. 219 patients participated of whom 129 were males (58.9%). Average annual direct cost of diabetes treatment was Rs 8,822 of which 52.1% was spend on medicines, 3.2% was spend on lasers, 12.6% was spend on surgical procedures, 11.6% spent on investigations and 10.4% was spend on clinician fees. Average annual indirect cost was Rs. 3949 of which 3.4% was spend on travelling purpose, 0.4% was spent on health classes, 4.9% was spent on diet control and 91.3% was loss of wages. Average expenditure done by lower middle class was 23.7% of their income. Average percentage of income for direct and indirect cost was 3.6% and 1.4% respectively. The cost of the treatment formed1.3% of the annual income for those in Socio-economic class I, 1.7% in class II, 3.7% in class III and 23.7% in class IV. The cost of managing diabetes was a significant proportion of the patients' income, especially for those on lower socio-economic scale (class IV).

Operational art in the 1962 Sino Indian War

Science.gov (United States)

2016-05-26

and Theory Development in the Social Sciences.41 Structurally, the monograph will apply a set of standardized questions to the case study. These...the strategic military objectives. 42 Bennett and George, Case Studies and Theory Development in the Social Sciences, 69. 43 Ibid., 67, 70. 16...it could no longer avoid a war with India.79 The CMC developed a counterattack to destroy Indian forces and advance south into Indian territory “in

Chronic disease risk factors among American Indian/Alaska Native women of reproductive age.

Science.gov (United States)

Amparo, Pamela; Farr, Sherry L; Dietz, Patricia M

2011-11-01

The magnitude of chronic conditions and risk factors among American Indian/Alaska Native women of reproductive age is unknown. The objective of our study was to estimate this magnitude. We analyzed data for 2,821 American Indian/Alaska Native women and 105,664 non-Hispanic white women aged 18 to 44 years from the 2005 and 2007 Behavioral Risk Factor Surveillance System. We examined prevalence of high cholesterol, high blood pressure, diabetes, body mass index (kg/m(2)) ≥25.0, physical inactivity, smoking, excessive alcohol consumption, and frequent mental distress, and the cumulative number of these chronic conditions and risk factors (≥3, 2, 1, or 0). In a multivariable, multinomial logistic regression model, we examined whether American Indian/Alaska Native race was associated with the cumulative number of chronic conditions and risk factors. American Indian/Alaska Native women, compared with white women, had significantly higher rates of high blood pressure, diabetes, obesity, smoking, and frequent mental distress. Of American Indian/Alaska Native women, 41% had 3 or more chronic conditions or risk factors compared with 27% of white women (χ(2), P Indian/Alaska Native race was not associated with having either 1, 2, or 3 or more chronic conditions or risk factors. Three out of every 5 American Indian/Alaska Native women aged 18 to 44 years have 3 or more chronic conditions or risk factors. Improving economic status and education for AI/AN women could help eliminate disparities in health status.

Sociocultural perspective on organ and tissue donation among reservation-dwelling American Indian adults.

Science.gov (United States)

Fahrenwald, Nancy L; Stabnow, Wendy

2005-11-01

To discover the sociocultural patterns that influence decisions about organ and tissue donation among American Indian (AI) adults. This qualitative ethnographic study used a social-ecological framework. A snowball sampling technique was used to recruit 21 Oglala Lakota Sioux participants (age >or= 19 years) living on the Pine Ridge Indian Reservation in South Dakota, USA. Face-to-face interviews were conducted using open-ended questions derived from the social-ecological perspective of Stokols (1992). Interviews were audiotaped and transcribed. Data were categorized into construct codes to identify concepts and to discover emerging themes. Personal and environmental themes regarding organ and tissue donation emerged. There were two personal themes: uncertain knowledge and the diabetes crisis. Participants knew very little about organ and tissue donation but there was a basic understanding of donor/recipient compatibility. The prevalence of diabetes in the community is contributing to a dire need for kidney donors. The diabetes crisis was acknowledged by every participant. There were three environmental themes: cultural transitions, healthcare system competence and outreach efforts. Traditional cultural beliefs such as entering the spirit world with an intact body were acknowledged. However, conversations reflected re-examination of traditional beliefs because of the need for kidney donors. The healthcare environmental context of organ and tissue donation emerged as a theme. Participants were not confident that the local health system was prepared to either address traditional beliefs about organ and tissue donation or implement a donation protocol. The final theme was the environmental context of outreach efforts. Participants desired relevant outreach targeted to the community and disseminated through local communication networks including the family, the media and tribal leaders. Sociocultural factors relevant to the personal and environmental context of the

Screening in Primary Care for Diabetic Retinopathy, Maculopathy and Visual Loss in South Africa.

Science.gov (United States)

Webb, Elizabeth M; Rheeder, Paul; Roux, Polla

2016-01-01

The aim of the study was to determine the prevalence of diabetic retinopathy, maculopathy and visual loss in primary care patients and to identify associated risk factors. We conducted a cluster randomised trial at primary care clinics in the Tshwane district in South Africa. Grades of retinopathy and maculopathy (with fundus camera) and visual acuity (Snellen chart) were assessed and, using mobile screening and teleophthalmology, clinical and biochemical testing was conducted to obtain information about glycaemic control and microvascular complications. The prevalence rates for any retinopathy, preproliferative retinopathy and proliferative retinopathy were 24.9, 19.5 and 5.5%, respectively. The prevalence rates of diabetic maculopathy, observable maculopathy and referable maculopathy were 20.8, 11.8 and 9.0%, respectively. The presence of retinopathy was associated with high body mass index, systolic blood pressure, being on insulin treatment, high HbA1c and the presence of neuropathy. High systolic blood pressure, being on insulin treatment, high HbA1c level and high low-density lipoprotein cholesterol level as well as the presence of albuminuria were significant in predicting any diabetic maculopathy. Laser photocoagulation was given to 8.3% of patients from the mobile unit and 12% of patients were referred to the nearest hospital with an outpatient eye clinic for follow-up treatment of various other eye conditions. Using the WHO categories, the study found that 78.1% of diabetes patients had normal vision, 19.3% were visually impaired and 2.2% were severely impaired or blind. High prevalence rates for diabetic retinopathy, maculopathy and visual loss were found and associations were identified. © 2016 S. Karger AG, Basel.

