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Biomedical subjects

V Vijay

Publications and source records attributed to V Vijay.

At least 37 records · Page 2Linked to original sources
PubMed2003

Age-specific prevalence and risk associations for impaired glucose tolerance in urban southern Indian population.

OBJECTIVES: A national survey of diabetes and impaired glucose tolerance (IGT) conducted in 2000 AD in six major cities of India showed a high prevalence of diabetes (12.1%) and IGT (14%). Prevalence of IGT was higher than that of diabetes in subjects with less than 40 years when compared with older subjects. This analysis was done to look for differences in the risk factors associated with IGT in the younger and older subjects. METHODS: Associations of body mass index (BMI), waist : hip ratio, physical activity, family history of diabetes and monthly income with IGT and with diabetes were tested in the age groups of < 40 and > or = 40 years separately. Multiple logistic regression analyses were done to test the associations. RESULTS: Prevalence of IGT was higher than diabetes in the younger group (13.1% Vs 5%, P < 0.001). Prevalence of obesity was higher in the older IGT subjects (38% Vs 30.5%, p < 0.003). Presence of positive family history of diabetes was similar in both the groups. In the > or = 40 year group age, BMI and family history of diabetes were common risk factors for diabetes and IGT. In the younger group, only BMI showed an association with IGT. The association of family history of diabetes with IGT was weaker than for diabetes even in the older subjects (Odds Ratio (OR) = 3.5 for diabetes, 1.33 for IGT). CONCLUSIONS: Prevalence of IGT was higher than diabetes in the age group < 40 years. Only BMI showed an association with IGT in them while the risk associations were similar to diabetes in the older group. Prospective studies will throw more light on the implications of these findings.

Adult↗
PubMed2002

Costs incurred by families having Type 1 diabetes in a developing country--a study from Southern India.

The aim of the study was to estimate the direct family costs of Type 1 diabetes in India. The study was carried out with the participation of the families of 209 Type 1 DM patients (M:F 126:83, mean age 26.6+/-12.7 years). The annual family income varied from Rs. 10,000 to 600,000/- (US$ 212-12,765) with a median of Rs. 60,000/- (US$ 1276). A median figure of Rs. 13,980 (US$ 310) was spent annually on diabetes by the families of patients; range Rs. 2046-87,150 (US$ 45-1936). Fifty six percent of patients were not earning. The median percentage of income spent on diabetes was 22% for the entire group, varying from 59% in the low socioeconomic group, 32% in the middle socioeconomic group, 18% in the upper middle income group and 12% in the high-income group. Patients managed on an outpatient basis alone incurred an expenditure of 16% of income while 23% of income was spent on those requiring hospitalisation.

Costs and Cost Analysis↗
PubMed2002

Prevalence of overweight in urban Indian adolescent school children.

The prevalence of diabetes mellitus (DM) and cardiovascular disease (CVD) is increasing in urban India. Overweight in adolescence is a marker of overweight in adult age, and it shows an association with the above diseases. There have been meagre data from India on the prevalence of childhood obesity. The objective of the study was to quantify the prevalence of overweight and its risk factors in adolescent children in urban India. School students in the age group of 13-18 years (n = 4700, M:F 2382:2318) were studied. Body mass index (BMI) was measured. Data on physical activity, food habits, occupation of parents and their economic status, birth weight of the children and age at menarche in girls were obtained by questionnaire. Age-adjusted prevalence of overweight was 17.8% for boys and 15.8% for girls. It increased with age and was higher in lower tertiles of physical activity and in higher socio-economic group. Birth weight and current BMI were positively associated. The study highlighted the high prevalence of overweight in adolescent children in urban India. Life style factors influenced BMI in adolescent age.

Adolescent↗
PubMed2002

Temporal changes in prevalence of type 2 diabetes and impaired glucose tolerance in urban southern India.

