Objectives-1)To study the association between neutrophil to lymphocyte ratio and GlyHb in Type 2 Diabetes mellitus.2)To study the association of HsCRP and GlyHb in Type 2 Diabetes mellitus.3)To study the association of neutrophil to lymphocyte ratio with HsCRP and GlyHb in Type 2 Diabetes mellitus.

sample size-100.

Description-Patients with Type 2 Diabetes meeting the inclusion/exclusion criteria will be included in the study after taking informed consent.Patients will be asked routine history and physical examination will be done.Tests like FBS,PPBS,GlyHb,absolute neutrophil count,absolute lymphocyte count will be done as standard of care.In this study we will draw an additonal blood sample/residual  blood sample and perform HsCRP on it.

Budget and funding source-30,000/- ,KMC Manipal.

Review of literature-patients with T2DM are in a state of low degree of chronic inflammation that induces hypersecretion of inflammatory factors,such as CRP,IL-6,TNF-alfa and MCP-1,which resultsin a constantly elevated neutrophilic granulocyte count.One mechanism by which increased levels of neutrophil could mediate insulin resistance may be through augmented inflammation.The increase in NLR appears to underlie the elevated levels of proinflammation,as evident from the persistent neutrophil activation and enhanced release of neutrophil proteases with T2DM.Lymphocytes are reduced as a result of hyperglycemia in T2DM.Also there is an insufficient proliferation of lymphocytes due to low experession of Il-2 receptor.Neutrophil to lymphocyte ratio is an essential marker of systemic inflammation.CRP produced by liver is acute phase response protein increased during inflammation.Many studies done showed-the HsCRP levels were elevated in diabetic subjects,compared with non diabetic subjects.So,studies have suggested that the ratio can be used as marker of inflammation in T2DM.