Lipohypertrophy of the injection site is a common and often-neglected complication of treatment with insulin. It causes unpredictable absorption of the drug, leading to higher glycemic variability. Using the correct injection technique, the lesion may be reversed. Here, we present the case of a patient with type 1 diabetes, whose lipohypertrophy regressed over time. Along with this, the patient also attained better glycemic control and freedom from diabetic ketoacidosis.
{"title":"A case of regression of insulin lipohypertrophy with correct injection technique","authors":"Dewark Sharma","doi":"10.4103/jod.jod_18_22","DOIUrl":"https://doi.org/10.4103/jod.jod_18_22","url":null,"abstract":"Lipohypertrophy of the injection site is a common and often-neglected complication of treatment with insulin. It causes unpredictable absorption of the drug, leading to higher glycemic variability. Using the correct injection technique, the lesion may be reversed. Here, we present the case of a patient with type 1 diabetes, whose lipohypertrophy regressed over time. Along with this, the patient also attained better glycemic control and freedom from diabetic ketoacidosis.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"75 1","pages":"184 - 186"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80578855","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}
{"title":"Diabetes prevention through religious leaders","authors":"B. Bhowmik, T. Siddiquee, A. Hussain, A. Khan","doi":"10.4103/jod.jod_45_22","DOIUrl":"https://doi.org/10.4103/jod.jod_45_22","url":null,"abstract":"","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"48 1","pages":"187 - 187"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83623639","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}
Objective: The study aimed to assess the knowledge, attitude, practice, satisfaction, and quality of life (QoL) of adult patients with type 2 diabetes (T2D) on insulin degludec/insulin aspart (IDegAsp). Materials and Methods: Data were collected through an online survey from patients with T2D being treated with IDegAsp at a single center in India. Results: Survey was completed by 247 participants. On the Likert scale, 1 to 5 (1: most difficult and 5: most easy), 41.6% and 26.6% scored 5 and 4, respectively, for ease of increasing or decreasing the dose. Most participants (n = 190) consulted a physician to adjust the dose; 53.3% and 28.8% scored 5 and 4, respectively, for a good experience while injecting IDegAsp; 89.8% of participants felt their QoL improved with a reduction in the number of pricks; 86.7% participants found it comfortable to inject IDegAsp in different social situations; 94.2% reported they could manage their day to day activities better after initiating IDegAsp. After initiating IDegAsp, the oral antidiabetic (OAD) pill burden reduced from three to one or two pills in 70% of patients. Conclusions: Our survey-based study shows the majority of participants found it easy to administer IDegAsp, inject IDegAsp in different social situations, they were able to increase and decrease the dose with ease, and benefited from reduced injection pricks and reduced OAD pill burden. The survey points towards a positive attitude towards achieving glycemic control with IDegAsp.
{"title":"Patient reported attitude, practice, satisfaction, and quality of life on insulin degludec/insulin aspart: A single-center survey from India in adult with diabetes","authors":"R. Kovil","doi":"10.4103/jod.jod_27_22","DOIUrl":"https://doi.org/10.4103/jod.jod_27_22","url":null,"abstract":"Objective: The study aimed to assess the knowledge, attitude, practice, satisfaction, and quality of life (QoL) of adult patients with type 2 diabetes (T2D) on insulin degludec/insulin aspart (IDegAsp). Materials and Methods: Data were collected through an online survey from patients with T2D being treated with IDegAsp at a single center in India. Results: Survey was completed by 247 participants. On the Likert scale, 1 to 5 (1: most difficult and 5: most easy), 41.6% and 26.6% scored 5 and 4, respectively, for ease of increasing or decreasing the dose. Most participants (n = 190) consulted a physician to adjust the dose; 53.3% and 28.8% scored 5 and 4, respectively, for a good experience while injecting IDegAsp; 89.8% of participants felt their QoL improved with a reduction in the number of pricks; 86.7% participants found it comfortable to inject IDegAsp in different social situations; 94.2% reported they could manage their day to day activities better after initiating IDegAsp. After initiating IDegAsp, the oral antidiabetic (OAD) pill burden reduced from three to one or two pills in 70% of patients. Conclusions: Our survey-based study shows the majority of participants found it easy to administer IDegAsp, inject IDegAsp in different social situations, they were able to increase and decrease the dose with ease, and benefited from reduced injection pricks and reduced OAD pill burden. The survey points towards a positive attitude towards achieving glycemic control with IDegAsp.