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Ma RX. A detective story of intermittent fasting effect on immunity. Immunology 2024. [PMID: 38922825 DOI: 10.1111/imm.13829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Intermittent fasting (IF) refers to periodic fasting routines, that caloric intake is minimized not by meal portion size reduction but by intermittently eliminating ingestion of one or several consecutive meals. IF can instigate comprehensive and multifaceted alterations in energy metabolism, these metabolic channels may aboundingly function as primordial mechanisms that interface with the immune system, instigating intricate immune transformations. This review delivers a comprehensive understanding of IF, paying particular attention to its influence on the immune system, thus seeking to bridge these two research domains. We explore how IF effects lipid metabolism, hormonal levels, circadian rhythm, autophagy, oxidative stress, gut microbiota, and intestinal barrier integrity, and conjecture about the mechanisms orchestrating the intersect between these factors and the immune system. Moreover, the review includes research findings on the implications of IF on the immune system and patients burdened with autoimmune diseases.
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Affiliation(s)
- Ru-Xue Ma
- School of Medical, Qinghai University, Xining, China
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2
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Hanif W, Ali SN, Bellary S, Patel V, Farooqi A, Karamat MA, Saeed M, Sivaprasad S, Patel K, Khunti K. Pharmacological management of South Asians with type 2 diabetes: Consensus recommendations from the South Asian Health Foundation. Diabet Med 2021; 38:e14497. [PMID: 33301625 DOI: 10.1111/dme.14497] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/27/2020] [Accepted: 11/30/2020] [Indexed: 12/27/2022]
Abstract
South Asians constitute approximately 1.6 billion people from the Indian subcontinent, comprising Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka; and make up the largest diaspora globally. Compared to the White European population, this group is at a higher risk of developing type 2 diabetes along with cardiovascular, renal and eye complications. Over the recent years, a number of new therapies for type 2 diabetes have become available for which cardiovascular outcome trials (CVOTs) have been published. The recent ADA/EASD consensus guidelines on diabetes, pre-diabetes and cardiovascular diseases' offer a transitional shift in type 2 diabetes management. The new consensus recommendations are based on recent CVOTs, many of which had a representation of South Asian cohorts. In light of this new evidence, there is urgent need for an integrated, evidence-based, cost-effective and individualised approach specific for South Asians. This review takes into consideration the evidence from these CVOTs and provides best practice recommendations for optimal management of South Asian people with type 2 diabetes, alongside the previously published consensus report from South Asian Health Foundation in 2014 [1].
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Affiliation(s)
- Wasim Hanif
- Diabetes & Endocrinology, CSL Diabetes, University Hospitals of Birmingham, South Asian Health Foundation, Birmingham, UK
| | - Sarah N Ali
- Diabetes and Endocrinology, Royal Free London NHS Foundation Trust, Diabetes Working Group, South Asian Health Foundation, Birmingham, UK
| | - Srikanth Bellary
- School of Life and Health Sciences, Aston University, University Hospitals Birmingham, Birmingham, UK
| | - Vinod Patel
- Diabetes and Clinical Skills, Warwick Medical School, University of Warwick, Coventry, UK
- South Asian Health Foundation, Birmingham, UK
| | - Azhar Farooqi
- East Leicester Medical Practice, Leicester City CCG, BME Centre for Health, ARC East Midlands, Leicester, UK
| | - Muhammad Ali Karamat
- Diabetes and Endocrinology, UHB TPD Diabetes and Endocrinology, Health Education, Birmingham, UK
| | - Mujahid Saeed
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, University of Birmingham, Birmingham, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre and UCL Institute of Ophthalmology, London, UK
| | - Kiran Patel
- South Asian Health Foundation, Birmingham, UK
- University Hospitals Coventry & Warwickshire NHS Trust, Warwick Medical School, University of Warwick, Coventry University, Coventry, UK
| | - Kamlesh Khunti
- South Asian Health Foundation, Birmingham, UK
- Primary Care Diabetes & Vascular Medicine, Diabetes Research Centre and The Centre for Black Minority Health, University of Leicester, Leicester, UK
