Management Of Diabetes Mellitus Research Articles

Quality assessment of glucose measurement with regard to epidemiology and clinical management of diabetes mellitus in Germany.

During the last decade, Germany has seen an increased prevalence and a redistribution from undetected to diagnosed diabetes mellitus. Due to this substantial epidemiological development, the number of people with documented type 2 diabetes was 8.7 million in 2022. An estimated two million undiagnosed subjects are to be added. Beyond that, the life expectancy of diabetic subjects is increasing due to more responsive health systems in terms of care. Possible reasons include improved screening of at-risk individuals, the introduction of HbA1c for diagnosis in 2010, and the higher use of risk scores. Additionally, quality aspects of the laboratory methodology should be taken into consideration. Epidemiology and clinical management of diabetes in Germany are presented in the light of publications retrieved by a selective search of the PubMed database. Additionally, the data from German external quality assessment (EQA) surveys for the measurands glucose in plasma and HbA1c in whole blood, reviewed from 2010 until 2022, were evaluated. Above this, data concerning the analytical performance of near-patient glucometer devices, according to the ISO norm 15197:2013, were analyzed. Two laboratory aspects are in good accordance with the observation of an increase in the diabetes mellitus prevalence when retrospectively reviewing the period 2010 to 2022: First, the analytical performance according to the ISO norm 15197:2013 of the glucometer devices widely used by patients with diabetes for the glucose self-testing, has improved during this period. Secondly, concerning the EQA program of INSTAND, the number of participating laboratories raised significantly in Germany. The spreads of variations of the specified results for plasma glucose remained unchanged between 2010 and 2022, whereas for HbA1c a significant decrease of the result scattering could be observed. These retrospectively established findings testify to an excellent analytical quality of laboratory diagnostics for glucose and HbA1c throughout Germany which may be involved in a better diagnosis and therapy of previously undetected diabetes mellitus.

Herbal Nanoformulations for Diabetes: Mechanisms, Formulations, and Clinical Impact.

Diabetes mellitus remains a global health challenge, demanding innovative therapeutic strategies. Herbal remedies have garnered attention for their potential in diabetes management, and recent advancements in nanotechnology have enabled the development of herbal nanoformulations with enhanced efficacy and bioavailability. This review aimed to comprehensively analyze the mechanisms, formulations, and clinical impact of herbal nanoformulations in managing diabetes mellitus. A systematic literature search was conducted to identify relevant studies exploring the mechanisms of action, various formulations, and clinical outcomes of herbal nanoformulations in diabetes management. Herbal nanoformulations exert their anti-diabetic effects through multiple mechanisms, including enhanced bioavailability, improved tissue targeting, and potentiation of insulin signaling pathways. Various herbal ingredients, such as bitter melon, fenugreek, and Gymnema sylvestre, have been encapsulated into nanocarriers, like liposomes, polymeric nanoparticles, and solid lipid nanoparticles, to enhance their therapeutic potential. Clinical studies have demonstrated promising results, showing improvements in glycemic control, lipid profile, and antioxidant status with minimal adverse effects. Herbal nanoformulations represent a promising avenue for the management of diabetes mellitus, offering improved therapeutic outcomes compared to conventional herbal preparations. Further research is warranted to optimize formulation strategies, elucidate long-term safety profiles, and explore the potential synergistic effects of herbal nanoformulations in combination therapies for diabetes management.

In vitro validation of anti-diabetic and free radical scavenging property of Naaval Kottai Mathirai, a promising Siddha drug for the management of Diabetes mellitus

In vitro validation of anti-diabetic and free radical scavenging property of Naaval Kottai Mathirai, a promising Siddha drug for the management of Diabetes mellitus

Effectiveness of a Disease Management Program (DMP) in controlling the progression of Chronic Kidney Diseaseamong hypertensives and diabetics.

