1
|
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
| | | |
Collapse
|
2
|
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
| | | |
Collapse
|
3
|
Chawla R, Makkar BM, Aggarwal S, Bajaj S, Das AK, Ghosh S, Gupta A, Gupta S, Jaggi S, Jana J, Keswadev J, Kalra S, Keswani P, Kumar V, Maheshwari A, Moses A, Nawal CL, Panda J, Panikar V, Ramchandani GD, Rao PV, Saboo B, Sahay R, Setty KR, Viswanathan V, Aravind SR, Banarjee S, Bhansali A, Chandalia HB, Das S, Gupta OP, Joshi S, Kumar A, Kumar KM, Madhu SV, Mittal A, Mohan V, Munichhoodappa C, Ramachandran A, Sahay BK, Sai J, Seshiah V, Zargar AH. RSSDI consensus recommendations on insulin therapy in the management of diabetes. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00783-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
|
4
|
Dunning T, Martin P. Diabetes and Palliative Care: A Framework to Help Clinicians Proactively Plan for Personalized care. Palliat Care 2019. [DOI: 10.5772/intechopen.83534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
5
|
Abstract
The elderly are an important and distinct yet heterogeneous group of persons living with diabetes. The elderly have a unique biomedical, psychological, and social constitution. Their needs are different from those of younger adults. This implies that special care must be taken while evaluating and planning their nursing and management. Diabetes management in the elderly should focus on prevention and limitation of geriatric syndromes (medical conditions encountered in elderly persons), hypoglycemia (low blood glucose), and neurocognitive dysfunction (impairment in the functioning of the nervous system and brain). This review takes a practical approach to the assessment, nursing care, and medical treatment of diabetes in the elderly. It highlights major challenges and suggests solutions to these commonly encountered clinical problems.
Collapse
Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India.
| | | |
Collapse
|
6
|
Tandon N, Kalra S, Balhara YPS, Baruah MP, Chadha M, Chandalia HB, Prasanna Kumar KM, Madhu SV, Mithal A, Sahay R, Shukla R, Sundaram A, Unnikrishnan AG, Saboo B, Gupta V, Chowdhury S, Kesavadev J, Wangnoo SK. Forum for Injection Technique and Therapy Expert Recommendations, India: The Indian Recommendations for Best Practice in Insulin Injection Technique, 2017. Indian J Endocrinol Metab 2017; 21:600-617. [PMID: 28670547 PMCID: PMC5477451 DOI: 10.4103/ijem.ijem_97_17] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Health-care professionals in India frequently manage injection or infusion therapies in persons with diabetes (PWD). Patients taking insulin should know the importance of proper needle size, correct injection process, complication avoidance, and all other aspects of injection technique from the first visit onward. To assist health-care practitioners in their clinical practice, Forum for Injection Technique and Therapy Expert Recommendations, India, has updated the practical advice and made it more comprehensive evidence-based best practice information. Adherence to these updated recommendations, learning, and translating them into clinical practice should lead to effective therapies, improved outcomes, and lower costs for PWD.
Collapse
Affiliation(s)
- Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India
| | - Yatan Pal Singh Balhara
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Manash P. Baruah
- Department of Endocrinology, Excel Center (Unit of Excel Care Hospitals), Guwahati, Assam, India
| | - Manoj Chadha
- Department of Endocrinology, P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Hemraj B. Chandalia
- Department of Endocrinology, Diabetes Endocrinology Nutrition Management and Research Centre, Mumbai, Maharashtra, India
| | - K. M. Prasanna Kumar
- Department of Endocrinology and Metabolism, M S Ramaiah Medical College, CEO-Bangalore Diabetes Hospital, Bengaluru, Karnataka, India
| | - S. V. Madhu
- Department of Medicine, Division of Endocrinology and Metabolism, University College of Medical Sciences, New Delhi, India
| | - Ambrish Mithal
- Department of Endocrinology, Medanta Medicity, Gurugram, Haryana, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Osmania General Hospital, Hyderabad, Telangana, India
| | - Rishi Shukla
- Department of Endocrinology, Regency Hospital, Private Ltd. and Centre for Diabetes and Endocrinology, Kanpur, Uttar Pradesh, India
| | - Annamalai Sundaram
- Department of Endocrinology, Ambedkar Institute of Diabetes, Government Kilpauk Medical College, Chennai, Tamil Nadu, India
| | - Ambika G. Unnikrishnan
