Diabetes Capital Research Articles

Emotional Stress Consequences in the Development of Type 2 Diabetes Mellitus and Solutions

India is recognized as diabetic capital of the world now and among all chronic diseases increased prevalence of Type 2 Diabetes mellitus has been recognized globally. Though various modifiable risk factors are identified for the development of type 2 diabetes mellitus such as prediabetes, overweight, obesity, poor diet, smoking, physical inactivity and given importance in the management of disease. But among all stress and anxiety has not been getting proper importance in development and management of Type 2 diabetes. Though number of studies have been identified stress as risk factor for type 2 diabetes. Thus, the present write up is aimed to review the effect of different emotional stressor as risk in the development and uncontrolled hyperglycemia in type 2 diabetes mellitus patients with effective solutions. Material and Methods: This review is based on data collected from classical Ayurvedic literature, and published research works in various journals. Observations and Results: cited based on research reviews to find out risk odds of different emotional stressor and type 2 diabetes with solutions based on Ayurveda and Yoga principles such as role of Raga therapy, Yogasan, Pranayama (breathing technique), Panchakarma procedures and use of Medhya Rasayana (nootropic) drugs. Conclusion: Counselling would be one of the best strategy to create awareness among healthy individual and type 2 diabetic to opt healthy behaviour to manage emotional stress and for the prevention and better control of type 2 diabetes mellitus. Thus, Present write up is an effort to provide attention on various emotional stressor as risk factor and also discuss the various healthy behavioural techniques to control emotional stress.

STUDY OF SERUM VITAMIN-D IN TYPE-2 DIABETES MELLITUS PATIENTS.

Background: Type-2 diabetes mellitus (T2DM) is a progressive and chronic disease characterized by both β-cell dysfunction and increased insulin resistance. Diabetes mellitus is now considered a giant killer disease of the 21st century with its vicious prongs in the South-East Asian countries, specially India, which is rightly said to be the ''Diabetes Capital'' of the world. Vitamin D has important effects on insulin action, and may impact on a number of pathways which may be of importance in the development of type 2 diabetes mellitus. Materials & Methods: In this study 62 Type-2 diabetic patients, 62 healthy controls were enrolled. Biochemical analytes measured were Serum glucose (Fasting Blood Sugar & Post Prandial Blood Sugar), Glycosylated Haemoglobin, Serum Vitamin-D. Results: The mean Serum Vitamin-D in Type-2 diabetic subjects were (16.3 ±3.0) while in healthy subjects(controls) the values were (39.3±5.2) respectively. These values were found to be statistically highly signicant(p<0.001). Conclusion: Serum Vitamin-D levels were decreased in Type 2 diabetic subjects as compared to the values in healthy subjects(controls).

A Proposed Evaluation Plan for the Diabetes Prevention and Control Program

Introduction: India is projected to be the diabetes capital by the next decade, and Asians are predisposed to central obesity and visceral adiposity which puts them at additional risk for diabetes. Materials and Methods: The proposed evaluation plan draws reference from the non-communicable disease prevention and control program, implemented by the Karnataka Health Systems Development & Reforms Project (KHSDRP), Directorate of Health Services, Government of Karnataka (GoK) in collaboration with the World Bank, New Delhi, during the period 2012 to 2016. This evaluation will be conducted by an external agency in consultation with the Medical Officer/Investigator. Results: The relevant reports will officially benefit the District Program Officer and District Health Officer of Davangere and Dakshina kannda districts, Karnataka, India, where the program is being implemented. Conclusion: The results of this plan will benefit health promotion planning by the Health Department including building of community advocacy for the promotional initiatives.

Use of ABI to detect peripheral arterial disease in diabetes - A recommendation for primary care physicians.

Background:India is considered the diabetes capital of the world. As per current practice, most of the diabetes patients go to primary care physicians for their monitoring and follow up. One of the dreaded complications of long-term diabetes is peripheral arterial disease.Methods:A cross-sectional observational study was conducted in a diabetes workshop. Totally, 48 patients were selected who satisfied the inclusion criteria. All were subjected to ankle-brachial index measurement (ABI) and doppler ultrasound was done to assess patency of the lower extremity arteries. The results were compared. The ankle-brachial index of less than 0.99 was considered abnormal.Results:Out of a total of 48 included patients 26 patients had normal ABI and 22 patients were found to have abnormal ABI. Out of those with normal ABI, 2 patients had features of peripheral arterial disease proved by doppler, whereas 3 patients with abnormal ABI had no feature of peripheral arterial disease in doppler. MedCalc software was used for statistical comparison.Conclusion:In the selected diabetic population prevalence of peripheral arterial disease was found to be 56.25%. Measurement of ABI was found to be quite a sensitive and specific method for diagnosing peripheral arterial disease of diabetics.