Gender norms in South Africa: Implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution

Science.gov (United States)

Mantell, Joanne E.; Needham, Sarah L.; Smit, Jennifer Ann; Hoffman, Susie; Cebekhulu, Queen; Adams-Skinner, Jessica; Exner, Theresa M.; Mabude, Zonke; Beksinska, Mags; Stein, Zena A.; Milford, Cecilia

2009-01-01

In post-Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women’s ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students who are a relatively ‘privileged’ group, there is little information on gender norms that might shape responses to HIV prevention programmes. To elicit gender norms regarding women’s and men’s roles, condom and contraceptive use, sexual communication, and sexual pleasure, we conducted 10 semi-structured focus group discussions with African and Indian female tertiary institution students so as to understand how norms might be used to buttress HIV and pregnancy prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women’s rights in the post-Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co-existence of traditional constructions of gender that operate to constrain women’s freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women’s protection against unintended pregnancy and HIV/STIs. PMID:19247859

Gender norms in South Africa: implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution.

Science.gov (United States)

Mantell, Joanne E; Needham, Sarah L; Smit, Jennifer Ann; Hoffman, Susie; Cebekhulu, Queen; Adams-Skinner, Jessica; Exner, Theresa M; Mabude, Zonke; Beksinska, Mags; Stein, Zena A; Milford, Cecilia

2009-02-01

In post-Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women's ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students, who are a relatively 'privileged' group, there is little information on gender norms that might shape responses to HIV-prevention programmes. To elicit gender norms regarding women's and men's roles, condom and contraceptive use, sexual communication and sexual pleasure, we conducted 10 semi-structured focus group discussions with African and Indian female tertiary institution students in order to understand how norms might be used to buttress HIV- and pregnancy-prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women's rights in the post-Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co-existence of traditional constructions of gender that operate to constrain women's freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women's protection against unintended pregnancy and HIV/STIs.

Recruiting South Asians to a lifestyle intervention trial: experiences and lessons from PODOSA (Prevention of Diabetes & Obesity in South Asians

Directory of Open Access Journals (Sweden)

Tuomilehto Jaakko

2011-10-01

Full Text Available Abstract Background Despite the growing emphasis on the inclusion of ethnic minority patients in research, there is little published on the recruitment of these populations especially to randomised, community based, lifestyle intervention trials in the UK. Methods We share our experience of recruitment to screening in the PODOSA (Prevention of Diabetes and Obesity in South Asians trial, which screened 1319 recruits (target 1800 for trial eligibility. A multi-pronged recruitment approach was used. Enrolment via the National Health Service included direct referrals from health care professionals and written invitations via general practices. Recruitment within the community was carried out by both the research team and through our partnerships with local South Asian groups and organisations. Participants were encouraged to refer friends and family throughout the recruitment period. Results Health care professionals referred only 55 potential participants. The response to written invitations via general practitioners was 5.2%, lower than reported in other general populations. Community orientated, personal approaches for recruitment were comparatively effective yielding 1728 referrals (82% to the screening stage. Conclusions The PODOSA experience shows that a community orientated, personal approach for recruiting South Asian ethnic minority populations can be successful in a trial setting. We recommend that consideration is given to cover recruitment costs associated with community engagement and other personalised approaches. Researchers should consider prioritising approaches that minimise interference with professionals' work and, particularly in the current economic climate, keep costs to a minimum. The lessons learned in PODOSA should contribute to future community based trials in South Asians. Trial Registration Current Controlled Trials ISRCTN25729565

We Have the Power To Prevent Type 2 Diabetes

Centers for Disease Control (CDC) Podcasts

2007-10-04

This podcast delivers a diabetes prevention message tailored for American Indians and Alaska Natives.  Created: 10/4/2007 by National Diabetes Education Program (NDEP), a joint program of the Centers for Disease Control and Prevention and the National Institutes of Health.   Date Released: 11/23/2007.

Socio-economic, environmental and nutritional characteristics of urban and rural South Indian women in early pregnancy: findings from the South Asian Birth Cohort (START).

Science.gov (United States)

Dwarkanath, Pratibha; Vasudevan, Anil; Thomas, Tinku; Anand, Sonia S; Desai, Dipika; Gupta, Milan; Menezes, Gladys; Kurpad, Anura V; Srinivasan, Krishnamachari

2018-06-01

High frequency of low birth weight (LBW) is observed in rural compared with urban Indian women. Since maternal BMI is known to be associated with pregnancy outcomes, the present study aimed to investigate factors associated with BMI in early pregnancy of urban and rural South Indian women. Prospective observational cohort. A hospital-based study conducted at an urban and a rural health centre in Karnataka State. Pregnant women (n 843) aged 18-40 years recruited in early pregnancy from whom detailed sociodemographic, environmental, anthropometric and dietary intake information was collected. A high proportion of low BMI (32 v. 26 %, Pwomen were younger, had lower body weight, tended to be shorter and less educated. They lived in poor housing conditions, had less access to piped water and good sanitation, used unrefined fuel for cooking and had lower standard of living score. The age (β=0·21, 95 % CI 0·14, 0·29), education level of their spouse (β=1·36, 95 % CI 0·71, 2·71) and fat intake (β=1·24, 95 % CI 0·20, 2·28) were positively associated with BMI in urban women. Our findings indicate that risk factors associated with BMI in early pregnancy are different in rural and urban settings. It is important to study population-specific risk factors in relation to perinatal health.

