A study of the prevalence of metabolic syndrome in newly detected Diabetes Mellitus Type 2

The metabolic disorder is depicted as bunches of irregularities, including stomach corpulence, insulin opposition, hypertension, hyperglycaemia, expanded fatty oils, and diminished high-thickness lipoprotein cholesterol. The study was aimed to assess the Pervasiveness of Metabolic disorder in recently identi ied sort 2 Diabetes mellitus Among 100 newly detected type 2 DM patients, 44.18% of male and 55.82% of female had metabolic syndrome. The maximum number of patients were in the age of 30-49 years. Most of the patients had a history of DM of 4-6 months (54%). Majority 60 patients (69.76%) and IDF criteria predictingMS in 40(46.51%) patientswhich is least compared to others. Modi ied WHO and NCEP ATP III criteria’s were predicting MS 55(63.95%), 48(55.81%) respectively. Raised serum TG for men (45.3%) and diminished HDL for ladies (45.3%) were most grounded single indicator successfully showing the presence of MS in recently identi ied type 2 DM patients. Signi icant WC was seen in 51.2% of patients, and 46.5% of patients had signi icant waist/hip ratio. CONCLUSIONRaised serum TG for men and lessened HDL for women were most grounded single pointers, satisfactorily exhibiting the presence of MS in as of late distinguished sort 2 DM patients.


Prevalence, Metabolic Syndrome, Diabetes Mellitus Type 2 A
The metabolic disorder is depicted as bunches of irregularities, including stomach corpulence, insulin opposition, hypertension, hyperglycaemia, expanded fatty oils, and diminished high-thickness lipoprotein cholesterol. The study was aimed to assess the Pervasiveness of Metabolic disorder in recently identi ied sort 2 Diabetes mellitus Among 100 newly detected type 2 DM patients, 44.18% of male and 55.82% of female had metabolic syndrome. The maximum number of patients were in the age of 30-49 years. Most of the patients had a history of DM of 4-6 months (54%). Majority 60 patients (69.76%) and IDF criteria predicting MS in 40(46.51%) patients which is least compared to others. Modi ied WHO and NCEP ATP III criteria's were predicting MS 55(63.95%), 48(55.81%) respectively. Raised serum TG for men (45.3%) and diminished HDL for ladies (45.3%) were most grounded single indicator successfully showing the presence of MS in recently identi ied type 2 DM patients. Signi icant WC was seen in 51.2% of patients, and 46.5% of patients had signi icant waist/hip ratio. CONCLUSION-Raised serum TG for men and lessened HDL for women were most grounded single pointers, satisfactorily exhibiting the presence of MS in as of late distinguished sort 2 DM patients.

INTRODUCTION
The metabolic condition (MS) is depicted as lots of anomalies including stomach rotundity, insulin restriction, hypertension, hyperglycaemia, extended greasy oils, and reduced high-thickness lipoprotein cholesterol (HDL-C) (Grundy, 1998). The measure of individuals with the metabolic condition likewise separates by sex, race, and character. Most patients with diabetes have a metabolic condition with studied ordinariness of 69.9 per cent for Whites, 64.8 per cent for Blacks, and 62.4 per cent for Mexican Americans. Type 2 diabetes mellitus (T2DM) is a signi icant danger factor for coronary course illness (CAD) and stroke. In any event, 65 per cent of individuals with T2DM die of some coronary illness and stroke (Thompson, 1999).
Patients with T2DM have an expanded commonness of lipid anomalies, which add to higher paces of CAD. High fatty oil and low HDL cholesterol levels were altogether identi ied with all coronary illness occasions and to coronary mortality in patients with T2DM (Lehto et al., 1997). Moreover, the commonness of CAD in diabetes patients expands fundamentally with the option of MS parts (Alexander et al., 2003). As indicated by Third National Health and Nutrition Examination Survey (NHANES III) information, individuals who didn't have MS, had the most reduced danger for cardiovascular illness (CVD) occasions, those with MS had a middle degree of danger, and those with diabetes had most elevated danger (Park et al., 2003).
Considering information from the National Health and Nutrition Examination Survey (NHANES) III, the age-balanced commonness of the metabolic issue in the United States is 34% for men and 35% for ladies. In France, a 30-64-year-old companion shows a <10% pervasiveness for every sexual orientation, albeit 17.5% are in luenced in the 60-64 year age.
Increments in midriff periphery prevail in ladies though fasting fatty substances >150 mg/dL and hypertension are more probable in men (Fauci et al., 2008). The term diabetes mellitus depicts a metabolic issue of different aetiology portrayed by unending hyperglycaemia with aggravations of sugar, fat and protein handling coming to fruition because of imperfections in insulin spread, insulin development, or both (World Health Organization, 1999).
The predominance of diabetes has expanded signi icantly over the most recent thirty years. A metabolic disorder is a solid danger factor for the occurrence of diabetes. Way of life mediations that help diminish body weight and pharmacologic intercessions that address insulin obstruction and additionally postprandial glycaemia may help forestall diabetes. Serious cardiovascular danger factor the executives ought to be a fundamental segment of any diabetes anticipation plan (Honnalli, 2012). The World Health Organization (WHO) Consultation in 1999 gave the primary working meaning of the MS. the American College of Endocrinology (ACE), and all the more as of late the International Diabetes Federation (IDF) (Hwang et al., 2009).