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3
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Chawla R, Madhu SV, Makkar BM, Ghosh S, Saboo B, Kalra S. RSSDI-ESI Clinical Practice Recommendations for the Management
of Type 2 Diabetes Mellitus 2020. Int J Diabetes Dev Ctries 2020. [PMCID: PMC7371966 DOI: 10.1007/s13410-020-00819-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Rajeev Chawla
- North Delhi Diabetes Centre Rohini, New Delhi, India
| | - S. V. Madhu
- Centre for Diabetes, Endocrinology & Metabolism, UCMS-GTB Hospital, Delhi, India
| | - B. M. Makkar
- Dr Makkar’s Diabetes & Obesity Centre Paschim Vihar, New Delhi, India
| | - Sujoy Ghosh
- Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal India
| | - Banshi Saboo
- DiaCare - A Complete Diabetes Care Centre, Ahmedabad, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana India
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4
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Ganesan K, Habboush Y, Dagogo-Jack S. Calorie Restriction and Intermittent Fasting: Impact on Glycemic Control in People With Diabetes. Diabetes Spectr 2020; 33:143-148. [PMID: 32425451 PMCID: PMC7228814 DOI: 10.2337/ds19-0064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Intermittent fasting has been suggested as an option for managing overweight and obesity. The purpose of this article is to present a balanced review of the practice of intermittent fasting and its impact on glycemic control in people with diabetes.
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Affiliation(s)
- Kavitha Ganesan
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN
| | | | - Samuel Dagogo-Jack
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN
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5
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Chawla R, Madhu SV, Makkar BM, Ghosh S, Saboo B, Kalra S. RSSDI-ESI Clinical Practice Recommendations for the Management of Type 2 Diabetes Mellitus 2020. Indian J Endocrinol Metab 2020; 24:1-122. [PMID: 32699774 PMCID: PMC7328526 DOI: 10.4103/ijem.ijem_225_20] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Rajeev Chawla
- North Delhi Diabetes Centre, Rohini, New Delhi, India
| | - S. V. Madhu
- Centre for Diabetes, Endocrinology and Metabolism, UCMS-GTB Hospital, New Delhi, India
| | - B. M. Makkar
- Dr. Makkar's Diabetes and Obesity Centre, Paschim Vihar, New Delhi, India
| | - Sujoy Ghosh
- Department of Endocrinology and Metabolism, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Banshi Saboo
- DiaCare - A Complete Diabetes Care Centre, Ahmedabad, Gujarat, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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6
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Arora B, Gupta L, Khandelwal D, Bhattacharya S, Kalra S, Chittawar S, Paliwal A, Lal PR, Dutta D. Knowledge, attitude, and practices of fasts in patients with type 2 diabetes among different religions in North India. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00760-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Hirode G, Vittinghoff E, Bharmal NH, Kandula NR, Kanaya AM. The association of religious affiliation with cholesterol levels among South Asians: the Mediators of Atherosclerosis in South Asians Living in America study. BMC Cardiovasc Disord 2019; 19:75. [PMID: 30925868 PMCID: PMC6441170 DOI: 10.1186/s12872-019-1045-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/14/2019] [Indexed: 01/04/2023] Open
Abstract
Background South Asians have disproportionately high rates of cardiovascular disease. Dyslipidemia, a contributing factor, may be influenced by lifestyle, which can vary by religious beliefs. Little is known about South Asian religions and associations with dyslipidemia. Methods Cross-sectional analyses of the MASALA study (n = 889). We examined the associations between religious affiliation and cholesterol levels using multivariate linear regression models. We determined whether smoking, alcohol use, physical activity, and dietary pattern mediated these associations. Results Mean LDL was 112 ± 32 mg/dL, median HDL was 48 mg/dL (IQR:40–57), and median triglycerides was 118 mg/dL (IQR:88–157). Muslims had higher LDL and triglycerides, and lower HDL, while participants with no religious affiliation had lower LDL and higher HDL. The difference in HDL between Muslims and those with no religious affiliation was partly explained by alcohol consumption. Conclusions Religion-specific tailoring of interventions designed to promote healthy lifestyle to reduce cholesterol among South Asians may be useful.