The occurrence rate of stage 5 chronic kidney disease (CKD) will be 151 per million population in India in the coming years. Comorbidities like diabetes mellitus and hypertension are the usual triggers of CKD. Hence this study aimed to control the progression of CKD and to note the effectiveness of a structured education program that would help in the prevention of complications related to diabetes and hypertension. This quasi-experimental study was conducted among 88 participants who had hypertension, diabetes mellitus, or both for five or more years. The study objective was to find the effect of a Disease Management Program on delaying progression of CKD in patients with hypertension or diabetes mellitus.The baseline data were obtained from demographic proforma, and the clinical data collected were the blood pressure, serum creatinine, and random blood sugar (RBS) of the participants. The management of hypertension and diabetes mellitus was taught to them. In the fourth and the eighth month, blood pressure and blood sugar were reassessed. At one-year blood pressure, blood sugar, and serum creatinine were tested. Baseline and one-year follow-up blood pressure, blood sugar, and estimated Glomerular Filtration Rate were compared. Descriptive statistics and "Wilcoxon signed-rank test" were used to analyze the data. In one year, the mean systolic blood pressure reduced by six mm of Hg and mean blood sugar by 24 mg/dl. The prevalence of CKD stage three and above (< 60 ml/min/m2) was nine (10.22%). The median decline in eGFR was 5 ml/min/m2 (Z= 5.925, P< 0.001). The Disease Management Program led to improvements in blood pressure and diabetes control and median progression of CKD was estimated at five ml/min/m2/year.

Education and Screening on Non-Communicable Diseases in Simokerto District, Surabaya, Indonesia

Non-communicable diseases (NCDs) are one of the leading causes of death in the world. Indonesia is one of the countries facing the problem of both communicable diseases and non-communicable diseases (NCDs). Non-communicable diseases are usually asymptomatic and do not show certain clinical signs, so most people are not aware of the dangers of non-communicable diseases. Non-communicable diseases (NCDs) are one of the health problems in society that has increased every year, and is the largest contributor to the incidence of death in Indonesia. Non-communicable diseases can be triggered by a lack of physical activity, smoking, ineffective diet, stress, which can lead to increased pressure, increased blood sugar, and increased blood fat. The purpose of this community service is to increase community knowledge and carry out health screening on non-communicable diseases in residents in RT 01 and RT 02 RW 04 Tambakrejo Village, Simokerto District, Surabaya City. The method of the community service are lectures on hypertension and diabetes mellitus followed by discussion and questions and answers. Furthermore, a demonstration on health screening in non-communicable diseases was conducted. To determine the benefits of this activity, the participants' knowledge was tested using questions in the pre-test and post-test sessions. Assessment of the participants' knowledge by counting the correct answers to the questions on the test sheet.There is an 80% increase in knowledge of residents about the management of hypertension and diabetes mellitus. The results of the screening identification obtained data that the body mass index of the community is as follows 45.2% of people with obese conditions; 41% of residents have grade 1 hypertension with blood pressure between 140- 159/90-99 mmHg; the results of random blood sugar checks are normal (79%); uric acid checks on residents have normal results (82%); and cholesterol levels in the body range normal, namely 52 people (71%). It is important to support residents' activities in improving healthy living behaviour through joint exercises.. It is expected that the cadres will maintain the performance that has been achieved, and form working groups in their respective neighbourhoods to share the health information in improving the level of health..

IDF23-0538 Bulgarian community pharmacists' knowledge towards diabetes mellitus management: results of a pilot survey

IDF23-0538 Bulgarian community pharmacists' knowledge towards diabetes mellitus management: results of a pilot survey

Use of ancient grains for the management of diabetes mellitus: A systematic review and meta-analysis

