S. Odhaib, S. Masood, J. Belkhadir, Mohamad A. Sandid, Z. Shaikh, Farah Farooq, F. Naz, Faryal T Masood, Ayesha Ayub, A. Bilal
Background: Diabetes care in humanitarian crises after the devastating 2005 earthquake in Pakistani Jammu and Kashmir, and in 2022 huge floodings across Pakistan is challenging due to many topographic reasons related to the terrain and the infrastructureMaterials and Methods: In this article, 197 articles were reviewed from PubMed and Google Scholar using conveniently related search terms in the titles and abstracts published from (2000-2022). Additional information was retrieved from the official sites of active international aid organizations and news agencies. Results: It was found that the preparedness plans for proper diabetes care in disaster and non-disaster settings are unsatisfactory in malfunctioning healthcare infrastructures and the non-availability of life-saving medications like insulins. These plans are not fulfilling the needs of the people living with non-communicable diseases like diabetes and hypertension. The role of the international aid organizations after 2005 was directed toward immediate care of traumatic conditions and their complications, infectious diseases control, mental health, care for the elderly, and orphanage care but not covering the diabetes care. Conclusions and Recommendations: The healthcare authorities should adjust a disaster preparedness plan for the country, integrating noncommunicable disease control as a pivotal part and mitigating the current deficit in diabetes care for people in need in different humanitarian crises.
{"title":"Diabetes care during humanitarian crises due to floodings and earthquakes in IDF-MENA region: Pakistan experience","authors":"S. Odhaib, S. Masood, J. Belkhadir, Mohamad A. Sandid, Z. Shaikh, Farah Farooq, F. Naz, Faryal T Masood, Ayesha Ayub, A. Bilal","doi":"10.4103/jod.jod_112_22","DOIUrl":"https://doi.org/10.4103/jod.jod_112_22","url":null,"abstract":"Background: Diabetes care in humanitarian crises after the devastating 2005 earthquake in Pakistani Jammu and Kashmir, and in 2022 huge floodings across Pakistan is challenging due to many topographic reasons related to the terrain and the infrastructureMaterials and Methods: In this article, 197 articles were reviewed from PubMed and Google Scholar using conveniently related search terms in the titles and abstracts published from (2000-2022). Additional information was retrieved from the official sites of active international aid organizations and news agencies. Results: It was found that the preparedness plans for proper diabetes care in disaster and non-disaster settings are unsatisfactory in malfunctioning healthcare infrastructures and the non-availability of life-saving medications like insulins. These plans are not fulfilling the needs of the people living with non-communicable diseases like diabetes and hypertension. The role of the international aid organizations after 2005 was directed toward immediate care of traumatic conditions and their complications, infectious diseases control, mental health, care for the elderly, and orphanage care but not covering the diabetes care. Conclusions and Recommendations: The healthcare authorities should adjust a disaster preparedness plan for the country, integrating noncommunicable disease control as a pivotal part and mitigating the current deficit in diabetes care for people in need in different humanitarian crises.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"9 1","pages":"62 - 67"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86979631","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}
M. Saad, S. Masood, Nizar Al Bache, S. Odhaib, J. Belkhadir, N. Shegem
Introduction: One hundred years after its discovery, insulin is still inaccessible for many people living with diabetes. In the recent World Health Organization (WHO) 2021 report on Barriers to Insulin Availability, WHO highlights the alarming state of global access to insulin. According to International Diabetes Federation (IDF), as reported in IDF Atlas, 10th edition, 73 million adult people with diabetes (PWD) live in Middle East and North Africa (MENA) Region. Materials and Methods: A survey was conducted in the International Diabetes Federation (IDF) MENA Region through its Member Associations in 2021. Eighteen countries out of 21 participated. Questions were about insulin support, beneficiaries, local production, insurance coverage, average cost, minimum wage, and barriers to access. Results: Fifty percent of countries had full government support and 44% had partial. In 56 % of countries, support is limited to human insulin, and the majority is restricted to citizens. Some PWDs have difficulties accessing insulin: low-income persons, refugees, noncitizens, or living in remote areas. Approximately 61% of countries have national social security funds and 61% private insurance coverage for insulin. In five countries, there is a law prohibiting nongovernmental organizations to receive international donations of insulin. Local production exists in only five countries surveyed. There is a wide variation in the cost of insulin from $1.42 to 100 and in the minimum wage ($7–2667). Additional barriers to access were delivery, storage, cost, electricity, war conditions, displacements, and sanctions. Conclusion: Although government support is available in the majority of countries, it is still mainly through the provision of human insulin and restricted to citizens. Many barriers affect access to insulin and its costremains unaffordable. Disparities exist between countries within the same classification of income. Mapping the current situation will help to improve it and monitor change. This document can be informative for PWD living or visiting any of these countries and can help understand cross-border travel for medical treatment, and local and regional policies.