- Department of Clinical Diabetology and Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Banshi Saboo
- Diabetologist and Endocrine and Metabolic Physician, Diacare-Diabetes Care and Hormone Clinic, Ahmedabad, Gujarat, India
| | | | - Subhankar Chowdhury
- Department of Endocrinology, IPGME & R and SSKM Hospital, Kolkata, West Bengal, India
| | - Jothydev Kesavadev
- Jothydev's Diabetes and Reserarch Center, Thiruvananthapuram, Kerala, India
| | - Subhash K. Wangnoo
- Apollo Centre for Obesity, Diabetes and Endocrinology, Indraprastha Apollo Hospital, New Delhi, India
| |
Collapse
|
7
|
Pratley RE, Heller SR, Miller MA. Treatment of type 2 diabetes mellitus in the older adult: a review. Endocr Pract 2016; 20:722-36. [PMID: 24518176 DOI: 10.4158/ep13192.ra] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE This review summarizes the particular challenges of diabetes in older individuals and the evidence base guiding the selection of treatment targets and strategies in this population. METHODS An in-depth literature search was conducted to identify the evidence base from randomized, controlled, and population-based epidemiological studies, as well as guidelines derived from expert opinion. RESULTS Older patients are a highly heterogeneous population with respect to the pathogenesis and course of diabetes and, as a group, manifest significant comorbidities that impact treatment goals and strategies. There is a lack of consensus regarding "optimal" glucose targets in older patients with diabetes. Hypoglycemia is more common in the older patient, contributes to increased morbidity and reduced quality of life, and limits treatment in many cases. Duration of diabetes, comorbidities, life expectancy, and functional status are other important factors to consider when identifying appropriate glycemic goals and choosing an antihyperglycemic agent for older patients with type 2 diabetes mellitus (T2DM). CONCLUSION Current, limited treatment recommendations in older patients with T2DM are based on expert opinion due to the general lack of evidence from randomized controlled trials. This underscores the importance of individualizing pharmacologic therapy in these patients with a focus on the risk-to-benefit ratio. Additional trials in older patients are needed to assess drug safety, efficacy, and dosing.
Collapse
Affiliation(s)
- Richard E Pratley
- Florida Hospital Diabetes and Translational Research Institutes, Sanford Burnham Medical Research Institute, Orlando, Florida
| | - Simon R Heller
- Sheffield Teaching Hospitals Foundation Trust, University of Sheffield, Sheffield, United Kingdom
| | | |
Collapse
|
8
|
Satpathy SV, Datta S, Upreti B. Utilization study of antidiabetic agents in a teaching hospital of Sikkim and adherence to current standard treatment guidelines. J Pharm Bioallied Sci 2016; 8:223-8. [PMID: 27413351 PMCID: PMC4929962 DOI: 10.4103/0975-7406.175975] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective: Diabetes has gradually emerged as one of the most serious public health problems in our country. This underlines the need for timely disease detection and decisive therapeutic intervention. This prospective cross-sectional observational study aims at analyzing the utilization pattern of antidiabetic agents in a remote North-East Indian tertiary care teaching hospital in the perspective of current standard treatment guidelines. Materials and Methods: Diabetic patients receiving antidiabetic medication, both as outpatients and inpatients in our hospital over a period of 12 months (May 2013–May 2014), were included in this study. The data obtained were sorted and analyzed on the basis of gender, type of therapy, and hospital setting. Results: A total of 310 patients were included in the study. Metformin was the single most frequently prescribed antidiabetic agent (66.8%) followed by the sulfonylureas group (37.4%). Insulin was prescribed in 23.2% of the patients. Combination antidiabetic drug therapy (65.1%) was used more frequently than monotherapy (34.8%). The use of biguanides (P < 0.0001) and sulfonylureas (P = 0.02) in combination was significant as compared to their use as monotherapy. A total of 48% of all antidiabetic combinations used, comprised metformin and sulfonylureas (n = 96). Insulin use was significantly higher as monotherapy and in inpatients (P < 0.0001). The utilization of drugs from the National List of Essential Medicines was 51.2%, while 11% of antidiabetics were prescribed by generic name. Conclusion: The pattern of utilization largely conforms to the current standard treatment guidelines. Increased use of generic drugs is an area with scope for improvement.