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Affiliation(s)
- Grishma Hirode
- OakCare Medical Group, Highland Hospital, 1411 E 31st St, Oakland, CA, 94602, USA
| | - Eric Vittinghoff
- UCSF Department of Epidemiology and Biostatistics, 550 16th St, San Francisco, CA, 94158, USA
| | - Nazleen H Bharmal
- U.S. Department of Health and Human Services, 200 Independence Avenue, Washington DC, 20201, USA
| | - Namratha R Kandula
- Department of General Internal Medicine, Northwestern University Feinberg School of Medicine, 750 N Lake Shore Drive, 6th Floor, Chicago, IL, 60611, USA
| | - Alka M Kanaya
- UCSF Department of Epidemiology and Biostatistics, 550 16th St, San Francisco, CA, 94158, USA. .,UCSF Division of General Internal Medicine, 1545 Divisadero Street, Suite 311, San Francisco, CA, 94115, USA.
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Kalra S, Bahendeka S, Sahay R, Ghosh S, Md F, Orabi A, Ramaiya K, Al Shammari S, Shrestha D, Shaikh K, Abhayaratna S, Shrestha PK, Mahalingam A, Askheta M, A. Rahim AA, Eliana F, Shrestha HK, Chaudhary S, Ngugi N, Mbanya JC, Aye TT, Latt TS, Akanov ZA, Syed AR, Tandon N, Unnikrishnan AG, Madhu SV, Jawa A, Chowdhury S, Bajaj S, Das AK. Consensus Recommendations on Sulfonylurea and Sulfonylurea Combinations in the Management of Type 2 Diabetes Mellitus - International Task Force. Indian J Endocrinol Metab 2018; 22:132-157. [PMID: 29535952 PMCID: PMC5838894 DOI: 10.4103/ijem.ijem_556_17] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
For decades, sulfonylureas (SUs) have been important drugs in the antidiabetic therapeutic armamentarium. They have been used as monotherapy as well as combination therapy. Focus on newer drugs and concerns about the risk of severe hypoglycemia and weight gain with some SUs have led to discussion on their safety and utility. It has to be borne in mind that the adverse events associated with SUs should not be ascribed to the whole class, as many modern SUs, such as glimepiride and gliclazide modified release, are associated with better safety profiles. Furthermore, individualization of treatment, using SUs in combination with other drugs, backed with careful monitoring and patient education, ensures maximum benefits with minimal side effects. The current guidelines, developed by experts from Africa, Asia, and the Middle East, promote the safe and smart use of SUs in combination with other glucose-lowering drugs.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | - Silver Bahendeka
- Department of Internal Medicine, Diabetes & Endocrinology, St. Francis Hospital, Nsambya, Kampala, Uganda
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India
| | - Sujoy Ghosh
- Department of Endocrinology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Fariduddin Md
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Abbas Orabi
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Kaushik Ramaiya
- Department of Internal Medicine, Hindu Mandal Hospital, Dar es Salaam, Tanzania
| | | | - Dina Shrestha
- Department of Endocrinology, Norvic International Hospital and Medical College, and Hospital for Advanced Medicine and Surgery, Maharajganj, Kathmandu, Nepal
| | - Khalid Shaikh
- Department of Diabetes, Faculty of Internal Medicine, Royal Oman Police Hospital, Muscat, Oman
| | - Sachitha Abhayaratna
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Pradeep K. Shrestha
- Department of Medicine, Tribhuvan University Teaching Hospital, Maharajganj, Kathmandu, Nepal
| | | | | | - Aly Ahmed A. Rahim
- Department of Internal Medicine, Diabetes & Metabolism Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Fatimah Eliana
- Department of Internal Medicine, Faculty of Medicine, YARSI University, Jakarta, Indonesia
| | - Hari K. Shrestha
- Department of Internal Medicine, Kathmandu University Hospital, Dhulikhel, Nepal
| | | | - Nancy Ngugi
- Department of Endocrinology, Kenyatta National Hospital, Nairobi, Kenya
| | - Jean Claude Mbanya
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaounde, Cameroon
| | - Than Than Aye
- Department of Endocrinology, University of Medicine 2, Yangon, Myanmar
| | - Tint Swe Latt
- Department of Medicine, University of Medicine 2, Yangon, Myanmar
| | - Zhanay A. Akanov
- Center of Diabetes, Clinic of Internal Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan
| | - Abbas Raza Syed
- Department of Endocrinology, Shaukat Khanum Hospital and Research Center, Lahore, Pakistan