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"9 1","pages":"177 - 183"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74800179","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: There is a dearth of studies evaluating sexual dysfunction in women with Type 2 Diabetes Mellitus (T2DM), despite anecdotal evidence suggesting an association between glycemic control and female sexual health. Materials and Methods: An observational cross-sectional study was carried out in 100 women with T2DM under follow-up at a regional diabetes center. Validated questionnaires, Female Sexual Function Index (FSFI), and Female Sexual Distress Scale (FSDS) were used to collate the prevalence and severity of female sexual dysfunction (FSD) in the subjects. Anthropometric and metabolic parameters were recorded by clinical examination and blood tests, respectively. Results: FSD was reported in 18% (95% CI: 10.5–25.5%) of the women enrolled in the study. The women with FSD were significantly older (50 ± 9.3 years vs. 43.9 ± 8.2 years, P = 0.006). In addition, the mean body mass index (BMI) (31.96 ± 5.5 Kg/m2 vs. 28.98 ± 4.63Kg/m2, P = 0.02) and waist circumference (38.88 ± 6.6 inches vs. 35.54 ± 5.62 inches, P = 0.03) were higher in the women with FSD compared with those without FSD. However, we observed no statistically significant association between FSD and the duration of diabetes, level of glycemic control, and serum testosterone level. Conclusion: Advanced age, higher BMI, and central adiposity were related with the development of FSD, whereas the duration of diabetes and level of HbA1c did not increase FSD risk.
{"title":"Sexual dysfunction in women with type 2 diabetes mellitus: An observational study","authors":"Manisha Gupta, R. Shukla, S. Verma, A. Kalhan","doi":"10.4103/jod.jod_108_21","DOIUrl":"https://doi.org/10.4103/jod.jod_108_21","url":null,"abstract":"Introduction: There is a dearth of studies evaluating sexual dysfunction in women with Type 2 Diabetes Mellitus (T2DM), despite anecdotal evidence suggesting an association between glycemic control and female sexual health. Materials and Methods: An observational cross-sectional study was carried out in 100 women with T2DM under follow-up at a regional diabetes center. Validated questionnaires, Female Sexual Function Index (FSFI), and Female Sexual Distress Scale (FSDS) were used to collate the prevalence and severity of female sexual dysfunction (FSD) in the subjects. Anthropometric and metabolic parameters were recorded by clinical examination and blood tests, respectively. Results: FSD was reported in 18% (95% CI: 10.5–25.5%) of the women enrolled in the study. The women with FSD were significantly older (50 ± 9.3 years vs. 43.9 ± 8.2 years, P = 0.006). In addition, the mean body mass index (BMI) (31.96 ± 5.5 Kg/m2 vs. 28.98 ± 4.63Kg/m2, P = 0.02) and waist circumference (38.88 ± 6.6 inches vs. 35.54 ± 5.62 inches, P = 0.03) were higher in the women with FSD compared with those without FSD. However, we observed no statistically significant association between FSD and the duration of diabetes, level of glycemic control, and serum testosterone level. Conclusion: Advanced age, higher BMI, and central adiposity were related with the development of FSD, whereas the duration of diabetes and level of HbA1c did not increase FSD risk.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"52 1","pages":"139 - 144"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85129898","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. Das, S. Wangnoo, R. Chawla, A. Shaikh, G. Bantwal, P. Kalra, S. Jaggi, M. Abhyankar, A. Prasad, Prashant Sarda
Background: Type 2 diabetes mellitus (T2DM) is a progressive disease affecting a huge chunk of the population globally. Aim: This study aimed to address the existing gaps in knowledge about the triple-drug combination and to provide guidance to the clinicians on the triple-drug combination in Indian settings. Materials and Methods: Doctors’ opinions (n = 2262) were recorded based on surveys and round table meetings. The National Expert Group approved a standard questionnaire that included 13 questions pertaining to T2DM management using a triple combination of glimepiride, metformin, and voglibose, which were prepared, discussed, and evaluated by the experts. After due discussions, the expert group analyzed the result and further recommendations were made and a consensus statement was derived. Results: Out of 2262, 1498 were consulting physicians, 358 were diabetologists, 93 were endocrinologists, 104 were cardiologists, and 209 were family physicians with focus on diabetes practice or had more than 10 years of experience from different regions from India. A strong consensus was observed for targeting postprandial hyperglycemia in the management of T2DM, which may reduce cardiovascular (CV) disease risk. The experts opined that meal pattern was the major factor affecting glycemic variability. The experts recommended early use of triple combination as it improves glycemic control (early aggressive control, beyond three oral drugs are on no benefit, ingrained). More than 90.0% of clinicians believed that this combination is cost-effective. Most agreed (32.0%) that this combination moderately reduces body weight. Additionally, it was felt that triple combination in patients with T2DM is also beneficial during Ramadan. Conclusion: In the present expert opinion-based consensus, most of the healthcare providers believed that triple-drug combination can potentially improve glycemic control and can delay/postpone the microvascular and CV complications. However, more multicentric studies are needed to support these recommendations.