{"title":"Accessibility and availability of insulin: A survey by International Diabetes Federation-Middle East and North Africa Region (IDF-MENA) Member Associations","authors":"M. Saad, S. Masood, Nizar Al Bache, S. Odhaib, J. Belkhadir, N. Shegem","doi":"10.4103/jod.jod_114_22","DOIUrl":"https://doi.org/10.4103/jod.jod_114_22","url":null,"abstract":"Introduction: One hundred years after its discovery, insulin is still inaccessible for many people living with diabetes. In the recent World Health Organization (WHO) 2021 report on Barriers to Insulin Availability, WHO highlights the alarming state of global access to insulin. According to International Diabetes Federation (IDF), as reported in IDF Atlas, 10th edition, 73 million adult people with diabetes (PWD) live in Middle East and North Africa (MENA) Region. Materials and Methods: A survey was conducted in the International Diabetes Federation (IDF) MENA Region through its Member Associations in 2021. Eighteen countries out of 21 participated. Questions were about insulin support, beneficiaries, local production, insurance coverage, average cost, minimum wage, and barriers to access. Results: Fifty percent of countries had full government support and 44% had partial. In 56 % of countries, support is limited to human insulin, and the majority is restricted to citizens. Some PWDs have difficulties accessing insulin: low-income persons, refugees, noncitizens, or living in remote areas. Approximately 61% of countries have national social security funds and 61% private insurance coverage for insulin. In five countries, there is a law prohibiting nongovernmental organizations to receive international donations of insulin. Local production exists in only five countries surveyed. There is a wide variation in the cost of insulin from $1.42 to 100 and in the minimum wage ($7–2667). Additional barriers to access were delivery, storage, cost, electricity, war conditions, displacements, and sanctions. Conclusion: Although government support is available in the majority of countries, it is still mainly through the provision of human insulin and restricted to citizens. Many barriers affect access to insulin and its costremains unaffordable. Disparities exist between countries within the same classification of income. Mapping the current situation will help to improve it and monitor change. This document can be informative for PWD living or visiting any of these countries and can help understand cross-border travel for medical treatment, and local and regional policies.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"30 1","pages":"73 - 80"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90727186","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}
Introduction: In uncontrolled hyperglycemia, lungs, tongue, oropharyngeal and nasopharyngeal airways having increased glycosylated angiotensin-converting enzyme 2 (ACE2) can serve as good viral binding sites for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leading to a greater tendency and considerable risk of prolonged life-threatening disease. This review was written with the objective to extract the recent advances, updates, and discoveries about the effects of coronavirus disease-2019 (COVID-19) on patients with diabetes and its microvascular complications. It was further written with the aim to discuss the current state of knowledge that has not yet been confirmed or unconfirmed, leading to various debatable issues about COVID-19-associated with microvascular complications in diabetes mellitus. Materials and Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched scientific sites related to our review article such as Web of Science, Embase, PubMed, Scopus, Google Scholar, and MEDLINE of last nearly two and half years. Results: The individuals who are suffering from type 2 diabetes mellitus experience more organ damage by SARS-Cov-2 due to cytokine storm. The pro-inflammatory state, lower primary immune system response, and increased ACE2 level with dysregulation of vascular function and the prothrombic state in patients with diabetes may increase the vulnerability for COVID-19 and worsened prognosis. The patients have reduced prognosis leading to microvascular complications such as diabetic nephropathy, neuropathy and retinopathy. In diabetes retinopathy, it induces the changes in the vasculature of the retinal veins. These viruses can directly affect the nervous tissue and/or can indirectly via activating the immune system-mediated mechanisms leading to diabetic neuropathy as well. Conclusions and Implications: During the cytokine storm the amount of D-dimer in the serum gets significantly increased, due to increased activating plasmin at the early stage of inflammation. Uncontrolled hyperglycemia leads to diabetic complications leading to increased mortality rate in patients with COVID-19. Thus, diabetes and its associated microvascular complications may lead to the severity and mortality in the patients with COVID-19. More of clinical practice and further studies should be implicated through this review article. Laboratory findings and clinical records are of much help in patients with diabetes and COVID-19. Worldwide studies from different countries apart from China should be considered to reach a conclusion about the conditions of patients with diabetes and microvasculature complications around the world.