| | - Nikhil Tandon
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, Pune, Maharashtra, India
| | - A. G. Unnikrishnan
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - S. V. Madhu
- Department of Medicine, University of Delhi, New Delhi, India
| | - Ali Jawa
- Department of Endocrinology, Diabetes and Metabolism, Wilshire Cardiovascular and Endocrine Center of Excellence, Lahore, Pakistan
| | - Subhankar Chowdhury
- Department of Endocrinology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Sarita Bajaj
- Department of Medicine, MLN Medical College, Allahabad, Uttar Pradesh, India
| | - Ashok Kumar Das
- Department of General Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
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Priya G, Kalra S, Dardi IK, Saini S, Aggarwal S, Singh R, Kaur H, Singh G, Talwar V, Singh P, Saini BJS, Julka S, Chawla R, Bajaj S, Singh D. Diabetes Care: Inspiration from Sikhism. Indian J Endocrinol Metab 2017; 21:453-459. [PMID: 28553604 PMCID: PMC5434732 DOI: 10.4103/ijem.ijem_52_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Religion has been proposed as a means of enhancing patient and community acceptance of diabetes and cultural specific motivational strategies to improve diabetes care. Sikhism is a young and vibrant religion, spread across the world and the Holy Scripture Sri Guru Granth Sahib (SGGS) is regarded as the living Guru by all Sikhs. The three key pillars of Sikhism are Kirat Karni (honest living), Vand Chakna (sharing with others) and Naam Japna (focus on God). They can help encourage the diabetes care provider, patient and community to engage in lifestyle modification, shared responsibility, positive thinking and stress management. The verses (Sabads) from the SGGS, with their timeless relevance, span the entire spectrum of diabetes care, from primordial and primary, to secondary and tertiary prevention. They can provide us with guidance towards a holistic approach towards health and lifestyle related diseases as diabetes. The SGGS suggests that good actions are based on one's body and highlights the relevance of mind-body interactions and entraining the mind to cultivate healthy living habits. The ethics of sharing, community and inclusiveness all lay emphasis on the need for global and unified efforts to manage and reduce the burden of the diabetes pandemic.
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Affiliation(s)
- Gagan Priya
- Department of Endocrinology, Fortis Hospital, Mohali, Punjab, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | | | - Simarjeet Saini
- Department of Electrical and Computer Engineering, University of Waterloo, Ontario, Canada
| | | | - Ramanbir Singh
- Department of Endocrinology, Apollo Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Anaesthesiology, ESI Hospital, Amritsar, Punjab, India
| | - Gurinder Singh
- Department of Plastic Surgery, Hargun Hospital, Amritsar, Punjab, India
| | - Vipin Talwar
- Department of Endocrinology, Golden Hospital, Jalandhar, Punjab, India
| | - Parminder Singh
- Department of Endocrinology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Brig J. S. Saini
- Department of Endocrinology, Oxford Hospital, Jalandhar, Punjab, India
| | - Sandeep Julka
- Department of Endocrinology, CHL Hospital, Indore, Madhya Pradesh, India
| | - Rajeev Chawla
- Department of Diabetology, North Delhi Diabetic Centre, New Delhi, India
| | - Sarita Bajaj
- Department of Medicine, MLN Medical College, Allahabad, Uttar Pradesh, India
| | - Devinder Singh
- Additional District Sessions Judge, Faridabad, Haryana, India
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10
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Julka S, Sachan A, Bajaj S, Sahay R, Chawla R, Agrawal N, Saboo B, Unnikrishnan AG, Baruah MP, Parmar G, Kalra S. Glycemic management during Jain fasts. Indian J Endocrinol Metab 2017; 21:238-241. [PMID: 28217525 PMCID: PMC5240069 DOI: 10.4103/2230-8210.192489] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This review describes the various fasts observed by adherents of the Jain religion. It attempts to classify them according to their suitability for people with diabetes and suggests appropriate regime and dose modification for those observing these fasts. The review is an endeavor to encourage rational and evidence-based management in this field of diabetology.