{"title":"Expert consensus on triple combination of glimepiride, metformin, and voglibose usage in patients with type 2 diabetes mellitus in Indian settings","authors":"A. Das, S. Wangnoo, R. Chawla, A. Shaikh, G. Bantwal, P. Kalra, S. Jaggi, M. Abhyankar, A. Prasad, Prashant Sarda","doi":"10.4103/jod.jod_118_21","DOIUrl":"https://doi.org/10.4103/jod.jod_118_21","url":null,"abstract":"Background: Type 2 diabetes mellitus (T2DM) is a progressive disease affecting a huge chunk of the population globally. Aim: This study aimed to address the existing gaps in knowledge about the triple-drug combination and to provide guidance to the clinicians on the triple-drug combination in Indian settings. Materials and Methods: Doctors’ opinions (n = 2262) were recorded based on surveys and round table meetings. The National Expert Group approved a standard questionnaire that included 13 questions pertaining to T2DM management using a triple combination of glimepiride, metformin, and voglibose, which were prepared, discussed, and evaluated by the experts. After due discussions, the expert group analyzed the result and further recommendations were made and a consensus statement was derived. Results: Out of 2262, 1498 were consulting physicians, 358 were diabetologists, 93 were endocrinologists, 104 were cardiologists, and 209 were family physicians with focus on diabetes practice or had more than 10 years of experience from different regions from India. A strong consensus was observed for targeting postprandial hyperglycemia in the management of T2DM, which may reduce cardiovascular (CV) disease risk. The experts opined that meal pattern was the major factor affecting glycemic variability. The experts recommended early use of triple combination as it improves glycemic control (early aggressive control, beyond three oral drugs are on no benefit, ingrained). More than 90.0% of clinicians believed that this combination is cost-effective. Most agreed (32.0%) that this combination moderately reduces body weight. Additionally, it was felt that triple combination in patients with T2DM is also beneficial during Ramadan. Conclusion: In the present expert opinion-based consensus, most of the healthcare providers believed that triple-drug combination can potentially improve glycemic control and can delay/postpone the microvascular and CV complications. However, more multicentric studies are needed to support these recommendations.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"1 1","pages":"145 - 153"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89499247","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 and Aims: The objective of the study was to compare the percent of patients with type 2 diabetes (T2D) requiring dose intensification and the time to dose intensification in patients on insulin degludec/insulin aspart (IDegAsp) versus those on basal insulin. Materials and Methods: Data were collected through retrospective chart review of patients with T2D being treated with insulin at a single center in India. The increase from once daily (OD) to twice daily dose or the addition of prandial insulin was considered as dose intensification. Chi-square test was conducted to compare the groups. Results: In the IDegAsp group (n = 515), 455 patients continued on the OD dose, and 60 patients (11.6%) were intensified. In the insulin glargine (IGlar) group (n = 173), 143 patients remained on the initial dose and 30 patients (17.34%) were intensified. Fewer patients on IDegAsp required treatment intensification than those on IGlar (P = 0.05). The time to treatment intensification (±standard deviation) was 11.98 ± 7.81 months in the IDegAsp group and 6.71 ± 6.86 months in the IGlar group. The time to treatment intensification was significantly longer in the IDegAsp than in the IGlar group (P = 0.0023). Conclusions: The study shows that significantly fewer patients on IDegAsp required dose intensification than those on IGlar. Additionally, the time to dose intensification was significantly delayed in patients on IDegAsp as compared to IGlar. However, HbA1c reduction with IGlar (nonintensified) was significant only at 6 months and failed to reach significance at 12 months, thereby pointing toward an early need for treatment intensification.