在未控制的高血糖中，肺、舌、口咽和鼻咽气道中糖基化血管紧张素转换酶2 (ACE2)升高可作为严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)的良好病毒结合位点，导致更大的趋势和相当大的危及生命的长期疾病风险。本综述旨在总结冠状病毒病-2019 (COVID-19)对糖尿病患者及其微血管并发症影响的最新进展、更新和发现。这篇文章的进一步目的是讨论尚未证实或未经证实的知识现状，这些知识导致了关于covid -19与糖尿病微血管并发症相关的各种有争议的问题。材料和方法:我们遵循PRISMA (Preferred Reporting Items for Systematic Reviews and meta - analysis)指南，检索了近两年半来与我们的综述文章相关的科学网站，如Web of Science、Embase、PubMed、Scopus、Google Scholar和MEDLINE。结果:2型糖尿病患者受SARS-Cov-2细胞因子风暴的损害更大。糖尿病患者的促炎状态、初级免疫系统反应降低、ACE2水平升高以及血管功能和血栓原状态失调可能增加COVID-19易感性和预后恶化。患者预后降低，导致微血管并发症，如糖尿病肾病、神经病变和视网膜病变。在糖尿病视网膜病变中，它引起视网膜静脉血管的改变。这些病毒可以直接影响神经组织和/或通过激活免疫系统介导的机制间接导致糖尿病神经病变。结论和意义:在细胞因子风暴期间，血清中d -二聚体的数量显著增加，这是由于炎症早期激活的纤溶酶增加。不受控制的高血糖会导致糖尿病并发症，导致COVID-19患者死亡率增加。因此，糖尿病及其相关微血管并发症可能导致COVID-19患者的严重程度和死亡率。更多的临床实践和进一步的研究应该通过这篇综述文章。实验室检查结果和临床记录对糖尿病和COVID-19患者有很大帮助。要得出世界范围内糖尿病患者及微血管并发症情况的结论，除中国外，还应考虑世界各国的研究。
{"title":"A systematic review approach in understanding the COVID-19 mechanism in diabetes and its progression to diabetic microvascular complications","authors":"G. Sonkar, Sangeeta Singh, S. Sonkar","doi":"10.4103/jod.jod_87_22","DOIUrl":"https://doi.org/10.4103/jod.jod_87_22","url":null,"abstract":"Introduction: In uncontrolled hyperglycemia, lungs, tongue, oropharyngeal and nasopharyngeal airways having increased glycosylated angiotensin-converting enzyme 2 (ACE2) can serve as good viral binding sites for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leading to a greater tendency and considerable risk of prolonged life-threatening disease. This review was written with the objective to extract the recent advances, updates, and discoveries about the effects of coronavirus disease-2019 (COVID-19) on patients with diabetes and its microvascular complications. It was further written with the aim to discuss the current state of knowledge that has not yet been confirmed or unconfirmed, leading to various debatable issues about COVID-19-associated with microvascular complications in diabetes mellitus. Materials and Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched scientific sites related to our review article such as Web of Science, Embase, PubMed, Scopus, Google Scholar, and MEDLINE of last nearly two and half years. Results: The individuals who are suffering from type 2 diabetes mellitus experience more organ damage by SARS-Cov-2 due to cytokine storm. The pro-inflammatory state, lower primary immune system response, and increased ACE2 level with dysregulation of vascular function and the prothrombic state in patients with diabetes may increase the vulnerability for COVID-19 and worsened prognosis. The patients have reduced prognosis leading to microvascular complications such as diabetic nephropathy, neuropathy and retinopathy. In diabetes retinopathy, it induces the changes in the vasculature of the retinal veins. These viruses can directly affect the nervous tissue and/or can indirectly via activating the immune system-mediated mechanisms leading to diabetic neuropathy as well. Conclusions and Implications: During the cytokine storm the amount of D-dimer in the serum gets significantly increased, due to increased activating plasmin at the early stage of inflammation. Uncontrolled hyperglycemia leads to diabetic complications leading to increased mortality rate in patients with COVID-19. Thus, diabetes and its associated microvascular complications may lead to the severity and mortality in the patients with COVID-19. More of clinical practice and further studies should be implicated through this review article. Laboratory findings and clinical records are of much help in patients with diabetes and COVID-19. Worldwide studies from different countries apart from China should be considered to reach a conclusion about the conditions of patients with diabetes and microvasculature complications around the world.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"19 1","pages":"322 - 330"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75508242","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: Prevalence of undiagnosed diabetes is 53.1% in India as reported by the International Diabetes Federation in 10th Diabetes Atlas 2021. Diabetes is affecting people of all ages and gender. Very high prevalence of abdominal obesity and large percentage of women in Haryana with elevated body mass index (BMI) make it crucial to screen them for type 2 diabetes. Indian Diabetes Risk Score (IDRS) is a proven tool to identify the people at risk of becoming diabetic in future. Early detection and primary prevention are the most effective ways to prevent the rising numbers among women. Objective: This study was conceived to estimate the risk of type 2 diabetes in young working women (25–40 years) using the IDRS tool. Materials and Methods: A descriptive, cross-sectional observational study was followed through with 504 working females in the age bracket 25–40 years. Data were taken down using a structured questionnaire administered through personal interview procedure. Demographics and parameters listed in IDRS such as age, waist circumference, family history of diabetes, and physical activity were itemized in the questionnaire. A purposive random sampling procedure was utilized for getting the numbers. Known cases of diabetes and subjects who refused to sign informed consent were excluded from the survey. Results: About 504 working women completed the survey questionnaire. IDRS scores revealed 18%, 53%, and 29% of the subjects in high-, moderate-, and low-risk brackets, respectively. Waist circumference, sedentary lifestyle, family history, and age were found to be significantly associated with the risk level. Conclusion: The research study brings forward the need for early detection though screening of young women at risk of becoming diabetic in future and necessary steps for primary prevention for the same. It remains imperative to device a comprehensive communication strategy for responsive transitional progression from high risk to absolute healthiness among the young working women.