Investigation of productivity in a south Indian Malabari goat herd shows opportunities for planned animal health management to improve food security.

Science.gov (United States)

Sargison, N D; Ivil, S A J; Abraham, J; Abubaker, S P S; Hopker, A M; Mazeri, S; Otter, I A; Otter, N

2017-03-18

Here the authors report the objective veterinary clinical measurement of productivity in a representative south Indian Malabari goat herd. The authors show failure to meet pragmatic production targets that are commensurate with the animals' genetic potential or adequate to meet the demands of global food security. The authors suggest that this situation may have arisen as a consequence of animal husbandry constraints and protein undernutrition and imply the involvement of nematode parasitism. Benzimidazole resistance was detected in Haemonchus species, showing the need for better understanding of the principles of sustainable helminth parasite control within the southern Indian context. This study highlights the need to understand the true costs of goat production in seasonally resource-poor environments, while also considering its impact on the overall ecosystem in which the animals are placed. They conclude that pragmatic opportunities for improvements in goat production efficiency lie in the development of problem-focused planned animal health and nutrition management. British Veterinary Association.

RELATIONSHIP OF ADIPOKINES AND PROINFLAMMATORY CYTOKINES AMONG ASIAN INDIANS WITH OBESITY AND YOUTH ONSET TYPE 2 DIABETES.

Science.gov (United States)

Gokulakrishnan, Kuppan; Amutha, Anandakumar; Ranjani, Harish; Bibin, Subramanian Y; Balakumar, Mahalingam; Pandey, Gautam Kumar; Anjana, Ranjit Mohan; Ali, Mohammed K; Narayan, K M Venkat; Mohan, Viswanathan

2015-10-01

It is well known that inflammation is associated with diabetes, but it is unclear whether obesity mediates this association in individuals with youth-onset type 2 diabetes mellitus (T2DM-Y). We recruited individuals with T2DM-Y (age at onset obesity and categorized as: nonobese NGT (n = 100), Obese NGT (n = 50), nonobese T2DM-Y (n = 50), and obese T2DM-Y (n = 50). We compared adipokines (adiponectin and leptin) and proinflammatory cytokines (tumor necrosis factor alpha [TNF-α] and monocyte chemotactic protein-1 [MCP-1]) across groups. Compared to nonobese NGT, the other 3 groups (obese NGT, nonobese T2DM-Y, and obese T2DM-Y) were found to have lower adiponectin (7.7 vs. 5.7, 4.2, 3.8 μg/mL, Pobese T2DM-Y (141 pg/mL, Pobese T2DM, respectively. However, adjusted for same factors, leptin, TNF-α, and MCP-1 were associated with markedly higher odds (5- to 14-fold) of nonobese and obese T2DM. In young Asian Indians, leptin and proinflammatory cytokines are positively, and adiponectin negatively, associated with both nonobese and obese T2DM-Y compared to nonobese NGT individuals.

Traditional Indian custOInS surrounding birth

African Journals Online (AJOL)

culture. Very few of these have described customs followed by Indians in South Africa. A review of .... water, rather than cooling s~bstances like tea. \\Vomen are believed to ..... 6. McGilvray DB. Sexual power and fertiliry in Sri Lanka: Barticaloa.

Epidemiology of Dysglycemia in Pregnant Oklahoma American Indian Women.

Science.gov (United States)

Azar, Madona; Stoner, Julie A; Dao, Hanh Dung; Stephens, Lancer; Goodman, Jean R; Maynard, John; Lyons, Timothy J

2015-08-01

Minority communities are disproportionately affected by diabetes, and minority women are at an increased risk for glucose intolerance (dysglycemia) during pregnancy. In pregnant American Indian women, the objectives of the study were to use current criteria to estimate the prevalence of first-trimester (Tr1) dysglycemia and second-trimester (Tr2) incidence of gestational diabetes mellitus (GDM) and to explore new candidate measures and identify associated clinical factors. This was a prospective cohort study. In Tr1 we performed a 75-g, 2-hour oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) to determine the following: fasting insulin; homeostasis model assessment of insulin resistance; serum 1,5-anhydroglucitol; noninvasive skin autofluorescence (SCOUT). We defined dysglycemia by American Diabetes Association and Endocrine Society criteria and as HbA1c of 5.7% or greater. In Tr2 in an available subset, we performed a repeat OGTT and SCOUT. Pregnant American Indian women (n = 244 at Tr1; n = 114 at Tr2) participated in the study. The prevalence of dysglycemia at Tr1 and incidence of GDM at Tr2 were measured. At Tr1, one woman had overt diabetes; 36 (15%) had impaired glucose tolerance (American Diabetes Association criteria and/or abnormal HbA1c) and 59 (24%) had GDM-Tr1 (Endocrine Society criteria). Overall, 74 (30%) had some form of dysglycemia. Associated factors were body mass index, hypertension, waist/hip circumferences, SCOUT score, fasting insulin, and homeostasis model assessment of insulin resistance. At Tr2, 114 of the Tr1 cohort underwent a repeat OGTT and SCOUT, and 26 (23%) had GDM. GDM-Tr2 was associated with increased SCOUT scores (P = .029) and Tr1 body mass index, waist/hip circumferences, diastolic blood pressure, fasting insulin, and triglyceride levels. Overall, dysglycemia at Tr1 and/or Tr2 affected 38% of the women. Dysglycemia at some point during pregnancy was common among American Indian women. It was associated with

