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| D-TECHCON ABSTRACTS |
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| Year : 2022 | Volume
: 1
| Issue : 6 | Page : 13-18 |
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D-TECHCON Abstracts
| Date of Web Publication | 23-Nov-2022 |
Correspondence Address:
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/2949-8457.361884
How to cite this article:
. D-TECHCON Abstracts. Int J Diabetes Technol 2022;1, Suppl S2:13-8 |
| 1. A Cross-Sectional, Multicentre Pilot Study to Assess The Efficacy of Intelligent Health Risk Assessment Software in The Early Detection of Type 2 Diabetes, Hypertension, Dyslipidemia | |  |
Gayathri Choda1, Melvin George2, D. T Arasu3, Chikkalingaiah Siddegowda4, Govardhan Rao5
1Project Director, Aarca Research India Pvt Ltd, Bangalore, India
2Department of Statistics, SRM MCH and RC, Kattankulathur, India
3Managing Director, iDD Research Solutions INC
4Department of General Medicine, Medstar Specialty Hospital, Bangalore, India
5Department of General Medicine, Excel Hospital, Hyderabad, India
Background and Objectives: Type 2 diabetes (T2D), hypertension (HTN), and dyslipidemia are the leading causes of mortality and morbidity worldwide. IHRA (Intelligent Health Risk Assessment) offers a technological solution to enable early detection of these conditions and is expected to improve patient outcomes. We compared the specificity and sensitivity of IHRA risk scores at a cut-off value against the gold standard methods for the diagnosis of T2D, HTN, and dyslipidemia.
Methodology: This cross-sectional, multi-centre, pilot study collected data from 497 participants (median age: 39 years) including demographics, physical examination, laboratory investigations, and vital signs. Using a recommended infrared thermal imaging camera, a full one-minute video of the participant's face was taken and risk scores were calculated using IHRA software. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) v16. A p-value < 0.05 was considered statistically significant.
Results: The ability of the IHRA-derived risk score for T2D to predict T2D was high [AUC = 0.88; p = 0.0001] with a sensitivity and specificity of 86% and 93% respectively (OGTT≥140 mg/dL & IHRA T2D >= 4). The ability of the IHRA-derived risk score for HTN to predict HTN was high [AUC = 0.84; p = 0.0001] with a sensitivity and specificity of 80% and 95% respectively (SBP >135 mm/Hg & DBP > 90 mm/Hg, IHRA HTN >= 5). The ability of IHRA-derived risk score for dyslipidemia to predict dyslipidemia was high [AUC = 0.77; p = 0.0001] with a sensitivity and specificity of 74% and 89% respectively (TC > 200 mg/dL & LDL > 100 mg/dL, IHRA dyslipidemia >= 3).
Conclusion: Our study has shown that IHRA is an effective and reliable technology for the early detection of metabolic conditions such as T2D, HTN, and Dyslipidemia. Evaluation of IHRA in a larger population is required in strengthening the case to utilize it as a routine technology for the early detection of T2D, HTN, and dyslipidemia, and as a Point of Care screening tool.
| 2. Virtual Insulin Dose Estimator: Making Caregiving for Diabetes Easy | | |
Sayonee Das
Department of Internal Medicine, KPC Medical College and Hospital, Kolkata, West Bengal, India
Background and Objectives: Virtual Insulin Dose Estimator (VIDE) is an application that helps people with diabetes, caregivers, and healthcare professionals including doctors and nursing staff to calculate the estimated short-acting dose to be taken or administered before a meal. The objective here is to introduce various features of VIDE.
Methodology: Users have to enter three parameters into the app: body weight, capillary blood glucose (CBG) levels, and what food the user will be having before a meal. The app already has a list of varied food items of different cuisines from which the user can select. Based on the blood glucose levels and carbohydrate intake of the patient at that moment, the app will calculate how much insulin the user should be taking.