Collapse
Affiliation(s)
- Sushrut Varun Satpathy
- Department of Pharmacology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, 5 Mile, Tadong, Gangtok, East Sikkim, India
| | - Supratim Datta
- Department of Pharmacology, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, 5 Mile, Tadong, Gangtok, East Sikkim, India
| | - Binu Upreti
- Department of Community Medicine, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, 5 Mile, Tadong, Gangtok, East Sikkim, India
| |
Collapse
|
9
|
Debnath P, Natasha K, Ali L, Bhaduri T, Roy TK, Bera S, Mukherjee D, Debnath S. Ayurpharmacoepidemiology Perspective: Health Literacy (Knowledge and Practice) Among Older Diabetes Patients Visiting Ayurveda Teaching Hospitals in India. J Evid Based Complementary Altern Med 2016; 22:242-250. [PMID: 27074784 DOI: 10.1177/2156587216643641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Older Indian diabetics lack proper health literacy making them vulnerable to complications. Assessment of health literacy was done by hospital-based cross-sectional study. Face-to-face interview was conducted by pretested structured questionnaires. Diabetes patients aged ≥60 years consisted of 56.22% males and 43.78% females; in addition, 34.2% respondents were without formal schooling. Diabetes was known to 63.56% respondents. Total knowledge and practice score of the respondents was good (18.9% and 35.1%), average (30.7% and 46.9%), and poor (50.4% and 18%), respectively. Knowledge and practice score was strongly associated ( P < .01) with religion, educational status, and diabetes duration with positive relationship ( R2 = 0.247, P < .01) between knowledge and practice score. The study highlights lack of health literacy among older diabetics undergoing ayurveda management. Baseline statistics will pave the way toward ayurpharmacoepidemiology.
Collapse
Affiliation(s)
- Parikshit Debnath
- 1 Gananath Sen Institute of Ayurvidya and Research, Kolkata, West Bengal, India
| | - Khurshid Natasha
- 2 Bangladesh University of Health Sciences, Mirpur, Dhaka, Bangladesh
| | - Liaquat Ali
- 2 Bangladesh University of Health Sciences, Mirpur, Dhaka, Bangladesh
| | - Tapas Bhaduri
- 3 Department of AYUSH, Government of West Bengal, Silampur RH, Malda, West Bengal, India
| | - Tushar Kanti Roy
- 4 Department of AYUSH, Government of West Bengal, Habaspur PHC, Murshidabad, West Bengal, India
| | - Sayantan Bera
- 5 Rajib Gandhi Memorial Ayurvedic College and Hospital, Belley-Sankarpur, Kankinara, West Bengal, India
| | - Debdeep Mukherjee
- 2 Bangladesh University of Health Sciences, Mirpur, Dhaka, Bangladesh
| | - Swati Debnath
- 6 Institute of Post Graduate Ayurvedic Education & Research at SVSP Hospital, Kolkata, West Bengal, India
| |
Collapse
|
10
|
Abstract
Diabetes mellitus (DM) frequency is a growing problem worldwide, because of long life expectancy and life style modifications. In old age (≥60-65 years old), DM is becoming an alarming public health problem in developed and even in developing countries as for some authors one from two old persons are diabetic or prediabetic and for others 8 from 10 old persons have some dysglycemia. DM complications and co-morbidities are more frequent in old diabetics compared to their young counterparts. The most frequent are cardiovascular diseases due to old age and to precocious atherosclerosis specific to DM and the most bothersome are visual and cognitive impairments, especially Alzheimer disease and other kind of dementia. Alzheimer disease seems to share the same risk factors as DM, which means insulin resistance due to lack of physical activity and eating disorders. Visual and physical handicaps, depression, and memory troubles are a barrier to care for DM treatment. For this, old diabetics are now classified into two main categories as fit and independent old people able to take any available medication, exactly as their young or middle age counterparts, and fragile or frail persons for whom physical activity, healthy diet, and medical treatment should be individualized according to the presence or lack of cognitive impairment and other co-morbidities. In the last category, the fundamental rule is "go slowly and individualize" to avoid interaction with poly medicated elder persons and fatal iatrogenic hypoglycemias in those treated with sulfonylureas or insulin.