{"title":"Women and diabetes: Risk profiling of young working women using Indian Diabetes Risk Score: A study from Northern India","authors":"M. Suri, P. Mahajan","doi":"10.4103/jod.jod_64_22","DOIUrl":"https://doi.org/10.4103/jod.jod_64_22","url":null,"abstract":"Background: Prevalence of undiagnosed diabetes is 53.1% in India as reported by the International Diabetes Federation in 10th Diabetes Atlas 2021. Diabetes is affecting people of all ages and gender. Very high prevalence of abdominal obesity and large percentage of women in Haryana with elevated body mass index (BMI) make it crucial to screen them for type 2 diabetes. Indian Diabetes Risk Score (IDRS) is a proven tool to identify the people at risk of becoming diabetic in future. Early detection and primary prevention are the most effective ways to prevent the rising numbers among women. Objective: This study was conceived to estimate the risk of type 2 diabetes in young working women (25–40 years) using the IDRS tool. Materials and Methods: A descriptive, cross-sectional observational study was followed through with 504 working females in the age bracket 25–40 years. Data were taken down using a structured questionnaire administered through personal interview procedure. Demographics and parameters listed in IDRS such as age, waist circumference, family history of diabetes, and physical activity were itemized in the questionnaire. A purposive random sampling procedure was utilized for getting the numbers. Known cases of diabetes and subjects who refused to sign informed consent were excluded from the survey. Results: About 504 working women completed the survey questionnaire. IDRS scores revealed 18%, 53%, and 29% of the subjects in high-, moderate-, and low-risk brackets, respectively. Waist circumference, sedentary lifestyle, family history, and age were found to be significantly associated with the risk level. Conclusion: The research study brings forward the need for early detection though screening of young women at risk of becoming diabetic in future and necessary steps for primary prevention for the same. It remains imperative to device a comprehensive communication strategy for responsive transitional progression from high risk to absolute healthiness among the young working women.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"31 1","pages":"363 - 367"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74682962","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}
Context: Metformin is known to increase in the risk of developing vitamin B12 deficiency. This study aimed to compare the effectiveness of nasal spray of methylcobalamin (NASO B12) and methylcobalamin tablets for treating vitamin B12 deficiency in diabetic patients receiving metformin. Materials and Methods: In this parallel-group, comparative, open-label clinical study, patients (n = 100) were assigned to two groups: nasal spray of methylcobalamin (NASO B12) (methylcobalamin 250 µg/spray), sprayed in each nostril every alternate day for a total of seven doses (Group 1: a total of 3500 µg methylcobalamin per patient) and oral methylcobalamin tablets, a single daily dose of 1500 µg for a total of seven doses (Group 2: a total of 10,500 µg methylcobalamin per patient). The assessment of efficacy was carried out by measuring serum vitamin B12 levels at baseline, day 7, and day 14. Statistical Analysis Used: The analysis used is Student’s unpaired t-test. Results: NASO B12 treatment resulted in vitamin B12 levels of ≥400 pg/mL (recently updated normal levels as per American Academy of Family Physicians) in 86% and 92% of patients, on day 7 and day 14, respectively, whereas no patient attained ≥400 pg/mL with oral therapy. NASO B12 therapy resulted in higher mean vitamin B12 levels of 485.88 and 570.16 pg/mL when compared with 172.26 and 185.44 pg/mL with oral tablets on day 7 and day 14, respectively. Conclusion: NASO B12 provided much superior absorption of vitamin B12 when compared with oral vitamin B12 tablets and can be used as an effective alternative.