Type 2 diabetes mellitus in children and adolescents

OpenAIRE

Reinehr, Thomas

2013-01-01

Type 2 diabetes mellitus is emerging as a new clinical problem within pediatric practice. Recent reports indicate an increasing prevalence of type 2 diabetes mellitus in children and adolescents around the world in all ethnicities, even if the prevalence of obesity is not increasing any more. The majority of young people diagnosed with type 2 diabetes mellitus was found in specific ethnic subgroups such as African-American, Hispanic, Asian/Pacific Islanders and American Indians. Clinicians sh...

South of Sahara | Page 38 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

South of Sahara. Sud du Sahara. Read more about Integrated Intervention for Diabetes Risk After Gestational Diabetes in South Africa. Language English. Read more about Essais cliniques d'un vaccin expérimental contre le virus Ebola : une intervention canadienne dans la recherche. Language French. Read more about ...

Genetic epidemiology of coronary artery disease: an Asian Indian ...

Indian Academy of Sciences (India)

The present review aims to consolidate the available literature on the genetics of. CAD in Asian Indians ... India and the US who were participating in the Sikh Diabetes ..... to undertake systematic large-scale studies in order to under- stand the ...

Convective Lofting Links Indian Ocean Air Pollution to Recurrent South Atlantic Ozone Maxima

Science.gov (United States)

Chatfield, R. B.; Guan, H.; Thompson, A. M.; Witte, J.

2003-12-01

We extend on our analysis of equatorial tropospheric ozone to illustrate the contributions of South Asian pollution export in forming episodes of high O3 over the Atlantic Ocean. We amplify on an earlier description of a broad resolution of the "Atlantic Paradox," for the Jan-Feb-March period, which included initial indications of a very long-distance contribution from South Asia. The approach has been to describe typical periods of significant maximum and minimum tropospheric ozone for early 1999, exploiting TOMS tropospheric ozone estimates jointly with characteristic features of the SHADOZ (Southern Hemisphere Additional Ozonesondes) ozone soundings. Further investigation of the Total Tropospheric Ozone (TTO) record for all of 1999 suggests that there are repeated periods of very long-distance Asian influence crossing Africa, with an apparent effect on those portions of the Atlantic Equatorial troposphere which are downwind. Trajectory analyses suggest that the pattern over the Indian Ocean is complex: a sequence invoving multiple or mixed combustion sources, low level transport, cumulonimbus venting, and high-level transport to the west seem to be indicated by the TTO record. Biomass burning, fossil and biofuel combustion, and lighting seem to all contribute. For the Atlantic, burning and lighting on adjacent continents as well as episodes of this cross-Africa long-distance transport are all linked in a coordinated seasonal march: all are related by movement of the sun. However, interseasonal tropical variability related to the Madden-Julian oscillation allows intermittent ozone buildups that depart from the seasonal norm.

Prevalence and risk factors for refractive errors in the South Indian adult population: The Andhra Pradesh Eye disease study

Directory of Open Access Journals (Sweden)

Sannapaneni Krishnaiah

2008-12-01

Full Text Available Sannapaneni Krishnaiah1,2,3, Marmamula Srinivas1,2,3, Rohit C Khanna1,2, Gullapalli N Rao1,2,31L V Prasad Eye Institute, Banjara Hills, Hyderabad, India; 2International Center for Advancement of Rural Eye Care, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India; 3Vision CRC, University of New South Wales, Sydney, NSW, AustraliaAim: To report the prevalence, risk factors and associated population attributable risk percentage (PAR for refractive errors in the South Indian adult population.Methods: A population-based cross-sectional epidemiologic study was conducted in the Indian state of Andhra Pradesh. A multistage cluster, systematic, stratified random sampling method was used to obtain participants (n = 10293 for this study.Results: The age-gender-area-adjusted prevalence rates in those ≥40 years of age were determined for myopia (spherical equivalent [SE] < −0.5 D 34.6% (95% confidence interval [CI]: 33.1–36.1, high-myopia (SE < −5.0 D 4.5% (95% CI: 3.8–5.2, hyperopia (SE > +0.5 D 18.4% (95% CI: 17.1–19.7, astigmatism (cylinder < −0.5 D 37.6% (95% CI: 36–39.2, and anisometropia (SE difference between right and left eyes >0.5 D 13.0% (95% CI: 11.9–14.1. The prevalence of myopia, astigmatism, high-myopia, and anisometropia significantly increased with increasing age (all p < 0.0001. There was no gender difference in prevalence rates in any type of refractive error, though women had a significantly higher rate of hyperopia than men (p < 0.0001. Hyperopia was significantly higher among those with a higher educational level (odds ratio [OR] 2.49; 95% CI: 1.51–3.95 and significantly higher among the hypertensive group (OR 1.24; 95% CI: 1.03–1.49. The severity of lens nuclear opacity was positively associated with myopia and negatively associated with hyperopia.Conclusions: The prevalence of myopia in this adult Indian population is much higher than in similarly aged white populations. These results confirm the previously

Prevalence of obesity among diabetics seen in a tertiary health care ...