Screening for obstructive sleep apnea in a diabetic retinopathy clinic in a tertiary care center.

Purpose:To screen for obstructive sleep apnea (OSA) in patients presenting to diabetic retinopathy (DR) clinic and to correlate its presence with the severity of DR.Methods:A prospective, cross-sectional study of diabetes mellitus patients in retina clinic of a tertiary care referral center, North India (January 2019–March 2020). All were subjected to STOP-Bang Questionnaire and Epworth Sleepiness Scale (ESS) score. Patients at high OSA risk (STOP-Bang score ≥5 and ESS score ≥10) were referred to Department of Otorhinolaryngology (sleep clinic) for polysomnography. Based on Apnea Hypopnea Index (AHI), OSA was graded as mild (AHI = 5–14/h), moderate (AHI = 15–30/h), and severe (AHI >30/h). Statistical analysis was done using three models of outcome measures: (1) “No DR” versus “any DR,” (2) “Less severe DR” versus “More severe DR,” and (3) “No diabetic macular edema (DME)” versus “DME.”Results:Of 362 patients screened, 18 (4.97%) had OSA (11 mild, 5 moderate, and 2 severe). Though OSA did not show a significant association with various outcome measures, patients with moderate–severe OSA had higher odds in developing “any DR” (OR = 7.408; 95% CI = 0.533–102.898), “more severe DR” (OR = 1.961; 95% CI = 0.153–25.215), and “DME” (OR = 2.263; 95% CI = 0.357–14.355), on multiple logistic regression.Conclusion:Ours is the first screening study of OSA in DR patients in India, the diabetes capital of the world. We detected OSA in 4.97% of patients in a DR clinic, with an increased risk of “any DR,” “more severe DR,” and “DME” in the presence of moderate–severe OSA.

Atherogenic Risk Factors among Young Indian Adults with Epilepsy on Treatment with Phenytoin: Need for Novel Therapeutic Strategies.

Risk for the development of coronary heart disease and diabetes is found to be more among people with epilepsy especially when on treatment. Redox imbalance contributes to this risk especially in India as it is the diabetic capital of the world with higher prevalence of inflammation. The aim of this study was to evaluate atherogenic risk factors; dyslipidemia, oxidative stress, and systemic inflammation among young Indian adults with epilepsy on treatment with Phenytoin. Three groups of age and gender-matched young subjects were recruited. Group 1-Healthy control subjects, Group 2- Newly diagnosed epileptic young adults with recent epileptic seizures, Group 3- Epileptic adults on treatment with Phenytoin for more than 6 months were recruited. Dyslipidemia was found among the newly diagnosed epileptic subjects in comparison to healthy subjects. The LDL-cholesterol further increased, and HDL-cholesterol further decreased in the third group treated with Phenytoin. Body mass index of these treated epileptic subjects was more in comparison to healthy control. Low-grade inflammation as assessed by hsCRP and oxidative stress were significantly higher among the newly diagnosed epileptic subjects when compared to the healthy controls which further increased on treatment with phenytoin. We found dyslipidemia, oxidative stress, and low-grade inflammation among newly diagnosed epileptic subjects which further increased on treatment with Phenytoin for more than 6 months. From this study, we conclude that dyslipidemia, oxidative stress and low-grade inflammation are identified among the newly diagnosed young adult Indian epileptic patients. Phenytoin treatment further augmented these complications.

