Indian Journal of Diabetes and Endocrinology

Background: A rare form of hypoglycemia called insulin autoimmune syndrome (IAS) occurs when someone who has never been exposed to endogenous insulin develops insulin auto antibodies. As far as our knowledge goes, only 30 cases have been reported in India. Here we report one case of insulin autoimmune syndrome diagnosed and managed in our hospital.

Case Presentation: We present a case of a 68 year-old male who presented with recurrent episodes of post-prandial hypoglycemia. On biochemical evaluation, he was found to have hyper insulinaemic hypoglycemia. Localization studies with CT abdomen were negative for insulinoma. The diagnosis was confirmed by elevated blood levels of insulin auto antibodies. The patient was treated with frequent low carbohydrate meals and high dose corticosteroids. The patient’s condition improved, and able to maintain euglycemia on a low dose of corticosteroids.

Conclusion: IAS is a rare endogenous cause of hyper insulinaemic hypoglycemia. It should be suspected in patients presenting with post prandial hypoglycemia, with high insulin and C peptide levels.

Background: Adolescent has been defined by world health organization as the period of the life spanning between 10 to 19 years. Adolescent girls are especially vulnerable to reproductive health problem, including early or unplanned pregnancy and infected by sexually transmitted disease like HIV and other serious reproductive health problem.1 Adolescence represents acceleration in terms of biological, psychosocial and sexual development.2 The reproductive health and sexual needs of an adolescent are not so openly discussed in Indian scenario due to cultural and traditional norms in society. Reproductive health is affected by a variety of socio cultural and biological factors on the one hand and the quality of the delivery system and its responsiveness to women's needs on the other. A woman based approach to reproductive health is one which responds to the needs of adult women and adolescent girls in a culturally sensitive manner.4 Inadequate information about sexuality and reproductive health has the potential to create misunderstanding in the youth, due to which they cannot adopt healthy practices and attitudes towards sex and reproductive health.5 Early intervention can alter pattern of behavior that would have placed adolescent girls at risk in later life. Therefore promoting of good reproductive health among adolescent girls is essential.

Objectives: The main objective of the study was to assess the effectiveness of the structured teaching program on knowledge regarding reproductive health among adolescent girls of a selected school, Uttarakhand.

Materials and Methods: The present study was conducted in Government Inter College, Doiwala, Uttarakhand. The research design was Pre Experimental, One Group Pre-test and Post-test Research Design. 50 adolescent girls were selected on the basis of inclusion criteria. Purposive sampling technique was used. The selected adolescent girl’s knowledge was assessed by using structured knowledge questionnaire. After assessing Pre-test knowledge, the Structure Teaching Program was given. After one week of Structured Teaching post-test was conducted with same questionnaire. The obtained data were analyzed by using Descriptiveand Inferential statistics.

Findings: The Pre-test finding revealed that among 50 samples, 50% (25) were having Inadequate knowledge, 44% (22) were having Moderate knowledge and 6% (3) were having Adequate knowledge. Whereas, in post-test it revealed maximum sample 94% (47) were having adequate knowledge and 6% (3) were having moderate knowledge.

The finding revealed that the meanpost-test score (23.24) were significantly higher than that of the mean pre-test score 10.32. The standard deviation of Pre-test was 3.771 and post-test was 2.264. The findings revealed an improved mean of 12.9 with ‘t’ value of 24.458 showing a high statistical significance at P <0.05 level.

Conclusion: All adolescents need support and care during this transition to adulthood, and some need special help. The lives of millions of adolescents worldwide are at risk because they do not have the information, skills and support they need to go through sexual development during adolescence. Reproductive teaching is increasingly recognized today as an important component of health care. The deficit in knowledge area suggests that basic fact regarding reproductive health. Nurses have unique role in educating the girls regarding different aspects of reproductive health. This study also highlighted that nurses should develop skill and knowledge to provide reproductive health among adolescent girls.

Context: Diabetes mellitus (DM) presents a significant worldwide public health challenge of epidemic proportions, and its incidence is rising, becoming a prominent cause of mortality Min most nations. Diabetes has a multifaceted aetiology in India and encompass a variety of factors, including genetic and environmental variables such as obesity in connection to rapid urbanization, and lifestyle changes.

Aims: This study is focused on the dietary and lifestyle patterns of Diabetes patients and their association with Obesity in central India. Methods and Material: This study was conducted as a descriptive cross-sectional survey of diabetic patients visiting the special medical clinics at the Apollo hospital, Indore, a tertiary care hospital of Central India.

Results: Overall, 385 participants were enrolled in this study out of which 198 were females (51.4%) and 187 (48.6%) were males. The majority of population belonged to middle age group (35-65 years) showing a mean age of 48.24 years. The mean weight and BMI of the population was 73.415 kg and 28.122 respectively. Out of the 385 participants maximum were obese (72.47%). 279 (72.47%) mentioned that they eat while watching TV, from this group 55.06% were seen to be obese. A majority (258) accounting for 67.01% were vegetarian, out of them 49.35% were obese. 24.93% males are physically active.

Conclusions: Our study's findings indicate that the adoption of lifestyle modifications among type 2 DM patients visiting a Tertiary Care Hospital was notably low. Additionally,

India has been labelled as the diabetic capital of the world due to its high prevalence of type 2 diabetes.1 Type 2 diabetes is a chronic metabolic disorder that affects the way the body processes glucose, the primary source of energy for cells. The condition arises when the body either resists insulin’s effects, a hormone that regulates glucose movement into cells, or does not produce enough insulin to maintain normal glucose levels.1-3

The World Health Organization (WHO) has also developed a package for diagnosis and management of type 2 diabetes as part of the Hearts initiative, which aims to improve cardiovascular health in primary health care settings.1,4-5 The package provides practical guidance on how to diagnose type 2 diabetes using fasting blood glucose or HbA1c tests, how to assess cardiovascular risk using simple clinical criteria or risk scores, how to prescribe appropriate medications for blood glucose, blood pressure and lipid control, how to monitor treatment response and adjust therapy as needed, and how to counsel patients on lifestyle modifications and adherence to treatment.