Source of data
All the patients aged > 18 years with newly detected Type 2 Diabetes Mellitus (< 6 months duration) admitted in Krishna Institute of Medical Sciences.

Inclusion criteria
Type 2 Diabetes Mellitus detected < 6 months both sexes Age 18 years and above

Exclusion criteria
Type 2 Diabetes Mellitus > 6 months

RESULTS
In this study, (Table 1)out of 100 newly detected diabetic patients males were 42, and females were 58.  (Table 4). Table 5 showed that the age group 30-49 yrs, 38 patients(44%) were predicting MS, and 6 patients (7%) were predicting MS for more than 70 years. 33 patients(38.4%) and 9 patients (10.5%) were in the group 50-59 years and 60-69 years respectively predicting MS. Our study showed more number of newly detected diabetes predicting MS were 30-49 years and least in more than 70 years. Mean age of male is 47.23±9.82, mean age of the female is 49.68±10.71, mean age of all cases is 48.60±10.48. Comparing this age among male and female Z = 1.10, p>0.05.
In our study, 18 patients have detected DM at the time of admission, 28 patients had since 1-3 months, and 54 patients had 4-6months. Our study suggested that more number of patients had a history of DM 4-6 months. Mean duration of DM of male and female is 3.06±1.32 months and 3.43±1.43 months, respectively. Mean duration of all cases is 3.27±1.31 months. Comparing among male and female Z=1.37, p>0.05 (Table 6).

Modi ied NCEP-ATP III criteria
In our study signi icantly decreased HDL was the most sensitive parameter of MS in modi ied NCEP ATP III criteria. Out of 54 patients (88.3%), 21 (33.3%) and 33 (55%) were males and females respectively. Decreased HDL was followed by, high FBS is seen in 49 patients.

NCEP ATP III criteria
SBP and HDL were highest and equal in several patients of MS by NCEP ATP III criteria. In which 18 males and 24 females had raised SBP and every 21 patients male and female had reduced HDL.

IDF criteria
All the 40 patients of IDF criteria had signi icant waist-hip ratio and increased waist circumference in which 16(40%) were males, and 24(60%) were females.

DISCUSSION
In our study 100 pts of newly detected diabetes mellitus were included, among these 18 patients were detected as newly DM, at the time of admission, 28 patients had 1-3 months history of DM and 54 patients had 4-6 months history of DM. Among 100 newly detected DM patients, 42 (42%) were males, and 58 (58%) were females.
Our study showed the prevalence of metabolic syn-  (de Simone et al., 2007).
Giovanni study results showed an almost equal number of patients of men and women predicting MS according to modi ied WHO but the study had similar results showing women predicting high prevalence compared to men with respective to NCEP ATP 111 and IDF criteria (Church et al., 2009).
In our study, the age of the newly detected type 2 DM patients included was 30 years to 73 years. The maximum number of patients were in the age group of 30-49 years (45%) predicting MS 44%. And minimum in the age group of more than 70 years (7%) predicting MS 7%. Age between 50-59 years was 36% predicting MS 38.4% and 60-69 years were 12 % predicting MS 10.5%. Mean age in our study was 49.15 years predicting metabolic syndrome in newly detected type 2 DM in this region.
The study was showing a mean age of 52.4 years with MS and type 2 DM, 46.8 years with only MS and 49.2 years with only type 2 DM (Church et al., 2009). Alexander et al. (2003) studied MS with type 2 DM only in the age group of more than 50 years, and the mean age was 65.5 years. Lorenzo et al. (2003) study had a mean age of 47.7 years. When considering the single strongest predictor for MS in newly diagnosed type 2 DM. In our study Triglyceride was showing in 79% of patients which was maximum compared to SBP (67.4%), FBS (64%), HDL (61.6%), WC (51.2%), Obesity (46.5%) and BMI (46.5%).

The single parameter with relation to sex
When considering single parameter for MS in newly detected type 2 DM and comparing in between male and female, our study result showed TG for men in 45.3 % and low HDL for female in 45.3 % where single strongest predictor for MS. Whereas TG for females was 33.7 %, SBP was 33.7%, WC 28 %, signi icant waist/hip ratio in %. Compared to males, SBP was equal to females, HDL C was low (16.3%), WC (23.3%), central obesity in 18.6%), almost all the single predictors were less compared to females, BMI in 27.9 % and 18.6 % for females and males respectively.
Our study result showed SBP in 50.9 % for females, TG in 45.4% where single strongest predictor according to modi ied WHO criteria, low HDL in 55% for females, FBS in 36.7 % in males were strong predictors according to modi ied NCEP ATP III. SBP in 50 % for females, TG, HDL, and FBS all in 43.8% for men had maximum prediction according to NCEP ATP III. Excess weight was the primary underlying contributors to the development of MS in women.

CONCLUSION
Raised serum TG for men and lessened HDL for women were most grounded single pointers, satisfactorily exhibiting the presence of MS in as of late distinguished sort 2 DM patients.