Progression of Prediabetes with and without Metformin: Real-World Evidence
S. Polisetti
The study presented at the IDF Congress in 2023 aimed to assess the progression of prediabetes in a real clinical setting with or without metformin treatment. The retrospective single-center electronic medical record (EMR) data analysis included 605 patients with prediabetes in an Indian healthcare setting, with 20% receiving metformin and 80% undergoing other treatment management. The study found a low rate of progression to type 2 diabetes (T2DM) in patients with prediabetes, regardless of therapy, and observed a reversal to normoglycemic indices in one-fifth of the patients. Significant improvements in glycemic indices were noted in the entire study population, irrespective of metformin use, with substantial differences in fasting and postprandial blood glucose levels in both groups and in HbA1c levels specifically in the metformin group. The findings suggest positive outcomes in the management of prediabetes in a real-world clinical practice, with metformin playing a role in improving glycemic control.
Undiagnosed Subclinical Hypothyroidism among Type 2 Diabetes Mellitus Patients -A Clinic Based Study in India
Dr. Anuj Maheshwari
The study conducted by the ACP India chapter aimed to address the lack of clarity in Indian guidelines regarding thyroid monitoring in Type 2 Diabetes Mellitus (T2DM) patients. The research focused on determining the prevalence of undiagnosed subclinical hypothyroidism (SCHT) among Indian T2DM patients without known thyroid disorders and assessing the relationship between thyroid-stimulating hormone (TSH) levels and glycemic status. The study, encompassing 1,271 T2DM patients from twenty locations in India, revealed that 23% of these patients had newly detected hypothyroidism, with 22% presenting subclinical hypothyroidism. Hyperthyroidism was found in 1% of the patients. The average HbA1c level in the euthyroid group was 8.05%, while in the group with elevated TSH (>5mIU/L), it was 7.75%, showing a statistically significant difference between the two groups. The findings underscore the importance of routine thyroid screening in T2DM patients for the early detection and management of subclinical thyroid dysfunction, suggesting a potential need for integration into T2DM guidelines in India.
Association of Dyslipidemia and Hypertension in newly diagnosed type 2 diabetes mellitus: A 12-year surveillance
Palaniappan Vinayagam
The study discusses a retrospective study conducted over 12 years in a rural Tamil Nadu, southern India, aiming to evaluate the association between dyslipidemia and hypertension among patients newly diagnosed with Type 2 Diabetes Mellitus (T2DM). The study involved 947 newly diagnosed T2DM patients, of whom 375 had dyslipidemia. The analysis revealed a significant association between male gender and a 1.33-fold increased odds of dyslipidemia, as well as a 2.48-fold increased odds for patients with hypertension. These findings align with previous reports suggesting that lipid derangements occur as early complications in T2DM, emphasizing the importance of early screening for dyslipidemia and hypertension to reduce complications, cardiovascular events, and strokes associated with T2DM. The study recommends integrating thyroid function tests into T2DM guidelines in India and calls for further multi-centric long-term studies to validate these findings. The research references other studies supporting the association between dyslipidemia, hypertension, and newly diagnosed T2DM. The conclusion suggests that early screening, education, and effective management of dyslipidemia and hypertension can help reduce T2DM complications and future cardiovascular risks.
Microvascular complications and body composition as predictors of osteoporosis and bone mineral density in type 2 DM.
Surapaneni Lakshmi
The study aimed to assess the impact of body composition and microvascular complications on bone health in individuals with Type 2 Diabetes Mellitus (T2DM) compared to healthy controls. The cross-sectional study included 131 participants with T2DM and 83 age, sex, and BMI-matched controls. Body composition analyses, including total lean mass, total fat mass, lean/fat mass ratio, and bone mineral density (BMD) at various sites, were conducted. The results indicated that male gender and hypertension were associated with increased odds of dyslipidemia among newly diagnosed T2DM patients. The findings suggest the importance of early screening for dyslipidemia and hypertension to reduce complications and cardiovascular risks associated with T2DM. Additionally, the study recommends further multi-centric long-term investigations to validate these findings. The research refers to previous studies supporting the association between dyslipidemia, hypertension, and newly diagnosed T2DM. The study concludes that early screening, education, and effective management of dyslipidemia and hypertension can help reduce T2DM complications and future cardiovascular risks.
