The objective of our study is to evaluate the demographic profile of childhood obesity. This is an on going cross sectional evaluation of childhood obesity cases. Thorough clinical evaluation followed by screening TSH, fasting blood sugar were done. A total of 33 out of 85 children screened have been included so far. Mean age was 11.15+2.50 years. Mean birth weight was 2.98+0.44 kg. Birth Weight more than 3.5kg was seen in 11/33 (34%). The mean BMI was 27. 54+4.61 kg/m2 and 13/33 (40%) had BMI> 28 kg/m2. acanthosis nigricans was seen in 23/33 (70%) and 21/33(64%) had a history of diabetes and/or obesity in parents. Only 2/33 (6%) had hypothyroidsm. Sedentary activities were preferred over physical play by 25/33 (75%). Thus were conclude that high birth weight and sedentary lifestyle are the major contributors of childhood obesity. Changing lifestyles has contributed to increased incidence of obesity. Prevention of obesity in children will go a long way to prevent metabolic syndrome and type 2 diabetes mellitus in adolescent and young adults.

Background : Patients with type 2 diabetes (T2DM) failing oral antihyperglycemic medication (OAM) are generally started on a single dose of intermediate acting insulin. We hypothesized that by targeting both fasting (F) and postprandial (PP) glucose levels, twice daily premixed insulin 30/70 [Humulin (30% regular human insulin, 70% NPH) insulin)] can be used as an insulin of initial choice in T2DM patients not adequately controlled by OAM alone. Patients And Methods : In This Multicountry, multicenter, single arm, observational study, data from patients not adequately controlled on OAM was collected for two months after starting 30/70 in an observational setting. Fasting (F) and postprandial (PP) blood glucose values were recorded at baseline (visit 1) at four weeks (visit 2) and at end of the study at eight week (visit 3). Information on insulin dose and adverse events were collected at each visit. A treatment preference questionnaire was administered at the end of the study. Results : This observational study on 1922 patients was conducted across centers in India, Nepal and Indonesia. Treatment with Humulin 30/70 resulted in significant improvement of F blood glucose (131+37 mg/dL at visit 3 Vs 221+66 mg/dL at baseline, p<0.0001) as well as PP blood glucose (185+50 mg/dL at visit 3 Vs 321+81 mg/dL at baseline, p<0.0001). The average daily dose of insulin at the end of the study was 31.6 units compared to 27.9 at the beginning of the study. Body mass index (BMI) was 24.7+3.9 kg/m2 at visit 3 Vs 24.6+4.1 at baseline (P< 0.0001), but with out evident clinical consequences. One patient developed severe hypoglycemia. Most patients (93.9%) felt better using Humulin 30/70 over their previous OAM. Conclusion : Although barriers exist to the early use of insulin therapy in Asian patients with T2DM, this observational study demonstrated improved glycemic control as well as high patient acceptance of 30/70 as the starter insulin therapy after inadequate control with OAM.

Objective : Premixed insulin is the most widely used insulin formulation in India. The objective of our study was to evaluate and document the usage and effectiveness of the newly introduced premix insulin aspart in type 2 diabetes in routine clinical practice. Methods : The study was done prospectively at 22 diabetes care clinics across India on the use of premix insulin aspart give alone or in combination with oral antidiabetic drug (OAD) for 12-weeks. Data was collected on 371 consecutive patients with type 2 diabetes at 3 time-points-baseline, 4 weeks later and end of 12-weeks. Study measures included demogramphy, FPG (fasting plasma glucose), PPPG (postprandial Plasma glucose), HbA1c, insulin dose and weight changes. Safety measures included reported adverse drug reaction (ADR) including hypoglycaemic episodes. Results : Premix insulin aspart caused statistically reductions in FPG (66.73+47.93 mg/dl; p<0.0001), PPPG (112.8+71.7 mg/dl; p< 0.0001) and HbA1c (1.51+1.05 % p<0.0001) at the end of 12-weeks compared to baseline. There was a very small increase in weight (0.68+2.6 kg; p<0.0001) over the 12 week period. Apart from episodes of minor hpoglycamia otherwise no ADRs were reported during the study. Conclusion : We conclude that newly introduced premix insulin aspart is an effective, safe and convenient option in insulin-requiring patients with type 2 diabetes.

Thyroid hormones have a significant effect on the female reproductive system and do affect all aspects of reproductive cycle of a women. The presentation of menorrhagia many a times leads to the diagnosis of hypothyroidism so does a routine infertility evaluation. Sometimes thyroid function tests done during pregnancy are misinterpreted leading to improper treatment. It is important to suspect, screen and treat the thyroid disorders properly as they have a far reaching effects on the pregnancy out comes as well as the child’s mental development. This article discusses the thyroid physiology during pregnancy, interpretation of thyroid function test during pregnancy and also the common thyroid problems during pregnancy like, hypothyroidism, hyperthyroidism and post partum thyroiditis.

McCune-Albright syndrome is characterized by fibrous dysplasia, café-au-lait pigmentation and multiple endocrine hyperfunction, most commonly precocious puberty in girls. Not all features of the syndrome may be present at initial diagnosis. We report two cases of precocious puberty, where McCune-Albright syndrome was diagnosed by the help of 99mTc-MDP (methylendiphosphonate) bone scan. The diagnosis of McCune-Albright syndrome is particularly useful where difficulties are encountered in etiological workup of gonadotropin independent precocious puberty in girls. In this setting, the diagnosis of McCune-Albright Syndrome could help in differentiation from an autonomous ovarian cyst or neoplasm, and prevent unnecessary surgery in these patients. We suggest that a bone scan is very useful in the evaluation of female subjects with gonadotropin independent precocious puberty.

Insulinoma in a patient with pre-existing diabetes is extremely rarel. Only a small number of cases have been reported all over the world 2. We report a case of Insulinoma in a patient with type 2 diabetes. A thirty five year old male was diagnosed to have diabetes mellitus three years back. He was started on Sulphonylurea and the dose was increased to achieve glycemic control. He had adequate glycemic control for one year, but thereafter, started developing recurrent episodes of hypoglycemia. These episodes continued even after sulfonylurea was with drawn. Endogenous hypoglycemia was confirmed with an insulin glucose ratio of 0.39 and 4 on two occasions. Imaging of the pancreas was normal. On exploratory laparotomy, the tail of pancreas felt tough and bulky. Intraoperative ultrasound showed heterogenous lesion in the tail of pancreas. Distal pancreatectomy was done. In the post operative period diabetes again developed and required Glimeperide for control.