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 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 and the skeleton

Dr Manju Chandran (Senior Consultant Endocrinologist and Director of the Osteoporosis and Bone Metabolism Unit at Singapore General Hospital) discussed Diabetes and the

skeleton: case studies that illustrate therapy.

Both Type 1 and Type 2 Diabetes affect bone health. Type 1 Diabetes is associated with decreased bone density, whereas for Type 2 Diabetes there is a paradox. They have a higher bone mass density but are also at higher risk of fragility fractures. A fragility fracture is a fracture resulting from a fall from standing height or less. These fractures, which most commonly occur at the hip, spine, or wrist, are an indication that the body's bones have been

weakened by an underlying illness. Roughly half of all women and up to one-quarter of all men will suffer a fragility fracture in their lifetime. People who have had a previous fragility fracture are twice as likely to suffer a fracture in the future.

This could be due to a bone quality problem - a problem with the structural properties of the bone. There is something called the porosity of the cortex which has been noticed in the people with Diabetes. In addition, some of the medications that people with Diabetes take may adversely affect bone health. Complications of Diabetes such as neuropathy (nerve damage) can actually increase risk of a fall, which could subsequently result in a fracture.

Osteoporosis by definition means porous bones. It develops when bone mineral density and bone mass decreases, or when the structure and strength of bone changes. So osteoporosis makes the bone weak and more susceptible to fragility fracture even with very minimal trauma. Osteoporosis is a silent disease - it lacks identifiable symptoms. One indication of osteoporosis is loss of height. Losing more than 4 centimetres of height as compared to your peak adult height, it could definitely suggest your vertebrae could have a fracture. 80 per cent of osteoporosis is genetic but 20 per cent of osteoporosis can be prevented by:

• Eat foods that support bone health - Get enough calcium, vitamin D, and protein each day. Low- fat dairy, leafy green vegetables, fish and fortified juices, milk, and grains are good sources of calcium. If your vitamin D level is low, talk with your doctor about taking a supplement.

• Get active - Choose weight-bearing exercise, such as strength training, walking, hiking, jogging, climbing stairs, tennis, and dancing. This type of physical activity can help build and strengthen your bones.

• Do not smoke - Smoking increases your risk of weakened bones.

• Limit alcohol consumption - Too much alcohol can harm your bones. Drink in moderation or not at all. Learn more about alcohol and aging.

However, lifestyle changes may not be enough if you have lost a lot of bone density. There are also several medications to consider. Some can slow your bone loss and others can help rebuild bone.

• Medications that slow down bone loss include bisphosphonates, calcitonin, RANKL blockers, estrogen, and drugs that change how estrogen acts in the body.

• Medications that help rebuild bone include a synthetic version of the parathyroid hormone and drugs that inhibit a protein called sclerostin.

Diabetes care, communication and culture

Dr. Alexandra Charnock (Lead of Behavioural and Social Science teaching at the School of Medicine, University of Dundee, UK) discussed Diabetes care, communication and culture.

Language has such an important role in healthcare. Successful Diabetes care depends on effective communication between health services providers and patients and their families. Establishing a good patient-provider communication is key to help patients improve Diabetes self-care behaviours. Cultural awareness can positively influence the relationship with patients. Cultural awareness is really more about becoming interested in patients' health beliefs, habits and explanatory models of health and disease and being able to interact with them in a genuine and respectful manner.

Continuing medical education courses are starting to regularly include activities that aim at improving physicians' knowledge and skills to address social and cultural aspects in health care. Similarly, medical schools are integrating cross-cultural health care models and strategies in their curriculum. All these efforts are likely to contribute to improve patient related outcomes and reduce health care disparities.

For more information, visit: www.cdidiabetessummit.org