New Findings in Diabetes

Awareness and knowledge can help prevent health complications. Education plays an important role in informing people about the condition and how best to manage it through a healthy diet, regular exercise and necessary medication. This holds especially true for Diabetes which is a chronic condition caused by high blood sugar levels.

The 6 International Diabetes Summit (Virtual) - 2022 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 - 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:

New drugs for Diabetes

Dr Ananda Basu (Harrison Professor of Medicine Division of Endocrinology, University of Virginia School of Medicine, USA) discussed newer drugs for Diabetes management which were undergoing Phase 2-3 trials. Dr Basu spoke about the newer longer acting Insulin icodec (administered once-a-week). Dr Basu discussed a study published in journal Diabetes Care in 2021 which compared this insulin with insulin glargine U100 (administered once-daily).

Insulin icodec is a novel, long-acting insulin analog designed to cover basal insulin requirements with once-weekly subcutaneous administration. The advantages of long acting insulin are that there are lower incidences of hypoglycaemia (very low blood sugar levels), decreased instances of blood sugar fluctuations, better patient compliance, increased flexibility of insulin dosage timing. But the disadvantage was the hypoglycaemia was not seen across types of Diabetes.

Dr Basu also spoke about smart insulin which are currently in animal studies. Smart insulins are glucose responsive insulins these insulins work

Challenges in coronary intervention in diabetic patients

Dr Michael Chan (Specialist in Cardiology, Honorary Consultant Gleneagles Hongkong Hospital, Honorary Clinical Assistant Professor, HKU) discussed when you have Diabetes, you are at risk of heart disease and more likely to have certain conditions that increase the chance of having a stroke, high blood pressure or high cholesterol.

People with Diabetes tend to develop heart disease at a younger age. If your blood sugar level is high and constantly fluctuating for a period of time, then sugar sticks to your red blood cells and builds up in your blood as your body can't use all of this sugar properly. This build-up can block and damage the interior surfaces of blood vessels carrying blood to and from your heart, starving the heart of oxygen and nutrients and this can lead to serious heart complications. This causes potentially higher levels of lipids or fats in the blood (including high cholesterol levels) associated with heart disease. When the blood sugar level is consistently high, this activates a biological pathway that causes irregular heartbeats - a condition called cardiac arrhythmia - that is linked to heart failure and sudden cardiac death.

Therefore, it is important to keep your blood sugar level as close to the target blood sugar and make healthy lifestyle changes such as eating a healthy diet, regularly exercising, managing stress and alcohol and tobacco cessation. These will help protect your blood vessels and lower blood pressure and cholesterol which in turn will improve your heart health.

Childhood Obesity: The rationale for early intervention

Dr Annika Janson (MD Specialist in Paediatric and Adolescent medicine, paediatric endocrinology, Karolinska University Hospital, Stockholm Sweden).

19.3 per cent of children in India are overweight or obese. In India, obesity in children was associated with affluence and was seen more in urban children than in rural children.

Many diseases like Diabetes, high cholesterol, liver disease, lung disease and other problems are increasingly seen in association with childhood obesity. The treatment of overweight and obese children and adolescents requires a multidisciplinary, multi-phase approach which includes dietary management, physical activity enhancement and restriction of sedentary behaviour. Additionally, drug therapy and surgery may be required in a minority of obese youngsters.

Diabetic foot management in clinical practice: 2021 update

Dr John Doupis (Director of Division of Diabetes of Iatriko Paleou Falirou Medical Center, Greece) discussed how long duration of uncontrolled blood sugar levels in the blood stream damages the nerves. This is known as peripheral neuropathy. It affects the blood vessels resulting in decreased or complete obstruction of the blood flow towards the extremities (feet). This is called peripheral arterial disease. Neuropathy and peripheral arterial disease either individually or together result in serious problems like non-healing ulcer, infections and even amputation.

People with Diabetes must undergo foot examination on an annual basis as chronic wounds require specialized podiatry care. Exposure of pre-existing calluses, corns, bruises, cuts and wounds to the advent of fungus, bacteria and other infections, increases the risk of infection. People with Diabetes can have healthy feet with good blood sugar control and by taking habitual good care of their feet.