J. Sethi, Lakshmi Natarajan, Deeksha Dev, Sanjana R Kothapalli, Sumeet Dhagia, V. Mohan, Ayyalasomayajula S Subrahmanyam, Yash Bhale, Hetansh S Shah, AnuHasini Bommathula, Pramodkumar T Aravindakshan
Aim: Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder that makes self-care challenging for T1DM individuals and their caregivers. This qualitative study aimed to explore the perceived benefits of the Back to Basics-Diabesties (B2B) session among T1DM individuals and their caregivers in India. Materials and Methods: The B2B session is a structured intervention provided through telephonic peer counseling, aimed at enhancing the understanding of T1DM that provides practical knowledge of diabetes management, insulin administration, blood glucose monitoring, diet, exercise, and psychosocial aspects of living with T1DM. Overall, more than 1560 participants (T1DM/caregivers/family/friends) have opted for B2B session. A qualitative telephonic interview was conducted (n = 96) using a semistructured open-ended questionnaire to collect data on the perceived benefits of B2B session. The information obtained was then coded, and grouped to form themes. Results: According to T1DM individuals, B2B sessions enhanced diabetes knowledge and confidence, self-management abilities, increased sense of community and peer support, and easy accessibility. Caregivers reported that the B2B session provided emotional support, disease knowledge, shared experiences, practical ideas, and coping strategies. Most widely appreciated salient feature of B2B session was the peer counselors were themselves with T1DM or caregivers of T1DM, which created unbreakable trust among the study participants. Clinical evidence after B2B session showed a 23% of improvement in the glycated hemoglobin (<8%) and nearly 8% of drop in hypoglycemic events and 17% of drop in hyperglycemic episodes. Conclusion: This study shows the benefits of peer counseling, which could help healthcare professionals and policymakers improve diabetes education and support programs for T1DM patients and their caregivers in India.
{"title":"A qualitative study on the perceived benefits of back to basics-diabesties session among individuals with type 1 diabetes mellitus and caregivers in India","authors":"J. Sethi, Lakshmi Natarajan, Deeksha Dev, Sanjana R Kothapalli, Sumeet Dhagia, V. Mohan, Ayyalasomayajula S Subrahmanyam, Yash Bhale, Hetansh S Shah, AnuHasini Bommathula, Pramodkumar T Aravindakshan","doi":"10.4103/jod.jod_56_23","DOIUrl":"https://doi.org/10.4103/jod.jod_56_23","url":null,"abstract":"Aim: Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder that makes self-care challenging for T1DM individuals and their caregivers. This qualitative study aimed to explore the perceived benefits of the Back to Basics-Diabesties (B2B) session among T1DM individuals and their caregivers in India. Materials and Methods: The B2B session is a structured intervention provided through telephonic peer counseling, aimed at enhancing the understanding of T1DM that provides practical knowledge of diabetes management, insulin administration, blood glucose monitoring, diet, exercise, and psychosocial aspects of living with T1DM. Overall, more than 1560 participants (T1DM/caregivers/family/friends) have opted for B2B session. A qualitative telephonic interview was conducted (n = 96) using a semistructured open-ended questionnaire to collect data on the perceived benefits of B2B session. The information obtained was then coded, and grouped to form themes. Results: According to T1DM individuals, B2B sessions enhanced diabetes knowledge and confidence, self-management abilities, increased sense of community and peer support, and easy accessibility. Caregivers reported that the B2B session provided emotional support, disease knowledge, shared experiences, practical ideas, and coping strategies. Most widely appreciated salient feature of B2B session was the peer counselors were themselves with T1DM or caregivers of T1DM, which created unbreakable trust among the study participants. Clinical evidence after B2B session showed a 23% of improvement in the glycated hemoglobin (<8%) and nearly 8% of drop in hypoglycemic events and 17% of drop in hyperglycemic episodes. Conclusion: This study shows the benefits of peer counseling, which could help healthcare professionals and policymakers improve diabetes education and support programs for T1DM patients and their caregivers in India.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"2 1","pages":"166 - 172"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78514243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Though numerous variables affect academic performance in children, one of the primary underlying causes is poor nutrition. Nutritional status determines how the body develops, how the mind works, and how one behaves and hence should be given sufficient priority in growing children. The likelihood of acquiring type 2 diabetes is becoming more common in children and adolescents with poor nutrition and unhealthy eating habits. Aim: This study aimed to determine the nutritional status of girls and boys studying in grade 9 and the influence of nutritional status with respect to achievements in academics. Materials and Methods: This was a descriptive study done based on the permission obtained in a private school located in North Chennai. The sample of 210 children of grade 9 was selected based on their academic performance, socioeconomic status, age, type of school, sex, family size (siblings order), and parent’s educational status randomly. Data were collected in the form of questionnaire to understand the impact of nutritional status influencing academic achievements. Results: Of the 210 participants studied, the nutritional status among boys and girls was perceived differently (P < 0.01). The nutritional status with respect to parental education and sibling order also had a significant difference (P < 0.01). There was a positive correlation between academic achievement in the quarterly and half-yearly exams and the nutritional status of the students. Conclusions: The study report clearly indicates that there is a relationship between the nutritional status of the children and their academic achievement. The nutritional status of children has also an impact on their risk of developing diabetes.