Collapse
Affiliation(s)
- Farida Chentli
- Department of Endocrine and Metabolic Diseases, Bab El Oued Teaching Hospital, Algiers, Algeria
| | - Said Azzoug
- Department of Endocrine and Metabolic Diseases, Bab El Oued Teaching Hospital, Algiers, Algeria
| | - Souad Mahgoun
- Department of Endocrine and Metabolic Diseases, Bab El Oued Teaching Hospital, Algiers, Algeria
| |
Collapse
|
11
|
Tandon N, Kalra S, Balhara YPS, Baruah MP, Chadha M, Chandalia HB, Chowdhury S, Jothydev K, Kumar PKM, V. MS, Mithal A, Modi S, Pitale S, Sahay R, Shukla R, Sundaram A, Unnikrishnan AG, Wangnoo SK. Forum for Injection Technique (FIT), India: The Indian recommendations 2.0, for best practice in Insulin Injection Technique, 2015. Indian J Endocrinol Metab 2015; 19:317-31. [PMID: 25932385 PMCID: PMC4366768 DOI: 10.4103/2230-8210.152762] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
As injectable therapies such as human insulin, insulin analogs, and glucagon-like peptide-1 receptor agonists are used to manage diabetes, correct injection technique is vital for the achievement of glycemic control. The forum for injection technique India acknowledged this need for the first time in India and worked to develop evidence-based recommendations on insulin injection technique, to assist healthcare practitioners in their clinical practice.
Collapse
Affiliation(s)
- Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences (AIIMS), Delhi, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India
| | - Yatan Pal Singh Balhara
- Department of Psychiatry, National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Manash P. Baruah
- Department of Endocrinology, Excel Center (unit of Excel Care Hospitals), Guwahati, Assam, India
| | - Manoj Chadha
- Department of Endocrinology, P.D. Hinduja Hospital and Research Centre, Mumbai, India
| | - Hemraj B. Chandalia
- Department of Endocrinology, Diabetes Endocrinology Nutrition Management and Research Centre (DENMARC), Mumbai, India
| | | | - Kesavadev Jothydev
- CEO and Director, Jothydev's Diabetes and Reserarch Center, Trivindrum, India
| | - Prasanna K. M. Kumar
- Department of Endocrinology and Metabolism, M S Ramiah Medical College, Bangalore, India
| | - Madhu S. V.
- Department of Medicine, Division of Endocrinology and Metabolism, University College of Medical Sciences, New Delhi, India
| | - Ambrish Mithal
- Department of Endocrinology, Medanta Medicity, Gurgaon, India
| | - Sonal Modi
- Department of Nutrition, Diabetes Endocrinology Nutrition Management and Research Centre (DENMARC), Mumbai, India
| | - Shailesh Pitale
- Department of Endocrinology, Pitale Diabetes and Hormone Center, Nagpur, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College and Osmania General Hospital, Hyderabad, India
| | - Rishi Shukla
- Department of Endocrinology, Regency Hospital Pvt. Ltd. and Centre for Diabetes and Endocrinology, Kanpur, India
| | - Annamalai Sundaram
- Department of Endocrinology, Ambedkar Institute of Diabetes, Govt. Kilpauk Medical College, Kilpauk, Chennai, India
| | | | - Subhash K. Wangnoo
- Consultant Endocrinologist and Head, Apollo Centre for Obesity, Diabetes and Endocrinology (ACODE), Indraprastha Apollo Hospital, New Delhi, India
| |
Collapse
|
12
|
Bajwa SJS, Sehgal V, Kalra S, Baruah MP. Management of diabetes mellitus type-2 in the geriatric population: Current perspectives. J Pharm Bioallied Sci 2014; 6:151-7. [PMID: 25035634 PMCID: PMC4097928 DOI: 10.4103/0975-7406.130956] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 06/06/2013] [Accepted: 09/29/2013] [Indexed: 01/04/2023] Open
Abstract
The prevalence of diabetes mellitus (DM) has increased exponentially throughout the world and there is rapid increase in elderly diabetics. DM is associated with increased mortality and considerable morbidity including stroke, heart disease, and diminished quality of life in the elderly. However, the unique features of geriatric diabetes have not been given due a prominence in medical literature. Hypoglycemia remains the biggest complicating factor and needs to be avoided in the elderly. Most people in the geriatric age group have some degree of renal insufficiency and medications need to be adjusted wisely with changing renal profile. Because safer and more effective pharmacological therapy is available, an individual approach to DM in the elderly is essential.