{"title":"Comparison of the efficacy of oral methylcobalamin tablets vs. nasal spray (NASO B12) in diabetic patients on metformin therapy","authors":"Syed Salman Farookh, C. Jayanti, A. Geetha","doi":"10.4103/jod.jod_92_22","DOIUrl":"https://doi.org/10.4103/jod.jod_92_22","url":null,"abstract":"Context: Metformin is known to increase in the risk of developing vitamin B12 deficiency. This study aimed to compare the effectiveness of nasal spray of methylcobalamin (NASO B12) and methylcobalamin tablets for treating vitamin B12 deficiency in diabetic patients receiving metformin. Materials and Methods: In this parallel-group, comparative, open-label clinical study, patients (n = 100) were assigned to two groups: nasal spray of methylcobalamin (NASO B12) (methylcobalamin 250 µg/spray), sprayed in each nostril every alternate day for a total of seven doses (Group 1: a total of 3500 µg methylcobalamin per patient) and oral methylcobalamin tablets, a single daily dose of 1500 µg for a total of seven doses (Group 2: a total of 10,500 µg methylcobalamin per patient). The assessment of efficacy was carried out by measuring serum vitamin B12 levels at baseline, day 7, and day 14. Statistical Analysis Used: The analysis used is Student’s unpaired t-test. Results: NASO B12 treatment resulted in vitamin B12 levels of ≥400 pg/mL (recently updated normal levels as per American Academy of Family Physicians) in 86% and 92% of patients, on day 7 and day 14, respectively, whereas no patient attained ≥400 pg/mL with oral therapy. NASO B12 therapy resulted in higher mean vitamin B12 levels of 485.88 and 570.16 pg/mL when compared with 172.26 and 185.44 pg/mL with oral tablets on day 7 and day 14, respectively. Conclusion: NASO B12 provided much superior absorption of vitamin B12 when compared with oral vitamin B12 tablets and can be used as an effective alternative.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"5 1","pages":"347 - 352"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81011531","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 long-acting oral glucagon-like peptide-1 (GLP-1) receptor agonist, semaglutide is a new armamentarium to glycemic treatments. The Peptide Innovation for Early Diabetes Treatment (PIONEER) 3, 4, 5, 6, and 10 provided the necessary evidence on the efficacy of semaglutide in type 2 diabetes. The American Diabetes Association considers GLP-1 receptor agonists and insulin a high glycemic efficacy therapy. Further, a GLP-1 receptor agonist is recommended when there is a need for minimizing weight gain or promoting weight loss. There are no reports or clinical trials on oral semaglutide in Indian subjects with type 2 diabetes. We present seven case reports where semaglutide was initiated with other antidiabetic medications to bring the glycated hemoglobin (HbA1c) under target and promote weight loss. Between 45 days and 60 days of treatment with antidiabetic drugs, including semaglutide, resulted in a 1.5% reduction in HbA1c. A reduction in body weight ranged from 1.7 kg to 10 kg. Large-scale randomized trial in Indian patients is warranted to confirm our findings.
{"title":"Glycemic treatment effect of oral semaglutide plus other antidiabetic medications: An Indian experience","authors":"M. Chawla, D. Sanyal, S. Bhattacharyya","doi":"10.4103/jod.jod_71_22","DOIUrl":"https://doi.org/10.4103/jod.jod_71_22","url":null,"abstract":"A long-acting oral glucagon-like peptide-1 (GLP-1) receptor agonist, semaglutide is a new armamentarium to glycemic treatments. The Peptide Innovation for Early Diabetes Treatment (PIONEER) 3, 4, 5, 6, and 10 provided the necessary evidence on the efficacy of semaglutide in type 2 diabetes. The American Diabetes Association considers GLP-1 receptor agonists and insulin a high glycemic efficacy therapy. Further, a GLP-1 receptor agonist is recommended when there is a need for minimizing weight gain or promoting weight loss. There are no reports or clinical trials on oral semaglutide in Indian subjects with type 2 diabetes. We present seven case reports where semaglutide was initiated with other antidiabetic medications to bring the glycated hemoglobin (HbA1c) under target and promote weight loss. Between 45 days and 60 days of treatment with antidiabetic drugs, including semaglutide, resulted in a 1.5% reduction in HbA1c. A reduction in body weight ranged from 1.7 kg to 10 kg. Large-scale randomized trial in Indian patients is warranted to confirm our findings.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"24 1","pages":"377 - 384"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77921415","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}
M. Khan, M. Khan, Mohammad Ahmad, Roshan Alam, Saba Khan, G. Jaiswal
