Predictors of Obesity among Type 2 Diabetes Mellitus Patients Attending a Tertiary Care Center of Province 1, Nepal

Background: Obesity and Diabetes Mellitus type 2 have a known association. Yet, the socio-demographic predictors of obesity in special populations like ours (Asian) who have DM remain unclear. The purpose of this study was to determine the socio-demographic predictors of obesity among newly diagnosed Diabetes Mellitus in adults. Materials and Methods: This was a descriptive cross-sectional study conducted in endocrine OPD of Nobel medical college. Total 124 subjects were enrolled who were newly diagnosed Diabetes Mellitus over a period of 1 year. Detailed history was taken for demographic and clinical variables. Height, weight, waist circumference and blood pressure were measured. Besides, Body Mass Index, the dependent variable, was calculated. Subjects were considered to have diabetes based on their fasting and postprandial blood sugar level for the first time. Results: The prevalence of obesity among the study population was 39.5%, overweight was 45.2%. Predictors for this study for obesity were found as abnormal blood pressure and hospital visit after symptoms development. Conclusion: Obesity is a important risk factor for Diabetes Mellitus and higher prevalence of obesity among type 2 diabetes was observed. Predictors for this study for obesity were found as abnormal blood pressure and hospital visit after symptoms development

Case Report: Rhino-orbital Mucormycosis Related to COVID-19: A Case Series Exploring Risk Factors

There has been a surge of rhino-orbital mucormycosis cases in India in the wake of the second wave of the COVID-19 pandemic. It has been widely suggested that dysglycemia resulting from diabetes which is a common comorbidity in COVID-19 patients, and indiscriminate steroid use has resulted in this surge. We report a series of 13 cases of rhino-orbital mucormycosis in COVID-19 patients admitted to our center between mid-April and early June 2021. The cases showed a male preponderance, two patients had loss of vision, and four of them showed intracranial extension of disease. Twelve patients had received steroids and 12 had preexisting or newly diagnosed diabetes, both steroid use and diabetes being the most common identified risk factors. Considering other possible risk factors, immunosuppressed state, antiviral or ayurvedic (Indian traditional) medications, and oxygen therapy were not associated with a definite risk of mucormycosis, because they were not present uniformly in the patients. We propose that COVID-19 itself, through molecular mechanisms, predisposes to mucormycosis, with other factors such as dysglycemia or steroid use increasing the risk.

Acute aortic thrombosis in a patient with SARS-CoV-2 coronavirus disease (COVID-19)

One of the rare and life-threatening conditions is acute aortic thrombosis. We have described a case of thrombosis of the aorta and iliac arteries in a patient against the background of viral pneumonia COVID-19, with newly diagnosed diabetes mellitus and arterial hypertension.

No evidence of long-term disruption of glycometabolic control after SARS-CoV-2 infection

Purpose To assess whether dysglycaemia diagnosed during SARS-CoV-2 pneumonia may become a potential public health problem after resolution of the infection. In an adult cohort with suspected COVID-19 pneumonia, we integrated glucose data upon hospital admission with fasting blood glucose (FBG) in the year prior to COVID-19 and during post-discharge follow-up. Methods From February 25th to May 15th 2020 660 adults with suspected COVID-19 pneumonia were admitted to the San Raffaele Hospital (Milan, Italy). Through structured interviews / medical record reviews we collected demographics, clinical features and laboratory tests upon admission and additional data during hospitalization or after discharge and in the previous year. Upon admission, we classified participants according to ADA criteria as having: a) pre-existing diabetes; b) newly diagnosed diabetes; c) hyperglycaemia not in the diabetes range; d) normoglycaemia. FBG prior to admission and during follow-up were classified as normal or impaired fasting glucose and fasting glucose in the diabetes range. Results In patients with confirmed COVID (n=589) the proportion with pre-existing or newly diagnosed diabetes, hyperglycaemia not in the diabetes range and normoglycaemia was 19.6%, 6.7%, 43.7% and 30.0%, respectively. Patients with dysglycaemia associated to COVID-19 had increased markers of inflammation and organs’ injury and poorer clinical outcome compared to those with normoglycemia. After the infection resolved, the prevalence of dysglycaemia reverted to pre-admission frequency. Conclusions COVID-19 associated dysglycaemia is unlikely to become a lasting public health problem. Alarmist claims on the diabetes risk after COVID-19 pneumonia should be interpreted with caution.

Implementation of high intensity interval training offers opportunity to enhance glycemic control in patients with type 2 diabetes

A clinical decision report using: Alvarez C, Ramirez-Campillo R, Martinez-Salazar C, et al. Low-Volume High-Intensity Interval Training as a Therapy for Type 2 Diabetes. Int J Sports Med. 2016;37(9):723-729. https://doi.org//10.1055/s-0042-104935 for a patient with newly diagnosed diabetes mellitus type 2.