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Affiliation(s)
- Sandeep Julka
- Department of Endocrinology, Radiance - The Hormone Health Clinic, CHL Hospitals, Indore, Madhya Pradesh, India
| | - Alok Sachan
- Department of Endocrinology and Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Sarita Bajaj
- Department of Medicine, MLN Medical College, Allahabad, Uttar Pradesh, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India
| | - Rajeev Chawla
- Department of Diabetology, North Delhi Diabetes Centre, New Delhi, India
| | - Navneet Agrawal
- Department of Medicine, Diabetes Obesity Thyroid Centre, Gwalior, Madhya Pradesh, India
| | - Banshi Saboo
- Department of Diabetology, Dia Care Diabetes Care Centre, Ahmedabad, Gujarat, India
| | | | - Manash P. Baruah
- Department of Endocrinology, Excel Hospitals, Guwahati, Assam, India
| | - Girish Parmar
- Consultant Endocrinologist, Department of Endocrine, Kokilaben Dhirubhai Ambani Hospital, Andheri, Mumbai, Maharashtra, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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11
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Gupta L, Khandelwal D, Singla R, Gupta P, Kalra S. Pragmatic dietary advice for diabetes during Navratris. Indian J Endocrinol Metab 2017; 21:231-237. [PMID: 28217524 PMCID: PMC5240068 DOI: 10.4103/2230-8210.196009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Navratri is one of the most common religious fasts observed among Hindus. A large number of people with diabetes follow Navratris fast irrespective of its health implications, often without proper education and medical advice. The quest for the scientific research on dietary advices for Hindu fasts including Navratris shows paucity of literature comparative to the dietary advices advocated during Ramadan. The eating and physical activity patterns during different fasts vary a lot depending up on social and cultural factors. Even eating pattern is not uniform among all persons following Navratris and is modified as per their region, local culture, and religious beliefs. Dietary advice during Navratris depends upon pattern of fasting, religious beliefs, and local sociocultural factors. In this review, efforts are made to provide pragmatic dietary advice for people with diabetes, modifications in the menus and cooking practices, and timings of the meals for successful blood glucose management during Navratris. This review will also help plan diet and physical activity advice for persons observing other fasts as well.
