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 7th International Diabetes Summit - 2023 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:

Diabetes in people undergoing kidney transplantation

Dr Pankaj Shah (Endocrinologist at the Mayo Clinic, USA) spoke about how kidney transplant patients have a higher risk for diabetes than people without a transplant. As many as 10 to 20 per cent of people undergoing kidney transplantation develop post-transplant Diabetes mellitus, which is associated with increased mortality.

A kidney transplant is an operation that places a healthy kidney into the body. A new kidney will usually function immediately. Post-transplant Diabetes mellitus refers to Diabetes mellitus that is diagnosed after kidney transplant, and acknowledges that some patients may have had undiagnosed pre- transplant Diabetes. After a kidney transplant, Diabetes is diagnosed if:

• fasting glucose > 126 mg/dL

• random glucose > 200 mg/dL

• a 2-hour glucose level after a 75-g oral glucose tolerance test (OGTT) > 200 mg/dL

OGTT is more sensitive than fasting glucose alone and should be considered the gold standard for the early diagnosis of PTDM.

Ketosis-prone Type 2 Diabetes: a case based perspective

Dr Shivani Misra (Consultant in Metabolic Medicine and faculty member at the Imperial College London, UK) discussed case studies of people with Type 2 Diabetes who are prone to ketosis. Ketosis is an increase in the ketone levels in the body.

Ketone production increases when you follow a very low carb diet. Many cells in the body prefer using glucose for fuel. When your body doesn't have enough glucose to power these cells, levels of the hormone insulin decrease, causing fatty acids to be released from body fat stores in large amounts. Many of these fatty acids are transported to the liver, where they're oxidized and turned into ketones, also called ketone bodies. These are then used as an alternative energy source throughout the body.

Ketosis may lead to weight loss, improved blood glucose management and reduced seizures in children with epilepsy. While the ketogenic diet can be enjoyable and beneficial for some people, it may not be for others. Therefore, speak with a healthcare professional before trying it.

Is there a need for gender-specific Diabetes guidelines?

Dr Usha Sriram (Physician, endocrinology and diabetes specialist, medical ethics expert, great communicator, women's health promoter, women's rights activist, Director of Aceerhealth) spoke about how biological

differences between women and men affected Diabetes management. Compared with men with Diabetes, women with Diabetes are disproportionately affected by depression and anxiety and have a lower quality of life, which can negatively affect attitudes towards self-management and, in turn, disease outcomes.

Gender differences are related to differences in the information contained in sex chromosomes, the specific gene expression of autosomes linked to sex, the different number and quality of sex hormones, and their different effects on systems and organs.

Gender differences are not only the result of our genetic makeup but are also mixed with

socio-cultural habits, behaviours, and lifestyles, differences between women and men. Our environment, the food we eat, lifestyle and the resulting stressors affect how people comply with treatment and management of diseases. These differences affect social behaviour and mental health. As a result, therapeutic outcome in chronic diseases are influenced by a complex combination of biological and environmental factors.

For more information, visit: www.cdidiabetessummit.org