New Findings in Diabetes

The 51th International Diabetes Summit (Virtual) 2021 organised by Chellaram Diabetes Institute, Pune was one such attempt to make an impact in the field of Diabetes. The three-day summit witnessed numerous national and international dignitaries connect virtually and speak on the latest findings, techniques and technologies in the field of Diabetes. The event brought several aspects into light related to

Diabetes - from clinical management to patient care, from the current challenges to the latest innovations in the world of Diabetes.

Following are some of the topics discussed during the three-day summit:

Challenges in managing hypoglycaemia

Hypoglycaemia or low blood sugar levels occur as a result of several factors such as long periods of fasting, increased physical activity, reduced fluid and nutrient intake and increased dosage of medication. Hypoglycaemia, if not treated in time, may lead to severe complications such as dizziness and collapsing. Dr Kamlesh Khunti (HoD and Professor, University of Leicester, UK) discussed the background and occurrence of hypoglycaemia

globally and how to manage it. Studies have found that people aged 18 years above, who are on insulin for more than a year and people with Type 2 Diabetes have a high risk of experiencing hypoglycaemia.

Severe or recurrent episodes of hypoglycaemia may increase the risk of heart attack and death. To overcome this, people with Diabetes should be educated and made aware of hypoglycaemia, especially nighttime hypoglycaemia and how it could be managed. Regular monitoring of blood sugar levels helps to identify low blood sugar levels and treat them in time. Self-monitoring and management of blood sugar levels help people to prevent complications.

Time-in-range and insulin therapy

The continuous glucose monitoring system is a wearable device that records and provides data on blood sugar levels for 24 hours. The data recorded for 24 hours provides a detailed view of the blood sugar patterns and reflects any hypoglycaemia or hyperglycaemia events that occur throughout the day. It provides the duration when the blood sugar levels were within the normal range, also known as time-in-range. A person with Diabetes is said to have good blood sugar control if their blood sugar level remains in the range for 70 per cent of the time or more than 17 hours of the day. Dr Banshi Saboo (Diabetologist, India) explained the practical use of time in range and how basal insulin can help to manage post-meal rising blood sugar levels. Basal or baseline insulin is a long­ acting insulin that remains in the blood for 24 hours and maintains blood sugar level during the fasting state. This leads to a stable blood sugar pattern for a long time.

Nutrition in Diabetes

Diet is one the most important aspects of health and dietary management plays a vital role in keeping the blood sugar levels under control. Once diagnosed with Diabetes,people often assume that they have to give up their favourite foods and have to switch to a diet devoid of taste and variation. However, this is not true. With correct guidance and knowledge of how different foods affect the body, one can enjoy everything in moderation. Dr Shehla Shaikh (Consultant Endocrinologist, India) explained how nutrition can be inculcated as a part of a self-care plan for an individual with Diabetes. Counselling people and bringing awareness about nutrition would be helpful. The inclusion of technology-based education, tailor­ made real-time feedback and community support can help people achieve their goal to eat healthily.

The latent onset of Diabetes

Latent Autoimmune Diabetes in Adults (LADA) is a slow-progressing autoimmune condition in which the pancreas stops producing sufficient insulin due to beta cell destruction. This type of Diabetes is also called Type 1.5 Diabetes or double Diabetes because the body experiences both the destruction of beta cells like Type 1 Diabetes and insulin resistance like Type 2 Diabetes. This form of Diabetes is usually seen in people age 30 and above. Dr Juliana Chan (Professor of Medicine and Therapeutics, Hong Kong) discussed the unique diagnostic challenges witnessed in such type of Diabetes and how it can be managed. People with LADA have a later age of diagnosis and have fewer risk factors for heart disease but have uncontrolled HbA1c and risk of hypoglycaemia. An additional test of C-peptide levels (a substance released by the pancreas along with insulin) and specific antibodies test could help with correct diagnosis and early treatment.