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Affiliation(s)
- Lovely Gupta
- Department of Dietetics, Maharaja Agrasen Hospital, Punjabi Bagh, Delhi, India
| | - Deepak Khandelwal
- Department of Endocrinology, Maharaja Agrasen Hospital, Punjabi Bagh, Delhi, India
| | - Rajiv Singla
- Department of Endocrinology, Kalpavriksh Superspeciality centre, Dwarka, New Delhi, India
| | - Piyush Gupta
- Department of Pediatrics, Maharaja Agrasen Hospital, Punjabi Bagh, Delhi, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and Bharti Research Institute of Diabetes and Endocrinology, Karnal, Haryana, India
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Kalra S, Ghosh S, Aamir AH, Ahmed MT, Amin MF, Bajaj S, Baruah MP, Bulugahapitiya U, Das AK, Giri M, Gunatilake S, Mahar SA, Pathan MF, Qureshi NK, Raza SA, Sahay R, Shakya S, Shreshta D, Somasundaram N, Sumanatilleke M, Unnikrishnan AG, Wijesinghe AM. Safe and pragmatic use of sodium-glucose co-transporter 2 inhibitors in type 2 diabetes mellitus: South Asian Federation of Endocrine Societies consensus statement. Indian J Endocrinol Metab 2017; 21:210-230. [PMID: 28217523 PMCID: PMC5240067 DOI: 10.4103/2230-8210.196029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Diabetes prevalence shows a continuous increasing trend in South Asia. Although well-established treatment modalities exist for type 2 diabetes mellitus (T2DM) management, they are limited by their side effect profile. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) with their novel insulin-independent renal action provide improved glycemic control, supplemented by reduction in weight and blood pressure, and cardiovascular safety. Based on the clinical outcomes with SGLT2i in patients with T2DM, treatment strategies that make a "good clinical sense" are desirable. Considering the peculiar lifestyle, body types, dietary patterns (long duration religious fasts), and the hot climate of the South Asian population, a unanimous decision was taken to design specific, customized guidelines for T2DM treatment strategies in these regions. The panel met for a discussion three times so as to get a consensus for the guidelines, and only unanimous consensus was included. After careful consideration of the quality and strength of the available evidence, the executive summary of this consensus statement was developed based on the American Association of Clinical Endocrinologists/American College of Endocrinology protocol.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | - Sujoy Ghosh
- Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - A. H. Aamir
- Department of Endocrinology and Metabolic Diseases, Post Graduate Medical Institute, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Md. Tofail Ahmed
- Department of Endocrinology, BIRDEM and Ibrahim Medical College, Dhaka, Bangladesh
| | - Mohammod Feroz Amin
- Department of Endocrinology, BIRDEM and Ibrahim Medical College, Dhaka, Bangladesh
| | - Sarita Bajaj
- Department of Medicine, MLN Medical College, Allahabad, Uttar Pradesh, India
| | - Manash P. Baruah
- Department of Endocrinology, Excel Centre Hospitals, Guwahati, Assam, India
| | | | - A. K. Das
- Department of Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Mimi Giri
- BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sonali Gunatilake
- Department of Endocrinology, Colombo South Teaching Hospital, Colombo, Sri Lanka
| | - Saeed A. Mahar
- Department of Medicine, National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Md. Faruque Pathan
- Department of Endocrinology, BIRDEM and Ibrahim Medical College, Dhaka, Bangladesh
| | | | - S. Abbas Raza
- Department of Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India
| | - Santosh Shakya
- Diabetes, Thyroid and Endocrinology Care Centre, Kopundole, Nepal
| | - Dina Shreshta
- Department of Endocrinology, Norvic Hospital, Kathmandu, Nepal
| | - Noel Somasundaram
- Department of Endocrinology, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | | | - A. G. Unnikrishnan
- Department of Endocrinology, Chellaram Institute of Diabetes, Pune, Maharashtra, India
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Kannan S, Mahadevan S, Seshadri K, Sadacharan D, Velayutham K. Fasting practices in Tamil Nadu and their importance for patients with diabetes. Indian J Endocrinol Metab 2016; 20:858-862. [PMID: 27867892 PMCID: PMC5105573 DOI: 10.4103/2230-8210.192921] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Religious practices and cultural customs related to eating habits have a significant impact on lifestyle and health of the community. The Ramadan fasting in Muslims and its influence on various metabolic parameters such as diabetes have been reasonably studied. However, literature related to Hindu religious customs related to fasting and food patterns during various festivals and its effect on diabetes are scarce. This article is an attempt to describe the Hindu religious customs related to fasting and food practices from the State of Tamil Nadu (South India) and to raise the awareness among physicians about its relationship with diabetes which may help in managing their diabetic patients in a better way.
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Affiliation(s)
- Subramanian Kannan
- Department of Endocrinology, Diabetes and Bariatric Medicine, Narayana Health City, Bengaluru, Karnataka, India
| | - Shriraam Mahadevan
- Department of Endocrinology, Diabetes and Metabolism, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
| | - Krishna Seshadri
- Department of Endocrinology, Diabetes and Metabolism, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
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