Indian Journal of Diabetes and Endocrinology

Presently, network pharmacology is being  popular in investigating the probable interaction of  secondary metabolites from herbal medicines with  multiple proteins involved in the various disease  pathogenesis and understanding the probable  molecular mechanism. The concept is based on  the multi compound-multi protein interaction and  somewhat different from a lock and key concept  of drug discovery. In this context, this minireview highlights the major aspects of network  pharmacology during the conceptualization of  herb-disease interaction.

Objectives: This study aimed to evaluate  manifestations of COVID-19 infection in patients of  raised fasting blood glucose (FBG) level without preexisting diabetes mellitus.

Methods: This study comparatively evaluate the  difference between patients of raised FBG level and  normal FBG level for COVID-19 manifestations by  enrolling 2750 admitted COVID-19 patients. Patients  were categorized into two Groups, where Group 1  had patients with raised FBG level (=126 mg/dL) and  Group 2 had patients with normal FBG level (<126  mg/dL). Information regarding clinical symptoms,  past medical history, laboratory feature, treatment  and outcome was extracted from medical records to  compare among both the Groups.

Results: COVID-19 patients with raised FBG  level were found to be have severe symptomatic  presentation, raised inflammatory markers and  hypercoagulable state. Total white cell count, NLR  (Neutrophil to Lymphocyte ratio), serum level of IL-6  (Interleukin-6), FDP and D-dimer were found to be  significantly higher (p<0.05) in case of raised FBG  level as compared to normal FBG level. Radiological  findings detected by chest radiograph and computed  tomography chest suggested severe lung involvement  in patients of raised FBG level. COVID-19 patients  with raised FBG level required intensive supportive  treatment as compared to patients of normal FBG  level in terms of ICU care (p=0.0033), non-invasive  ventilation (p=0.0323) and invasive ventilation  (p=0.0455). Patients with raised FBG level had  higher mortality (p=0.0178) and required prolonged   hospitalization (p=0.0008) as compared to patients of  normal FBG level.

Conclusion: FBG >126 mg/dL at admission without  pre-existing diabetes mellitus, should be considered  a risk factor for higher susceptibility of COVID-19  infection and severity by clinical presentation,  inflammatory storm, pulmonary invasion,  requirement of more intensive treatment and a poor  outcome.

The present study was conducted to assess the  knowledge and practice regarding prevention and  management of hypoglycemia among patients with  Diabetes mellitus in a selected hospital, Thrissur. The  objectives of the study were to assess the knowledge  and practice regarding prevention and management of  hypoglycemia among patients with Diabetes mellitus,  to find out the relationship between knowledge and  practice regarding prevention and management of  hypoglycemia among patients with Diabetes mellitus,  to associate the knowledge and practice regarding  prevention and management of hypoglycemia among  patients with Diabetes mellitus with their selected  demographic variables and to prepare and distribute  a self-instructional module regarding prevention and  management of hypoglycemia among patients with  Diabetes mellitus. Quantitative research approach  with a descriptive cross sectional survey design  was used in this study. One hundred samples were  selected by using purposive sampling technique  from selected medical OPDs of Aswini Hospital  Ltd. The data collection was done with a structured  knowledge questionnaire and a self-reported practice  checklist regarding prevention and management of  hypoglycemia. The study results showed that, 71%  had good knowledge, 26% had average knowledge  and 3% had excellent knowledge, regarding  prevention and management of hypoglycemia. In  terms of practice, 62% had average practice, 29% had  good practice and 9% had poor practice regarding  prevention and management of hypoglycemia.  There was no significant relationship between  knowledge and practice regarding prevention and  management of hypoglycemia (r = 0.05 ns, p = 0.625)  and there was no association between knowledge and  practice regarding prevention and management of  hypoglycemia among patients with Diabetes mellitus  with any one of their selected demographic variables.  A self-instructional module regarding prevention  and management of hypoglycemia was prepared and  distributed to the patients to enhance their knowledge  and practice.