{"title":"Nutritional status impacting academics among school children in selected schools of North Chennai","authors":"B. A, R. M.","doi":"10.4103/jod.jod_33_23","DOIUrl":"https://doi.org/10.4103/jod.jod_33_23","url":null,"abstract":"Background: Though numerous variables affect academic performance in children, one of the primary underlying causes is poor nutrition. Nutritional status determines how the body develops, how the mind works, and how one behaves and hence should be given sufficient priority in growing children. The likelihood of acquiring type 2 diabetes is becoming more common in children and adolescents with poor nutrition and unhealthy eating habits. Aim: This study aimed to determine the nutritional status of girls and boys studying in grade 9 and the influence of nutritional status with respect to achievements in academics. Materials and Methods: This was a descriptive study done based on the permission obtained in a private school located in North Chennai. The sample of 210 children of grade 9 was selected based on their academic performance, socioeconomic status, age, type of school, sex, family size (siblings order), and parent’s educational status randomly. Data were collected in the form of questionnaire to understand the impact of nutritional status influencing academic achievements. Results: Of the 210 participants studied, the nutritional status among boys and girls was perceived differently (P < 0.01). The nutritional status with respect to parental education and sibling order also had a significant difference (P < 0.01). There was a positive correlation between academic achievement in the quarterly and half-yearly exams and the nutritional status of the students. Conclusions: The study report clearly indicates that there is a relationship between the nutritional status of the children and their academic achievement. The nutritional status of children has also an impact on their risk of developing diabetes.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"29 1","pages":"161 - 165"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80997945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Shobana, Rajagopal Gayathri, G. Sangavi, V. Kavitha, N. Gayathri, R. Anjana, V. Sudha, Viswanathan Mohan
Background and Objectives: “Adai” is a traditional South Indian breakfast prepared using the wet ground batter of white rice and pulses. Convenience foods are gaining popularity and owing to the increasing prevalence of noncommunicable diseases such as diabetes, there is a need for food products with lower glycemic index (GI). The current study aimed to develop an instant adai mix using brown rice, millets, pulses, and spices. Materials and Methods: The instant adai mix was prepared by blending pulverized brown rice, sorghum, and pulses (green gram, horse gram, decorticated and split red gram, black gram, and chickpea) along with roasted cumin, red chilies, and salt. The nutritional composition of the instant adai mix was analyzed, and GI of “adai” was evaluated in healthy human volunteers using International organization for standardization protocol. Results: The instant adai mix was rich in whole grains (48%) and pulses (45%). Nutritional profiling of the instant adai mix revealed that it is rich in protein and dietary fiber. One hundred grams of instant adai mix fulfill 27.8% of protein and 29.6% of dietary fiber requirements of recommended dietary allowance of adult male. Likewise, 100 g of instant adai mix fulfill 34.9% of protein requirements of the estimated average requirement of an adult male. The “adai” prepared from the instant mix exhibited medium GI (65.1). Conclusion: The instant “adai” mix was found to be nutritionally superior, and the adai prepared from the mix showed a medium GI. It can be a healthy option compared with instant mixes containing refined grains such as white rice. More formulation trials are needed to prepare an adai mix to achieve a low GI. Reformulation of traditional foods with nutritious ingredients and achieving a lower GI can expand the healthier food choices for this vulnerable population who are at risk for type 2 diabetes.
