Menopausal yet diabetic

In the Name of God, Most Gracious, Most Merciful : 

In the Name of God, Most Gracious, Most Merciful

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By- Mohammad Sadiq Azam Undergraduate Meenakshi Medical College & Research Institute MENOPAUSAL, YET DIABETIC – AN INTRIGUING ALLIANCE

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Pilot Project started in May 2008: A study on Ty2DM (APCON 08, SRMC) Oct 08: Obesity & Ty2DM – Cause or effect? (APPICON 08, KMC, Manipal) Jan 09: Menopausal, yet diabetic – An intriguing alliance (WDA 09, KMC) STUDY BACKGROUND

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To : Determine the prevalence of Type 2 diabetes mellitus (Ty2DM) in Meenakshi Medical College & Research Institute, Kanchipuram, Tamil Nadu, India. To identify the relationship between Ty2DM & menopause. AIM OF THE STUDY

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Total number of cases reviewed: 200 Type of study: Cross sectional study. Method of sampling used: Random sampling. Confirmatory test for DM: Fasting blood sugar level. 1 Criteria for menopause: 1 yr of cessation of menstruation. 2 Criteria for obesity: BMI. 3 1 Genuth S et al; Expert committee on the diagnosis & classification of diabetes mellitus. Follow up report on the diagnosis of diabetes mellitus. Diabetes care 26(11):3160-3167; Nov 2003. 2 Shaw’s textbook of Gynaecology 13th edition, Menopause & Hormone Replacement therapy. 3 Robert B Baron, Nutritional disorders, NIH Guidelines on obesity, CMDT 29:1085-1102; 2008. MATERIALS AND METHODS

STUDY : 

STUDY P ROFORMA

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Ty2DM: FBS = 126 mg/dl on > 1 occasion New Cases Menopause: One year of cessation of menstruation. Obesity: BMI = 30 INCLUSION CRITERIA STUDY CRITERIA

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EXCLUSION CRITERIA Patients with causes of 2o hyperglycemia Hormonal tumours Pharmacological agents Liver disease Muscle disorders Adipose tissue disorders Insulin receptor disorders Old cases of Diabetes Cases on Oral Hypoglycaemic Agents (OHA) Causes of 2o amennorrhoea STUDY CRITERIA

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PREVALENCE OF TY 2 DM Total Cases: 200 Type 2 DM: 72 Prevalence: 360/1000 population (36%) 128 72 (As on 29/6/2008 in MMCRI) OBSERVATIONS

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CLINICAL PRESENTATION n = 72 OBSERVATIONS

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Mean Age: 57.32 years MEAN AGE / SEX OBSERVATIONS

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MEAN AGE AT PRESENTATION IN WOMEN OBSERVATIONS Mean Age of diabetic Women: 58.73 years

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MENOPAUSAL VS PRE-MENOPAUSAL OBSERVATIONS n = 30

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OBESE vs. NON OBESE DIABETICS n = 24 OBSERVATIONS

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ASSOCIATED COMPLICATIONS OBSERVATIONS SHT IHD CVA

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STATISTICAL ANALYSIS HIGHLY SIGNIFICANT

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Menopausal women have a higher incidence of Ty2DM when compared to their pre-menopausal counterparts. Non-obese diabetics >> Obese diabetics There is an increase in the occurrence of IHD, SHT & CVA in diabetic post menopausal women than in diabetics alone. CONCLUSION

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DISCUSSION GENETICS??!!! PICA OF MENOPAUSE??!!!

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DISCUSSION GENETICS??!!! PICA OF MENOPAUSE??!!!

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“As a white candle in a holy place so is fine beauty of an aged face…”

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Women’s Doctors Association of TN Vice Chancellor, Meenakshi University Dean, Meenakshi Medical College & Research Institute Departments of Internal Medicine, Physiology, Obstetrics & Gynaecology, MMCRI Patients Family & Friends ACKNOWLEDGEMENTS

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Presented at the Annual Conference of the Women Doctors Association of TN 28th March 2009, KMC, Chennai Awarded the “Best Paper Award”