Study of effect of yoga on blood pressure, blood glucose, and glycosylated hemoglobin levels of patients with Type 2 diabetes mellitus

Background: India is known as the diabetic capital of the world. Yoga induces relaxation, which is also a crucial factor in the healthy functioning of the internal organs of the body. It can help to maintain normal BSL. Aims and Objectives: This study was planned to assess and compare the effect of yoga on BP, fasting blood glucose, and Glycosylated hemoglobin (HbA1C) level before and after the intervention (Yoga) in patients of Type 2 diabetes mellitus (T2DM). Materials and Methods: Current research has been conducted in collaboration with the Department of Medicine, Department of Pathology, and Department of Biochemistry, Department of Physiology, Jhalawar Medical College and Hospital, Jhalawar (Rajasthan) and Yoga OPD. A randomized, controlled study is currently underway. The test group consisted of 50 subjects with a control group of 50 subjects. The goal of this research was to examine the 3-month effect of yoga practice on subjects with T2DM. Results: In the current study, differences in blood pressure between cases and controls were not relevant in terms of height, whereas mean fasting glucose levels, HbA1C, and body mass index were found to be significantly lower in the yoga-medication study community relative to controls who took only non-yogapractice drugs. Conclusion: Yogic practices play a role in both primary and secondary prevention of DM. Yoga therapy can also be considered to be a beneficial adjuvant in the treatment of T2DM.

Pattern of Disease and Therapy for Diabetes along with Impact of Generic Prescribing on Cost of Treatment among Outpatients at a Tertiary Care Facility.

ABSTRACTBackground:India has become the diabetes capital of the world. Analyzing trends in drug prescribing helps in judging rationality of prescriptions in different settings. This study aimed to assess disease and prescribing trends with a special emphasis on evaluating use of metformin, insulin, fixed dose combinations (FDCs), concomitant medications, pill burden, and costs of drug therapy in diabetes.Materials and Methods:This was a cross-sectional study in which patients of either sex who attended the diabetes clinic at a tertiary care center over 9 months were included consecutively. Basic demographic profile, clinical, and treatment details on the day of visit were collected from the prescription charts. Drug costs for prescriptions were calculated using generic and median brand prices of formulations using a recognized commercial drug directory and generic price list of the government, respectively. Data were analyzed by using Microsoft Excel and Open Epi online software to compare results with published studies.Results:Average age of diabetics was 53.9 ± 11.8 years and disease duration was 8.13 ± 7.78 years in 336 prescriptions analyzed. Dual drug regimens were seen in 32.7% prescriptions, most commonly metformin and sulfonylureas, followed by triple drug regimens (25%) with inhibition of dipeptidyl peptidase IV (DPP IV) inhibitor. Metformin was prescribed in 95% prescriptions (mean dose 1511 ± 559.87 mg) and insulin in 22.6% prescriptions. Angiotensin receptor blocker (ARBs) and statins were the most commonly prescribed concomitant drugs. One FDC per prescription (median) each for diabetes and comorbidities were prescribed. Daily pill burden was 4.59 ± 2.65 pills. The median monthly cost of drug therapy with branded prescribing was INR 870.43 and INR 393.72 with the use of generics. Inferences drawn by comparison with published data showed variable results for different parameters analyzed.Conclusion:Disease pattern was as expected for the region and trends of therapy showed concurrence with rational prescribing. Pill burden and cost of therapy remain high with a significant contribution of comorbidities.

Comparison of single step versus double step screening for GDM

Introduction: There is a lot of debate over what type of screening is needed to be done for GDM, especially with India being touted as the diabetes capital of the world. Materials and Methods: A total of 240 consecutive patients were screened using the two methods in accordance with the laid down procedures and guidelines for the tests with 120 patients in each arm of the study. The positive cases were then followed up till delivery to describe risk of Caesarean section and perinatal morbidities if any were encountered. Results: In the primary outcome it was found that though more cases of GDM were detected with Single Step, maternal and neonatal morbidities were the same and no significant statistical difference was found in either of them. Conclusions: This study shows that both Single step and double step are efficacious though double step seems to be more convenient for maximum number of patients. Keywords: Gestational Diabetes Mellitus, Screening GDM, Diagnosis of GDM.

