Low prevalence of ICA in MRDM.
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Autoantibodies↗
Biomedical subjects
V Mohan
Publications and source records attributed to V Mohan.
The genetic predisposition to fibrocalculous pancreatic diabetes.
Fibrocalculous pancreatic diabetes (previously known as tropical pancreatic diabetes) is a rare cause of diabetes confined to countries within the tropical belt. The aetiology of fibrocalculous pancreatic diabetes is thought to be environmental although the agent(s) is unknown. We have investigated a possible genetic basis of this disease by looking for restriction fragment length polymorphisms of genes implicated in the aetiology of diabetes mellitus. Seventy-six Dravidian patients with fibrocalculous pancreatic diabetes were studied, and the restriction fragment length polymorphisms obtained compared to racially matched control subjects (n = 94), patients with Type 2 (non-insulin-dependent) diabetes (n = 87) and Type 1 (insulin-dependent) diabetes (n = 58). No association of fibrocalculous pancreatic diabetes was found with restriction fragment length polymorphisms of the insulin receptor gene. Although no association of fibrocalculous pancreatic diabetes was found with polymorphism of the HLA DR alpha/DQ alpha/DX alpha genes, an association was found with the Taq 1 restriction fragment length polymorphisms of the DQ beta gene (DQ beta T2/T6 present in 39% of patients with fibrocalculous pancreatic diabetes compared to 19% in control subjects; p = 0.01; corrected p value = 0.04) which is similar to that found in Type 1 but not Type 2 diabetes. An association of fibrocalculous pancreatic diabetes was also found with the hypervariable region in the 5-prime flanking region of the insulin gene; 40% of patients possessed the class 3 allele compared to 9.5% of control subjects p = 0.0001; corrected p value = 0.0008).(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Aneurysmal bone cysts of the dorsal spine.
Aneurysmal bone cyst is an uncommon but interesting condition, more so when it involves the vertebrae. Three cases of aneurysmal bone cysts of the dorsal spine, suspected on clinicoradiological findings and confirmed by histopathology, are reported in this paper. The authors believe that when the disease affects the pedicles or transverse processes of a vertebra, the plain roentgenographic findings are quite typical of the disease, and a confident radiological diagnosis is possible in the majority of cases.
Adult↗
Familial aggregation in tropical fibrocalculous pancreatic diabetes.
There is very little information on the genetic factors associated with fibrocalculous pancreatic diabetes (FCPD). Ninety-eight first-degree relatives of FCPD patients were subjected to detailed studies, which included glucose tolerance tests, x-ray films of the abdomen, ultrasonography, and studies of exocrine pancreatic function. The study shows that there is a familial aggregation of FCPD with evidence of vertical transmission of the disease from parent to offspring in some families. Routine screening of families of FCPD probands helped to pick up cases in the stage of impaired glucose tolerance. There is heterogeneity in FCPD with respect to familial factors. Some families show marked familial aggregation of FCPD while in others the disease occurs either sporadically or in association with other family members who have abnormal glucose handling.
Adolescent↗
Exocrine pancreatic function in tropical fibrocalculous pancreatic diabetes.
Exocrine pancreatic function was studied by fecal chymotrypsin test in three groups of diabetic patients seen in southern India. Exocrine pancreatic insufficiency, as shown by low fecal chymotrypsin levels, was seen in 87.5% of patients with fibrocalculous pancreatic diabetes (FCPD), in 23.5% of insulin-dependent diabetes mellitus patients, and in 4.5% of non-insulin-dependent diabetes mellitus patients. There was no correlation between fecal chymotrypsin levels and serum amylase, serum lipase, age, body mass index, duration of diabetes, fasting plasma glucose, or glycosylated hemoglobin levels. The fecal chymotrypsin test is a useful additional investigation for the diagnosis of FCPD found in tropical countries.
Adult↗
Retinopathy in insulin dependent diabetes mellitus (IDDM) in south India.
The prevalence of diabetic retinopathy was assessed by direct and indirect ophthalmoscopy in a group of patients with insulin dependent diabetes mellitus (IDDM). Fourteen percent of patients had retinopathy. Proliferative retinopathy and severe background retinopathy including maculopathy were both seen in four percent of patients. It is possible that the lower prevalence rates for these complications is due to the shorter duration of diabetes in our patients.
Adult↗
Fibrocalculous pancreatic diabetes in the elderly.
Fibrocalculous pancreatic diabetes (FCPD) is a form of diabetes seen in tropical countries. It is secondary to chronic, calcific, non-alcoholic pancreatitis. FCPD is usually a disease of youth. This paper reports on two elderly onset cases of FCPD. Macrovascular complications are usually rare in FCPD patients. These two patients had evidence of macrovascular diseases probably due to the older age group of the patients.
Calcinosis↗
Abnormalities in erythrocyte insulin binding in offspring of conjugal non-insulin-dependent diabetic parents.
