Indian Journal of Diabetes and Endocrinology

Wound dressings signify a part of the organization of diabetic foot ulceration. Preferably, dressings should assuage symptoms, provide wound protection, and persuade healing. No single dressing fulfills all the requirements of a diabetic patient with an infected foot ulcer. Dressing’s research in this area is in general poor. On the other hand, each category of dressings has particular characteristics that aid selection. Non glue dressings are simple, low-cost, and well tolerate. Foam and alginate dressings are highly absorbent and effective for heavily exuding wounds Dressings contain inadine and silver may aid in managing wound infection. Occlusive dressings should be avoided for infected wounds. All dressings require frequent change for wound inspection. Profoundly exudation ulcers require frequent change to reduce maceration of surrounding skin. Dressing alternative should be guided by the characteristics of the ulcer, the requirements of the patient, and costs.

Type 2 Diabetes mellitus; HbA1c; Depression; Patient health questionnaire-9; Depression severity

Background: The pandemic due to coronavirus disease caused by SARS CoV-2 has caused significant morbidity and mortality across the globe. Underlying conditions such as hypertension, diabetes, cardiovascular diseases escalate the risk of various complications associated with covid-19 and leads to poorer prognosis. Therefore it is of prime importance to understand the cause of the severity of symptoms observed in patients with pre-existing type-2 Diabetes Mellitus. It is also imperative to decipher the chemical pathways involved in the causation of Diabetes which when intertwined with covid-19 leads to critical outcomes. Objective: The increasing per capita income has meant that the burden of non-communicable diseases now falls at India’s doorstep. So, we attempt to study diabetes in the backdrop of prevailing nCoV[1]2. According to World Health Organization (WHO), India had 69.2 million people living with diabetes in 2015. Thus it is crucial in a country like India with so many diabetic patients to explore the consequences of the pandemic on this cohort. Methods and Materials: We systematically searched the PubMed and Google scholar database for the published articleson diabetes and Covid-19till 11th July 2020. Conclusion: The relationship between Diabetes and Covid-19 and the likely chemical pathways involved in the pathophysiology have been elucidated. Based on the evidence that is available it is not possible to draw any certain conclusions. Though the present data that we have warranted further research to expound upon the poor prognosis observed in diabetic patients suffering from Covid-19.

Introduction: Depression and diabetes are both chronic devastating conditions & their co-occurrence has been associated with poor outcomes. The link between depression and type 2 diabetes is bidirectional, significant candidate pathways include the innate inflammatory response, the hypothalamic[1]pituitary-adrenal (HPA) axis, and insulin resistance, which all interrelate with each other. In formerly undiagnosed diabetic patients, depression had a higher prevalence and might be due to an unfavorable or stressful lifestyle such as condensed physical activity, socioeconomic scarcity, social adversity, unhealthy diet. In this study, the emphasis was made on screening for depression in patients with T2DM. Aim of the study: To investigate the incidence of Depression in Patients with T2DM. Objectives of the study: To obtain demographic details, to assess the depression levels, and to establish the relation based on the severity of depression in T2DM patients. Methodology: It is a prospective observational study design, the patient health questionnaire (PHQ[1]9) was used to assess depression in 387 patients aged between 30-80 years. Venous blood was collected to assess fasting blood sugar (FBS), post-lunch blood sugar (PLBS) and Glycated hemoglobin (HbA1c). Results: The PHQ-9 revealed that 182 patients (47%) are minimal in depression severity followed by 169 patients (38.5%) are mild in depression severity. Female gender, increased age, obese patients, and longer duration of diabetes was associated with increased odds of depression. Whereas, being married was protective and was associated with decreased odds of depression. Conclusion: In our study, we found the majority of subjects with minimal severity of depression when correlated between depression and T2DM. When HbA1c levels are compared, patients with higher levels of HbA1c are presented by subjects with moderate levels of depression. 