The prevalence of type 2 diabetes and impaired glucose tolerance (IGT) is increasing in urban areas of developing countries, especially in India. This is a report of the temporal changes in the prevalence of diabetes and IGT in urban areas of Chennai (Madras), India, in adults aged > or =20 years, with an emphasis on identifying the risk factors responsible for the changes. Three urban diabetic surveys conducted in 1989, 1995 and 2000 were compared for the age-standardized prevalence, anthropometric, demographic and lifestyle characteristics of the glucose-intolerant groups. Multiple logistic regression analyses were used for the identification of risk variables associated with diabetes and IGT. The trend was statistically significant for diabetes (chi(2)=18.0, P<0.001) and for IGT (chi(2)=48.2, P<0.001). The period between 1989 and 1995 showed a 40% rise in the prevalence of diabetes and a further increase of 16.4% in the next 5 years. Age increased in each survey for both genders. Waist girth and waist:hip ratio were significantly higher in women, in the 2000 survey. There was no change in the mean body mass index with time in both genders. An increase in IGT was seen in year 2000, especially so in subjects aged <40 years. The prevalence of diabetes and IGT is increasing in India. Increasing age and positive family history showed associations with diabetes.

Adult↗
PubMed2002

Impact of poverty on the prevalence of diabetes and its complications in urban southern India.

AIM: The impact of poverty on the profile of diabetes and its complications was studied. METHODS: A comparative study of low income group (LIG) (family income Rs. < 30,000/annum (approx. 432 pounds sterling) and high income group (HIG) (family income Rs. greater-than-or-equal 60,000/annum (approx. pounds sterling) subjects of > or = 40 years was done in Madras, India. By screening 1748 LIG subjects (M/W 844/904) 301 diabetic subjects were identified and 218 underwent tests for diabetic complications. Population data available in 635 (M/W 309/326) HIG subjects from the survey were used for comparison of glucose tolerance profile. Complications were studied in 221 diabetic HIG subjects. RESULTS: Age-standardized prevalences of diabetes (12.6% vs. 25.5%; chi(2) = 56.9, P < 0.0001) and impaired glucose tolerance (IGT) (8.9% vs. 19.0%) were significantly lower (chi(2) = 57.7; P < 0.0001) in the LIG. Hypertension was more common in LIG (53.7% vs. 40.0% in HIG; chi(2) = 34.9; P < 0.0001). LIG subjects were more physically active; 73.8% did not go to school. Parameters significantly associated with diabetes were body mass index (BMI), age, higher income, waist--hip ratio and physical inactivity. Higher income, BMI and age were associated with IGT. Diabetic LIG subjects had a higher prevalence of cardiac disease, neuropathy and cataract and a lower prevalence of retinopathy than HIG subjects. The risk variables such as hyperglycaemia, dyslipidaemia, hypertension, smoking and alcohol consumption were more in the LIG group. CONCLUSIONS: The urban poor in the developing world has a lower prevalence of diabetes than the urban poor in developed societies. However, they have higher rates of complications of diabetes.

Adult↗
PubMed2001

High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey.

AIMS/HYPOTHESIS: There has been no reported national survey of diabetes in India in the last three decades, although several regional studies show a rising prevalence of diabetes. The aim of this study was to assess the prevalence of diabetes and impaired glucose tolerance in six major cities, covering all the regions of the country. METHODS: Using a stratified random sampling method, 11216 subjects (5288 men; 5928 women) aged 20 years or above, representative of all socio-economic strata, were tested by OGTT. Demographic, anthropometric, educational and social details were recorded using a standard proforma. Physical activity was categorised using a scoring system. Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. Glucose tolerance was classified using the 2-h values (WHO criteria). Prevalence estimations were made taking into account the stratified sampling procedure. Group comparisons were done by t-test or analysis of variance or Z-test as relevant. Univariate and multiple logistic regression analyses were used to study the association of variables with diabetes and impaired glucose tolerance. RESULTS: Age standardised prevalences of diabetes and impaired glucose tolerance were 12.1% and 14.0% respectively, with no gender difference. Diabetes and impaired glucose tolerance showed increasing trend with age. Subjects under 40 years of age had a higher prevalence of impaired glucose tolerance than diabetes (12.8% vs 4.6%, p < 0.0001). Diabetes showed a positive and independent association with age, BMI, WHR, family history of diabetes, monthly income and sedentary physical activity. Age, BMI and family history of diabetes showed associations with impaired glucose tolerance. CONCLUSIONS/INTERPRETATION: This national study shows that the prevalence of diabetes is high in urban India. There is a large pool of subjects with impaired glucose tolerance at a high risk of conversion to diabetes.