Introduction: Adiponectin (APN) is an adipose-derived protein. It has shown a variety of functions such as anti-inflammatory, anti-atherogenic, antidiabetic, and insulin-sensitizing and lipid-oxidation-enhancing activities. The APN levels have shown a significant relationship with the risk factors for type 2 diabetes mellitus (T2DM). As per the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS), Asian Indians have high risk factors for T2DM and its complications. APN levels influence the risk factors for T2DM and its complications. Its circulatory level also varied with the age, family history of T2DM, waist circumference, and level of physical activity. Aim: The purpose of this narrative review is to find the association of circulatory APN with the parameters of MDRS-IDRS. Materials and Methods: Articles were searched by various databases such as PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar. Abstract, free full-text, and full-text articles were searched from the year 2003 to 2022. For this review, observational study, original articles, narrative review, systematic review, and meta-analysis articles published in the English language were included. It is needed to establish the association between the APN levels and the parameters of MDRF-IDRS. The modifiable risk factors of MDRF-IDRS may play a significant role to regulate the level of APN. The non-modifiable risk factors of MDRF-IDRS may help in the better management of APN levels and reduce the prevalence of T2DM. It is needed to clear that the APN levels influence the disease severities or not. It is also needed to improve the physical activity to regulate the APN level and to reduce the systemic inflammation and insulin resistance in Asian Indian population. Conclusion: Improvement in modifiable risk factors of MDRF-IDRS and level of APN may play a significant role in the therapeutic approach to prevent and/or delay the development of T2DM and its complications.
脂联素(APN)是一种脂肪衍生蛋白。它具有多种功能，如抗炎、抗动脉粥样硬化、抗糖尿病、胰岛素增敏和脂质氧化增强活性。APN水平与2型糖尿病(T2DM)的危险因素有显著关系。根据马德拉斯糖尿病研究基金会-印度糖尿病风险评分(MDRF-IDRS)，亚洲印度人患2型糖尿病及其并发症的风险因素较高。APN水平影响T2DM及其并发症的危险因素。其循环水平也随年龄、2型糖尿病家族史、腰围和体力活动水平而变化。目的:本文旨在探讨循环APN与mdr - idrs参数的关系。材料和方法:文章通过PubMed, MEDLINE, Scopus, Web of Science和Google Scholar等各种数据库进行搜索。检索2003年至2022年的摘要、免费全文和全文文章。本综述纳入了以英语发表的观察性研究、原创文章、叙述性综述、系统综述和元分析文章。需要确定APN水平与MDRF-IDRS参数之间的关联。MDRF-IDRS的可改变危险因素可能对APN水平起重要调节作用。MDRF-IDRS的不可改变的危险因素可能有助于更好地管理APN水平并降低2型糖尿病的患病率。需要明确APN水平是否影响疾病的严重程度。提高体育活动水平调节APN水平，减少亚洲印度人群的全身炎症和胰岛素抵抗，也是有必要的。结论:改善MDRF-IDRS的可改变危险因素和APN水平可能在预防和/或延缓T2DM及其并发症的治疗方法中发挥重要作用。
{"title":"Association of circulatory adiponectin with the parameters of Madras Diabetes Research Foundation-Indian Diabetes Risk Score","authors":"M. Khan, M. Khan, Mohammad Ahmad, Roshan Alam, Saba Khan, G. Jaiswal","doi":"10.4103/jod.jod_86_22","DOIUrl":"https://doi.org/10.4103/jod.jod_86_22","url":null,"abstract":"Introduction: Adiponectin (APN) is an adipose-derived protein. It has shown a variety of functions such as anti-inflammatory, anti-atherogenic, antidiabetic, and insulin-sensitizing and lipid-oxidation-enhancing activities. The APN levels have shown a significant relationship with the risk factors for type 2 diabetes mellitus (T2DM). As per the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS), Asian Indians have high risk factors for T2DM and its complications. APN levels influence the risk factors for T2DM and its complications. Its circulatory level also varied with the age, family history of T2DM, waist circumference, and level of physical activity. Aim: The purpose of this narrative review is to find the association of circulatory APN with the parameters of MDRS-IDRS. Materials and Methods: Articles were searched by various databases such as PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar. Abstract, free full-text, and full-text articles were searched from the year 2003 to 2022. For this review, observational study, original articles, narrative review, systematic review, and meta-analysis articles published in the English language were included. It is needed to establish the association between the APN levels and the parameters of MDRF-IDRS. The modifiable risk factors of MDRF-IDRS may play a significant role to regulate the level of APN. The non-modifiable risk factors of MDRF-IDRS may help in the better management of APN levels and reduce the prevalence of T2DM. It is needed to clear that the APN levels influence the disease severities or not. It is also needed to improve the physical activity to regulate the APN level and to reduce the systemic inflammation and insulin resistance in Asian Indian population. Conclusion: Improvement in modifiable risk factors of MDRF-IDRS and level of APN may play a significant role in the therapeutic approach to prevent and/or delay the development of T2DM and its complications.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"203 1","pages":"331 - 339"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89314236","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}
