Background: Type 2 diabetes mellitus (T2DM) is the most common metabolic disorder and its pathogenesis is characterized by a combination of peripheral insulin resistance and impaired insulin secretory capacity of pancreatic β cell. Genetic predisposition interacts with environmental factors including diet, physical activity, and age leading to the development of diabetes. Objective: To determine the proportion of overweight and obese persons with type 2 diabetes and to compare the fasting blood sugar, fasting serum insulin, insulin resistance and β-cell function in G972R carrier and non-carrier overweight and obese persons with type 2 diabetes. Methodology: One hundred overweight and obese patients with T2DM were recruited from persons with diabetes attending the Diabetes Outpatient Department of Yangon General Hospital. History taking and physical examination were done and blood samples were collected. Plasma glucose level was determined by the glucose oxidase method and fasting serum insulin was measured by enzyme linked immunoassay (ELISA) kit method. Polymerase chain reaction and Restriction Fragment Length Polymorphism were done for genetic polymorphism. Results: Among 100 overweight and obese subjects with T2DM, 81 patients were of homozygous (G/G) genotype, 18 patients were of heterozygous (G/A) and only one patient of homozygous (A/A) genotype. There was no statistically significant difference in the proportion of genotypes between overweight and obese subjects with T2DM.There was no significant difference in fasting blood sugar (FBS), fasting serum insulin, HOMA-IR, β-cell function, lipid parameters between IRS-1 (G972R) carriers and non-carriers. There is significant negative correlation between insulin resistance and TG level (r2=0.0529, p=0.01). Conclusion It was concluded that IRS-1 G972R polymorphism was not important in insulin resistance, β-cell function and lipid parameters in overweight and obese T2DM. There could be a number of candidate genes in the pathophysiology of diabetes mellitus, genetic sequencing of IRS-1 and other genes in the insulin signaling pathway, and finding out the alteration in their genetic patterns would provide clues for the association of the site-specific polymorphisms of these genes with insulin resistance in T2DM.
Insulin Resistance

Background   Since the Alma Ata Declaration in 1978, Community Health Volunteers (CHVs) have become critical assets to assist tuberculosis (TB) control programs in low and middle-income countries, such as in case finding and treatment support activities. Yet community-based tuberculosis control programs (CBTBC) are faced with numerous challenges, including recruitment and retaining of CHVs. While the possible effect of financial incentives has been extensively discussed, other motivational factors have received less attention. Objective   This study sought to explore on potential motivations for entering, remaining, and exiting volunteer work among CHVs working in a CBTBC project run by an NGO, Japan Anti-Tuberculosis Association (JATA), in urban townships of Yangon, Myanmar.Methods   A semi-structured questionnaire was administered to CHVs who were working for a JATA CBTBC project in Yangon, Myanmar. The questionnaire consisted of closed- and open-ended questions asking about demographic characteristics, their experiences, and their motivations for entering, remaining and exiting volunteer work. Functional theory of motivation was used as a conceptual framework for analysis.Results   A total of 69 volunteers participated in the survey, representing 69% of all CHVs for JATA CBTBC (69/100). From the questionnaire, we found that altruism, self-empowerment, and psychological job satisfaction mainly influenced CHVs’ motivation to enter and remain in volunteer work. Expectations for financial incentives were less important. Being busy with housework and other work priorities could motivate them to temporarily exist volunteer work, while ill-health and old age potentially triggered permanent exit. Conclusions   CHVs working in JATA CBTBC were motivated mainly by altruism, self-empowerment, and psychological job satisfaction - however, their volunteer work must be systematically supported so as to avoid unnecessary burden on CHVs. Further qualitative study would extend the evidences of the potential factors which might contribute to sustaining CHV participation.