African Journals Online (AJOL)

Background: Obesity is a leading determinant for diabetes mellitus. The objective of this study was to assess the prevalence of overweight/obesity among diabetic patients seen at a tertiary hospital in South-South Nigeria. Methods: A retrospective study of 244 diabetic patients seen between January 2010 and June 2012.

Geochemistry of the mantle beneath the Rodriguez Triple Junction and the South-East Indian Ridge

International Nuclear Information System (INIS)

Michard, A.; Montigny, R.; Schlich, R.

1986-01-01

Rare earth element abundances and SR, Nd, Pb isotope compositions have been measured on zero-age dredge samples from the Rodriguez Triple Junction (RTJ) and the South-East Indian Ridge (SEIR). Along the SEIR, the geochemical ''halo'' of the St. Paul hot spot has a half-width of about 400 km and the data may be fairly well accounted for by a binary mixing between an Indian MORB-type component ( 87 Sr/ 86 Sr=0.7028, 143 Nd/ 144 Nd=0.51304, 206 Pb/ 204 Pb=17.8) and the plume type St. Paul component (0.7036, 0.5129 and 18.7 respectively). The alignment of the lead isotope data is particularly good with age of 1.95+-0.13 Ga and Th/U source value of 3.94. One sample dredged on the ridge 60 km southeast of St. Paul bears a definite Kertguelen isotopic signature. The RTJ has distinctive geochemical properties which contrast with those of the adjacent ridge segments. Low 206 Pb/ 204 Pb ratios which plots to the left of the geochron, rather high 208 Pb/ 204 Pb and 87 Sr/ 86 Sr ratios (17.4, 37.4, and 0.7031 respectively) a striking isotopic homogeneity, and variable LRE/HREE fractionation with (LA/S)sub(N) 0.3-0.8 make this triple junction an anomalous site. The geochemical properties of the Indian Ocean basalts have been examined using a three-component mantle model involving (a) a normal MORB-type source though to represent the depleted upper mantle matrix, (b) an OIB-type source of uncertain parentage (recycled oceanic crust), and (c) a component with low μ, Low Sm/Nd, high Rb/Sr (time-averaged value) which is tentatively assigned to ancient hydrothermal and abyssal sediments recycled in the mantle. The high 208 Pb/ 204 Pb and 87 Sr/ 86 Sr ratios typical of the Dupal anomaly are likely due to the widespread distribution of this latter component in the basalt source from this area, including that for MORBs. (orig.)

Geochemistry of the mantle beneath the Rodriguez Triple Junction and the South-East Indian Ridge

Science.gov (United States)

Michard, A.; Montigny, R.; Schlich, R.

1986-05-01

Rare earth element abundances and Sr, Nd. Pb isotope compositions have been measured on zero-age dredge samples from the Rodriguez Triple Junction (RTJ) and the South-East Indian Ridge (SEIR), Along the SEIR. the geochemical "halo" of the St. Paul hot spot has a half-width of about 400 km and the data may be fairly well accounted for by a binary mixing between an Indian MORB-type component ( 87Sr/ 86Sr = 0.7028. 143Nd/ 144Nd = 0.51304. 206Pb/ 204Pb = 17.8) and the plume-type St. Paul component (0.7036, 0.5129, and 18.7 respectively). The alignment of the lead isotope data is particularly good with an apparent age of 1.95 ± 0.13 Ga and Th/U source value of 3.94. One sample dredged on the ridge 60 km southeast of St. Paul bears a definite Kerguelen isotopic signature. The RTJ has distinctive geochemical properties which contrast with those of the adjacent ridge segments. Low 206Pb/ 204Pb ratios which plots to the left of the geochron, rather high 208Pb/ 204Pb and 87Sr/ 87Sr ratios (17.4. 37.4, and 0.7031 respectively), a striking isotopic homogeneity, and variable LREE/HREE fractionation with (La/Sm) N, = 0.3-0.8 make this triple junction an anomalous site. The geochemical properties of the Indian Ocean basats have been examined using a three-component mantle model involving (a) a normal MORB-type source though to represent the depleted upper mantle matrix, (b) an OIB-type source of uncertain parentage (recycled oceanic crust?), and (c) a component with low μ. low Sm/Nd. high Rb/Sr (time-averaged value) which is tentatively assigned to ancient hydrothermal and abyssal sediments recycled in the mantle. The high 208Pb/ 204Pb and 87Sr/ 86Sr ratios typical of the Dupal anomaly are likely due to the widespread distribution of this latter component in the basalt source from this area. including that for MORBs.

Elevated glycated hemoglobin predicts macrosomia among Asian Indian pregnant women (WINGS-9).

Science.gov (United States)

Bhavadharini, Balaji; Mahalakshmi, Manni Mohanraj; Deepa, Mohan; Harish, Ranjani; Malanda, Belma; Kayal, Arivudainambi; Belton, Anne; Saravanan, Ponnusamy; Ranjit, Unnikrishnan; Uma, Ram; Anjana, Ranjit Mohan; Mohan, Viswanathan

2017-01-01

The aim of this study was to determine the optimal glycated hemoglobin (HbA1c) cut point for diagnosis of gestational diabetes mellitus (GDM) and to evaluate the usefulness of HbA1c as a prognostic indicator for adverse pregnancy outcomes. HbA1c estimations were carried out in 1459 pregnant women attending antenatal care centers in urban and rural Tamil Nadu in South India. An oral glucose tolerance test was carried out using 75 g anhydrous glucose, and GDM was diagnosed using the International Association of the Diabetes and Pregnancy Study Groups criteria. GDM was diagnosed in 195 women. Receiver operating curves showed a HbA1c cut point of ≥ 5.0% (≥31 mmol/mol) have a sensitivity of 66.2% and specificity of 56.2% for identifying GDM (area under the curve 0.679, confidence interval [CI]: 0.655-0.703). Women with HbA1c ≥ 5.0% (≥31 mmol/mol) were significantly older and had higher body mass index, greater history of previous GDM, and a higher prevalence of macrosomia compared to women with HbA1c Indian pregnant women, a HbA1c of 5.0% (31 mmol/mol) or greater is associated with increased risk of macrosomia.