{"title":"Comparing time to intensification between insulin degludec/insulin aspart and insulin glargine: A single-center experience from India","authors":"R. Kovil","doi":"10.4103/jod.jod_20_22","DOIUrl":"https://doi.org/10.4103/jod.jod_20_22","url":null,"abstract":"Background and Aims: The objective of the study was to compare the percent of patients with type 2 diabetes (T2D) requiring dose intensification and the time to dose intensification in patients on insulin degludec/insulin aspart (IDegAsp) versus those on basal insulin. Materials and Methods: Data were collected through retrospective chart review of patients with T2D being treated with insulin at a single center in India. The increase from once daily (OD) to twice daily dose or the addition of prandial insulin was considered as dose intensification. Chi-square test was conducted to compare the groups. Results: In the IDegAsp group (n = 515), 455 patients continued on the OD dose, and 60 patients (11.6%) were intensified. In the insulin glargine (IGlar) group (n = 173), 143 patients remained on the initial dose and 30 patients (17.34%) were intensified. Fewer patients on IDegAsp required treatment intensification than those on IGlar (P = 0.05). The time to treatment intensification (±standard deviation) was 11.98 ± 7.81 months in the IDegAsp group and 6.71 ± 6.86 months in the IGlar group. The time to treatment intensification was significantly longer in the IDegAsp than in the IGlar group (P = 0.0023). Conclusions: The study shows that significantly fewer patients on IDegAsp required dose intensification than those on IGlar. Additionally, the time to dose intensification was significantly delayed in patients on IDegAsp as compared to IGlar. However, HbA1c reduction with IGlar (nonintensified) was significant only at 6 months and failed to reach significance at 12 months, thereby pointing toward an early need for treatment intensification.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"24 1","pages":"171 - 176"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87485746","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}
H. Sangma, Anshul Singh, A. Srivastava, R. Singh, V. Misra
Objective: The aim of this work was to study the association of autoimmune thyroiditis (AIT) in the patients of latent autoimmune diabetes of adult (LADA). Materials and Methods: The subjects included were more than 30 years of age, presenting with the deranged glycemic profile. After GAD65 autoantibody testing, they were grouped into LADA positive and LADA negative groups. Simultaneously, a thyroid workup for the presence of AIT was done. Statistical Analysis: The Student’s unpaired t test and chi-square test (χ2 test) were used to test for the significance of the difference in AIT between LADA and type 2 diabetes mellitus (T2DM) subjects as applicable. A value of P < 0.05 was taken as significant. Results: A total of 77 patients were included in the study. The mean age was 48 ± 13 years and M:F ratio was 1:3. A high frequency of AIT was found in the LADA group (80%) when compared to the true T2DM group (35%). Mean values of both anti-thyroid peroxidase antibody (anti-TPO) and anti-thyroglobulin antibody (anti-TG) antibodies were found to be significantly different between LADA and T2DM. Percentage positivity for anti-TPO, anti-TG, as well as combined anti-TPO and anti-TG were also found to be significantly different. Conclusion: Based on the significant association of AIT with LADA found in our study, we recommend all AIT patients to undergo simultaneous screening for LADA for a multimodal treatment.