Anemia in Type 2 Diabetes Mellitus (T2dm) and its association with vitamin B12 deficiency

Introduction: India is the diabetic capital of the world. Vitamin B12 deficiency has been recognized since many years ago as an important side effect in diabetic patients who take metformin for more than 5-10 years.This research aimed to determine the prevalence of anemia in type 2 diabetes mellitus (T2DM) and its association with vitamin B12 deficiency due to use of Metformin. Materials and Methods: Total 200 type 2 diabetes mellitus (T2DM) males and females were included in the study.Blood collection for Fasting blood glucose and Hba1c levels were measured from all participants in tubes without anticoagulant. Hemoglobin, mean corpuscular volume (MCV) were measured by automated cell counters. Measurement of vitamin B12 level was done only in those patients who presented with Macrocytic anemia. Results: Among 200 patients, 113 patients were on vegetarian. The prevalence of anemia in this study population was 65(32.5%). 11(16.9%) were diagnosed as Normocytic Normochromic anemia, 22 (33.8%) with Microcytic Hypochromic Anemia, 26(40%) with Macrocytic Anemia and 6(9.2%) with Dimorphic anemia. Among these 32 patients, who presented with macrocytic and dimorphic anemia, vitamin B12 levels were measured. For 23 vitamin B 12 level was200 pg/ml. 149 patients were on Metformin. Conclusion: Our findings suggest that correction of anemia may have a significant role in prevention of other diabetic complications, thus we recommend that treatment criteria for diabetes should include routine hematological tests and annual screening of Vitamin B12 deficiency along with supplementation should be adopted while treating T2DM. Keywords: Macrocytic Anemia, Type-2 Diabetes Mellitus.

A LIPID PROFILE STUDY AMONGST THE CASES OF TYPE 2 DIABETES MELLITUS - A CROSS SECTIONAL STUDY

Introduction: India leads the world with largest number of diabetic cases and is often referred to as the diabetes capital. Diabetic dyslipidemia in India is one of the main causes for Coronary Artery Disease (CAD) mortality of the world. Dyslipidemia are disorders of lipoprotein metabolism, including lipoprotein overproduction or deficiency. It is a preventable risk factor which is mostly observed in diabetes cases and that may precipitate the cardiovascular disorders. Our aim of the study is to determine the impact of type 2 diabetes mellitus (T2DM) on lipid profile of diabetic cases reporting at tertiary care hospital. Materials and methods: It was a cross sectional study conducted at Department of Biochemistry, Patna Science College, Patna, Bihar. Total 140 diabetic cases were randomly selected and they were examined for dyslipidemia. Fasting blood glucose concentration and Lipid Profile [Total Cholesterol (TC), High Density Lipoprotein (HDL), Very Low Density Lipoprotein (VLDL) and Triglycerides (TG)] were investigated by using commercially available reagent kits in Biochemistry analyzer. Collected data was analyzed by using appropriate software. Results: Out of total 140 diabetic cases examined, the mean age of cases was 48.93 ± 12.1 years. In present study we found the mean Fasting Blood Sugar (FBS) was 188.76 ± 54.63 mg/dl. The prevalence rates in our study for high Total Cholesterol (TC) and Triglycerides (TG) were 13.6% and 41.4% respectively. The prevalence rates for high LDL-C, very high LDL-C and low HDL-C in the diabetic subjects were 8.6%, 5.0% and 72.9% respectively. Conclusion: The diabetic cases had elevated serum total cholesterol, elevated triglyceride (triacylglycerol) and slightly elevated low density lipoprotein (LDL-C) and reduced levels of high density lipoprotein (HDL-C) indicating that diabetic cases were more prone to cardiovascular diseases. Type 2 Diabetes Mellitus, Dyslipidemia, Triglyceride, HDL-C, LDL-C, Total Cholesterol.

Primary Prevention of Type 2 Diabetes Mellitus: Multiple Health Care Strategies

Kerala being the diabetic capital of India, need to evolve a less expensive method to reduce the tangible andintangible cost of type 2 diabetes mellitus(T2DM). Hospital based single blinded randomised controlled trialwas undertaken at Indian Institute of diabetes, Kerala, India with an aim to assess the effect of multilateralhealth care strategies on metabolic profile. Pre-diabetic individuals were screened using American DiabeticAssociation criteria and randomly allocated to experimental and control group. Experimental group received3 weeks training in yoga, exercise and healthy diet preparation. Control group received only heath counsellingalone on diabetes prevention. Subjects were followed up for one year. The multiple health strategies wereplanned based on evidences and successfully implemented to curtail the menace of DM in India. The presentpaper details the multiple health care strategies and methodology addressing the primary prevention ofprimary prevention of T2DM.

