Indian Journal of Diabetes and Endocrinology

Diabetic foot ulcers (DFUs) represent one of the most serious and debilitating complications of diabetes mellitus. Affecting a significant proportion of individuals with diabetes, DFUs are a leading cause of hospitalization and non-traumatic lowerlimb amputation worldwide, imposing substantial personal, social, and economic burdens. This paper provides a comprehensive overview of DFUs, exploring their complex pathogenesis driven primarily by peripheral neuropathy, peripheral artery disease (PAD), and infection. It details the clinical presentation, diagnostic approaches including assessment of wound characteristics and underlying systemic factors, and outlines the principles of multidisciplinary management. Key therapeutic strategies discussed include aggressive wound care (debridement and appropriate dressings), offloading, infection control, revascularization where indicated, and systemic metabolic optimization. Prevention, through patient education, regular foot examinations, and risk factor management, is emphasized as paramount in reducing the incidence of these challenging lesions. Addressing DFUs requires a coordinated effort from a diverse healthcare team to achieve limb salvage, prevent recurrence, and improve patient quality of life.
 

Thyroid nodules are commonly encountered in clinical practice, with the vast majority being benign. Studies suggesting that up to 50% of adults may have at least one thyroid nodule detectable by ultrasound. While most thyroid nodules are benign and asymptomatic, a subset may cause symptoms, such as difficulty swallowing, pain, or cosmetic concerns due to their size or location. Microwave ablation (MWA) has emerged as a promising minimally invasive treatment option for such nodules, offering a safe and effective alternative to surgery. We present a case of a 55-yearold female with a large symptomatic benign thyroid nodule successfully treated with MWA. This case highlights the clinical outcomes, procedural aspects, and potential advantages of MWA as a treatment modality for benign thyroid nodules.
 

Type 2 Diabetes Mellitus (T2DM) poses a significant public health challenge in India, with projections indicating an increase from 77 million cases in 2019 to 134 million by 2045. This review article examines recent advancements in T2DM management, guided by the Indian Council of Medical Research (ICMR) and International Diabetes Federation (IDF) guidelines, while also highlighting the contributions of Indian diabetologists. The ICMR has established a comprehensive framework emphasizing early diagnosis, lifestyle modifications, and proactive management of complications tailored to the Indian population’s unique needs. Key recommendations include regular screening of high-risk individuals, a balanced diet rich in fiber and lean proteins, and regular physical activity, including yoga. Pharmacological treatments range from metformin to newer agents like SGLT2 inhibitors and GLP-1 receptor agonists. Continuous monitoring for diabetes-related complications is crucial for reducing morbidity and mortality associated with T2DM.The IDF guidelines adapt to the Indian context by focusing on cost-effective strategies and culturally relevant lifestyle interventions. These guidelines advocate for personalized treatment plans and the integration of technological advancements such as continuous glucose monitoring (CGM) to enhance patient engagement. Contributions from Indian diabetologists emphasize culturally appropriate dietary guidelines, the role of yoga in managing diabetes, and community-based approaches that address social determinants of health. Moreover, traditional practices rooted in Ayurveda and holistic approaches continue to play a vital role in diabetes management. This review underscores the importance of combining modern medical practices with traditional methods to provide a comprehensive strategy for T2DM management in India. Future directions include a focus on personalized medicine and digital health technologies, which promise to enhance patient outcomes through tailored interventions.