Results: VIDE based on the carbohydrate intake and CBG levels calculates the amount of short-acting insulin the user needs. In case of a heavy meal as during festivals or parties, VIDE will suggest the user take more insulin to combat the inevitable rise in blood sugar. Whereas in case the patient is planning to eat light or even skip a meal, the app will suggest a smaller amount of insulin to prevent hypoglycemia. VIDE has a precautionary measure for patients with low CBG levels (below 100) and automatically alerts them not to take any insulin. Similarly, in scenarios of high CBG (more than 400 or un-recordable by the testing kit), VIDE alerts the patient of the probability of having either Hyperosmolar Hyperglycemic Syndrome (HHS) or Diabetic Ketoacidosis (DKA) and asks the patient to immediately visit the nearby hospital for further evaluation and management. However, VIDE can only estimate the dose of short-acting insulin. Users should confirm the type of insulin they are using before using the app.
Conclusion: VIDE can serve as an essential tool for patients with diabetes or their caregivers as well as for health care professionals for better management of blood glucose. Strict glycemic control is irrefragable and this app attempts to it for a better quality of life for patients living with diabetes.
| 3. Usage of Technology in Glycemic Control for Sub-Rural People With Diabetes | | |
Mohammed Muzammil1, Mohammed Riyaz2
1Department of Medicine, Shadan Institute of Medical Sciences, Hyderabad Telangana, India
2Department of Medicine, MNR Medical College, Sangareddy, Telangana, India
Background and Objectives: In a technological triad model, a connection is established between a medical centre, a health worker, and a diabetes educator to monitor remotely the patient's glycemic levels and educate the patients online via conference video calls following up and daily monitoring the regular treatment and diet intake. Here, we studied the role of teamwork in achieving glycemic control in rural patients using a cost-effective technological triad model.
Methodology: 65 people with diabetes were selected based on inclusion criteria, out of which only 30 agreed to participate in the study.
Inclusion criteria: Men and women aged between 20 to 70 years with type 2 diabetes mellitus (T2DM), having an uncontrolled fasting blood sugar (FBS), post prandial blood sugar (PPBS) and HbA1c between 7.1 - 10.5 %. Exclusion criteria: Type 1 diabetes mellitus (T1DM), pre-existing renal, hepatic, or cardiac disease, HbA1c > 10.5 %. Tie up was made with the multipurpose health worker to monitor remotely the patient's glycemic levels and educate the patients online via conference video call following up and daily monitoring the regular treatment and diet intake. A technological triad was established between Shadan Institute of Medical Sciences health worker, and diabetes educator.
Results: 30 patients were randomly divided into two groups, i.e., group A and B which comprised of 15 patients each. Parameters such as FBS, PPBS, HbA1c and lipid profile, complete blood count, complete urinary analysis, Liver function test, Serum Creatinine, BMI were collected on day 1 and follow up data which includes measurement of FBS, PPBS, HbA1c and lipid profile were collected at 3 months and at 6 months. Data obtained was measured with SPSS version 17 software. Group A (15 patients, 10 males) were monitored on daily basis remotely with the help of health worker for proper diet intake, regular intake of oral hyperglycemic agent (OHA) without skipping a single dose in entire 6 months duration whereas the Group B (15 patients; 8 males) were monitored on day 1 and these patients of Group B were explained about the drug dosage, frequency of drug intake, diet plan and life style modification. Both these groups were followed on monthly basis in the out-pateint department (OPD) clinic for review. There was no statistically significant difference in the mean FBS, PPBS, HbA1c and lipid profile at the start of the study. On the first follow up after 3 months it was observed that the mean FBS, and PPBS were significantly low in the group A p <0.05. HbA1c was lower in group A but the decrease was not found to be statistically significant p >0.05. At 6 months it was observed that mean FBS, PPBS, HbA1c, total cholesterol, TGL, and LDL was significantly low in group A p <0.05. There was no statistically significant difference in the mean HDL levels between groups.