Adult↗
PubMed2001

MAST system: a new condensed cardiopulmonary bypass circuit for adult cardiac surgery.

There have been many refinements in cardiopulmonary bypass (CPB) techniques over the past few decades specific to design, materials and function. Despite these improvements, use of the standard length circuit tubing and pump oxygenator alter cellular, biochemical and rheological properties by inducing a systemic inflammatory response, persisting well into the early postoperative phase. We have designed a new condensed CPB circuit, the MAST system, where the oxygenator and the pumps are brought closer to the operating table (within 30 inches) with the help of a series of telescopic swivel steel poles to which they are attached. The control console is retained at the usual remote location of 2ft behind the MAST system. This configuration accomplishes a decrease in tubing length, priming volume and blood circulatory time within the extracorporeal circuit. Early experience of a hundred consecutive cases utilizing the MAST CPB system is presented along with a comparative analysis of prime volume, hemodilution and transfusion parameters of MAST system vs the low prime system, which is another newly developed CPB circuit utilizing a pediatric oxygenator to reduce prime volume and hemodilution.

Adult↗
PubMed2001

Foot care economics--cost burden to diabetic patients with foot complications: a study from southern India.

OBJECTIVE: To estimate the direct cost burden of diabetic patients with foot complications. METHODS: An illustrative sample of 270 subjects with type two diabetes were seen at the clinic selected for the study. Among them 164 were without any complication (Group I) and 106 patients were with foot complications (Group II). In the latter group 83 (Group IIA) required in-patient (IP) care and 23 (Group IIB) required out-patient (OP) care. Annual expenses on medical care were estimated by a questionnaire method. Validation of the questionnaire data was verifying the amount spent by checking up the bills. RESULT: Group I spent Rs.4373 (US $ 104 Approx.), Group II spent Rs.15450 (US $ 343 Approx.), Group IIA spent Rs.7200 (US $ 171 Approx.) and Group IIB spent Rs.16910 (US $ 403 Approx.) in the study year. In the total sample of 270 subjects 61% were without foot problems, 22% had foot problems requiring OP treatment only (Group IIA), and 78% had foot problems requiring IP treatment (Group IIB). CONCLUSION: Group IIB spent significantly greater percentage of their income than Group IIA, and both groups spent greater percentage of their income than Group I. All differences were statistically significant.

Cost of Illness↗
PubMed2000

Limitations of glycosylated haemoglobin as an index of glucose intolerance.

This study was conducted (a) to establish a normal cut-off value for glycosylated haemoglobin measured as HbA1c in South Indian subjects, and (b) to evaluate its usefulness in demarcating different categories of glucose intolerance. HbA1c measurement was carried out in 1261 cases with no known history of diabetes, while being tested by oral glucose tolerance test (M:F 850:411, mean age 40+/-12 years). An immunoturbidimetric procedure for HbA1c assay (Tina-Quant, Boehringer Mannheim, Germany) was used. The specificity and sensitivity of HbA1c in demarcating normal glucose tolerance (NGT) from abnormal tolerance were calculated using the ROC procedure. By the ROC analysis, a cut-off value of HbA1c > or = 6.0% gave a sensitivity of 88.5% and specificity of 62.8% using the WHO criteria (2-h plasma glucose > or = 200 mg/dl). Using the ADA criterion (fasting plasma glucose > 125 mg/dl) the sensitivity and specificity for the same cut-off value were 85.2 and 61.2%. In NGT, only a small percentage of the variance in HbA1c was explained by the fasting plasma glucose (FPG) values. The overall correlation coefficient between the fasting plasma glucose and HbA1c was r = 0.8, r2 = 0.64 and, in the case of 2-h post glucose, r = 0.82, r2 = 0.67. This showed that more than 35% of the variations in HbA1c were not explained by the plasma glucose values. The study showed that HbA1c values of > or = 6.0% gave a reasonably high sensitivity and specificity for diagnosis using the WHO or ADA criteria. However, nearly 35% of the variations in HbA1c were not explained by the variations in plasma glucose. Wide inter-individual variations even in the normoglycaemic range make the test unsuitable for diagnostic purpose.