AimsA systematic review and meta-analysis of published randomized controlled trials was conducted to collate evidence from studies implementing ancient grains and investigate the impact of ancient grain consumption on health outcomes of patients with Diabetes Mellitus (DM). Data synthesisTwenty-nine randomized controlled trials were included, and 13 were meta-analyzed. Interventions ranged from 1 day to 24 weeks; most samples were affected by DM type 2 (n = 28 studies) and the ancient grains used were oats (n = 10 studies), brown rice (n = 6 studies), buckwheat (n = 4 studies), chia (n = 3 studies), Job's Tears (n = 2 studies), and barley, Khorasan and millet (n = 1 study). Thirteen studies that used oats, brown rice, and chia provided data for a quantitative synthesis. Four studies using oats showed a small to moderate beneficial effect on health outcomes including LDL-c (n = 717, MD: 0.30 mmol/l, 95% CI: 0.42 to −0.17, Z = 4.61, p < 0.05, I2 = 0%), and TC (n = 717, MD: 0.44 mmol/l, 95% CI: 0.63 to −0.24, Z = 4.40, p < 0.05, I2 = 0%). Pooled analyses of studies using chia and millet did not show significant effects on selected outcomes. ConclusionsFor adults affected by DM type 2, the use of oats may improve lipidic profile. Further experimental designs are needed in interventional research to better understand the effects of ancient grains on diabetes health outcomes. Prospero registrationCRD42023422386.

IDF23-0442 Assessing Early Stage Design of a mHealth App for Gestational Diabetes Mellitus Management in Bangladeshi Women

IDF23-0442 Assessing Early Stage Design of a mHealth App for Gestational Diabetes Mellitus Management in Bangladeshi Women

Protective Effect of Nigella sativa Seed Extract and its Bioactive Compound Thymoquinone on Streptozotocin-induced Diabetic Rats.

The lack of a substantial breakthrough in the treatment of diabetes, a global issue, has led to an ongoing quest for herbs that contain bioactive elements with hypoglycemic properties. To investigate the potential protective effect of Nigella sativa seeds ethanol extract and its active ingredient, thymoquinone, on streptozotocin-induced diabetic rats. To induce diabetes, the male Wistar rats were administered an intraperitoneal injection of STZ at a dosage of 90mg/kg body weight in 0.9 percent normal saline after being fasted for 16 hours and made diabetic Group 1; 7 rats non-diabetic control (saline-treated), Group 2; 7 untreated diabetic rats, Group 3; 7 diabetic rats treated orally with N. sativa extract at a dose of 100mg/kg body weight, Group 4; 7 diabetic rats treated orally with thymoquinone at a dose of 10mg/kg body weight and Group 5; 7 diabetic rats treated orally with Metformin at a dose of 5mg/kg body weight. After the treatment of 28 days, all groups were examined for body weight and biochemical alterations. The results showed a significant decrease in blood glucose, urea, creatinine, uric acid, total protein, total cholesterol, low-density lipoprotein, and very low-density lipoprotein, while high-density lipoprotein was increased. Hepatic enzymes, alanine transaminase, aspartate aminotransferase, and alkaline phosphate were also normalized and significantly increased body weight. These preliminary findings demonstrate that the ethanol extract of N. sativa seeds and its active ingredient, thymoquinone have a protective effect against streptozotocin-induced diabetic rats. The present study opens new vistas for the use of N. sativa and its bioactive compound, thymoquinone, regarding its clinical application as a new nontoxic antidiabetic agent for managing diabetes mellitus.

Formulation and Evaluation of Lozenges Containing Freeze Dried Aqueous Extract of Mangifera indica for Management of Diabetes Mellitus

Objective: This study focused on the formulation of freeze dried Mangifera indica. (MI) lozenges dosage form, which enables proper dosing of MI for patients that are unable to swallow solid drugs. Methods: Soft lozenges containing freeze dried aqueous extract of MI were prepared by melting Polyethylene glycol 1000(PEG 1000) to 70o C and gradually addition of MI with stirring after cooling. The mixture was poured into a lozenges mould. MI combinations with standard diabetic drugs namely Glibenclamide and Metformin lozenges were also prepared. Evaluation of lozenges including weight uniformity test, specific gravity test, dissolution rate test, in-vitro release test and physical stability tests were carried out. Investigation on anti-diabetic effect of lozenges containing MI individual and combinations with standard drugs on streptozotocin induced diabetic rats were carried out. The fasting blood sugar and change in weight of diabetic rats at the end of 14 days treatment were determined. Results: All the lozenges passed weight uniformity test. Drug release profile showed that 100% MI was released after 1 min. The maximum anti-diabetic dose for MI lozenges was 250 mg/kg. The antidiabetic effect of MI lozenges was 65.03±12.09 %. The anti-diabetic activity of individual MI lozenge was the same with the Glibenclamide (65.30±14.33). Weight gained by MI lozenges treatment group was significantly higher (p&lt;0.05) than Glibenclamide standard group. Conclusion: Lozenges containing MI freeze dried aqueous extract passed all parameters evaluated. The MI lozenges demonstrated significant anti-diabetic effect. MI combined with standard had no advantage over individual lozenges.

