Objective:
To assess the real-world management practices of subjects with type 2 diabetes mellitus (T2DM) and type 1 diabetes mellitus (T1DM) in India.
Methods:
This cross-sectional study was ...conducted between 7 March 2016 and 15 May 2016 in India as part of the seventh wave (2016) of the International Diabetes Management Practices Study (IDMPS). Adult subjects with T1DM or T2DM visiting physicians during a 2-week recruitment period were included.
Results:
A total of 55 physicians included 539 subjects who met eligibility criteria. Of 495 subjects with T2DM, 303 were treated with oral glucose lowering drugs (OGLDs) only, 158 were treated with OGLD + insulin, and 27 received insulin only. Among 44 subjects with T1DM receiving insulin, 13 (29.5%) were also treated with OGLD therapy. The most commonly used insulin regimens were basal alone (69/184; 37.5%) and premixed alone (63/184; 34.2%) in subjects with T2DM, and basal + prandial insulin (24/44; 54.5%) in subjects with T1DM. Proportions of subjects achieving glycemic targets were low glycated haemoglobin (HbA1c) <7%: T1DM = 7.3% (3/44), T2DM = 25.2% (106/495); as targeted by the treating physician: T1DM = 31.8% (14/44), T2DM = 32.1% (59/185); global target: T1DM = 4.8% (2/42) and T2DM = 1.7% (8/482). In subjects with T2DM, HbA1c <7% was noted in 11/22 subjects receiving insulin only and 76/260 receiving only OGLDs. Lack of experience in self-managing insulin dosing, poor diabetes education and failure to titrate insulin dosages were the main reasons for non-achievement of glycemic targets.
Conclusion:
Timely insulinization, education and empowerment of people with diabetes may help improve glycemic control in India.
In this article, we study the numerical solution of singularly perturbed 2D degenerate parabolic convection-diffusion problems on a rectangular domain. The solution of this problem exhibits parabolic ...boundary layers along x=0,y=0 and a corner layer in the neighborhood of (0, 0). First, we use an alternating direction implicit finite difference scheme to discretize the time derivative of the continuous problem on a uniform mesh in the temporal direction. Then, to discretize the spatial derivatives of the resulting time semidiscrete problems, we apply the upwind finite difference scheme on a piecewise-uniform Shishkin mesh. We derive error estimate for the proposed numerical scheme, which shows that the scheme is ε-uniformly convergent of almost first-order (up to a logarithmic factor) in space and first-order in time. Some numerical results have been carried out to validate the theoretical results.
In this paper, we study the numerical solution of singularly perturbed degenerate parabolic convection-diffusion problem on a rectangular domain. The solution of the problem exhibits a parabolic ...boundary layer in the neighbourhood of x=0. First, we use the backward-Euler finite difference scheme to discretize the time derivative of the continuous problem on uniform mesh in the temporal direction. Then, to discretize the spatial derivatives of the resulting time semidiscrete problem, we apply the hybrid finite difference scheme, which is a combination of central difference scheme and midpoint upwind scheme on piecewise uniform Shishkin mesh. We derive the error estimates, which show that the proposed hybrid scheme is ϵ-uniform convergent of almost second-order (up to a logarithmic factor) in space and first-order in time. Some numerical results have been carried out to validate the theoretical results.
Background: A high prevalence of hypogonadism in men with Type-2 diabetes mellitus (T2DM) has been reported worldwide. Objectives: To evaluate the prevalence of hypogonadism in Indian males with T2DM ...and assess the primary and secondary hypogonadism along with androgen deficiency. Materials and Methods: In this cross-sectional study, 900 men with T2DM were evaluated using androgen deficiency in aging male questionnaire. They were screened for demographic characteristics, gonadal hormone levels, lipid profile, and glycosylated hemoglobin. Results: The prevalence of hypogonadism in T2DM patients was found to be 20.7% (186 out of 900). Hypogonadism was of testicular origin (primary) in 48/186 (25.8%) patients, of pituitary or hypothalamic origin (secondary) in 14/186 (7.53%), and remaining 124/186 (66.67%) patients were found to have low testosterone with the inappropriate normal level of luteinizing hormone and Follicle-stimulating hormone. 451/900 (50.1%) patients were only symptomatic but had normal testosterone levels. Further 263 patients out 900 were asymptomatic, of which 51/900 (5.7%) patients had low levels of testosterone and 212/900 (23.5%) patients had normal testosterone level without symptoms. There were no deaths or other serious adverse events except mild pyrexia which was not related to the study. Conclusion: Hypogonadism diagnosis, at times, might not be validated with the help of androgen deficiency questionnaire or symptoms only. Given the large number of patients of T2DM in India, the incidence of hypogonadism is more in diabetic patients as compared to the general population. Hence, implementation of screening programs in diabetic patients is necessary to understand and detect individuals with low serum total testosterone at any early stage and to supplement testosterone accordingly.
Liraglutide, a human glucagon-like peptide-1 receptor agonist, decreases glycosylated hemoglobin and causes weight loss. However, the cost of therapy and gastrointestinal side- effects such as nausea ...and diarrhea are important impediments to adherence and long-term compliance. We assessed the efficacy, safety and tolerability of low dose (0.6 mg) liraglutide in obese uncontrolled longstanding type 2 diabetes in Indian patients. Low dose liraglutide improved glycemic control and decreased weight. However, there was a significant drop out because of gastrointestinal intolerance and financial constraints.
In this paper, we study the numerical solution of singularly perturbed degenerate parabolic convection-diffusion problem on a rectangular domain. The solution of the problem exhibits a parabolic ...boundary layer in the neighbourhood of x=0. First, we use the backward-Euler finite difference scheme to discretize the time derivative of the continuous problem on uniform mesh in the temporal direction. Then, to discretize the spatial derivatives of the resulting time semidiscrete problem, we apply the hybrid finite difference scheme, which is a combination of central difference scheme and midpoint upwind scheme on piecewise uniform Shishkin mesh. We derive the error estimates, which show that the proposed hybrid scheme is GREEK LUNATE EPSILON SYMBOL-uniform convergent of almost second-order (up to a logarithmic factor) in space and first-order in time. Some numerical results have been carried out to validate the theoretical results.
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