Adult↗
PubMed2000

Expenditure on health care incurred by diabetic subjects in a developing country--a study from southern India.

The objective of the study was to estimate the direct costs of diabetes care to patients attending secondary care facilities in Madras, India. A total of 596 subjects were studied, at the Private Hospital for Diabetes Mellitus (PHD) (n = 422), and at the Government General Hospital (GGH) (n = 174). A simple interview schedule enabled a face to face interaction with the patients by the research investigator which elicited a frank and true response. The validity of the data collected was established by independent scrutiny of financial records in a sub sample. Payment bills for expenses of 140 subjects chosen on a random basis from the total sample of 422 PHD patients were compared with the costs reported by the subjects. There were no statistically significant differences both in the inpatient and the outpatient cases between the reported cost and actual cost. Median bill value (total costs)=Rs.1010 (range 195-16700) reported value=880 (110-20355) Z = -0.97, P = 0.33 and, for outpatients, median bill value=Rs.800 (195-4560) reported value=Rs. 740 (110-6320) Z = -1.56, P = 0.12. For inpatients, median bill value = Rs. 4235 (1289-16700) reported value=Rs.5459 (1285-20355), Z = -1.27, P5 years duration of diabetes spent more than those who had <5 years of duration; Rs.5570 (360-75200) and Rs.3220, (460-25600), respectively. All differences between these sub-groups were statistically significant. Within the ambit of economic aspects of the population in a developing country, the direct cost on diabetes health care is very high for many people.

Costs and Cost Analysis↗
PubMed2000

Vascular complications in young Asian Indian patients with type 1 diabetes mellitus.

To determine the prevalence of micro vascular and macro vascular complications in Asian Indian Type 1 diabetic subjects. There has been no major report on the prevalence of vascular complications in Type 1 diabetic patients in India. This study was done in Type 1 diabetic patients, aged < or =20 years at diagnosis of diabetes (n=617, M:F 322:295) with a minimum of 3 year follow-up. Standard diagnostic methodologies were used to test for micro vascular and macro vascular complications of diabetes. Retinopathy was detected in 13. 4% (background diabetic retinopathy 11.2%, proliferative diabetic retinopathy 1.9%, preproliferative 0.31%, maculopathy was seen in 13.3% of retinopathy cases), nephropathy in 7.1%, sensory neuropathy in 3.0%, ischaemic heart disease in 0.5% and peripheral vascular disease in 0.5% of the study subjects. Duration of diabetes showed positive association with retinopathy, nephropathy and neuropathy. Average glycosylated haemoglobin values, at follow up showed an association with retinopathy. Although the glycaemic control was suboptimal in the study group, prevalences of all complications, especially macro vascular complications were lower in Type 1 diabetic patients in this ethnic group, in comparison with the European or American counterparts.

Adolescent↗
PubMed2000

Postprandial hypertriglyceridaemia in treated type 2 diabetic subjects --the role of dietary components.