PREPARATION AND CHARACTERIZATION OF MICROSPHERES UTILIZING RATE-CONTROLLING MEMBRANES FOR THE MANAGEMENT OF DIABETES MELLITUS

The present research work aimed at the formulation of film-coated microspheres incorporating glibenclamide drug and their evaluation for the management of diabetes mellitus (DM). Microspheres were prepared by solvent evaporation methodology by the usage of ethyl cellulose as polymer, ethanol and dichloromethane as solvents and Tween 80® as a non-ionic surfactant. The film-coated membrane was prepared by pan coating method, incorporating ethyl cellulose, isopropyl alcohol, diethyl phthalate and sodium lauryl sulfate. This film membrane was coated on microspheres with the help of a spray gun. The efficiency of entrapment of the film coated microspheres of F5* batch, among different formulations, is highest and comes out to be in the range of 76.65±0.58. The percentage yield was observed to be 73.32±0.14. Morphological studies conducted by scanning electron microscope show spherical microspheres of uniform size. In vitro drug release study conducted of the coated microspheres of glibenclamide shows the highest amount of release of 97.44% in the F5*batch. The best-fit model was determined by the highest R2 value. Further, the developed formulation helps in reduction in dose dumping, with better patient compliance, and also masks the bitter taste of the drug.

Pencegahan Diabetes Mellitus melalui Pemeriksaan Gula Darah Acak dan Promosi Kesehatan di Masyarakat

Introduction: Diabetes Mellitus is a health problem that is increasing in prevalence throughout the world. This is of serious concern because of its far-reaching impact on public health and the health system as a whole. Objective: The purpose of this service was Increase access to public health services, especially in diabetes mellitus examination, in addition to increasing public knowledge about diabetes mellitus management. Method: Activities are carried out in several stages, namely the preparation stage includes taking care of permits, the next stage is the implementation of carrying out random blood sugar checks and health promotion. Result: It was found that respondents who carried out the examination were found to have mostly high random blood sugar values as many as 15 respondents or 62.5%. There was a significant change in knowledge from before and after health promotion Conclusion: The community has a potential risk of undetected diabetes mellitus, therefore the participation of health workers is needed to provide counseling. Through counseling delivered by health workers, the public can be given a better understanding of risk factors, symptoms, and ways to prevent diabetes mellitus

Current status of screening and management of gestational diabetes in early pregnancy: a questionnaire survey in Japan.

Our aim is to investigate the obstetric practices in Japan regarding the screening and management of gestational diabetes mellitus (GDM) diagnosed before 20weeks of gestation (early-GDM). A web-based questionnaire survey was administered to 991 teaching hospitals between November 2021 and February 2022, and 602 responses were received (a response rate of 61%). Screening tests for all pregnant women in the first trimester were conducted in 553 (92%) hospitals, and nearly all of these hospitals (535/553 [97%]) adhered to an individual protocol, predominantly relying on random plasma glucose measurements (488/535 [91%]). A quarter (139 [26%]) implemented a risk profile assessment for GDM screening, taking into account factors such as previous gestational diabetes, prior macrosomia, and family history of diabetes. A small number (23 [4%]) targeted only women at high risk of GDM using the risk profile assessment. The majority of hospitals (501 [94%]) employed a 75g oral glucose tolerance test as a diagnostic measure, and glycemic control for early-GDM was established in most hospitals (429 [80%]). Of the 535 hospitals that maintained an individual management protocol, 356 [67%] facilitated dietary management, self-monitoring of blood glucose, and insulin administration if needed to meet glycemic targets. Our survey revealed a widespread adoption of universal screening and subsequent treatment for early-GDM in Japan.