A New Care Model for Diabetes and Hypertension: Impact on Patients’ Knowledge, Lifestyle, and Adherence in Rural Cambodia
Jad Sbeity
The study aimed to evaluate the impact of a community-based intervention called SAKAM on knowledge, lifestyle, and medication adherence among patients with diabetes and/or hypertension in rural Cambodia. The intervention involved testing and coaching sessions on diet, nutrition, disease complications, and medication adherence, with participants paying a monthly subscription fee. The results indicated that after the intervention, there was a significant improvement in knowledge, lifestyle, and medication adherence for the entire population, particularly in hypertensive patients. However, further interventions are deemed necessary for diabetic patients to prevent long-term complications. The study emphasizes the importance of greater public awareness about treatment and adherence. The proportion of participants who stopped their medication decreased significantly, highlighting the positive impact of the intervention on medication adherence. The conclusion suggests the need for ongoing efforts to address knowledge gaps and promote healthier lifestyles among patients with diabetes and hypertension in Cambodia.
Mild cognitive impairment in elderly patients with diabetes: effects of changes on BMI and appetite.
Jinlei Li
The research aimed to investigate the associations between body mass index (BMI), body weight changes, appetite alterations, and mild cognitive impairment (MCI) in elderly patients with type 2 diabetes. The study included 1355 participants aged 60 years or older, and cognitive status was assessed using the Montreal Cognitive Assessment. The results revealed that patients with MCI were more likely to report weight loss and appetite reduction in the past three months. Overweight in childhood and late life was associated with MCI among diabetes patients. The conclusion suggests a positive correlation between higher BMI, weight loss, appetite reduction, and MCI in diabetes patients. Monitoring body weight and BMI decline is recommended for early detection of MCI in individuals with diabetes. The study was supported by the China Medical Board, and ethical approval was obtained from the Chinese Academy of Medical Sciences. The authors declared no conflicts of interest.
The association between BAP levels and other markers of vascular calcification in patients with T2DM.
A Gupta
The study investigated the correlation between bone-specific alkaline phosphatase (BAP) levels and other markers of vascular calcification in patients with type 2 diabetes mellitus (T2DM) who exhibited unexplained elevations in alkaline phosphatase (ALP). A total of 100 patients were examined, with 50 in the normal ALP group and 50 in the high ALP group. The results showed that the high ALP group had significantly higher estimated LDL values and phosphate levels, while HDL values were lower compared to the normal ALP group. BAP levels were notably higher in the high ALP group, and there was a positive association between BAP and serum fetuin-A levels. The study suggests that unexplained elevations in ALP in T2DM patients may be attributed to an increase in BAP, and this elevation may be linked to an increased risk of vascular calcification. The persistence of high ALP after adjusting for estimated glomerular filtration rate (eGFR) suggests that chronic kidney disease did not contribute to the elevated ALP. The findings emphasize the importance of monitoring BAP levels and understanding their potential association with vascular calcification in T2DM patients. The study references previous research indicating the association of serum alkaline phosphatase with coronary artery calcification in hemodialysis patients.
Comparison of clinical characteristics and other pregnancy-related outcomes between GDM and overt DM
Ms. Savani Apte
The study compares the clinical characteristics and pregnancy-related outcomes between Gestational Diabetes Mellitus (GDM) and Overt Diabetes Mellitus (ODM) during pregnancy. Both GDM and ODM are types of diabetes first detected during pregnancy. The study aimed to assess glycemic parameters, including Fasting Blood Glucose (FBG) and Post Prandial Blood Glucose (PPBG), and other factors in 32 participants (16 in each group). Results indicated significant differences in FBG, PPBG, and Gestational Weight Gain (GWG) between GDM and ODM groups (p<0.005). Specifically, ODM participants had a higher history of abortions, possibly linking metabolic diseases post-abortion to increased susceptibility to hyperglycemia in subsequent pregnancies. Electrolyte concentrations did not show significant differences between the groups. The study emphasizes the relevance of Gestational Weight Gain as a risk factor for uncontrolled glycemic index during pregnancy, potentially leading to maternal health complications. The findings suggest that monitoring GWG and understanding its association with glycemic control is crucial, especially in pregnancies complicated by diabetes. The research sheds light on the distinct clinical characteristics and outcomes in GDM and ODM, offering insights into the management of diabetes during pregnancy.