Biobanking for Translational Diabetes Research in India

India is declared as the diabetic capital of the world. Clinically well-annotated blood samples will advance diabetes research for better diagnostic and treatment methods. Building a disease-specific biobank with high-quality peripheral blood mononuclear cells (PBMCs) and clinical follow-up data system will serve as a good platform for clinical research in diabetes. Processing and storage of high-quality biospecimen for translational research in diabetes demand the implementation of good clinical laboratory practices. “Certification or accreditation programs” that improve biorepository processes and frameworks are lacking in Indian context. To sustain and translate the research into clinical practice, good governance of the biobank and financial resources is required. For ethical issues related to health needs of the people and participants in the research, issues related to research process, translational research, and commercialization, data sharing should be addressed. For India to be an innovation and sustainable country Indian government is supporting translational research facilities, including biobanks. India has developed biobanks for various diseases; however, diabetes-specific research biorepository is lacking. Given the dangers of diabetic burden, India should set up a diabetes disease-specific repository learning from the global organizations and customize to the needs of Indian context. It is important to have private agencies get involved to develop biobanks and future research as there are commercial goals to translate research into practice. New technologies of specimen storing and preservation, data management, and data sharing should be adopted for developing cost-effective long-standing disease-specific population biobank in India.

Observational study on ocular manifestations in type 2 diabetes patients attending the ophthalmology department, at RVM hospital, South India

Introduction: India is infamously known as the Diabetes capital of the world. The national wide prevalence of diabetes in India now is 9%. By 2030, India will have 100 million people with type 2 Diabetes. Methodology: Cross sectional observational study, Study was conducted in ophthalmology department at RVM Hospital, Siddipet District, and Telangana State. The study was conducted in April 2018 to December 2019.The Sample Size is 300. Results: 188(63%) were males and 112(37%) are females. Among both sexes, age groups between 51 to 60 years had maximum number of patients (34%).33 patients had some lid lesions, out of which 12 had stye followed by 10 had Xanthelasma Conjunctival lesions found were pterygium 13(4.33%) and conjunctivitis 6(2%).6 patients had corneal ulceration (2%), 3 had reduced corneal sensation (1.0%) while 1 patient had perforation (0.33%). 11.5% people are affected by mild NPDR within 5 years, which increases significantly to 26.6% in 10 years. Conclusion: Thus both prevalence and severity of retinopathy correlates with HbA1C levels in this study group. The most common type of cataract found was cortical type (39.13%) followed by senile posterior cortical cataract (32.60%). In general, the visual prognosis following cataract surgery in diabetic patients is favourable. The prevalence of Primary open angle glaucoma was 2.33% and 2.0% had neo-vascular glaucoma. Diabetes predisposes to infection in different body parts, and ocular structures are not an exception.

Variation in central corneal thickness in diabetes: A comparative prospective study at a tertiary care hospital

Diabetes being the greatest challenge of the century and the fact that it affects almost all of the tissues and organs in the body warrants research into the effects of diabetes on every structure. This study was designed with the aim of finding out any association between diabetes and central corneal thickness and to evaluate the effect of diabetes treatment on central corneal thickness. Objectivesa. To find out the differences between CCT values amongst diabetic and non-diabetic patients, if any. b. To assess the presence of any significant change in these measurements after successful control of hyperglycaemia. Methods: A comparative prospective study was conducted in the Dept. of Ophthalmology, Sree Mookambika Institute of Medical Sciences, Kulasekharam to evaluate the effect of diabetes on CCT. A total of 84 subjects were studied which included 42 diabetics. After thorough systemic and ocular CCT was measured using ultrasound pachymeter. The study was initiated after obtaining ethical clearance from the institution’s ethical clearance committee. The collected data was analysed using SPSS software version 20.0. Results: Majority of the study subjects were male in both diabetic group (52.4%) and non-diabetic group (54.8%). The mean CCT among non-diabetics were 529 and among diabetics were 554.5. Students ‘t’ test was used to compare the corneal thickness between diabetic and non-diabetic patients. P value less than 0.05 is considered as significant. In this study it is found that there is significant difference in CCT OD 1 and CCT OS 1 in diabetic and non-diabetic patients. And the difference in CCT was found to be statistically significant. In this study we have also found out that there is strong positive correlation between CCT and diabetic control as per the pearson coefficient evaluation. In this study it is found that there is no significant difference in CCT following diabetic control in diabetic patients. Also, CCT was not correlated with the duration of diabetes. But the effect of control was not evaluated with serial HbA1c and a few patients didn’t have good control of diabetes either. Conclusion: Diabetes is a serious and extremely prevalent systemic illness in today’s scenario which was previously considered a disease of the affluent, diabetes has become a problem of epidemic proportions, contributing to significant morbidity and mortality. And India is moving fast in this race to become a Diabetes Capital of the world. Such being the case, it warrants further research in the field by the medical fraternity, to aid in prevention, early diagnosis, delaying progression and management of the disease. The effects of diabetes on the eye have been studied but as the prevalence of diabetes increases with all the generation, it demands further detailed research activities into the effect’s diagnosis and management of diabetes in the eye. In our study we tried to bring to light the effects of diabetes on corneal thickness, which in turn might affect even the management of glaucoma. We evaluated a group of diabetics and compared them with matched controls. After conducting this study we arrived at a conclusion that central corneal thickness is increased in diabetics and that control of diabetes doesn’t have a significant effect on central corneal thickness.