A review on diabetes mellitus: complications, synthetic anti-diabetic agents and herbal treatment

Background Diabetes mellitus is a metabolic disorder with multiple symptoms and complications. The management of these conditions involve the use of synthetic anti-diabetic agents, natural products and medicinal plants. Synthetic anti-diabetic agents are associated with side effects whereas medicinal plants have minimal side effects and are less expensive. The aim of this work is to highlight various (i) complications associated with diabetes (ii) synthetic anti-diabetic agents used for treatment (iii) medicinal plants as anti-diabetic agents. Methods Electronic databases such as Web of Science, Google Scholar, Science Direct, Springer, Pub Med, Medline and Scopus were searched to identify complications linked with diabetes, synthetic anti-diabetic agents, and herbs used in the management of diabetes mellitus. Results The present article is an updated review of the published literature on types of diabetes and their complications, synthetic anti-diabetic drugs and medicinal herbs used for management of diabetes. Conclusions Given the complications associated with diabetes mellitus, a search for medicinal herbs with anti-diabetic properties will be useful in the management of this disease.

CLINICAL STUDY OF YOGASANA AND PATHYAAHARA IN MANAGEMENT OF MADHUMEHA (DIABETES MELLITUS-2)

Introduction: About 422 million people worldwide, most of whom reside in low and middle-income nations, have diabetes (metabolic lifestyle disorder), according to the World Health Organisation, contributing to 1.5 mil-lion deaths annually. Aahara (diet) and Yoga asanas are essential for controlling and preventing lifestyle disor-ders. Thus, this study assessed how yoga techniques and the Aahara contribute to managing diabetes mellitus. Methodology: A single arm open randomised clinical study was conducted on 30 clinically diagnosed patients with diabetes mellitus 2 for Yoga asanas (Mandukasana, Kurmasana, Vakrasana, and Ardhamatsyendrasana) and Ayurvedic Aahara plan in the Postgraduate Institute of Ayurved, DSRRAU, Jodhpur. The study evaluates their role in the management of Prabhoot Mutrata (Polyuria), Avila Mutrata (Urine turbidity), Pipasadhikya (Polydipsia), Kshuda Adhikya (Polyphagia), Sweda Adhikya (The excessive sweating) The, Dourbalya The (Weakness The/Tiredness The), The Alasya (The Laziness) The, Atinidra (Excessive sleep), Karpada Daha (Burning sensation in hands and feet) and blood sugar level (i.e. FBS and PPBS, HbA1c). Result: The result of the study depicts that Yoga asanas and Ayurvedic Aahara have significantly helped in reducing the Prabhoot Mutrata, Avila Mutrata, Pipasadhikya, Kshuda Adhikya, Sweda Adhikya, Dourbalya, Alasya, Atinidra, Karpada Daha and blood sugar level. Conclusion: The study concluded that Yoga therapy and the Aahara plan have a role in managing diabetes mellitus by lowering medication dosages, increasing physical and mental alertness, and preventing complications. Results should be validated in larger sample sizes and multicentric models to es-tablish it as a well-known treatment.

Budget impact analysis for three glucagon-like peptide-1 receptor agonist-based therapies for type 2 diabetes mellitus management in Saudi Arabia