{"title":"Preparation, nutritional and glycemic properties of multigrain instant “adai” mix","authors":"S. Shobana, Rajagopal Gayathri, G. Sangavi, V. Kavitha, N. Gayathri, R. Anjana, V. Sudha, Viswanathan Mohan","doi":"10.4103/jod.jod_18_23","DOIUrl":"https://doi.org/10.4103/jod.jod_18_23","url":null,"abstract":"Background and Objectives: “Adai” is a traditional South Indian breakfast prepared using the wet ground batter of white rice and pulses. Convenience foods are gaining popularity and owing to the increasing prevalence of noncommunicable diseases such as diabetes, there is a need for food products with lower glycemic index (GI). The current study aimed to develop an instant adai mix using brown rice, millets, pulses, and spices. Materials and Methods: The instant adai mix was prepared by blending pulverized brown rice, sorghum, and pulses (green gram, horse gram, decorticated and split red gram, black gram, and chickpea) along with roasted cumin, red chilies, and salt. The nutritional composition of the instant adai mix was analyzed, and GI of “adai” was evaluated in healthy human volunteers using International organization for standardization protocol. Results: The instant adai mix was rich in whole grains (48%) and pulses (45%). Nutritional profiling of the instant adai mix revealed that it is rich in protein and dietary fiber. One hundred grams of instant adai mix fulfill 27.8% of protein and 29.6% of dietary fiber requirements of recommended dietary allowance of adult male. Likewise, 100 g of instant adai mix fulfill 34.9% of protein requirements of the estimated average requirement of an adult male. The “adai” prepared from the instant mix exhibited medium GI (65.1). Conclusion: The instant “adai” mix was found to be nutritionally superior, and the adai prepared from the mix showed a medium GI. It can be a healthy option compared with instant mixes containing refined grains such as white rice. More formulation trials are needed to prepare an adai mix to achieve a low GI. Reformulation of traditional foods with nutritious ingredients and achieving a lower GI can expand the healthier food choices for this vulnerable population who are at risk for type 2 diabetes.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"23 1","pages":"143 - 148"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88335185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Punam Bhende, Dishant Rakholia, Chetan Manoj Agarwal, M. R. Patel
{"title":"More weightage to diabetes in undergraduate and postgraduate curriculum in medical colleges: Has the time arrived?","authors":"Punam Bhende, Dishant Rakholia, Chetan Manoj Agarwal, M. R. Patel","doi":"10.4103/jod.jod_8_23","DOIUrl":"https://doi.org/10.4103/jod.jod_8_23","url":null,"abstract":"","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81747364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Poongothai, S. Latha, Mokkapati Lalasa, Karthikeyan Swetha, Viswanathan Mohan
Aim: The aim of this study was to develop and validate the situational anxiety scale (SAS) during COVID-19 among adults with type 2 diabetes attending a tertiary diabetes center in Southern India. Materials and Methods: A total of 100 individuals aged from 18 to 65 years with type 2 diabetes attending a tertiary care diabetes center completed a structured SAS at two visits. The first visit (visit 1) survey was conducted in April 2021 and the second visit (visit 2) survey was conducted in March 2022. The SAS was administered to all 100 individuals. The State Trait Anxiety Inventory Scale (STAI-S) consisting of 20 questions was administered to the same 100 individuals in addition to the SAS during Visit 2. Results: The SAS showed good internal consistency for visit 1 (α = 0.855) and visit 2 (α = 0.795). Exploratory factor analysis showed four factors and explained 69% of variance. The four factors identified were as follows: (1) fear, (2) desire for COVID-free state, (3) lack of interest and energy, and (4) financial worries. A weak positive correlation was observed between SAS visit 2 and STAI-S, and it was statistically significant (r = 0.223; P = 0.026). Conclusion: The SAS is a valid and reliable tool for measuring situational anxiety during pandemics and post-COVID anxiety levels, which can help in the development of a holistic approach.