{"title":"Association of autoimmune thyroiditis with latent autoimmune diabetes of adults (LADA): A study from North India","authors":"H. Sangma, Anshul Singh, A. Srivastava, R. Singh, V. Misra","doi":"10.4103/jod.jod_121_21","DOIUrl":"https://doi.org/10.4103/jod.jod_121_21","url":null,"abstract":"Objective: The aim of this work was to study the association of autoimmune thyroiditis (AIT) in the patients of latent autoimmune diabetes of adult (LADA). Materials and Methods: The subjects included were more than 30 years of age, presenting with the deranged glycemic profile. After GAD65 autoantibody testing, they were grouped into LADA positive and LADA negative groups. Simultaneously, a thyroid workup for the presence of AIT was done. Statistical Analysis: The Student’s unpaired t test and chi-square test (χ2 test) were used to test for the significance of the difference in AIT between LADA and type 2 diabetes mellitus (T2DM) subjects as applicable. A value of P < 0.05 was taken as significant. Results: A total of 77 patients were included in the study. The mean age was 48 ± 13 years and M:F ratio was 1:3. A high frequency of AIT was found in the LADA group (80%) when compared to the true T2DM group (35%). Mean values of both anti-thyroid peroxidase antibody (anti-TPO) and anti-thyroglobulin antibody (anti-TG) antibodies were found to be significantly different between LADA and T2DM. Percentage positivity for anti-TPO, anti-TG, as well as combined anti-TPO and anti-TG were also found to be significantly different. Conclusion: Based on the significant association of AIT with LADA found in our study, we recommend all AIT patients to undergo simultaneous screening for LADA for a multimodal treatment.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"27 1","pages":"154 - 158"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87185728","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: Recently, attention is paid on strategies and policies to halt or reverse the forecast type 2 diabetes mellitus (T2DM) epidemic across the globe and in India. Metabolic syndrome (MetS) predisposed us to T2DM along with cardiovascular disease (CVD). Our study aims to develop a reversal model for people with MetS through an education program under observation. This paper will describe the design of the reversal model for metabolic syndrome (RMMS) study along with intervention strategies. Materials and Methods: The RMMS study is a multi-center, parallel arm, quasi-experimental study. The study will be done in western (viz., Ahmedabad) and eastern (viz., Guwahati and Dibrugarh) parts compromising 707 patients from each part. The intervention arm will be part of the “observation cum self-management education program” for a period of 6 months. The non-intervention arm will be followed up to 6 months with routine care. The analysis for the outcome will be done at the end of 6 months. The primary outcome measures will be the reversal of MetS or the components of MetS. The piloting of the study has been done after the ethical clearance, and necessary changes are also done in a proforma. Conclusion: The RMMS is first of its kind among Indian population to study the effectiveness of the reversal model. The results will provide insights into changes in the prevalence of the components of MetS and hence can be used as primary prevention strategies for T2DM and CVD.
{"title":"The reversal model for metabolic syndrome (RMMS) study: The rationale and design","authors":"Subhajyoti Ghosh, B. Saboo","doi":"10.4103/jod.jod_8_22","DOIUrl":"https://doi.org/10.4103/jod.jod_8_22","url":null,"abstract":"Background: Recently, attention is paid on strategies and policies to halt or reverse the forecast type 2 diabetes mellitus (T2DM) epidemic across the globe and in India. Metabolic syndrome (MetS) predisposed us to T2DM along with cardiovascular disease (CVD). Our study aims to develop a reversal model for people with MetS through an education program under observation. This paper will describe the design of the reversal model for metabolic syndrome (RMMS) study along with intervention strategies. Materials and Methods: The RMMS study is a multi-center, parallel arm, quasi-experimental study. The study will be done in western (viz., Ahmedabad) and eastern (viz., Guwahati and Dibrugarh) parts compromising 707 patients from each part. The intervention arm will be part of the “observation cum self-management education program” for a period of 6 months. The non-intervention arm will be followed up to 6 months with routine care. The analysis for the outcome will be done at the end of 6 months. The primary outcome measures will be the reversal of MetS or the components of MetS. The piloting of the study has been done after the ethical clearance, and necessary changes are also done in a proforma. Conclusion: The RMMS is first of its kind among Indian population to study the effectiveness of the reversal model. The results will provide insights into changes in the prevalence of the components of MetS and hence can be used as primary prevention strategies for T2DM and CVD.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"72 1","pages":"166 - 170"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86091645","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, Viswanathan Gopinath, V. Kavitha, N. Kalpana, P. Vijayalakshmi, Rajagopal Gayathri, Mookambika Ramya Bai R, Raman Ganeshjeevan, N. Malleshi, R. Unnikrishnan, R. Anjana, C. Henry, Kamala Krishnaswamy, V. Sudha, V. Mohan
Background and Objectives: Beaten or flattened rice (flakes) is very popular in India for preparing the meal “upma.” Commonly marketed rice flakes are fiber depleted, starchy, and may be nutritionally poor. Hence, this study aimed at preparing brown rice flakes (BRF) for such “upma” preparation and compared the nutritional and glycemic properties of it with those of white rice flakes (WRF). Materials and Methods: Flakes were prepared from brown rice (BR, ADT-45 variety) by steaming and flattening using a roller flaker. The BRF and commercial WRF were analyzed for nutrient composition, and upma prepared from both the flakes was evaluated for glycemic index (GI) in normal healthy volunteers by using a validated protocol. Results: BRF contained significantly higher (6.2 g%) dietary fiber as compared with WRF (1.8 g%, P < 0.001). Stereo-zoom microscopic examination of BRF revealed retention of bran and germ. BRF was thicker, firmer, and had a lower surface area compared with WRF. BRF upma exhibited medium GI (63.3 ± 6.2), whereas WRF upma showed high GI (70.4 ± 5.6), though the GI values were not statistically significant. Interpretation and Conclusions: BRF upma, a medium GI category meal choice, could be considered a healthier option compared to high GI WRF upma considering the nutritional profile. The BRF described in the study is easy to cook and suitable enough to replace WRF. More trials are required to design and devise innovative protocols for the preparation of BRF with significantly lower glycemic properties.