Conclusion: Modern technological usage has a lot of advantages. Adherence to therapies is a primary factor that determines the success of therapy and decreases the negative consequences not only for the patient but also for the health care provider. A single contact with a physician could not achieve good glycemic control as seen in group B when compared to a systematic approach and close monitoring that increased the adherence to medication and diet as demonstrated in group A.
| 4. Development and Evaluation of “Yen Fight Diabetes” Digital Model for Comprehensive and Holistic Diabetes Care at Yenepoya Medical College Hospital for Prevention and Management of Diabetes Mellitus | | |
Shaheen Banu Shaikh
Department of Biochemistry, Yenepoya Medical College, Mangaluru, Karnataka, India
Background and Objectives: As a medical society, we have increased our knowledge about diabetes, beyond managing the cornerstones of self-management: blood glucose, physical activity, medication, and diet. We have recently unmasked the effects of less-known factors like sleep, stress, or even temperature on blood glucose levels. While it is theoretically ideal to understand all factors that affect disease, to effectively treat it, it also inadvertently adds further pressure on healthcare providers (HCPs) and patients to not only track these factors but also to understand and react to them. In fact, in the field of digital world, patients will become vastly knowledgeable.
We aim to use digital tools to empower people with diabetes to increase the knowledge about diabetes so that they look after their health, prevent diseases, enable interaction and feedback between users and HCPs and to use effectively by both parties to facilitate shared-decision making and collaboration in achieving better diabetes care.
Methodology: Pre-post educational interventional study was conducted. Thirty five people with diabetes were recruited. All people with diabetes attending the OPD who are using an android phone and who can read, speak and understand English were selected for the study. The blood samples were collected for the assessment of fasting blood sugar (FBS), post prandial basal sugar (PPBS), HbA1c and the patients were administered a pre-assessment questionnaire. All people with diabetes were educated one to one in all the domains, i.e., diabetes consultation, diet counseling, physiotherapy and the use of digital education portal. After 3 months, FBS, PPBS nad HbA1c was analysed. A post assessment questionnaire was administered.
Results: The distribution of awareness scores was found to be centered at lower values at baseline, the distribution is shifted towards the higher values after the intervention, indicating that the intervention is successful in elevating (increasing) the awareness scores of the subjects. The FBS, PPBS and HbA1c values were significantly reduced after the intervention (P value-0.001). The awareness scores have increased after the intervention. (P value-0.001) and all the subjects were found to have awareness scores of more than 70%.
Conclusion: This model increases the awareness of diabetes and improved diabetes care in the local community and provides a complete Comprehensive diabetes care to empower people with diabetes with good knowledge so that they can take care of their health and prevent diseases and its associated complications. The model also adds a new dimension to diabetes management.
| 5. Knowledge, Attitudes, and Practices on Oral Fluid, Electrolyte and Energy Management in Various Acute Non-Diarrheal Illnesses among Indian Physicians | | |
Harshad Malve
Department of Medical Affairs, Therapy Area Head, Johnson and Johnson India, Mumbai, Maharashtra, India
Background and Objectives: Currently, there is limited understanding of the management of oral fluid and electrolyte imbalance along with caloric supplementation and its impact on the speed of recovery from acute non-diarrheal illnesses such as fever (including dengue, malaria, and typhoid), nausea, vomiting, heat-related illnesses, upper respiratory tract infections, and urinary tract infections with dehydration. This survey aimed to understand Indian physicians' knowledge, attitude, and practices (KAP), in treating fluid, electrolyte and energy (FEE) deficits in patients with acute non-diarrheal illness along with the core treatment.
Methodology: A cross-sectional, online survey was designed based on the KAP approach, and conducted among 494 physicians (including General Practitioners, Internal Medicine, Paediatrics and Obstetrics-Gynaecology), who are either frequent prescriber or non-prescriber (1:1) of ready-to-drink (RTD) fluids in India. Here we present the subgroup analysis for general physicians and internal medicine physicians (n=190), with more than 25% people with diabetes in their overall patient pool). This data represents the KAP in general for treating fluids, electrolytes, and energy (FEE) deficits in patients with acute non-diarrheal illness along with the core treatment. Physicians were not asked about specific details for people with diabetes.
