Background: Type 2 diabetes mellitus (T2DM), a metabolic disorder with high levels of glucose due to absolute insulin deficiency or relative insulin deficiency (insulin resistance) affects about 20 percent of adults in South Asia (SA) in the United Kingdom (UK). This is similar to that of urban Indian population, where the incidence is about 15 percent. Despite this, there is a scarcity of data comparing SA with that of the Indian urban community in the UK. Objective: The aim of the present study was to study the prevalence and differences of undiagnosed diabetes and associated risk factors between the urban adult Indian populations living in Bangalore and in South Asians residing in the UK. Materials and Methods: The general publics above age of 30 (adult) were encouraged to come for general checkup including capillary blood glucose test during public health events held at various town halls in UK. In the UK, nearly 230 SA adults were screened at 3 separate events held in Preston, Bolton and London. While in Bangalore, at 4 events were held at mosques and the community centres and 412 adult subjects were tested. Subjects known to have diabetes (DM) were analyzed separately from those that were not known to have diabetes (non-DM. Clinical monitoring of anthropometric data and random levels of capillary blood glucose were analyzed. Results: We found that 14.6 % and 42.7% of subjects had previously documented diabetes in the UK and India, respectively (P<0.001). No characteristic differences in age and BMI were found between the subjects of SA in the UK and those in India. In Bangalore, more men (69%) attended screening programme compared to the UK (14.6 percent). Of people without history of diabetes 30.1% of Indians in urban Bangalore had elevated blood sugar in comparison to SA in the UK (10.8%). Conclusion: There is an urgent need to perform screening of adult population for diabetes in urban India, where almost 20% people have impaired glucose tolerance.
Background: Diabetes Mellitus is a multifactorial metabolic disorder characterized by hyperglycaemia which on long standing results in microvascular and macrovascular complications.Knowledge, attitude and practices concerning diabetes mellitus are imperative to minimize the prevalence and morbidity associated with diabetes mellitus.Materials & Methods: This cross-sectional study was conducted at a teaching rural hospital among 100 known diabetic patients visiting the hospital for regular check-up.The self-administered questionnaire collected the data to assess knowledge, attitude and practices towards diabetes and knowledge determinant factors.Participant's socio-demographic characteristics including gender, level of education and duration of diabetes was reported using descriptive statistics.Mean and SD was used to express the age, anthropometric measurements, glucose levels and knowledge score.The response of knowledge, attitude and practice questions was expressed as frequency and percentage.The logistic regression analysis was done to determine the association between gender, age group, educational status and duration of diabetes with knowledge score.The level of statistical significance was set at p< 0.05.Results: Of the total 100participants, 52% were males and 135 were illiterate.77% had good knowledge of diabetes symptoms, risk factors, complications, life style modifications and glucose monitoring.77%, 88% and 76% had good knowledge, positive attitude and good practices respectively.The regression analysis showed increased odds of good knowledge among females [(1.552 (0.559 -4.311)] and in subjects with diabetes of more than 5years [1.090 (0.278 -4.264)].Further the analysis showed that the knowledge on diabetes was poor as participant's age advanced [OR: 0.281(0.065-1.217) & OR: 0.199 (0.046 -0.864)].Additionally, there were increased odds of good knowledge in participants with increase in educational level.Conclusion: Majority of the participants had good knowledge, positive attitude and good practices, however there is still scope for improvement in the areas such as inclusion of regular exercise, periodic lipid profile analysis and eye examination.