P. Agrawal, Shoorvir Singh, M. Khurana, Kanika Agarwal, N. Pursnani, A. Gautam
Introduction: Diabetic patients are at an increased risk of multiple complications, among which one of the most dreaded complications is diabetic nephropathy. Early diagnosis and appropriate management will at least prolong the life of the kidney and prevent the development of end-stage renal failure. Materials and Methods: Simple urinalysis is a useful tool for early diagnosis of diabetic kidney disease and helps differentiate between diabetic and nondiabetic kidney diseases. In this review, we have discussed the usefulness of urinalysis for a diabetic patient. Results: Early detection of an abnormality can be an alarming sign, and we can diagnose treatable causes of renal failure in diabetic patients. Conclusions: History, examination, and urinalysis are sufficient in most of the cases for diagnosing diabetic kidney disease. Renal biopsy is indicated in special situations where diagnosis cannot be made even after appropriate non-invasive investigations. Few limitations of the study are resource settings and knowledge of this simple test to predict an alarming sign of the kidney disease.
{"title":"Interpretation of urine routine report of a diabetic patient: A review","authors":"P. Agrawal, Shoorvir Singh, M. Khurana, Kanika Agarwal, N. Pursnani, A. Gautam","doi":"10.4103/jod.jod_89_22","DOIUrl":"https://doi.org/10.4103/jod.jod_89_22","url":null,"abstract":"Introduction: Diabetic patients are at an increased risk of multiple complications, among which one of the most dreaded complications is diabetic nephropathy. Early diagnosis and appropriate management will at least prolong the life of the kidney and prevent the development of end-stage renal failure. Materials and Methods: Simple urinalysis is a useful tool for early diagnosis of diabetic kidney disease and helps differentiate between diabetic and nondiabetic kidney diseases. In this review, we have discussed the usefulness of urinalysis for a diabetic patient. Results: Early detection of an abnormality can be an alarming sign, and we can diagnose treatable causes of renal failure in diabetic patients. Conclusions: History, examination, and urinalysis are sufficient in most of the cases for diagnosing diabetic kidney disease. Renal biopsy is indicated in special situations where diagnosis cannot be made even after appropriate non-invasive investigations. Few limitations of the study are resource settings and knowledge of this simple test to predict an alarming sign of the kidney disease.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"8 1","pages":"317 - 321"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72865166","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}
G. Aarthi, R. Pradeepa, V. Mohan, P. Venkatasubramanian, R. Anjana
Background: A city’s planning, design, and construction can have a profound influence on health, specifically on non-communicable diseases such as diabetes and obesity, which are often referred to as “diabesity.” This study describes the designs and methods to understand the relationship between food and physical activity environments on diabesity. Materials and Methods: This study was a community-based cross-sectional door-to-door survey conducted as part of a large National Institute of Health and Care Research-funded surveillance project. For this study, two wards in Chennai were selected randomly. In each ward, five community enumeration blocks were selected using systematic random sampling technique. A consecutive sampling approach was used to select the study participants. Two categories of data were collected: (1) health data and (2) built environment (BE) data. Health and lifestyle questionnaires, anthropometric, and biochemical data were collected from all the study participants. For categorizing BE, an online questionnaire was developed using the KoBo toolbox to collect information about food and physical activity environments, as well as geographic locations. Expected Outcome: This study is expected to reveal data on the relationship between food and physical activity environments and diabesity. It will help policy-makers to understand the importance of access to healthy foods and spaces for physical activity in prevention and control of diabesity. It can also enable community-based interventions to improve health outcomes and help urban planners to plan cities that promote active lifestyles for its residents.