Non-communicable diseases awareness and control in a rural population in an epidemiologically advanced stage of transition (Kerala): results of the epidemiology of non-communicable diseases in rural areas study

Background: India carries the greatest burden of non-communicable diseases (NCDs) amongst nations. It is estimated that by the year 2030 there will be 101 million diabetics, 218 million hypertensives in India. NCDs would account for 53% of deaths in India by the year 2020 of which CVD would be the cause in 43%. Kerala is the diabetic and cardiovascular disease capital of India, with rates of prevalence as high as twice the national average. The age-adjusted CAD mortality rates per 100,000 is 382 for men and 128 for women in Kerala.Methods: The study was carried out in 5 contiguous panchayats of Ernakulam district, Kerala state. The study was carried out in 2 Phases. In the first phase individuals self-reported non communicable diseases and risk factors through the medium of an ASHA administered Questionnaire. In the second phase blood tests were done in individuals from the study population in those above the age of 30 years.Results: Of the 114,064 surveyed 63,051 individuals were above 30 years of age with a prevalence of diabetes at 11.1%, hypertension 15.6% and dyslipidemia 6.9% when self-reported. In the Phase 2 of the study blood sugar, total cholesterol and blood pressure was measured in close to 8000 individuals in whom 48% of individuals with high sugars, 37% with high blood pressure and 85% with high cholesterol values were unaware of their disease status. More females were unaware of their diabetic and lipid status and males of their hypertensive status. About 25% of diabetics, 40% of hypertensives and 6% of dyslipidemics had normal values. This study provided prevalence of NCDs on a large enough scale to help in policy planning if not for the country at least for the state of Kerala.Conclusions: The study results suggested low awareness and poor control of NCDs in the study population.

A Study of Microbial Profile and Drug Resistance Pattern in the Patients with Diabetic Foot at a Tertiary Health Care Center

Introduction: Diabetic Foot Ulcer (DFU) is a serious and common complication of Diabetes Mellitus (DM). India has been called "the diabetes capital of the world.” The most common cause of morbidity and mortality in DFU is infections. Diabetic foot wounds are commonly infected, and infection leads to the formation of microthrombi causing further ischemia, necrosis, and progressive gangrene. These types of situations necessitate limb amputation. Thus, accurate diagnosis of the causative organism is essential for the management of these cases. Aims and Objectives: To Study microbial profile as well as drug resistance pattern in the patients having diabetic foot at a tertiary care center. Methodology: Approval from institutional ethical committee was obtained. 62 patients of diabetic foot were selected for the present study over 1 year. Wound discharge culture and antibiotic sensitivity testing were carried out using standard microbiological procedures. Result: In the study carried out it was observed that the majority of the patients fell under the age group consisting of those >60. The most common organism was Staphylococcus followed by Streptococci, Enterococcus. Gram positive organisms were most commonly sensitive to Vancomycin. Gram negative organisms were susceptible to Piperacillin-Tazobactum. Maximum resistance was found to be for Gentamycin. Conclusion: From the study it can be conclusively noticed that majority patients belonged to the age group consisting of >60 Yrs. Gram positive organisms showed highest sensitivity to Vancomycin. In case of Gram negative organism's antibiotic with highest sensitivity was Piperacillin-Tazobactam. Gentamicin was the drug with highest resistance. This resistance pattern to various pathogens in our study will be helpful in treatment of Diabetic foot in future.