Results: More than 75% of physicians thought dehydration was a major clinical challenge due to complex and varying pathophysiology. More than 70% of physicians agreed that dehydration in hospitalized patients is associated with poorer outcomes, i.e., increased morbidity and mortality. Overall, 95% of physicians rated high to medium level of importance to FEE management for patient health during acute non-diarrheal illnesses. More than 93% of physicians rated medium to high for the impact of chronic, undetected dehydration on health. Only 60% of physicians assess all their patients on the hydration levels and only 31% recommend FEE management to more than 70% of the eligible patients. 87% of physicians agree that oral FEE management recommendations aid in improving the speed of recovery in their patients. Around 95% of physicians agreed that patients taking RTD oral FEE formulations have faster recovery as compared to patients taking non-RTD formulations.
Conclusion: For physicians with more than 25% of people with diabetes in their patient pool, the importance of FEE management for patients' health in non-diarrheal illnesses with dehydration is well recognized. However, proactive assessment of dehydration in such patients and recommending FEE is a challenge. Across most respondents, FEE management recommendation was perceived to improve the speed of recovery in patients with acute non-diarrheal illnesses. Further investigation is needed to determine if the FEE management with RTD formats has any specific benefits for people with diabetes and with acute non-diarrheal illnesses
| 6. The Awareness on Diabetes Control among Ophthalmologists | | |
Tulika Ghoshal
Department of Ophthalmology, KPC Medical College and Hospital, Kolkata, West Bengal, India
Background and Objectives: Glycated haemoglobin (HbA1c) levels correlate well with diabetes control, the progress of, and the outcome of diabetic retinopathy. This study evaluates the awareness of ophthalmologists about HbA1c estimation.
Methodology: A printed questionnaire comprising of questions regarding the normal and abnormal levels of HbA1c, clinical significance, association of HbA1c with diabetic retinopathy, and other co-morbid conditions was circulated amongst ophthalmologists who attended an annual conference.
Results: The normal range of HbA1c was correctly answered by only 92 out of 230 ophthalmologists (40%) as 4- 5.6%. 28.70% recommended HbA1c only for patients with diabetic retinopathy. 80% thought that HbA1c provided an average of plasma glucose control for the last 8- 12 weeks. 40.87% responded that HbA1c should be less than 7%. 58.26% thought it should be done every 3 months.
Conclusion: Ophthalmologists in India need to be much more aware of HbA1c and its numerous implications in diabetes patients who are at risk of losing their sight permanently.
| 7. Clinical Sub Typing of People With Newly Detected Type 2 Diabetes on The Basis of Pancreatic Beta Cell Function and Degree of Insulin Resistance and Their Clinical Characterization | | |
Avijit Saha
Department of General Medicine, Malda Medical College and Hospital, Malda, West Bengal, India
Background and Objectives: Type 2 diabetes (T2DM) is not a homogenous disease; a lot of heterogeneity exists in its etiopathogenesis and clinical presentations. Insulin resistance is a major cause for developing T2DM, but is not synonymous. Pancreatic beta cell dysfunction probably needs to be set in for clinical occurrence of type 2 diabetes. So, knowledge regarding residual beta cell function & degree of insulin resistance are essential.
We estimated the degree of insulin resistance (HOMA-IR) & pancreatic beta cell functional capacity (HOMA-B %) among people with newly detected T2DM. We also identified different clinical phenotypic presentations of T2DM on the basis of this functional assessment.
Methodology: The present study was conducted in newly diagnosed treatment naïve patients with T2DM. After obtaining informed consent, anthropometric & clinical examinations were carried out in all the patients. Venous blood samples were drawn for fasting plasma glucose (FPG), c-peptide, fasting insulin level, HbA1c, lipid profile & postprandial glucose. HOMA-IR & HOMA-B% was calculated using HOMA 2 calculator. Appropriate statistical tests were done to test the significance of the findings.