Postprandial hyperlipidaemia is a risk factor for cardiovascular diseases (CVD). This study was done (a) to evaluate whether postprandial hypertriglyceridaemia was common in Indian type 2 diabetic patients on treatment and (b) to see whether the high carbohydrate content of the diet was a cause of the lipid abnormality. Two hundred type 2 diabetic subjects (M:F, 137:63; mean age 51.6+/-10.2 years, mean BMI 25.5+/-3.1 kg/m(2)) with diabetes duration of 7.6+/-5.6 years were studied. Fasting and 2 h post prandial responses of plasma glucose and triglycerides (TG) were measured using a breakfast meal, usually consumed by the patient with the intake of usual hypoglycaemic drugs. Patients with a post prandial TG value greater than 15% of the corresponding fasting TG value were designated as group 2 and the remaining subjects as group 1. Dietary composition of the breakfast were calculated. Among the 200 subjects, 52 (26%) had post prandial TG higher than the fasting values. This was seen in patients who were consuming lower percentage of carbohydrates and higher percentage of fats than prescribed. Therefore the postprandial rise in TG was probably due to the high fat content of the diet and due to a lower insulin sensitivity. This study highlights the facts that postprandial hypertriglyceridaemia is seen only in a small proportion of the treated patients and the high carbohydrate diet does not produce hypertriglyceridaemia, either in the fasting or post prandial state. The minority who show an increased TG value at 2 h have been taking lower carbohydrate with higher fat content in the meal. This could have produced a lower insulin sensitivity in these patients.

Blood Glucose↗
PubMed2000

Cosegregation of obesity with familial aggregation of type 2 diabetes mellitus.

OBJECTIVE: We have shown that a positive family history of diabetes, and the variables of general and central obesity are independent risk factors for type 2 diabetes in our population. This study was done to evaluate whether a familial predisposition to diabetes resulted in a tendency for adverse anthropometric and haemodynamic profiles in south Indian non-diabetic subjects. METHODS: The analysis was carried out on 2463 subjects (M: F, 1196: 1267) with normal glucose tolerance (NGT). The study subjects were selected from population surveys for diabetes. Details of age, sex, family history of diabetes, body mass index (b.m.i.), waist-to-hip ratio (WHR) and blood pressure were recorded. Serum cholesterol and triglycerides were estimated. RESULTS: A positive family history of diabetes was present in 24.7% of our subjects. Mean b.m.i. and percentage of obesity were significantly higher in families with a positive family history (group 2) vs. families with no family history (group 1). Subjects in group 2 had a higher 2-h plasma glucose (p < 0.001) and higher prevalence of hypertension (chi2 = 6.91, p = 0.0086). Factor analysis with principle components analysis (PCA) showed that a family history of diabetes clustered with WHR in men, and with b.m.i. and WHR in women. The b.m.i. formed a different domain with blood pressure in both sexes. WHR and b.m.i. clustered with cholesterol and triglycerides in another domain. CONCLUSIONS: In this population, general and central obesity are associated with a family history of diabetes. A family history of diabetes may increase the risk of hypertension and hyperlipidaemia indirectly through its connection with b.m.i.

Adipose Tissue↗
PubMed2000

Insulin resistance alone does not explain the clustering of cardiovascular risk factors in southern India.

AIMS: To determine whether insulin resistance (IR calculated using the HOMA model) has a dominant role in the clustering of cardiovascular risk factors in the Asian Indian population. METHODS: A total of 654 non-diabetic subjects aged > or =40 years (male 396: female 258) were selected from a population survey. They had estimates of fasting and 2 h plasma glucose, insulin levels, body mass index (BMI), waist-to-hip ratio (WHR) and blood pressure. Factor analysis was carried out using the principle components analysis (PCA) with varimax orthogonal rotation of continuously distributed variables, considered to represent the components of insulin resistance syndrome including the calculated IR. RESULTS: There were three major clusters of cardiovascular disease (CVD) risk variables in men and four clusters in women. Insulin resistance, 2 h plasma glucose, insulin and obesity aggregated as the major domain. Insulin resistance was not linked with hypertension. BMI was a common link for all the three factors in men, and for three of the four in women. CONCLUSIONS: Insulin resistance is not the only underlying factor for the clustering of CVD risk factors in south Indians. These findings are consistent with the presence of several distinct physiological domains, as shown in other ethnic groups.

Adult↗
PubMed2000

Clinical profile of diabetic foot infections in south India--a retrospective study.