Objective: Erectile dysfunction (ED) is a common complications in men with type 2 diabetes. The present study was undertaken to investigate to À nd out the socio–demographic and clinical correlates of erectile dysfunction among men with type 2 diabetes mellitus. Materials and methods: Married men aged 20-60 years with a diagnosis of non-insulin-dependent (Type 2) diabetics attending the outpatient unit of Department of Endocrinology at PSG Hospitals, Coimbatore during the months of May and June 2019 were enrolled. Erectile function was assessed using International index of Erectile Function(IIEF-5). All subjects were evaluated for obesity, physical activity, hypertension, retinopathy, glycated hemoglobin, total cholesterol, and medication use. Results: Among 204 patients studied, 65 (31.86%) were found to have erectile dysfunction. Mild to moderate, moderate and severe ED was present in 17.2%, 11.8% and 2.9% patients respectively. In unadjusted analyzis, ED was signiÀ cantly associated with patients who were having less physical activity (p=0.003), hypertension (p=0.001), obesity (p=0.021) and retinopathy (p=0.000). In the multivariate linear regression analysis, less physical activity (odds ratio (OR)=2.395 (95% conÀ dence interval (CI):1.171-4.899, p=0.017) and diabetic retinopathy (OR=3.869 (95% CI:1.568-9.606, p=0.004)) were found to be signiÀ cant independent predictors of ED in the study population. Conclusion: Prevalence of ED was higher in type 2 diabetic male patients. Diabetic retinopathy and less physical activity was signiÀ cant risk factors associated with ED, making it possibly a preventable condition.

Objectives: Our current study objective was to assess the nature of antidiabetes prescriptions across the Apollo Sugar Ecosystem, India, a healthcare organization with more than 30 centers (standalone, secondary and tertiary institutions) that provide care to patients with diabetes Methods: An eligible 20608 prescriptions with a diagnosis of type 2 diabetes mellitus (T2DM) from 2017 to 2019 were included in this analyzis to determine the choice of therapy, frequency of usage of a different class of antidiabetes medications, types of insulin, combination and number of oral hypoglycemic agents (OHAs) with insulin. Descriptive statistics were applied to do the analyzis and report the results. Results: The mean age of the patients was 53.2 years, 63% males and 37% females. The majority of the patients were on OHAs (68.2%) with 22.8% of patients on OHAs+insulin and 9.0% on insulin alone. Biguanides (55.7%) were most commonly prescribed in combination with other OHAs followed by DPP4 inhibitors (DPP4i) (35%) and 63% of patients requiring insulin were using at least one oral drug. The most common drugs used along with insulin include biguanides (50.5%) and DPP4i (46.7%). Among Insulins short-acting insulin (45.6%) was most commonly prescribed followed by insulin glargine (22.5%) and premixed insulin and analogues (13.5%) Conclusions: Our large cross-sectional data analysis reveal a significant number of patients on monotherapies other than metformin. The data provided here give a snap shot of the changing trends in the adoption of therapeutic practices with the availability of newer medications, physician education and patient ability to afford care. Keywords: Anti-diabetes drugs; anti-hyperglycemic agents; Diabetes, India; Insulin, Prescription; oral; Type 2 diabetes mellitus

Aim: To compare the effectiveness of teneligliptin/ metformin as monotherapies with teneligliptin[1]metformin combination therapies in an Indian setting. Patients and Methods: The prospective observational study included 207 subjects aged >40 years with suboptimal control of T2DM (glycated hemoglobin (HbA1c) >7.5%). The subjects were categorized into the following three groups based on the treatment received: 63 (30.4%) in group 1 received 20 mg of teneligliptin and metformin SR (500 mg) as individual therapies, 76 (36.7%) in group 2 were managed with 1000 mg metformin and 20 mg of teneligliptin in combination, and 68 subjects (32.9%) in group 3 received 500 mg metformin and 20 mg of teneligliptin in combination. HbA1c, FGS, and PPBG were measured for all the participants at baseline and after the administration of drugs (HbA1c at 12 weeks, and FGS and PPBG at 4 and 12 weeks). Anthropometric and laboratory parameters were compared by ANOVA for normal data, Kruskal Wallis for not normal data and chi-square test for counts data. Results: The mean age of patients was 53.94 ± 10.64 years with a male-to-female ratio of 1:0.76. Comparisons of all the variables between baseline and 12th week were found to be highly significant across the three groups and further t-test analysis also corroborated the findings (P<0.001). Percentage changes showed that the overall effects of the drugs in reducing HbA1c, FGS and PPBS were more prominent in the group 3 followed by group 2 > and 1. Conclusion: Combined pill metformin (500 mg)- teneligliptin (20 mg) may serve as effective alternative to metformin/teneligliptin individual therapies, thereby to reduce the pill burden and improve patient compliance in an Indian setting.