Background and Objectives This study presents a budget impact analysis (BIA) conducted in Saudi Arabia, evaluating the cost implications of adopting semaglutide, tirzepatide, or dulaglutide in the management of type 2 diabetes mellitus (T2DM) patients. The analysis aims to assess the individual budgetary impact of these treatment options on healthcare budgets and provide insights for decision-makers. Methods A prevalence-based BIA was developed using real-world and clinical trials data. The model considered disease epidemiology, medication prices, diabetes management expenses, cardiovascular (CV) complications costs, and weight reduction savings over a 5-year time horizon. One-way and probabilistic sensitivity analyses (OWSA, PSA) were performed to assess the robustness of the results. Results Over a 5-year period, the cumulative budget impact for semaglutide, tirzepatide, and dulaglutide were 85,923,089 USD, 169,790,195 USD, and 94,558,356 USD, respectively. Hypothetical scenarios considering price parity between semaglutide and tirzepatide are associated with financial impacts of 85,923,091 USD and 86,475,335 USD, respectively. In the public sector, semaglutide showed the lowest incidence of 3-point major adverse CV events (3P-MACE), with tirzepatide leading in weight loss and HbA1c reduction, and dulaglutide presenting the highest 3P-MACE rates and least improvements in HbA1c and weight. A breakeven analysis suggested that tirzepatide’s list price would need to be $199.91 lower than its current list price to achieve budget impact parity with semaglutide based on currently available evidence. Results from the OWSA suggested that risk reductions for CV events were key drivers of budget impact. PSA results were confirmatory of base-case analyses. Conclusions CV cost-offsets and drug acquisition considerations may make semaglutide a favorable use of resources for Saudi budget planners and decision-makers. These results were robust to assumptions regarding the list price of tirzepatide.

Prescription Trends on the Preference of Hypoglycemic Agents for the Management of Diabetes Mellitus in India

The management of type 2 diabetes requires multifactorial approach in terms of diet, lifestyle modification and pharmacological treatment to prevent or delay complications and maintain the quality of life. Several studies have been conducted to enhance the treatment of type 2 diabetes. However, there was a lack of data regarding the prescription pattern of antidiabetics among clinicians. So, a cross-sectional, questionnaire based study was conducted to gather information about the prevalence, risk factors, and management of diabetes within a population. The data was collected from 551 doctors across all over India. About 44% doctors reported that 5-10 patients per week were newly diagnosed with type 2 diabetes. In this study, 66% of the doctors reported cardiovascular events as a major complication and 28% of the doctors reported renal complications in uncontrolled type 2 diabetes patients. 48% of the 551 clinicians used DPP4 inhibitors as an add on, followed by 30% who reported the use of SGLT2 inhibitors. Notably, 92% of the participants reported urinary tract infection as the most common undesirable effect in their patients, with the usage of dapagliflozin. Nearly 30% of the clinicians in our survey have prescribed SGLT2 inhibitors for patients who are at &gt;50% risk of developing chronic kidney disease. The results from our study, stated that most of the clinicians use DPP4 inhibitors and SGLT2 inhibitors as an add on to metformin in patients with a failure to control the glycaemic index. Dapagliflozin is prescribed not only to control the glycaemic index but also to reduce the hospitalization due to heart failure and other cardiovascular and renal co-morbidities.

MONITORING OF MEDICINE THERAPY IN DM (Diabetes Mellitus) PATIENTS, MELENA, ANEMIA, HIPOALBUMIN AND SEPSIS IN HOSPITAL “ X ”

Diabetes Mellitus (DM) is a group of chronic metabolic diseases with hyperglycemia characteristics, this disease can attack several organs of the body causing various complaints. Diabetes Mellitus (DM) is a disease characterized by blood sugar levels. Physical activity is any body movement produced by skeletal muscles that requires energy. Lack of physical activity is an independent risk factor for chronic disease. This study aims to determine the effect of physical activity on blood sugar levels in patients with diabetes mellitus. Sepsis is the invasion of pathogenic microorganisms or their toxins into the blood or other tissues, resulting in an exaggerated systemic response to infection, which causes a collection of clinical symptoms and ends in a life-threatening state of organ dysfunction. Anemia is indeed not a direct complication caused by Type 2 DM, but in patients with diabetes, diabetes can damage blood vessels in the body and can cause kidney problems in the long term if not controlled. Impaired kidney function can cause anemia. Melena is a condition when the stool becomes dark or black in color, which is caused by bleeding in the upper gastrointestinal tract. Hypoalbuminemia in critical illness is an important marker of mortality. The pathophysiology of hypoalbuminemia in critical illness including decrease of production, inflammation marker, vascular leakage, and malnutrition. Administration of intravenous human albumin is needed to be considered for treatment of hypoalbuminemia in critical illness.This report was conducted to find out drug related problems (DRP's) in the treatment management of DM (Diabetes Melius) Patients, Melena Anemia, Hipoalbumin and Sepsis at “ X “ Hospital. The patient on behalf of Mrs.R.M was treated in the inpatient room. Drug Therapy Monitoring to ensure rational use of drugs, so that unwanted events do not occur.