AIMS: The aim of the study was to determine the profile of diabetes foot infections in south Indian diabetic subjects. The causative factors for delayed wound healing and the recurrence of infection were also studied. METHODS: During a period of 6 months, 374 patients who had undergone some surgical procedure for foot infection were available for follow-up (M:F 227:147, mean age 54.9 +/- 9.4 years, diabetes duration 10.9 +/- 7.7 years). All of them had records of clinical and treatment details, laboratory data including biothesiometry, Doppler tests and electrocardiogram (ECG) records. Foot ulcers were classified according to Wagner's classification. RESULTS: Majority of the patients had grade II and III ulcers (50% and 26.5%, respectively), grade IV was seen in another 21.9%. The median healing time was 44 days. Recurrence of infection which occurred in 53% was more common in patients with neuropathy and peripheral vascular disease (PVD). CONCLUSIONS: Recurrence of foot infection was common among south Indian Type 2 diabetic subjects and was related to the presence of PVD and neuropathy. There is also a need for improvement in footwear and foot care education.

Adult↗
PubMed2000

Cost burden to diabetic patients with foot complications--a study from southern India.

AIM: To study the economic burden of management of diabetes in patients with foot complications, as a large number of them suffer from foot complications of varying severity. This study relates to direct cost to diabetic patients with foot complications. MATERIAL AND METHODS: An illustrative sample of 270 Type 2 diabetic subjects, 164 without foot complications (Control group, Group 1) and 106 with foot complications (Group 2) were studied. They were available for the study during a six month period from January to June 1998. Group 2 had two sub-groups, i.e., those who needed out-patient (OP) treatment only (n = 23) and those who needed treatment in the hospital (HP) (n = 83). The study subjects were interviewed personally by the educator to collect demographic data and treatment expenditure. RESULTS: Total median expenditure incurred by the diabetic subjects without foot complications (Group 1) was Rs. 4373/- and by those with foot complications (Group 2) was Rs. 15,450/-. Patients who required hospitalised treatment incurred higher expenses than the OP patients, towards doctor's fees and hospitalisation (P < 0.0001). The percent of total income spent by the HP patients was higher than by the OP patients (P < 0.02). CONCLUSIONS: Diabetic subjects with foot problems incur very heavy expenditure in the treatment process. Most of the direct costs of diabetes treatment results from its complications. The hospitalisation costs for the complications of diabetes are particularly heavy. This underscores the need to reduce complications and also their economic burden.

Cost of Illness↗
PubMed1999

Familial aggregation of diabetic kidney disease in Type 2 diabetes in south India.

The study was done to assess whether there was a familial aggregation of diabetic kidney disease (DKD) in Type 2 diabetic subjects. The profile of associated complications was also studied. Two groups of diabetic siblings of Type 2 diabetic patients, matched for age, body mass index (BMI) and duration of diabetes mellitus were studied. The siblings also had Type 2 diabetes. Group A comprised of siblings of probands with diabetic nephropathy and retinopathy (n = 30, M:F = 20:10) and Group B were siblings of probands without diabetic nephropathy or microalbuminuria (MAU) (n = 30, M:F = 14:16). Anthropometry, measurement of blood pressure and tests for proteinuria, MAU and retinopathy and ECG and biothesiometry were carried out for all study subjects. Persistent proteinuria was present in 15 (50%) siblings in group A and none in group B. MAU was detected in 26.7% (n = 7) in Group A and 3.3% (n = 1) in Group B (P = 0.057). Thus a total of 22 out of 30 cases in Group A had albuminuria. In Group A, seven (23.3%) had proteinuria and hypertension. Hypertension was present in nine (30.0%) in group A, and in five (16.7%) in group B (NS). Occurrence of retinopathy was found to be significantly higher in group A than in group B (33.3 vs 6.7%, chi2 = 5.1, P = 0.023). Abnormal ECG changes were present in 10% and 6.7% in Group A and Group B, respectively. In Group A, one patient had peripheral vascular disease (PVD) while in Group B none had PVD. A comparison of sib pairs, matched for age, duration of diabetes and the level of metabolic control showed that there was strong familial clustering of diabetic kidney disease in south Indians with Type 2 diabetes. This was independent of the familial clustering of diabetes. Prevalence of other vascular complications were also higher in Group A.

Albuminuria↗