Results: A total of 100 newly diagnosed patients with type 2 diabetes were selected for the study. The mean HOMA-IR & HOMA-B% was 2.55±1.75 & 40.67±23.55% respectively. 71% of the study population had HOMA-B% value below 50% and half of study population had significant amount of insulin resistance. Three distinct clinical phenotypes were identified. Insulin resistance predominant group (30%), Beta cell dysfunction predominant group (45%). Both abnormalities coexist group (25%).
Conclusion: Our study demonstrated, by the time of diagnosis of Type 2 diabetes, more than two-third study population had less than 50% residual beta cell function left and more than half had significant degree of insulin resistance. So, this functional assessment needs to be done for appropriate antidiabetic drug selection and for the identification of different clinical phenotypes.
| 8. Advanced Glycation End Products Formed in Diabetes Mellitus Possess Antigenicity | | |
Alok Raghav1, Richa Giri2, Saurabh Agarwal3
1Department of Multidisciplinary Research, GSVM Medical College, Kanpur, India
2Department of Medicine, KPS Institute of Medicine, GSVM Medical College, Kanpur, India
3Department of Medicine, Institute of Medicine, GSVM Medical College, Kanpur, India
Background and Objectives: Protein glycation and the formation of advanced glycation end products (AGEs) play an important role in the pathogenesis of diabetic complications like retinopathy, nephropathy, neuropathy, cardiomyopathy along with some other diseases such as rheumatoid arthritis, osteoporosis and aging. Glycation of proteins interferes with their normal functions by disrupting molecular conformation, altering enzymatic activity, and interfering with receptor functioning. This study analyzes the detrimental effect of non-enzymatic glycation on human serum albumin (HSA) leading to the production of advanced glycation end products (AGEs).
Methodology: HSA (20μM) incubated with glucose (400 mg/dL) formed AGEs and was confirmed by scanning electron microscopy. DNA-damage in subjects with diabetes mellitus was assessed with comet assay. Antibodies against in-vitro formed AGEs were evaluated in the sera of patients with diabetes by enzyme-linked immunosorbent assay. Molecular docking was used to demonstrate affinity of native and glycosylated HSA with IgG. Low-grade systemic inflammation was quantified with IL-4, IL-6, TNF-α and NF-κβ in serum and mRNA expression.
Results: The SEM showed the formation of aggregates in glycated-HSA. Serum auto-antibodies from patients with diabetes and with chronic kidney disease (CKD) showed appreciably high recognition of glycated-HSA compared to native HSA. Comet showed severe DNA damage in subjects with CKD compared to healthy individuals. Molecular docking showed less affinity of glycosylated-HSA with IgG compared to native-HSA. Serum IL-4, IL-6, and TNF-α were found significantly higher in subjects with CKD compared to T2DM and healthy individuals. mRNA expression of IL-4, IL-6 and NF-κβ are also found significantly higher in CKD.
Conclusion: The non-enzymatic glycation-induced damage to the HSA and generate neo-epitopes that possess immunogenic response and low-grade systemic inflammation.
| 9. Sugar.Fit's Artificial Intelligence Integrated Approach as A Holistic Type 2 Diabetes Reversal Model | | |
Shivtosh Kumar, Annie Mattilda R, Chhavi Mehra, Mridul Maheshwari, Anuj Modi
Cheif Product Officer, Ragus Healthcare Private Limited, Bengaluru, Karnataka, India
Background and Objectives: Type 2 diabetes (T2DM) has emerged as one of the most rapidly growing health challenges. It is pricey, difficult to manage and often leads to life-threatening conditions. This study highlights use of multifaceted holistic interventions, personalized for each participant and delivered by diabetes expert coaches through AI based electronic medical records for over 90 days and aims to study this integrated system's effectiveness in reducing glycemic levels.
Methodology: A total of 150 participants with (HbA1c of over 6.5%) were enrolled into the 3-month Sugar.fit's Diabetes Reversal Program (SDRP) and 110 clients were recruited as controls. The study aimed to retrospectively evaluate the Sugar.fit approach includes a selection of lifestyle interventions, education and self-monitoring of blood glucose (SMBG) with or without involvement of pharmacological therapy.