{"title":"Built environment correlates of diabetes and obesity: Methodology","authors":"G. Aarthi, R. Pradeepa, V. Mohan, P. Venkatasubramanian, R. Anjana","doi":"10.4103/jod.jod_93_22","DOIUrl":"https://doi.org/10.4103/jod.jod_93_22","url":null,"abstract":"Background: A city’s planning, design, and construction can have a profound influence on health, specifically on non-communicable diseases such as diabetes and obesity, which are often referred to as “diabesity.” This study describes the designs and methods to understand the relationship between food and physical activity environments on diabesity. Materials and Methods: This study was a community-based cross-sectional door-to-door survey conducted as part of a large National Institute of Health and Care Research-funded surveillance project. For this study, two wards in Chennai were selected randomly. In each ward, five community enumeration blocks were selected using systematic random sampling technique. A consecutive sampling approach was used to select the study participants. Two categories of data were collected: (1) health data and (2) built environment (BE) data. Health and lifestyle questionnaires, anthropometric, and biochemical data were collected from all the study participants. For categorizing BE, an online questionnaire was developed using the KoBo toolbox to collect information about food and physical activity environments, as well as geographic locations. Expected Outcome: This study is expected to reveal data on the relationship between food and physical activity environments and diabesity. It will help policy-makers to understand the importance of access to healthy foods and spaces for physical activity in prevention and control of diabesity. It can also enable community-based interventions to improve health outcomes and help urban planners to plan cities that promote active lifestyles for its residents.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"8 1","pages":"340 - 346"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89107321","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}
Shobana Shanmugam, Jayanthan Mathiyazhagan, V. Parthasarathy, R. Jeevan, Rajagopal Gayathri, P. Karthikeyan, Priyanka Bakshi, N. Malleshi, R. Anjana, R. Unnikrishnan, Kamala Krishnaswamy, S. Jamdar, V. Mohan, Sudha Vasudevan
Brown rice (whole grain, BR) has lower glycemic index (GI), is a healthy replacement for white rice (WR). However, BR has a short shelf life, is susceptible to pest infestation. Gamma irradiation is a safe approach to prevent the latter. This study examines effect of gamma irradiation on the physical, cooking, nutritional, shelf life and glycemic properties of three Indian parboiled BR. Parboiled BR of ADT-43, BPT-5204, and Swarna rice varieties were packed in polyester and polypropylene pouches (60 µ thickness) and subjected to gamma irradiation [750–820 Gy] (IR). Appropriate controls without irradiation (NIR) were maintained. Irradiation did not induce major changes in the physical and nutritional properties, except for resistant starch which significantly increased after irradiation in ADT-43 and BPT-5204. Irradiation reduced the cooking time, increased loss of solids in the cooking water and decreased apparent water uptake (particularly in BPT-5204). IR varieties exhibited longer shelf life (8–9 months) compared to 6 months shelf life of NIR varieties. The shelf stability of IR Swarna rice was superior in terms of delayed rancidity development compared to all other rice. All BR samples exhibited the ranking of ‘like moderately’ in the sensory acceptability tests at 6 months of storage and scores decreased subsequently. Irradiation did not affect GI [all showed medium GI, except a high GI for IR BPT 5204] and helped in shelf life extension of parboiled BR by preventing insect infestation.
{"title":"Effect of gamma irradiation on shelf life, nutritional, and glycemic properties of three indian brown rice varieties","authors":"Shobana Shanmugam, Jayanthan Mathiyazhagan, V. Parthasarathy, R. Jeevan, Rajagopal Gayathri, P. Karthikeyan, Priyanka Bakshi, N. Malleshi, R. Anjana, R. Unnikrishnan, Kamala Krishnaswamy, S. Jamdar, V. Mohan, Sudha Vasudevan","doi":"10.4103/jod.jod_83_22","DOIUrl":"https://doi.org/10.4103/jod.jod_83_22","url":null,"abstract":"Brown rice (whole grain, BR) has lower glycemic index (GI), is a healthy replacement for white rice (WR). However, BR has a short shelf life, is susceptible to pest infestation. Gamma irradiation is a safe approach to prevent the latter. This study examines effect of gamma irradiation on the physical, cooking, nutritional, shelf life and glycemic properties of three Indian parboiled BR. Parboiled BR of ADT-43, BPT-5204, and Swarna rice varieties were packed in polyester and polypropylene pouches (60 µ thickness) and subjected to gamma irradiation [750–820 Gy] (IR). Appropriate controls without irradiation (NIR) were maintained. Irradiation did not induce major changes in the physical and nutritional properties, except for resistant starch which significantly increased after irradiation in ADT-43 and BPT-5204. Irradiation reduced the cooking time, increased loss of solids in the cooking water and decreased apparent water uptake (particularly in BPT-5204). IR varieties exhibited longer shelf life (8–9 months) compared to 6 months shelf life of NIR varieties. The shelf stability of IR Swarna rice was superior in terms of delayed rancidity development compared to all other rice. All BR samples exhibited the ranking of ‘like moderately’ in the sensory acceptability tests at 6 months of storage and scores decreased subsequently. Irradiation did not affect GI [all showed medium GI, except a high GI for IR BPT 5204] and helped in shelf life extension of parboiled BR by preventing insect infestation.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"27 1","pages":"368 - 376"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86970657","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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