{"title":"Development and validation of a situational anxiety scale screening assessment among adults with type 2 diabetes during COVID-19 at a tertiary centre in Chennai, India","authors":"S. Poongothai, S. Latha, Mokkapati Lalasa, Karthikeyan Swetha, Viswanathan Mohan","doi":"10.4103/jod.jod_127_22","DOIUrl":"https://doi.org/10.4103/jod.jod_127_22","url":null,"abstract":"Aim: The aim of this study was to develop and validate the situational anxiety scale (SAS) during COVID-19 among adults with type 2 diabetes attending a tertiary diabetes center in Southern India. Materials and Methods: A total of 100 individuals aged from 18 to 65 years with type 2 diabetes attending a tertiary care diabetes center completed a structured SAS at two visits. The first visit (visit 1) survey was conducted in April 2021 and the second visit (visit 2) survey was conducted in March 2022. The SAS was administered to all 100 individuals. The State Trait Anxiety Inventory Scale (STAI-S) consisting of 20 questions was administered to the same 100 individuals in addition to the SAS during Visit 2. Results: The SAS showed good internal consistency for visit 1 (α = 0.855) and visit 2 (α = 0.795). Exploratory factor analysis showed four factors and explained 69% of variance. The four factors identified were as follows: (1) fear, (2) desire for COVID-free state, (3) lack of interest and energy, and (4) financial worries. A weak positive correlation was observed between SAS visit 2 and STAI-S, and it was statistically significant (r = 0.223; P = 0.026). Conclusion: The SAS is a valid and reliable tool for measuring situational anxiety during pandemics and post-COVID anxiety levels, which can help in the development of a holistic approach.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"103 1","pages":"56 - 61"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85252555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The pivotal role of alpha cells in glucose homeostasis, primarily through glucagon secretion, necessitates a deeper understanding of their potential as therapeutic targets in diabetes management. This narrative review explores the emerging paradigm of incretin-based therapies targeting alpha cells to ameliorate hyperglycemia associated with diabetes. Amidst the prevailing focus on beta cells, this review accentuates the lesser-explored potential of alpha cells in modulating glucose levels. Incretin hormones, notably glucagon-like peptide-1 (GLP-1), not only augment insulin secretion but also inhibit glucagon release, thereby acting as a dual mechanism for glucose control. Contemporary pharmaceutical agents like GLP-1 receptor agonists and DPP-4 inhibitors exhibit promise in modulating alpha-cell function, with evidence suggesting their efficacy in reducing postprandial glucagon and improving glycemic control. Clinical trials evince a favorable safety profile with minimal hypoglycemia risk. Moreover, DPP-4 inhibitors demonstrate a unique potential in reducing glycemic variability by nuanced modulation of alpha-cell activity. This review underscores the imperative for further research to elucidate the molecular pathways underpinning alpha-cell dysfunction in diabetes and to explore combinatory regimens for optimizing glycemic control. The insights garnered could pave the way for novel therapeutic strategies, enriching the armamentarium against diabetes through a more holistic approach targeting both alpha and beta cells.