Results: The findings on completion of the study showed that the Sugar.fit approach led to significant improvements, with an average reduction in HbA1c by 1.9% compared to the control group which saw a slight gain of 0.04%. SDRP saw an average drop of 62.2 mg/dL in fasting blood sugar (FBS) value when control saw a reduction of 1.42 mg/dL after 90 days. An average weight loss of 3.3 Kg was seen in overweight participants in SDRP while the control group gained weight of 0.5 Kg in 90 days from baseline.
Conclusion: Diabetes management requires a holistic and multidisciplinary team approach. Delivering therapies with the help of technology for ambulatory glucose profile, self-monitoring of blood glucose (SMBG), precision nutrition and personalized fitness has resulted in improved clinical and emotional parameters. Artificial Intelligence (AI) based tech has made food logging easy and effective to correct glycemic variability which is the biggest challenge in diabetes management. This model has therefore proved that leveraging technology in medical therapy can significantly improve quality care.
| 10. Can Dynamic Plantar Pressure Monitoring Coupled With an 'Intelligent' Feedback System be Utilized to Prevent Recurrence of Diabetic Foot Ulcers? A Prospective Study from Eastern India | | |
Riddhi Dasgupta1, S. Mondal1, M. Lodh2, A. Ganguly3
1Department of Endocrinology, Healthworld Hospitals, Durgapur, West Bengal, India
2Department of Clinical Biochemistry, Healthworld Hospitals, Durgapur, West Bengal, India
3Department of Medicine, Healthworld Hospitals, Durgapur, West Bengal, India
Background and Objectives: Devising effective strategies to prevent recurrent diabetic foot ulcers (DFU) remains a clinical challenge, with recurrent ulcers often leading to limb-threatening complications. Our objective is to develop an indigenous, innovative insole system with a concomitant 'intelligent' feedback mechanism that would empower patients in self-offloading of aberrant plantar pressures, which in turn will diminish diabetic foot ulcer recurrence in such patients.
Methodology: We conducted a prospective, randomised-study, including patients with type 2 diabetes (T2DM) with peripheral neuropathy and a recent history of plantar foot Ulceration, attending a tertiary care hospital of Eastern India. They were randomly assigned to either intervention or control. All patients received an insole system, which measured plantar pressure continuously during daily life. In addition, the intervention group received a smartwatch linked to the insole system that would send out audio-visual alerts when plantar pressures were exceeded, followed by offloading instructions to alleviate the aberrant pressures. The control group did not receive any smartwatch-linked alerts. The primary outcome was plantar foot ulcer occurrence within 18 months. The insole system detected plantar pressure exceeding capillary perfusion pressure (>35 mm Hg) in real time, and integrated that pressure data over time. For every minute of wear, pressure readings over the previous 15 minutes were analysed by the device and categorised as high (95–100% readings ≥35 mm Hg), medium (35–94% readings ≥35 mm Hg), or low (0–34% readings ≥35 mm Hg) integrated pressure. Pressure readings were wirelessly transmitted to a smartwatch where data were stored.
Results: A total of n=128 patients conforming to pre-determined inclusion criteria were included in the study, of which n=67 were assigned to intervention group and n=61 were assigned to control group. At follow-up, recurrence of DFU occurred in a greater number of patients in the control group [n=13 (21%)] than in the intervention group [8(12%, p=0.01)], with twenty-one ulcers from 13786 person-days being recorded in the control group and eight ulcers from 14595 person-days in the intervention group(p=0.01): a 74% reduction in ulcer incidence in the intervention group compared with the control group on Poisson regression analysis (incidence rate ratio 0.32, 95% CI, 0·14–0·49; p=0·01). Based on device data, patients in the intervention group wore the device for a median of 789 hrs (IQR: 390–1675.8h), compared with 885hrs (IQR: 219·4–15321.4) for the control group (p=0·65). The control group wore the device for 7.1 h per day (4·6–9.1) versus 6.8 h per day (4·2–7·5) for the intervention group (p=0·25). In an exploratory analysis of good compliers (n=102), ulcer incidence was reduced by 89% in the intervention group versus control group (incidence rate ratio 0·17, 95% CI 0·05–0-27; p=0·01). On Cox proportional hazards regression model, the hazard ratio for the intervention versus control groups (0·29, 95% CI 0·09, 0.56; p=0·11) showed no significant effect of intervention on time to ulceration in patients who ulcerated. Adding age, diabetes type, and ethnicity into the model did not significantly affect the hazard ratio.