{"title":"Nutritional and glycemic properties of brown and white rice flakes “upma”","authors":"S. Shobana, Viswanathan Gopinath, V. Kavitha, N. Kalpana, P. Vijayalakshmi, Rajagopal Gayathri, Mookambika Ramya Bai R, Raman Ganeshjeevan, N. Malleshi, R. Unnikrishnan, R. Anjana, C. Henry, Kamala Krishnaswamy, V. Sudha, V. Mohan","doi":"10.4103/jod.jod_91_21","DOIUrl":"https://doi.org/10.4103/jod.jod_91_21","url":null,"abstract":"Background and Objectives: Beaten or flattened rice (flakes) is very popular in India for preparing the meal “upma.” Commonly marketed rice flakes are fiber depleted, starchy, and may be nutritionally poor. Hence, this study aimed at preparing brown rice flakes (BRF) for such “upma” preparation and compared the nutritional and glycemic properties of it with those of white rice flakes (WRF). Materials and Methods: Flakes were prepared from brown rice (BR, ADT-45 variety) by steaming and flattening using a roller flaker. The BRF and commercial WRF were analyzed for nutrient composition, and upma prepared from both the flakes was evaluated for glycemic index (GI) in normal healthy volunteers by using a validated protocol. Results: BRF contained significantly higher (6.2 g%) dietary fiber as compared with WRF (1.8 g%, P < 0.001). Stereo-zoom microscopic examination of BRF revealed retention of bran and germ. BRF was thicker, firmer, and had a lower surface area compared with WRF. BRF upma exhibited medium GI (63.3 ± 6.2), whereas WRF upma showed high GI (70.4 ± 5.6), though the GI values were not statistically significant. Interpretation and Conclusions: BRF upma, a medium GI category meal choice, could be considered a healthier option compared to high GI WRF upma considering the nutritional profile. The BRF described in the study is easy to cook and suitable enough to replace WRF. More trials are required to design and devise innovative protocols for the preparation of BRF with significantly lower glycemic properties.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"44 10 1","pages":"49 - 55"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75694114","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}
Jayshree Swain, S. Jena, Ankit Manglunia, Jaspreet Singh
The year 2021 marks 100 years of insulin discovery. In 1921, Banting and Best identified the pancreas as a key organ mainly responsible for carbohydrate metabolism and pathogenesis of diabetes. This work led to the purification of extract from the pancreas, which was later identified to be insulin. Since its discovery, there has been a lot of work to refine the properties of insulin and improve patient outcomes. Presently, short-acting, rapid-acting, intermediate-acting, long-acting, ultra-long-acting co-formulations, biosimilar, concentrated insulins are available and have revolutionized diabetes management and patient care. These new preparations have onset of action in a few minutes and some have their action lasting around 48 h. Also, there are a lot of advances in insulin delivery devices with the availability of ultra-fine needles and prefilled, reusable pens to hybrid closed-loop systems in which insulin is delivered as per continuous glucose monitoring recordings. Our article enfolds the milestones in insulin discovery and its evolution from the crude extract to highly designed once-weekly insulin.
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