Diabetes Mellitus is a chronic metabolic disorder characterized by hyperglycemia due to abnormal insulin secretion, action or both. The synthetic available anti-diabetic drugs exhibited various adverse effects such as diarrhea, hypoglycemia. In recent years, scientists have turned their attention towards the medicinal plants which bear the rich source of metabolites which offer specific therapeutic function in the human body without any adverse effect. Sterculia setigera and Ficus platyphylla are medicinal plants that are used to treat various diseases and including diabetes traditionally. The present study is aimed at investigating the antidiabetic activity of the S. setigera and F. platyphylla methanol stem bark extracts. Phytochemical screening was determined using the standard method. In vitro studies were carried out using α-amylase and glycosylated hemoglobin inhibitory assay. The results of phytochemical constituents detected were flavonoids, Tannins, Steroids, Saponins, cardiac glycosides, Terpenoids, and Phenols. Inhibitory effects of both plant extracts were dose dependent against haemoglobin glycosylation and α-amylase. At highest concentration (25mg/ml), highest inhibitions were recorded in S. setigera (70.30%) and F. platyphylla (70.00%) which was comparable to Metformin (57. 2%). IC50 of Sterculia setigera (3.18mg/ml) and Ficus platyphylla (5.97mg/ml) were lower than metformin (8.84 mg/ml) against hemoglobin glycosylation. At concentration of (1.0mg/ml) S. setigera (72.21%) and F. platyphylla the (70.41%) showed the highest inhibitory effect which was not significantly different (p<0.05) compared to Voglibose (83.47%). In the present study, the IC50 of both extracts were higher (0.64 and 0.69mg/ml) and not significantly comparable to the Voglibose (0.26mg/ml). In conclusion, this study suggests that Sterculia setigera and Ficus platyphylla methanol stem bark extract possess hypoglycaemic potentials. This justifies their ethnomedicinal use for the treatment of diabetes.
To compare the change in immunogenic response, safety and efficacy of insulin glargine in Glaritus ® and Lantus ® treatment arms from baseline to six months in patients with type 2 diabetes mellitus (T2DM) uncontrolled on oral antidiabetic drugs (OADs).Material and methods: In an ongoing prospective, open-label, randomized, parallel-group, comparative, multicenter, phase IV study, adult patients with uncontrolled T2DM are treated with either Glaritus ® once daily or Lantus ® once daily for six months, both given subcutaneously.Glaritus ® treatment arm is to be continued for another six months.The primary endpoint for the study was the percentage change in anti-insulin antibodies (AIA) titer to glargine in both treatment arms from baseline to six months.Results: Ninety patients were randomized to each group.Baseline characteristics were comparable between the groups (p>0.05).There was no significant difference in percent change in the AIA titer between the two treatment arms at the end of six months in ITT (intent-to-treat) and mITT(modified intent to treat) population (LS mean diff [95% CI]: 2.2% (-15.1%,19.6%), p=0.7987 and 3.4% (-15.1%,21.9%), p=0.7181, respectively).No significant between-group difference was seen in change in the HbA1c level at the end of six months in ITT and mITT population [LS mean diff (95% CI): -0.2 (-0.4,0.0), p=0.1072 for ITT population; and -0.1 (-0.3, 0.1), p=0.2283, for mITT population].There was also no significant difference between two groups for the incidence of adverse events [Glaritus ® 17 (18.9%)and Lantus ® 20 (22.2%) p=0.5800].Conclusion: Glaritus ® was found to be non-inferior to Lantus ® in glycaemic control and comparable in immunogenic response and safety at the end of six months in patients with T2DM uncontrolled on OADs.
Type 2 Diabetes Mellitus (T2DM) is a chronic, progressive metabolic disease that is an international epidemic.General Practitioners (GPs) are the cornerstones of T2DM management.The aim of this study was to determine the scope of care and management of patients with T2DM within General Practice, while highlighting domains of success and areas where improvement can be made.Demographic and laboratory cross sectional data were collected by examining electronic patient records at one rural General Practice to address the aims of the study.Data included key management parameters of Hemoglobin A1c (HbA1c), estimated Glomerular Filtration Rate (eGFR), microalbuminuria, blood pressure and cholesterol levels, in addition to age, sex, and residential postcode.Further, data regarding the use of insulin, antihypertensive medications and lipid-lowering medications were collected and analyzed.Descriptive and inferential statistics were used and significance was determined at p≤0.05.A total of 294 electronic patient records were examined.Glycaemic control was shown to have clinically improved over time, with only 10.8% of patients having poor control at their latest HbA1c test.Despite improvement in HbA1c, only 35.4% of patients had been referred for diabetes education to a diabetes clinic.eGFR showed an overall decline in patient kidney function above the level of decline consistent with aging.Males were significantly more likely to have microalbuminuria with increased severity than females.The study demonstrated an overall clinical improvement in the diabetic control of patients, while identifying key at risk sub-populations.The findings suggest the need for continuous patient orientated management, while highlighting areas for improvement that impact patient health outcomes and avenues for service sustainability greater.