Diabetes and Risk of Surgical Site Infection: A Narrative Review

Background: Diabetes Mellitus (DM) significantly elevates the risk of surgical site infections (SSIs), a major postoperative complication that increases morbidity, prolongs hospital stay, and escalates healthcare costs. The complex interplay between hyperglycemia-induced immunosuppression, impaired wound healing, and the increased propensity for infections in diabetic patients underscores the need for a comprehensive understanding of the mechanisms at play and effective management strategies. Objective: This narrative review aims to synthesize current evidence on the relationship between DM and the risk of SSIs, emphasizing the pathophysiological mechanisms, the impact of glycemic control on surgical outcomes, and the role of advanced surgical techniques in mitigating this risk. Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for studies published up to April 2023, using keywords related to DM, SSIs, and perioperative management. Inclusion criteria targeted studies on the association between DM and SSIs, focusing on outcomes in diabetic versus non-diabetic patients, and the effectiveness of glycemic control. Data extraction and synthesis were performed using a narrative approach, with quality assessment based on study design-specific appraisal tools. Results: The review highlights that diabetic patients exhibit a significantly higher risk of developing SSIs compared to non-diabetic individuals, attributed to impaired immune response, microvascular complications, and delayed wound healing associated with hyperglycemia. Effective preoperative and postoperative glycemic control, maintaining hemoglobin A1c (HbA1c) levels below 7%, has been shown to reduce the incidence of SSIs. Furthermore, advancements in minimally invasive surgical techniques have contributed to lower SSI rates by reducing tissue trauma and preserving immune function. Conclusion: Diabetes mellitus is a significant risk factor for surgical site infections, underscoring the importance of stringent glycemic control and the adoption of advanced surgical techniques in the perioperative management of diabetic patients. Future research should focus on refining glycemic control strategies, understanding the genetic and molecular mechanisms underlying increased SSI risk, and developing targeted therapies to improve surgical outcomes in this high-risk population.

Physicians Perspectives on the Preference of Antihyperglycemics for the Management of Diabetes Mellitus in India

As they were commonly prescribed together for blood glucose control, metformin and more recent sulfonylureas, such as glimepiride, have been shown in numerous clinical studies to effectively reverse insulin resistance and promote insulin secretion. In India, primary care physicians and specialists used the fixed-dose combination of metformin and glimepiride in various doses. The results of clinical trials needed to be applied to regular clinical practice in the real world in order to close the knowledge gap. Regarding this, professional opinions will provide insightful information about the use of antihyperglycemics and their combinations, including their safety, effectiveness, and usefulness for a particular subgroup of patients with diabetes. So, a cross-sectional study was conducted on the prescription pattern of oral anti-diabetic drugs for patients with diabetes mellitus. The choice of oral anti-diabetic agents for diabetic patients with comorbidities was analysed by using 26 questions. About 845 physicians participated in the survey by sharing their opinions/views on the questionnaire. Also, 400 physicians out of 845 prefers glimepiride and metformin as the preferred combination to achieve the targeted glycated haemoglobin level. Moreover, 723 physicians out of 845 experienced glycated haemoglobin reduction with glimepiride and metformin for more than 3 years. Maximum glycated haemoglobin reduction with glimepiride and metformin was 1.5%-2% by 383 physicians as per the survey. They also experienced good glycaemic control and good cardiovascular safety with glimepiride and metformin. Thus, the experts recommended glimepiride and metformin very often in elderly individuals. Glycated haemoglobin reduction was more than 3 years with glimepiride and metformin, as per the clinical experience of the experts participated in the survey. They also witnessed good glycaemic control and cardiovascular safety profile with glimepiride and metformin combination.