Conclusion: To our knowledge, this is the first Indian study to develop an 'intelligent', indigenous, feedback-enhanced insole system, which by continuous plantar pressure monitoring and dynamic offloading guidance, can lead to a reduction in diabetic foot ulcer site recurrence.
| 11. Reduction in HbA1c Levels Using Triple Combination and Lifestyle Intervention Approach in Patients With Type 2 Diabetes Mellitus | | |
Khushboo Aggarwal
Founder, Zyla Health Private Limited, New Delhi, India
Background and Objectives: It is well known that diabetes is a chronic disorder that needs to be managed with regular monitoring and lifestyle interventions so that long-term complications are delayed, and quality of life is improved. The most significant barrier to effective diabetes management is the lack of awareness about the right approach, which needs to be personalized for each individual. The Triple Combination Therapy approach at Zyla coupled with highly personalized, holistic & continuous care which focused on improving health outcomes for every patient, proved to be beneficial in diabetes management.
Methodology: We assessed the baseline levels of Glycated haemoglobin (HbA1c Levels Using Triple Combination And Lifestyle Intervention Approach In Patients With Type 2 Diabetes Mellitus[/TAG:2]
Khushboo Aggarwal
Founder, Zyla Health Private Limited, New Delhi, India
Background and Objectives: It is well known that diabetes is a chronic disorder that needs to be managed with regular monitoring and lifestyle interventions so that long-term complications are delayed, and quality of life is improved. The most significant barrier to effective diabetes management is the lack of awareness about the right approach, which needs to be personalized for each individual. The Triple Combination Therapy approach at Zyla coupled with highly personalized, holistic & continuous care which focused on improving health outcomes for every patient, proved to be beneficial in diabetes management.
Methodology: We assessed the baseline levels of Glycated haemoglobin (HbA1c), cardiac complications, and chief complaints- paraesthesia of skin (numbness & tingling), flatulence, and related conditions and functional dyspepsia (acidity) for 1 year among 5192 patients between May 2020-May 2021. This was a retrospective and observational study. Details of the patients were collected from medical records.
Results: All the patients who provided consent for the study, had type 2 diabetes mellitus (T2DM); >18 years of age. Out of the total patients, 62% patients were males and 38% females. Majority of the patients reported comorbidities like hypertension, obesity, hypothyroidism, dyslipidemia and fatty liver, with an average of 3 co-morbidities per patient.
Out of 5192 people with diabetes, a drop of 8.64% was observed in median HbA1c of the patients. Only 4.17% users developed any cardiac complication post enrolment while the incidence rate for neuropathy, nephropathy and retinopathy stands at 0. Holistic lifestyle modification further resulted in a significant improvement in neuropathic symptoms and gastric symptoms.
Conclusion: We concluded that patients were able to achieve glycaemic control and reduce the burden of complications along with symptoms. As an end result, it helped reduce the complications of the disease.
| 12. Role of Alimfus to Facilitate Transport and Metabolism of Drugs | | |
Vyankatesh Shivane
Sadhana Diabesity Clinic, Mumbai, Maharashtra, India
Background and Objectives: Airborne Low Intensity Multi frequency Ultrasound (ALIMFUS) uses thermal and non-thermal principal of ultrasound to facilitate transportation of drugs into the cells and its metabolism. A randomized, multi-centre, double blind, interventional, placebo controlled study was conducted to evaluate efficacy and safety of ALIMFUS as an Add-on therapy to oral hypoglycemic Agent (OHA) in Type 2 diabetes mellitus.