{"title":"Alpha cells as targets for incretin therapy","authors":"Om Jitendra Lakhani","doi":"10.4103/jod.jod_97_23","DOIUrl":"https://doi.org/10.4103/jod.jod_97_23","url":null,"abstract":"Abstract The pivotal role of alpha cells in glucose homeostasis, primarily through glucagon secretion, necessitates a deeper understanding of their potential as therapeutic targets in diabetes management. This narrative review explores the emerging paradigm of incretin-based therapies targeting alpha cells to ameliorate hyperglycemia associated with diabetes. Amidst the prevailing focus on beta cells, this review accentuates the lesser-explored potential of alpha cells in modulating glucose levels. Incretin hormones, notably glucagon-like peptide-1 (GLP-1), not only augment insulin secretion but also inhibit glucagon release, thereby acting as a dual mechanism for glucose control. Contemporary pharmaceutical agents like GLP-1 receptor agonists and DPP-4 inhibitors exhibit promise in modulating alpha-cell function, with evidence suggesting their efficacy in reducing postprandial glucagon and improving glycemic control. Clinical trials evince a favorable safety profile with minimal hypoglycemia risk. Moreover, DPP-4 inhibitors demonstrate a unique potential in reducing glycemic variability by nuanced modulation of alpha-cell activity. This review underscores the imperative for further research to elucidate the molecular pathways underpinning alpha-cell dysfunction in diabetes and to explore combinatory regimens for optimizing glycemic control. The insights garnered could pave the way for novel therapeutic strategies, enriching the armamentarium against diabetes through a more holistic approach targeting both alpha and beta cells.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135662398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Krishna G Seshadri, Aravind R Sosale, Kanakatte M Prasanna Kumar, Sanjay C Reddy, Purvi Chawla
Abstract The metabolic changes attributable to diabetes are due to both deficiency of insulin as well as excess glucagon (GC). The glucagon receptor (GCGR) is a G protein-coupled receptor. GC is predominantly found in the liver. GC exerts its action both at the GCGR and the glucagon-like peptide receptor (GLP1R). Knockout studies as well as human mutation analysis have indicated therapeutic potential as well as concerns of modulation of the GCGR as a potential target for diabetes therapies. Three approaches to GCGR antagonism—small molecules, monoclonal antibodies, and antisense oligonucleotides—have demonstrated an impressive reduction in HbA1C in preclinical and clinical studies. However, adverse events such as an increase in weight cholesterol liver enzymes and alpha cell hyperplasia have stalled further clinical development. On the other hand, balancing the hyperglycemic effect of glucagon and retaining their beneficial effects, especially with weight loss and decrease in weight loss and hepatic steatosis by use of unimolecular coagonists with GLP1 and GIP have shown considerable promise in clinical trials.
{"title":"Glucagon receptor modulation: Its role in diabetes care","authors":"Krishna G Seshadri, Aravind R Sosale, Kanakatte M Prasanna Kumar, Sanjay C Reddy, Purvi Chawla","doi":"10.4103/jod.jod_106_23","DOIUrl":"https://doi.org/10.4103/jod.jod_106_23","url":null,"abstract":"Abstract The metabolic changes attributable to diabetes are due to both deficiency of insulin as well as excess glucagon (GC). The glucagon receptor (GCGR) is a G protein-coupled receptor. GC is predominantly found in the liver. GC exerts its action both at the GCGR and the glucagon-like peptide receptor (GLP1R). Knockout studies as well as human mutation analysis have indicated therapeutic potential as well as concerns of modulation of the GCGR as a potential target for diabetes therapies. Three approaches to GCGR antagonism—small molecules, monoclonal antibodies, and antisense oligonucleotides—have demonstrated an impressive reduction in HbA1C in preclinical and clinical studies. However, adverse events such as an increase in weight cholesterol liver enzymes and alpha cell hyperplasia have stalled further clinical development. On the other hand, balancing the hyperglycemic effect of glucagon and retaining their beneficial effects, especially with weight loss and decrease in weight loss and hepatic steatosis by use of unimolecular coagonists with GLP1 and GIP have shown considerable promise in clinical trials.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135662399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aneeket T Marwah, T. Marwah, K. Parikh, S. Malhotra
{"title":"Effects of dapagliflozin on type 2 diabetes and other metabolic disorders: Results from a prospective, observational DIATOM study","authors":"Aneeket T Marwah, T. Marwah, K. Parikh, S. Malhotra","doi":"10.4103/jod.jod_15_23","DOIUrl":"https://doi.org/10.4103/jod.jod_15_23","url":null,"abstract":"","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85845856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract For decades all attention focused on the hormone insulin as a key player in diabetes and the role of glucagon was less studied or understood. We now know that both these pancreatic hormones play a critical role in maintaining glucose homeostasis in the body and the secretion of one controls the secretion of the other in an inverse relationship as described by the bihormonal theory of Unger. Glucagon, secreted by the α-cells of the islets of pancreas is a key hormone that has a “hyperglycemic” effect and is secreted in response to low plasma glucose concentration. Besides hypoglycemia, glucagon release is also stimulated by prolonged fasting or starvation, exercise as well as consumption of protein-rich meals. It is regulated by several key endocrine and paracrine mechanisms and the autonomic system in response to various stimuli including nutrient intake through various complex neurohormonal factors. It primarily increases endogenous hepatic glucose production, stimulates lipid and protein catabolism, and plays a key role in appetite regulation and increasing energy expenditure. Therefore, glucagon functions as a counter-regulatory hormone to insulin stimulating hepatic glycogenolysis, gluconeogenesis, fatty acid oxidation, and ketogenesis. With mounting evidence, there has been a paradigm shift in the management of diabetes following the advent of new agents that address different pathophysiological mechanisms contributing to worsening hyperglycemia. Targeting the alpha-cell defect and consequent glucagon hypersecretion has therefore emerged as an important therapeutic strategy in type 2 diabetes mellitus (T2DM) management as well as body weight management. The currently available medications, including glucagon-like peptide 1 (GLP-1) receptor agonists, DPP-4 inhibitors, and amylin mimics (pramlintide), essentially focus on lowering glucagon levels and correcting this critical pathophysiological component in the multifactorial T2DM management strategies.