Insulin binding to erythrocyte insulin receptors was studied in 23 offspring (13 men and 10 women) born of conjugal diabetic parents having type 2 diabetes. Nine of the offspring were obese and 14 were non-obese, but all had normal glucose tolerance. Twenty-three age-, sex- and weight-matched non-diabetic subjects without a family history of diabetes were studied as controls. In the non-obese offspring mean basal plasma immunoreactive insulin (IRI) was elevated (P less than 0.01), but the mean stimulated IRI showed no change in comparison to that of controls. In the obese offspring mean basal plasma IRI was similar, but the mean stimulated IRI was lower than that of obese controls (P less than 0.01). Mean specific insulin binding was decreased in both obese (P less than 0.01) and non-obese (P less than 0.01) offspring when compared with the respective controls. Scatchard analysis of the binding data and the higher insulin concentrations required to achieve 50% inhibition of tracer binding indicated decreased receptor affinity in both obese and non-obese offspring. Analysis by average affinity profiles also indicated decreased receptor affinity, as shown by a lower average affinity constant Kc for the empty sites, in the offspring in comparison to that of controls (P less than 0.001). Abnormalities in insulin binding to its receptor along with decreased affinity in the face of normal glucose tolerance may be an early biochemical marker of potential diabetes in this group at high risk of developing diabetes.
Adult↗
High prevalence of diabetes in an urban population in south India.
An urban population in a township in south India was screened for diabetes with an oral glucose tolerance test, every fifth person aged 20 and over registered at the local iron ore company's hospital being screened. Of 678 people (346 men and 332 women) who were tested, 34 (5%; 20 men and 14 women) had diabetes and 14 (2%; 8 men and 7 women) had impaired glucose tolerance. Thirteen subjects were already known to be diabetic. Diabetes was present in 21% (37/179) of people aged over 40. The peak prevalence (41%; 7/17) was in the group aged 55-64. A family history of diabetes was present in 16 of the 34 subjects with diabetes and nine of the 15 with impaired glucose tolerance. Diabetes was significantly related to obesity in women but not in men (57% (8/14) v 5% (1/20)). The plasma glucose concentration two hours after glucose loading was correlated to body mass index, age, and income in both sexes. The prevalence of diabetes was significantly higher in subjects whose income was above the mean. When the overall prevalence of diabetes was adjusted to the age distribution of the Indians living in Southall, London, and in Fiji it increased to 10% and 9%, respectively. The prevalence of diabetes is high among urban Indians and is comparable with the high prevalence seen in migrant Indian populations.
Adult↗
Prevalence of non-insulin-dependent diabetes mellitus in Asian Indian families with a single diabetic parent.
Offspring of one parent diabetic (OPDR-A) and offspring of one parent diabetic with a first-degree family history on the non-diabetic parental side (OPDR-B) were studied to assess the influence of familial aggregation on the prevalence of non-insulin-dependent diabetes mellitus (NIDDM). All parents and offspring were tested for diabetes by oral glucose tolerance test. All parents had NIDDM. The prevalence of diabetes was 36% and 54% in the OPDR-A and OPDR-B families, respectively. The prevalence rate in OPDR-B was higher compared to OPDR-A families (P less than 0.01). The prevalence of diabetes in OPDR families was not different whether the father or the mother had diabetes. There was a male predominance among the diabetic offspring. The age at diagnosis was lower in the offspring compared to that in their parents in both groups. The expected risk of diabetes was greater in OPDR-B families compared to OPDR-A families. Thus it is seen that there is high prevalence of NIDDM in our population even in families with only one diabetic parent.
Adolescent↗
Clinical features of diabetes in the young as seen at a diabetes centre in south India.
This study reports on the clinical pattern of 545 consecutive young diabetic patients with age at onset below 30 years attending a diabetes centre in Southern India. Three hundred and fourteen patients (57.7%) were classified as having non-insulin-dependent diabetes of the young (NIDDY), 119 (22%) as insulin-dependent diabetes (IDDM) and 28 (5%) as malnutrition-related diabetes (MRDM); 4% fibrocalculous pancreatic diabetes and 1% protein-deficient pancreatic diabetes. The remaining 84 patients could not be classified into any of the above categories. A positive family history of diabetes was more common in NIDDY compared to the other groups (P less than 0.001). While 40.3% of patients with IDDM had age at onset below 15 years, the other types of diabetes were rarely seen in patients younger than this. Body mass index (BMI) did not reliably indicate the MRDM forms of diabetes as 70% of patients with IDDM also had a BMI of less than 18, one of the criteria recommended for the diagnosis of MRDM. C-peptide levels in MRDM were intermediate between the IDDM and NIDDY groups. Microvascular complications were present in all the groups of young diabetics. The frequency was higher in NIDDY patients who also had a longer duration of diabetes. There was an increasing prevalence of complications with increasing duration of diabetes.
