Practical guidance on insulin injection practice in diabetes self-management in the Indian setting: an expert consensus statement

This consensus statement aimed to provide a simple and easily implementable practical educational guide- line for healthcare professionals (HCPs) and patients regarding insulin injection practice in diabetes self- management in the Indian setting. A group of experts analysed published data from guidelines, clinical trials and real world evidence to reach consensus recommendations on optimal insulin injection practices in terms of a) the injection sites (preparation of site of injection, choosing the injec- tion site, site rotation), b) choice of device and storage of insulins, and c) safety precautions, sharp disposal practice and complications. Findings from Global and Indian arm of 2014-2015 ITQ Study were considered to emphasize a need for improved practice by HCPs covering all the vital topics essential to proper injection habits. The consensus statement provides a simple and easily implementable practical educational guideline for HCPs and patients to optimize insulin injection practices in accordance with recent advances in device manufac- turing, newer research findings, and updated interna- tional guidelines as well as widespread concerns about neglected safety precautions such as single-patient use of pens and appropriate sharp disposal practices.This consensus statement aimed to provide a simple and easily implementable practical educational guide- line for healthcare professionals (HCPs) and patients regarding insulin injection practice in diabetes self- management in the Indian setting. A group of experts analysed published data from guidelines, clinical trials and real world evidence to reach consensus recommendations on optimal insulin injection practices in terms of a) the injection sites (preparation of site of injection, choosing the injec- tion site, site rotation), b) choice of device and storage of insulins, and c) safety precautions, sharp disposal practice and complications. Findings from Global and Indian arm of 2014-2015 ITQ Study were considered to emphasize a need for improved practice by HCPs covering all the vital topics essential to proper injection habits. The consensus statement provides a simple and easily implementable practical educational guideline for HCPs and patients to optimize insulin injection practices in accordance with recent advances in device manufac- turing, newer research findings, and updated interna- tional guidelines as well as widespread concerns about neglected safety precautions such as single-patient use of pens and appropriate sharp disposal practices

A review on generation of real-world evidence

Real-world evidence can generate credible evidence to inform treatment decisions. Real-world evidence is in developmental stage and is fast evolving yet there are many unexplained attributes of real-world evidence. Real-world evidence informs benefit-risk decisions and is increasingly being used to support regulatory decision making. Potential benefits of real-world data include determination of extended outcomes including long-term outcomes, opportunities to partner with patients in innovative ways, and reduction in time and cost to generate dependable evidence. Limitations of real-world evidence include uncertainty in the quality of datasets and lack methodologic rigor in real-world studies. Use of real-world evidence for healthcare practices and policies is limited. Ensuring completeness, homogeneity, and linkage of datasets can enhance utility for epidemiological investigations and improvement in health outcomes. Research should be strengthened for real-world studies and technical standards should be reinforced. Collaborations of stakeholders is key to formulation and adoption of guidance for real-world evidence. Real-world data cannot be a substitute to randomized clinical studies but can possibly augment the generated evidence

Praktyczne wskazówki dotyczące samodzielnych iniekcji insuliny w leczeniu cukrzycy w warunkach indyjskich: stanowisko zespołu ekspertów

Celem niniejszego konsensusu było dostarczenie prostych i łatwych do wdrożenia w praktyce wytycznych edukacyjnych dla pracowników opieki zdrowotnej i pacjentów, dotyczących wstrzykiwania insuliny w samoleczeniu cukrzycy w warunkach indyjskich. Zespół ekspertów krytycznie przeanalizował opublikowane dane z wytycznych, badań klinicznych i rzeczywistej praktyki klinicznej i uzgodnił zestaw praktycznych zaleceń dotyczących optymalnego stosowania insulinoterapii w odniesieniu do: a) miejsc wstrzyknięcia (przygotowanie miejsca wstrzyknięcia, wybór miejsca wstrzyknięcia, rotacja miejsca); b) wyboru urządzenia i przechowywania insuliny; c) środków ostrożności, utylizacji ostrych przedmiotów i powikłań. Eksperci poddali analizie wyniki uzyskane w części ogólnej i indyjskiej badania 2014–2015 ITQ, zwracając uwagę na potrzebę poprawy opieki diabetologicznej w zakresie wszystkich aspektów wpływających na prawidłowe wstrzykiwanie insuliny.  Niniejszy dokument zawiera proste i łatwe do stosowania praktyczne zalecenia edukacyjne dla pracowników opieki zdrowotnej i pacjentów, dotyczące optymalizacji techniki wstrzykiwania insuliny zgodnie z najnowszymi osiągnięciami w zakresie urządzeń do podawania insuliny, najnowszymi wynikami badań i uaktualnionymi wytycznymi międzynarodowymi, a także związane z powszechnymi obawami dotyczącymi nieprzestrzegania środków ostrożności, takich jak używanie wtryskiwacza wyłącznie u jednego pacjenta i odpowiednia utylizacja ostrych przedmiotów.

Management of anemia in patients with diabetic kidney disease: A consensus statement

This consensus statement focuses on the window of opportunity, which exists while treating patients with diabetic kidney disease and anemia

Consensus dietary guidelines for healthy living and prevention of obesity, the Metabolic syndrome, Diabetes, and related disorders in Asian Indians

India is undergoing rapid nutritional transition, resulting in excess consumption of calories, saturated fats, trans fatty acids, simple sugars, salt and low intake of fiber. Such dietary transition and a sedentary lifestyle have led to an increase in obesity and diet-related non-communicable diseases (type 2 diabetes mellitus [T2DM], cardiovascular disease [CVD], etc.) predominantly in urban, but also in rural areas. In comparison with the previous guidelines, these consensus dietary guidelines include reduction in the intake of carbohydrates, preferential intake of complex carbohydrates and low glycemic index foods, higher intake of fiber, lower intake of saturated fats, optimal ratio of essential fatty acids, reduction in trans fatty acids, slightly higher protein intake, lower intake of salt, and restricted intake of sugar. While these guidelines are applicable to Asian Indians in any geographical setting, they are particularly applicable to those residing in urban and in semi-urban areas. Proper application of these guidelines will help curb the rising "epidemics" of obesity, the metabolic syndrome, hypertension, T2DM, and CVD in Asian Indians