Awareness of diabetes amongst undergraduates in a Nigerian University, South West Nigeria

Directory of Open Access Journals (Sweden)

Olubukunola Omobuwa

2014-01-01

Full Text Available Background: Diabetes mellitus (DM is a disease of global public health importance whose prevention and control may be largely influenced by improved knowledge amongst populations. This study set out to examine the level of awareness, knowledge, and some risk factors for developing DM among students of the Osun State University, Nigeria. Materials and Methods: A descriptive cross-sectional study was conducted amongst students of the Osun State University in South-western Nigeria. Study participants were recruited using multistage sampling technique. A self-administered semi-structured questionnaire was used to obtain information on respondents′ socio-demographics; awareness, knowledge and perception of DM and lifestyle characteristics such as dietary habits, physical activity, use of alcohol, and tobacco smoking. Results: A total of 166 students participated in the study, 75.9% of whom have heard of DM and 40.4% of them correctly defined the condition. Seventy-two (43.4% of the study participants erroneously associated excessive intake of sugar with development of DM. Nearly one-third (30.1% of them did not know any preventive measure for DM. Fourteen (56% of the 25 respondents who had a diabetic relative said the diabetic person was their first degree relative. Sixty-one (36.7% subjects engaged in daily consumption of soft drinks, and only 8.5% engaged in regular physical exercise. Only 6.0% of the participants had ever heard of body mass index (BMI. Conclusion: This study showed high awareness level of DM among participants but the knowledge and attitude toward DM was relatively poor.

Dietary Transition in the South Asian Diaspora: Implications for Diabetes Prevention Strategies.

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Parackal, Sherly

2017-01-01

South Asians (SA) have a four to five fold higher risk for type 2 diabetes mellitus (T2DM) in comparison to other Asian migrant groups. Dietary patterns have been attributed as an important independent modifiable risk factor. The aim of this review is to document the dietary patterns of SA migrants in Western countries and to summarize the evidence for the association of dietary patterns with T2DM and its predisposing factors. Using key search words articles from 1990 onwards were sourced from MEDLINE Pro- Quest and PubMed (not MEDLINE) databases for this narrative review. A significant shift in meal pattern with frequent dining out and eating fast foods, traditional festival foods and Western desserts and snacks was common among SA. Consumption of potatoes, dairy, oil, meat and fish increased and beans, lentils, fruits and vegetables decreased post-migration. "Animal protein" and "fried snacks, sweets and high-fat dairy" were associated with greater insulin resistance and lower HDL cholesterol. A "mixed" dietary pattern was associated with obesity and hypertension and a "western" dietary pattern was associated with overall risk for Metabolic Syndrome. A 70% increase in the odds of diabetes per standard deviation in gram of protein intake was also observed. Dietary patterns pave the way to develop diabetes and other obesity related diseases among SA as duration of residence increases. The first five years since migration maybe a window of opportunity to provide targeted interventions to ensure maintenance of healthy dietary habits. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Service design attributes affecting diabetic patient preferences of telemedicine in South Korea.

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Park, Hayoung; Chon, Yucheong; Lee, Jongsu; Choi, Ie-Jung; Yoon, Kun-Ho

2011-01-01

Attempts to introduce telemedicine in South Korea have failed mostly, leaving critical questions for service developers and providers about whether patients would be willing to pay for the service and how the service should be designed to encourage patient buy-in. In this study, we explore patients' valuations and preferences for each attribute of telemedicine service for diabetes management and evaluate patient willingness to pay for specific service attributes. We conducted a conjoint survey to collect data on patients' stated preferences among telemedicine service alternatives. The alternatives for diabetes-related service differed in 10 attributes, including those related to price, type of service provider, and service scope. To estimate the relative importance of attributes, patients' willingness to pay for each attribute, and their probable choice of specific alternatives, we used a rank-ordered logit model. A total of 118 respondents participated in the survey. All 10 attributes significantly affected patients' valuations and preferences, and demographic and disease characteristics, such as existence of complications and comorbidities, significantly affected patients' valuations of the attributes. Price was the most important attribute, followed by comprehensive scope of service, the availability of mobile phone-based delivery, and large general-hospital provided services. The study findings have significant implications for adoption policy and strategy of telemedicine in diabetes management care. Further, the methodology presented in this study can be used to draw knowledge needed to formulate effective policy for adoption of the necessary technology and for the design of services that attract potential beneficiaries.

Total Atheism: Making 'Mental Revolution' in South India

NARCIS (Netherlands)

Binder, S.

2017-01-01

The dissertation titled “Total Atheism: Making ‘mental revolution’ in South India” is an anthropological study of an organised atheist movement in the two South Indian states of Andhra Pradesh and Telangana. This movement consists of groups and individuals who self-identify as atheists,

Polymorphisms in the non-muscle myosin heavy chain gene (MYH9 are associated with lower glomerular filtration rate in mixed ancestry diabetic subjects from South Africa.