Collapse
Affiliation(s)
- Sukhminder Jit Singh Bajwa
- Department of Anaesthesiology and Intensive Care Medicine, Gian Sagar Medical College and Hospital, Patiala, Punjab, India
| | - Vishal Sehgal
- Department of Internal Medicine, The Common Wealth Medical College, Scranton, PA 18510, USA
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and B.R.I.D.E., Karnal, Haryana, India
| | | |
Collapse
|
13
|
Affiliation(s)
- Bharti Kalra
- Department of Gynaecology, Bharti Hospital and BRIDE, Karnal, Haryana, India. E-mail:
| | - Sonia Malik
- Southend Fertility and IVF Centres, National Capital Region, India
| |
Collapse
|
14
|
Lopez JMS, Bailey RA, Rupnow MFT, Annunziata K. Characterization of type 2 diabetes mellitus burden by age and ethnic groups based on a nationwide survey. Clin Ther 2014; 36:494-506. [PMID: 24508418 DOI: 10.1016/j.clinthera.2013.12.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 12/17/2013] [Accepted: 12/30/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is the most common form of diabetes. Risk factors for its development include older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. OBJECTIVE The purpose of this study was to characterize T2DM burden, from a patient perspective, with respect to age and race/ethnicity. METHODS Adults aged ≥18 years with T2DM from a large, Internet-based, nationwide survey were retrospectively analyzed. Demographic and clinical characteristics (glycemic control, body mass index [BMI], comorbidities, and diabetes-related complications), hypoglycemic episodes, and medication adherence were used to assess diabetes burden. Degree of burden was compared across age (18-64, 65-74, and ≥75 years) and racial/ethnic (white, African American, Hispanic, Asian, and American Indian) groups. RESULTS An apparent association was found between glycemic control and medication adherence. Hispanics had the lowest percentage of participants with a hemoglobin A1c (HbA1c) level <7.0% (24.4%) and the highest percentage of those not knowing their HbA1c levels (55.4%) but also had the poorest medication adherence among racial/ethnic groups. Conversely, American Indians and whites had the best glycemic control, HbA1c knowledge, and medication adherence. The 18- to 64-year age group had the poorest glycemic control (28.8%), the most with unknown HbA1c levels (46.3%), and the poorest medication adherence of the age groups. Mean BMIs were high (>30 mg/kg(2)) for all racial/ethnic groups other than the Asian group (28.9 mg/kg(2)). Approximately 71% of Asians were obese or overweight compared with ≥90% in the other racial/ethnic groups. Mean BMIs decreased with increasing age group (34.5, 32.6, and 29.8 kg/m(2) for the age groups of 18-64, 65-74, and ≥75 years, respectively). Regarding diabetes-related comorbidities, the Asian group had the lowest percentages of those with hypertension (39.1%) and hypercholesterolemia (46.6%). The Asian group had the lowest mean Charlson Comorbidity Index (CCI) score (score of 1.4); the American Indian group had the highest CCI score (score of 1.8). Of the age groups, the 65- to 74-year group had the highest percentages of those with hypertension (69.0%) and hypercholesterolemia (67.4%). The mean CCI scores in the 65- to 74-year and ≥75-year age groups (scores of 1.8 for both) were significantly higher than in the 18- to 64-year age group. The Asian group had the lowest percentage of participants reporting hypoglycemia (37.3%). The 18- to 64-year age group had the highest percentage of participants reporting hypoglycemia (52.7%). Limitations of this study include selection bias (Internet-based survey), recall bias, missing values, and descriptive analyses without adjustment for multiplicity. CONCLUSION There are many factors that contribute to diabetes burden and the complexity of diabetes management. The results of this study provide insight from a patient perspective regarding how these factors vary across age and race/ethnicity to aid in the individualization of diabetes treatment.
Collapse
Affiliation(s)
- Janice M S Lopez
- Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Raritan, New Jersey.