Polyherbal antidiabetic drug: An approach to cure diabetes

In recent years, diabetes has become a major health concern. India is referred to as the diabetes capital of the world. There are plenty of chemical agents available to monitor and treat diabetic patients, but up to this date, no complete recovery from diabetes has been recorded. Many herbal plants with hypoglycemic properties are known from around the world as an alternative to these synthetic agents; which is a natural remedy to keep the blood sugar under control by consuming vegetables & herbs in our diet. Such medicinal plants & their herbal preparation with proven antidiabetic and related beneficial effects were used in the treatment of diabetes in rats. The effect of polyherbal drug Anti-hyperglycemic activity is studied in rats against alloxaninduced diabetes. This polyherbal drug consists of 16 antidiabetic plants. Disorders in diabetes-induced glucose metabolism have been shown to be regulated. The present study was conducted in the Dept. of Pharmacology and Dept. of Biochemistry at Central Animal House Facility of the SBH Govt Medical College, Dhule, in collaboration with Datta Meghe Medical College, (Datta Meghe Institute of Medical Sciences Sawangi, Meghe) Nagpur, Maharashtra, India. After the treatment, fasting blood glucose, plasma insulin and glycosylated hemoglobin (HbA1c) were determined in normal and experimental rats. Polyherbal mixture was seen to be an effective and safe method for management of diabetes which reduces blood sugar levels & shows positive effect in altering blood glucose levels. The herbal formulation could be lowering the insulin resistance, thereby normalizing the uptake of glucose by cells.

Knowledge, Attitude and Practice of Insulin Use of Diabetic Patients in India

Diabetes mellitus (DM) is a group of common metabolic disorders that share the phenotype of hyperglycemia. India is emerging as the world diabetic capital. Insulin is a therapeutic option to treat either type 1 and type 2 DM. Inadequate awareness about the use of insulin is likely to influence its acceptance and adherence. The present study was done to assess the knowledge, attitude, and practice regarding insulin use among diabetic patients at Victoria Hospital, Bangalore, India. Knowledge, attitude, and practice of sixty diabetic patients (either inpatients or outpatients) were assessed by using a validated questionnaire consisting of 24 items. Scores were allotted to each question and evaluated after applying appropriate statistical tests. The mean age of the patients was 53.51±6.48 years (58.33% males). The mean knowledge score was 9.06±1.88 out of 22, attitude score was 4.78±1.37 out of 12 and practice score was 7.75±1.24 out of 11. The mean score of attitude was better in females compared to male patients (5.32±1.34 vs. 4.4±1.28). Male patients scored 38.57% compared to female patients (41.33%) for the question regarding symptoms of hypoglycemia. 57.14% of male patients and 72% of female patients carried simple carbohydrates when going out. Despite good practice scores, the knowledge and attitude scores regarding insulin use were inadequate. Potential adverse effects of insulin can be avoided and better knowledge, attitude, and practice can be achieved by providing proper education to patients. Keywords: knowledge, attitude, practice, diabetic, insulin

Study on prevalence of risk factors of diabetes among adult population in a rural area of West Bengal, India

Background: India is currently in the grip of an explosive epidemic of type 2 diabetes. The International Diabetes Federation (IDF) estimates that by 2030, 8.4% of the adult population will have diabetes in India, which already is the world’s diabetes capital. Indian diabetic risk score (IDRS) is a cost effective and simple method for mass screening at community level. The objective of the study was to find out the prevalence of risk factors of diabetes among rural adults of Amdanga, West Bengal and to study the socio-demographic correlates of higher risk.Methods: A community-based, cross-sectional study was carried out in Amdanga, North 24 Parganas district of West Bengal from 1st August 2019 to 30 th September 2019 among 104 adult population on risk status for type 2 diabetes mellitus using IDRS. Interview was conducted using pre-designed semi-structured questionnaire followed by anthropometric measurement. The data were analyzed by SPSS 16.0 version.Results: Out of 104 study subjects, 9.6% study subjects were not at risk of having diabetes, 45.2% were at moderate risk and 45.2% were at high risk of having diabetes. Marital status, hypertension, outside food intake, exercise and strenuous activity were significantly associated with the risk of diabetes.Conclusions: Majority of the adult population were at moderate and high risk of developing type 2 diabetes, hence screening is of utmost importance so that interventions can be initiated at an early stage and change of lifestyle should be initiated as soon as possible to delay the occurrence of type 2 diabetes.