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Tandi Edith Matsha

Full Text Available OBJECTIVE: Though single nucleotide polymorphisms (SNPs in the non-muscle myosin gene (MYH9 have been reported to explain most of the excess risk of nondiabetic chronic kidney disease (CKD, in African-Americans, some studies have also shown associations with diabetic end-stage renal disease. We investigated the association of MYH9 SNPs with renal traits in a mixed-ancestry South African population prone to diabetes. RESEARCH DESIGN AND METHODS: Three SNPs known to be associated with CKD (rs4821480, rs5756152 and rs12107 were genotyped using Taqman assay in 716 adults (198 with diabetes from the Bellville-South community, Cape Town. Glomerular filtration rate was estimated (eGFR and urinary albumin/creatinine ratio (ACR assessed. Multivariable regressions were used to relate the SNPs with renal traits. RESULTS: Mean age was 53.6 years, with the expected differences observed in characteristics by diabetic status. Significant associations were found between rs575152 and serum creatinine, and eGFR in the total population, and in diabetic participants (all p≤0.003, but not in non-diabetics (all p≥0.16, with significant interactions by diabetes status (interaction-p≤0.009. The association with ACR was borderline in diabetic participants (p = 0.05 and non-significant in non-diabetics (p = 0.85, with significant interaction (interaction p = 0.02. rs12107 was associated with fasting-, 2-hour glucose and HbA1c in diabetic participants only (interaction-p≤0.003, but not with renal traits. CONCLUSION: MYH9 SNPs were associated with renal traits only in diabetic participants in this population. Our findings and other studies suggest that MYH9 may have a broader genetic risk effect on kidney diseases.

Anxiety, depression and psychological well-being in a cohort of South African adults with Type 2 diabetes mellitus

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Samantha Ramkisson

2016-07-01

Full Text Available Background: The prevalence of diabetes mellitus (DM has increased at alarming rates globally. South Africa has the second highest number of people in Africa living with DM, with prevalence rates being among the top five countries in Africa. Accordingly, psychological issues associated with DM have been a growing focus of attention. Studies have found that patients with DM have elevated levels of anxiety and depression, and decreased levels of well-being. In South Africa, there is a paucity of studies on the psychological issues associated with DM. Objectives: The aim of this paper was to explore the prevalence and association of anxiety, depressive features and psychological well-being in patients with Type 2 DM. Method: In a cross-sectional survey, patients with Type 2 DM were recruited from public and private facilities. The Hospital Anxiety and Depression Scale (HADS, the General Health Questionnaire (GHQ-28 and WHO-5 Well-being Index (WHO-5 were administered. Results: Four hundred and one participants completed the questionnaires. On the WHO-5, 277 (69% reported good well-being, while 124 (31% indicated poor well-being and were considered at risk for depressive features. On the HADS, 186 (46% had mild-to-severe depressive features and 128 (32% had mild-to-severe anxiety. There was a strong negative correlation between the WHO-5, HADS and General Health Questionnaire (GHQ scales, which indicated that an increase in anxiety and depressive features decreased psychological well-being. Conclusion: Health-care providers should identify and treat anxiety and depression as a standard part of diabetes care. Patients should also be referred to the appropriate mental health professional as part of the management of diabetes. Keywords: type 2 diabetes; anxiety;depression;psychological well-being; adults

Insulin secretion and action in North Indian women during pregnancy

DEFF Research Database (Denmark)

Arora, G P; Almgren, P; Thaman, R G

2017-01-01

. RESULTS: Gestational diabetes defined using both criteria was associated with decreased insulin secretion compared with pregnant women with normal glucose tolerance. Women with gestational diabetes defined by the adapted GDM2013, but not GDM1999 criteria, were more insulin resistant than pregnant women......AIM: The relative roles(s) of impaired insulin secretion vs. insulin resistance in the development of gestational diabetes mellitus depend upon multiple risk factors and diagnostic criteria. Here, we explored their relative contribution to gestational diabetes as defined by the WHO 1999 (GDM1999...... independently associated with increased insulin resistance. CONCLUSIONS: Gestational diabetes risk factors influence insulin secretion and action in North Indian women in a differential manner. Gestational diabetes classified using the adapted GDM2013 compared with GDM1999 criteria is associated with more...

Attitudes towards gestational diabetes among a multiethnic cohort in Australia.

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Carolan, Mary; Steele, Cheryl; Margetts, Heather

2010-09-01

This study aimed to examine the attitudes and beliefs towards gestational diabetes of a multiethnic sample of pregnant women with gestational diabetes. Women from non-Caucasian background are disproportionately represented in gestational diabetes statistics. This is of particular importance in multicultural Australia, where increasing numbers of non-Caucasian women give birth. Cross-sectional survey. The Diabetes Attitude Scale, version 3 was administered to 200 women with gestational diabetes from Vietnamese, Indian, Filipino and Caucasian backgrounds. A total of 143 questionnaires were returned indicating a response rate of 71·5%. There were significant between group differences in terms of educational level (p = 0·001) and English fluency (p = 0·001). Lower educational level, though not English language fluency, was associated with poorer appreciation of gestational diabetes as a serious condition and also with a lower valuing of tight glucose control. This effect was seen irrespective of ethnic group. Indian and Vietnamese women indicated a lower valuing of patient autonomy and also reported less negative psychological effects than Caucasian and Filipino women. Women from non-Caucasian ethnicities may be at risk of poorer self-management of gestational diabetes related to lower education, lower health literacy and a lower appreciation of gestational diabetes as a serious condition. Nurses and midwives provide information and advice to women with gestational diabetes. Knowledge about factors that impact on attitude towards gestational diabetes among multiethnic populations is important for developing educational programmes to address their needs. © 2010 Blackwell Publishing Ltd.