{"title":"Glucagon in health and diabetes","authors":"Rajeev Chawla, Shalini Jaggi","doi":"10.4103/jod.jod_102_23","DOIUrl":"https://doi.org/10.4103/jod.jod_102_23","url":null,"abstract":"Abstract For decades all attention focused on the hormone insulin as a key player in diabetes and the role of glucagon was less studied or understood. We now know that both these pancreatic hormones play a critical role in maintaining glucose homeostasis in the body and the secretion of one controls the secretion of the other in an inverse relationship as described by the bihormonal theory of Unger. Glucagon, secreted by the α-cells of the islets of pancreas is a key hormone that has a “hyperglycemic” effect and is secreted in response to low plasma glucose concentration. Besides hypoglycemia, glucagon release is also stimulated by prolonged fasting or starvation, exercise as well as consumption of protein-rich meals. It is regulated by several key endocrine and paracrine mechanisms and the autonomic system in response to various stimuli including nutrient intake through various complex neurohormonal factors. It primarily increases endogenous hepatic glucose production, stimulates lipid and protein catabolism, and plays a key role in appetite regulation and increasing energy expenditure. Therefore, glucagon functions as a counter-regulatory hormone to insulin stimulating hepatic glycogenolysis, gluconeogenesis, fatty acid oxidation, and ketogenesis. With mounting evidence, there has been a paradigm shift in the management of diabetes following the advent of new agents that address different pathophysiological mechanisms contributing to worsening hyperglycemia. Targeting the alpha-cell defect and consequent glucagon hypersecretion has therefore emerged as an important therapeutic strategy in type 2 diabetes mellitus (T2DM) management as well as body weight management. The currently available medications, including glucagon-like peptide 1 (GLP-1) receptor agonists, DPP-4 inhibitors, and amylin mimics (pramlintide), essentially focus on lowering glucagon levels and correcting this critical pathophysiological component in the multifactorial T2DM management strategies.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"2010 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135703809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 49-year-old woman with type 2 diabetes and hypertension presented to our outpatient department with complaint of wasting of facial muscles on both sides of face for the last 8–10 months. On further workup, she also had other signs and symptoms of metabolic syndrome. We ruled out other causes of lipodystrophy. Therefore, probably, this is the first case of acquired partial lipodystrophy of face associated with resistant diabetes.
{"title":"Facial-acquired partial lipo dystrophy associated with diabetes","authors":"P. Agrawal, N. Pursnani, A. Gautam, P. Gupta","doi":"10.4103/jod.jod_118_22","DOIUrl":"https://doi.org/10.4103/jod.jod_118_22","url":null,"abstract":"A 49-year-old woman with type 2 diabetes and hypertension presented to our outpatient department with complaint of wasting of facial muscles on both sides of face for the last 8–10 months. On further workup, she also had other signs and symptoms of metabolic syndrome. We ruled out other causes of lipodystrophy. Therefore, probably, this is the first case of acquired partial lipodystrophy of face associated with resistant diabetes.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"11 1","pages":"62 - 63"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84312222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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