Hypertension Control, still a Cause of Concern in the Elderly Population with Diabetes & Dyslipidaemia: A Multicentre Study Across India
Aashish Saxena
This multicenter study across India aimed to assess hypertension control in elderly populations with diabetes and dyslipidemia, emphasizing the relationship between hypertension and dyslipidemia. The study involved a substantial number of patients with type 2 diabetes mellitus (T2DM) across 14 nationwide centers. Results indicated a significant association between hypertension control and dyslipidemia. Dyslipidemia was found to be more prevalent among hypertensive patients compared to non-hypertensive patients. The study focused on individuals with T2DM, emphasizing the increased risk of cardiovascular diseases in diabetic patients. Optimal blood pressure management and maintaining favorable lipid profiles were highlighted for cardiovascular benefits. The prevalence of dyslipidemia was particularly high in hypertensive patients, especially in the elderly population. In terms of demographics, the study showed that 63% of the total T2DM patients were aged below 60 years, and 37% were 60 years or older. Among those aged 60 years and above, 45.3% had hypertension, and 16% had dyslipidemia. Dyslipidemia was notably higher (81.7%) in patients with hypertension compared to those without hypertension (18.3%). In conclusion, the study underscored the importance of addressing hypertension control, especially in elderly diabetic patients, and its connection to dyslipidemia, which plays a crucial role in cardiovascular risk management.
A Population-Based Study to Determine the Control of ABC Goals (A1C, BP, LDL-C) Among Type 2 Diabetes Mellitus Patients in India
Dr. Ashish Saxena
This real-world study aimed to assess the control of ABC goals in patients with type 2 diabetes (T2DM), recognizing the correlation between poor management of blood pressure (BP), lipids, and glycosylated hemoglobin (A1C) and adverse outcomes in T2DM. The study, conducted in 14 centers across the country, utilized an EMR (MEDEVA) integrated research proforma to collect data on patients’ medical history, comorbidities, and complications from March to August 2022. The results indicate suboptimal control, with less than half of the participants achieving at least one ABC target, posing concerns, particularly among younger individuals. Possible factors contributing to poor control include insufficient patient education and a cautious approach to diabetes care by treating physicians. Less than half of the participants in this population-based study, including a significant number of younger individuals, have achieved at least one of the three ABC targets (HbA1c, BP, and LDL-C) in managing Type 2 Diabetes Mellitus. The overall attainment of the ABC target is only 1.5%, raising concerns about diabetes control. Possible contributors to this poor control include a lack of patient education and a cautious approach to diabetes care by treating physicians. The study emphasizes the need for improved strategies and interventions to enhance the management of diabetes and achieve better ABC target control in the Indian population.
Understanding the Link: Hypertension Awareness and Behaviour Among Type 2 Diabetes Mellitus Patients
S.S. Dariya
The study focused on the coexistence of Type 2 Diabetes Mellitus (T2DM) and hypertension (HTN) among 2367 patients in India, revealing that approximately two-thirds of T2DM patients also had HTN. Patients with HTN, on average, were older, more likely to be male, and demonstrated higher awareness of risk factors than those without HTN. Although 74.1% of patients with HTN exhibited high blood pressure, 33.2% reported using a BP monitoring device. Encouragingly, 91% of patients with HTN were aware of at least one risk factor associated with high BP. The study emphasizes the need for targeted interventions to improve awareness, monitoring, and management, particularly in patients facing the dual challenge of T2DM and HTN in India.
Impact of Vildagliptin 100mg SR OD on Glycemic control & Weight in Type 2 Diabetes Mellitus patients with Obesity–a Pan India Retrospective study
Dr. Sona Warrier
The study focused on the impact of Vildagliptin 100mg SR OD on glycemic control and weight in patients with Type 2 Diabetes Mellitus (T2DM) and obesity. Among 2180 T2DM patients, 33% had obesity. No significant age difference was noted, but the diabetes obesity group had more females. After 3 months of Vildagliptin 100mg SR OD usage, the obese group exhibited a significantly higher drop in weight (2.7 kgs) compared to the non-obese group (1.5 kgs). The drop in HbA1c was 0.5% in the obese group and 0.7% in the non-obese group, with both differences being statistically significant. The study concludes that Vildagliptin 100mg SR OD resulted in significant weight loss and improved HbA1c levels in both obese and non-obese T2DM patients.
Effectiveness of Vildagliptin 100mg SR OD in Type 2 Diabetes Mellitus patients with Hypertension – A Pan India Retrospective study
Dr. Sona Warrier
This study evaluates the effectiveness of Vildagliptin 100mg SR OD on glycemic parameters and blood pressure control in patients with Type 2 Diabetes Mellitus (T2DM) and Hypertension (HTN). Involving 2180 subjects from 146 Indian sites, the study found that Vildagliptin 100mg SR OD, a once-daily formulation, resulted in significant improvements in HbA1c levels after 3 months. Among T2DM patients with HTN, the reduction in HbA1c was greater in the HTN group than the non-HTN group. Additionally, the study suggests that Vildagliptin 100mg SR OD maintains blood pressure levels over the 3-month period. Overall, the findings indicate positive outcomes for glycemic control and blood pressure maintenance with the use of Vildagliptin 100mg SR OD in this patient population.