Methodology: 103 subjects out of 186 subjects completed the study and received 10 minutes either ALIMFUS therapy on alternate day for 90 days or placebo. Baseline and end of the study lab parameters such as HbA1c, blood sugars, lipid Profile, Serum Hs-CRP (High-sensitivity C-reactive protein), Serum Interleukin-6, Serum TNF-α (Tumour necrosis factor- alpha), Serum homocysteine, Serum vitamin D, Serum leptin, Serum adiponectin and quality of life score were assessed.
Results: At the end of study ALIMFUS group achieved greater (0.77 ± 1.13 vs0.48 ± 0.79) but non-significant reduction in HbA1c. More subjects in ALIMFUS group (30.76 % vs 27.45%) achieved HbA1c < 7 %. Significant reduction in fasting and postprandial glucose noted in both groups whose baseline HbA1c was ≥8%. Significant reduction in lipid profile noted in ALIMFUS group compared to placebo. Insulin, adiponectin, CRP and homocysteine and quality of life were significantly better in ALMFUS group compared to baseline; but non-significant compared to placebo. No adverse events were associated with ALIMFUS.
Conclusion: ALIMFUS could be a novel technology in diabetes management for patients unable to achieve glycemic targets on combination therapy. However, further exploratory long-term studies are required to demonstrate its effective role as add-on therapy in diabetes management.
| 13. To Evaluate The Impact of Beat Diabetes Win Life Education Course on Knowledge and Awareness about Diabetes Mellitus in Indian Settings | | |
Rajeev Chawla1, Kirti Samudra2, Abhijit Jadhav3, CH Siva Kumar4, Suresh S Sawardekar5, Mayuri Talathi6
1Department of Diabetes, North Delhi Diabetes Centre, New Delhi, India
2Department of Diabetes, Diabetes Care Clinic, New Panvel, Navi Mumbai, Maharashtra, India
3Department of Diabetology, Aaditya Care, Ghatkopar, Mumbai, Maharashtra, India
4Department of Diabetology, Cherri Sivakumar Diabetes Centre, Visakhapatnam, Andhra Pradesh, India
5Department of Diabetes, Diabetes and Thyroid Clinic, Santacruz(E), Mumbai, Maharashtra, India
6Senior Manager, Medical Advisor, Scientific Services, USV Pvt. Ltd, Mumbai, Maharashtra, India
Background and Objectives: Today the rule of 50% is prevalent in terms of diabetes awareness, detection, treatment and control. In fact, 1 in 2 Indians is unaware that they have diabetes. Awareness about risk factors is a prerequisite for the prevention of diabetes mellitus and its related complications. This study aims to assess the impact of Beat Diabetes Win Life (BDWL), an educational program on patients' knowledge regarding diabetes and its complications.
Methodology: A Diabetes Education Certificate Course was provided for patients under the umbrella of BDWL. There were 12 Modules containing an average of 8-10 multiple choice questions each [Table 1]. Each module also displayed patient education videos specific to the module. Prior to initiating the modules, participant's knowledge regarding diabetes was analysed. The participant's knowledge level was captured before and after completion of all the modules by a 4-point rating scale:  | Table 1: Percentage change in knowledge of participants at the end of each module
Click here to view |
“Not Aware<Partial < Basic <Advanced.”
Results: A total of 765 participants were enrolled for the course. Before the course, the rating of most of the participants was “Not Aware” or “Basic”. However, after completion of all the modules, their knowledge level increased significantly. There was an average 81% increase in participant's knowledge from “Basic”, “Not Aware” & “Partial” to advance for all modules [Figure 1]. | Figure 1: % Change in knowledge of participants after completion of the course
Click here to view |
Conclusion: “Beat Diabetes Win Life” is a unique initiative undertaken to improve patients' knowledge and awareness about diabetes and its complications. This would encourage the patients for self-monitoring, regular blood glucose check, improve adherence to diabetes regime and regular follow-up with the doctor as well as enable healthcare teams to manage diabetes patients more efficiently.
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