| | - Robert A Bailey
- Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Raritan, New Jersey
| | - Marcia F T Rupnow
- Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Raritan, New Jersey
| | | |
Collapse
|
15
|
Kumar KVSH, Misra A. Endocrine and diabetes research from SAARC (South Asian Association for Regional Cooperation) countries. Indian J Endocrinol Metab 2013; 17:950-951. [PMID: 24083196 PMCID: PMC3784898 DOI: 10.4103/2230-8210.117213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- K. V. S. Hari Kumar
- Department of Endocrinology, Command Hospital, Lucknow, Uttar Pradesh, India
| | - Anil Misra
- Department of Medicine, Career Institute of Medical Sciences and Hospital, Lucknow, Uttar Pradesh, India
| |
Collapse
|
16
|
Liu Y, Cao DL, Guo LB, Guo SN, Xu JK, Zhuang HF. Amniotic stem cell transplantation therapy for type 1 diabetes: A case report. J Int Med Res 2013; 41:1370-7. [PMID: 23828649 DOI: 10.1177/0300060513487640] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
This case report presents an evaluation of the clinical effects of an allogeneic amniotic cell transplant for the treatment of type 1 diabetes mellitus. A 26-year-old man with type 1 diabetes was treated with stem cells isolated from his neonatal son’s amniotic membrane, collected at birth (2 × 107 cells). The cells, which expressed high levels of cluster of differentiation (CD) 133 and CD34 as assessed by flow cytometry, were infused into the pancreatic dorsal artery through the left femoral artery. The main study outcome was the change in exogenous insulin requirements, which began to decrease 3 days after transplantation. At 3 months post-transplantation, the patient was insulin independent and remained so for 6.2 months. During a 36-month follow-up, the patient’s blood glucose remained under control and insulin treatment was readjusted to a dosage of 8 IU/day. These preliminary data suggest that amniotic membrane stem cell transplantation can improve islet-cell function in response to glucose in vivo, although an alternative explanation (such as a honeymoon period due to reduced glucose toxicity) also has to be considered.
Collapse
Affiliation(s)
- Ying Liu
- Stem Cell Clinical Application Centre, Siping Central Hospital, Siping, Jilin Province, China
- Jilin Zhongke Bioengineering Company Ltd, Changchun, Jilin Province, China
| | - Dong-Lin Cao
- Department of Laboratory Medicine, Provincial People’s Hospital, Guangzhou, Guangdong Province, China
| | - Li-Bin Guo
- Stem Cell Clinical Application Centre, Siping Central Hospital, Siping, Jilin Province, China
| | - Sheng-Nan Guo
- Stem Cell Clinical Application Centre, Siping Central Hospital, Siping, Jilin Province, China
| | - Jin-Kai Xu
- Stem Cell Clinical Application Centre, Siping Central Hospital, Siping, Jilin Province, China
| | - Hong-Feng Zhuang
- Stem Cell Clinical Application Centre, Siping Central Hospital, Siping, Jilin Province, China
| |
Collapse
|
17
|
Abstract
BACKGROUND Stress has negative effect on health and type 2 diabetes patients may be at an increased risk. Abnormally high levels of free radicals and the simultaneous decline of antioxidant defense mechanisms can increase lipid peroxidation and insulin resistance. The objective of the present study was to demonstrate the efficacy of yogic practice in geriatric patients with type 2 diabetes mellitus and also to compare the efficacy with the state of glycaemic control. MATERIALS AND METHODS Seventy three (73) healthy elderly patients of type 2 diabetes mellitus in the age group of 60 to 70 years with a history of diabetes for 5 to 10 years and with poor glycaemic control (HbA(1c) >8 %) residing in Kozhikode district were recruited for the study. The subjects were divided into three groups according to their glycaemic control. Group I with HbA(1c) 8.6-9.7 %, group II with HbA(1c) 9.8-10.7 % and group III with HbA(1c) 10.8-12.7 %. Participants did yogic practice under the supervision of experienced trainer, daily 90 minutes and for three months. Biochemical estimation of HbA(1c), glucose, lipid profile, cortisol, ferritin, malondialdehyde (MDA) and catalase activity were carried out on 0 day and 90(th) day. Seventy patients participated in a comparable control session. RESULTS The participants in the test group showed statistically significant (P < 0.001) decrease in glucose, HbA(1c), lipids, cortisol, ferritin, MDA and significant increase in catalase activity after yogic practice. CONCLUSIONS Yoga may improve risk profiles induced by stress in geriatric patients with type 2 diabetes and may have promise for the prevention or delay in diabetes complications. And at all stages of the disease a significant improvement can be achieved by yogic practice in geriatric diabetes.
Collapse
Affiliation(s)
- Rani K Beena
- Department of Life Sciences, University of Calicut, Kerala, India
| | | |
Collapse
|
18
|
Affiliation(s)
- Sujeet Raina
- Department of Medicine, Dr. RPGMC Campus, Tanda, Kangra, Himachal Pradesh, India
| |
Collapse
|
19
|
Affiliation(s)
- David Owens
- Professor of Diabetes Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK
| | - Sanjay Kalra
- Department of Endocrinology, BRIDE, Karnal, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Hospital, Hyderabad, India
| |
Collapse
|