Adult↗
Leri-Weill syndrome (dyschondrosteosis): a family study.
Madelung's deformity due to Leri-Weill Syndrome (Dyschondrosteosis) is a rare condition. Six cases of this entity involving two generations in one family are reported in this communication. The differential diagnosis of the various causes of Madelung's deformity are briefly discussed.
Adolescent↗
Erythrocyte insulin binding abnormalities in fibro calculous pancreatic diabetes.
Insulin binding to erythrocyte insulin receptors was studied in 17 patients (13 men and 4 women) with fibrocalculous pancreatic diabetes mellitus (FCPD) and compared with that of 14 newly diagnosed NIDDM patients matched for age, sex and severity of hyperglycemia, and 14 age and sex-matched non-diabetic control subjects. In the uncompensated diabetic state, mean (+/- S.D.) specific binding of insulin was lower in both FCPD and NIDDM patients, compared with non-diabetic controls (P less than 0.001). Control of diabetes with short term therapy (2-6 weeks) resulted in a significant improvement in the mean specific insulin binding in both FCPD and NIDDM patients (P less than 0.001) due to increased binding affinity in the former, and increased affinity and the number of binding sites in the latter. As compared to short term therapy, chronic therapy (5-8 months) in FCPD patients resulted in a marginal decrease in specific insulin binding. However, this was still significantly higher than the basal value (P less than 0.05). FCPD patients had an initial low mean basal plasma IRI and a much lower mean stimulated IRI response as compared to NIDDM and non-diabetic controls.
Adult↗
Insulin resistance in Fibrocalculous (tropical) pancreatic diabetes.
Insulin resistance was assessed by Insulin Tolerance Test (ITT) in 12 patients with FCPD, 10 with NIDDM and 12 age and sex matched control subjects. The mean BMI of the FCPD was lower than the NIDDM and control groups (P less than 0.001). There was no significant difference between the mean fasting plasma glucose or HbA1 between the FCPD and NIDDM patients. The mean fasting C-peptide of the FCPD group was significantly lower than the NIDDM and control groups (P less than 0.001). The mean glucose disposal rate (KITT) was 5.57 +/- 2.28 in the control group, 2.15 +/- 2.00 in the FCPD and 1.77 +/- 0.91 in the NiDDM group (P less than 0.001, control vs FCPD and NIDDM). The difference in KITT between FCPD and NIDDM groups was not significant statistically. The data suggests that patients with FCPD have evidence of insulin resistance and this is similar to that seen in NIDDM patients.
Adult↗
Tuberculosis of the calvaria mimicking eosinophilic granuloma.
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Diagnosis, Differential↗
Solitary plasmacytoma of the spine (a case report and review of literature).
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Adult↗
HLA-D region RFLPs indicate that susceptibility to insulin-dependent diabetes in South India is located in the HLA-DQ region.
Recently close markers for insulin-dependent diabetes mellitus in Western 'Caucasoid' subjects have been defined from DQ region (both alpha and beta genes) restriction fragment length polymorphisms. In order to define the genetic contribution to insulin-dependent diabetes mellitus in an Indian population we have analysed 58 unrelated Dravidian (South Indian) insulin-dependent diabetic patients and 43 controls. In insulin-dependent diabetes an increased frequency of the Taq 1 DQ beta restriction fragment length polymorphisms designated T2 omega/T6 (relative risk = 10.6), and of homozygotes for Taq 1 DQ alpha 4.6 kb (relative risk = 11), was found in the patients. The highest relative risk for insulin-dependent diabetes mellitus was obtained by comparing patients and control subjects who either (a) co-inherited DQT2 omega/T6 with certain DQ alpha restriction fragment length polymorphisms or (b) were DQ alpha 4.6 kb homozygotes, the combination of (a) and (b) accounting for 55.5% of insulin-dependent diabetes mellitus subjects and none of the controls (relative risk = 101; 95% confidence limits 93-109).
Diabetes Mellitus, Type 1↗
Evaluation of a non-mydriatic camera in Indian and European diabetic patients.
The value of the Canon CR3-45NM non-mydriatic fundus camera in screening for diabetic retinopathy has been assessed in two ethnic groups, namely, 45 Indian and 40 European diabetic patients. There was 72% agreement between ophthalmoscopy by an ophthalmologist and the photographic assessment, and 100% agreement on clinically important lesions requiring treatment. However, peripheral retinal lesions, seen on ophthalmoscopy but lying outside the photographic field, occurred in 4% of eyes. 6% of photographs were totally unassessable and an additional 12% were only partially assessable. The prevalence and severity of retinopathy was similar in Indian and European patients. The advantages and disadvantages of the non-mydriatic camera in screening for diabetic retinopathy are discussed.
Diabetic Retinopathy↗