Health system challenges in organizing quality diabetes care for urban poor in South India.

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Bhojani, Upendra; Devedasan, Narayanan; Mishra, Arima; De Henauw, Stefaan; Kolsteren, Patrick; Criel, Bart

2014-01-01

Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. We used the health system dynamics framework to analyze a health system in KG Halli, a poor urban neighborhood in South India. We conducted semi-structured interviews with healthcare providers located in and around the neighborhood who provide care to diabetes patients: three specialist and 13 non-specialist doctors, two pharmacists, and one laboratory technician. Observations at the health facilities were recorded in a field diary. Data were analyzed through thematic analysis. There is a lack of functional referral systems and a considerable overlap in provision of outpatient care for diabetes across the different levels of healthcare services in KG Halli. Inadequate use of patients' medical records and lack of standard treatment protocols affect clinical decision-making. The poor regulation of the private sector, poor systemic coordination across healthcare providers and healthcare delivery platforms, widespread practice of bribery and absence of formal grievance redress platforms affect effective leadership and governance. There appears to be a trust deficit among patients and healthcare providers. The private sector, with a majority of healthcare providers lacking adequate training, operates to maximize profit, and healthcare for the poor is at best seen as charity. Systemic impediments in local health systems hinder the delivery of quality diabetes care to the urban poor. There is an urgent need to address these weaknesses in order to improve care for diabetes and other chronic conditions.

Health system challenges in organizing quality diabetes care for urban poor in South India.

Directory of Open Access Journals (Sweden)

Upendra Bhojani

Full Text Available BACKGROUND: Weak health systems in low- and middle-income countries are recognized as the major constraint in responding to the rising burden of chronic conditions. Despite recognition by global actors for the need for research on health systems, little attention has been given to the role played by local health systems. We aim to analyze a mixed local health system to identify the main challenges in delivering quality care for diabetes mellitus type 2. METHODS: We used the health system dynamics framework to analyze a health system in KG Halli, a poor urban neighborhood in South India. We conducted semi-structured interviews with healthcare providers located in and around the neighborhood who provide care to diabetes patients: three specialist and 13 non-specialist doctors, two pharmacists, and one laboratory technician. Observations at the health facilities were recorded in a field diary. Data were analyzed through thematic analysis. RESULT: There is a lack of functional referral systems and a considerable overlap in provision of outpatient care for diabetes across the different levels of healthcare services in KG Halli. Inadequate use of patients' medical records and lack of standard treatment protocols affect clinical decision-making. The poor regulation of the private sector, poor systemic coordination across healthcare providers and healthcare delivery platforms, widespread practice of bribery and absence of formal grievance redress platforms affect effective leadership and governance. There appears to be a trust deficit among patients and healthcare providers. The private sector, with a majority of healthcare providers lacking adequate training, operates to maximize profit, and healthcare for the poor is at best seen as charity. CONCLUSIONS: Systemic impediments in local health systems hinder the delivery of quality diabetes care to the urban poor. There is an urgent need to address these weaknesses in order to improve care for diabetes

Comparison in maternal body composition between Caucasian Irish and Indian women.

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Farah, N; Murphy, M; Ramphul, M; O'Connor, N; Kennelly, M M; Turner, M J

2011-08-01

The use of body mass index (BMI) for the diagnosis of obesity has limitations, especially when comparing ethnic groups with different body proportions. The aim of this prospective study was to compare maternal body composition in early pregnancy between Caucasian Irish and Indian women. A total of 81 Indian women and 81 Irish Caucasian women were matched for age, parity and BMI. Maternal weight and height were measured, and body composition analysed using bioelectrical impedance. The Irish women were taller and weighed more than the Indian women (pIndian women had a higher total body fat percentage, visceral fat level and high fat percentage than the Irish women (p=0.024, 0.001 and 0.001, respectively). Our findings suggest that lower BMI cut-offs should be used for screening for gestational diabetes mellitus in Indian women attending our antenatal services.

Seabirds indicate changes in the composition of plastic litter in the Atlantic and south-western Indian Oceans.

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Ryan, Peter G

2008-08-01

I compare plastic ingested by five species of seabirds sampled in the 1980s and again in 1999-2006. The numbers of ingested plastic particles have not changed significantly, but the proportion of virgin pellets has decreased 44-79% in all five species: great shearwater Puffinus gravis, white-chinned petrel Procellaria aequinoctialis, broad-billed prion Pachyptila vittata, white-faced storm petrel Pelagodroma marina and white-bellied storm petrel Fregetta grallaria. The populations sampled range widely in the South Atlantic and western Indian Oceans. The most marked reduction occurred in great shearwaters, where the average number of pellets per bird decreased from 10.5 to 1.6. This species migrates between the South and North Atlantic each year. Similar decreases in virgin pellets have been recorded in short-tailed shearwaters Puffinus tenuirostris in the Pacific Ocean and northern fulmars Fulmarus glacialis in the North Sea. More data are needed on the relationship between plastic loads in seabirds and the density of plastic at sea in their foraging areas, but the consistent decrease in pellets in birds suggests there has been a global change in the composition of small plastic debris at sea over the last two decades.

Nodules of the Central Indian Ocean Basin