Evidence from Experience: Unity in Diversity

Diabetes in India presents unique challenges, which merit bespoke solutions. The early onset and rapid progression of diabetes, along with late presentation to the healthcare system, call for more proactive management strategies. At the same time, persons living with diabetes ask for convenient, uncomplicated treatment regimens, which offer comprehensive control with minimal dose frequency. The original research published in this issue highlights the relevance of fixed-dose combinations (FDCs) of sulfonylurea and metformin, as well as fixed-ratio combinations (FRCs) of rapid-acting and long-acting insulin analogs, in diabetes care. In this editorial, we highlight the similar preferences of oral and insulin medication, and explore the rationale behind this. We hope that this insight will encourage further discussion and research on ethnocentric pharmacotherapy in diabetology

ASSESSMENT OF DIABETES KNOWLEDGE USING DIABETES KNOWLEDGE QUESTIONNAIRE AMONG PEOPLE WITH TYPE 2 DIABETES MELLITUS

Type 2 diabetes is a metabolic disorder, the effective management of which requires not only medication use but also patient diabetes knowledge foradopting necessary life-style modifications. Those with greater knowledge of diabetes are expected to maintain better glycemic control. Assessmentof the diabetes knowledge using diabetes knowledge questionnaire (DKQ) among Type 2 diabetes mellitus (T2DM) subjects and its correlationwith glycated hemoglobin (HbA1c) levels. A cross-sectional study was conducted at the outpatient clinics Department of Endocrinology, OsmaniaHospital. Subjects with T2DM of either gender, between the age of ≥18 years and <85 years, capable of understanding and completing questionnaireswere included. Subject who were not willing to participate and not capable of understanding and completing the questionnaires were excluded.DKQ adapted for South Asian population was used to assess patient's diabetes knowledge. DKQ score was based on 18 point scale with 0.2 and 18points, with ≥9 score were considered as satisfactory score. Associations between DKQ scores and HbA1c and duration of diabetes were measured.80 subjects with T2DM were enrolled in this study. 74 completed study and 6 not completed questionnaires due to various reasons. Mean durationof diabetes 6.5±5.9 years and DKQ score mean was 5.14±2.205. HbA1c levels (n=66) mean was 8.76±1.862. DKQ score did not show significantcorrelation with HbA1c levels but correlated with disease duration. Level of diabetes knowledge among study population was low. Majority of peoplewere illiterate, and level of education was less among study population. Improving diabetes knowledge of people with diabetes might allow achievingbetter glycemic control. Involving a clinical pharmacist with endocrinologist might achieve this objective of improving patient knowledge of diabeteswhen followed longitudinally.Keywords: Questionnaire, collaborative care, diabetes knowledge level, diabetes education, Barrier

Prediabetes: A Platform for Prevention of Diabetes

Editoria

Insulin is Essential: The National List of Essential Medicines, India, 2022

Editoria

Insulin is Essential: The National List of Essential Medicines, India, 2022

Guest Editorial&nbsp

Adrenal Advocacy: Focus on Addison’s Disease

GUEST EDITORIA

ADAPTATION OF DIABETES KNOWLEDGE QUESTIONNAIRE FOR SOUTH ASIAN COUNTRIES CONTEXT

Objective: To adapt diabetes knowledge questionnaire (DKQ) which would be suitable for assessing diabetes knowledge of subjects with type 1 and type 2 diabetes of the South Asian region.Methods: For content validation of DKQ, Delphi survey of 111 opinion leaders was conducted during the South Asian Federation of Endocrine Societies (SAFES) summit in Hyderabad. The participants are endocrinologists, diabetologists, physicians, primary care physicians and researchers from India, Srilanka, Bangladesh, Nepal, and Pakistan. Participants were asked to indicate their opinion on each of the 15 questions of DKQ as whether to include it in modified DKQ on five points Likert's scale. Participants were also requested to provide their critical comments for modification, opinion, and applicability of DKQ. The consensus was considered to be reached when 67% of participants indicated agree or strongly agree, comments regarding modification, opinion, and applicability of DKQ. Data was analyzed using descriptive statistics with IBM SPSS 19.0 version.Results: Final resultant modified DKQ comprises 13 multiple choice questions common in subjects with type-1 and type-2 diabetes, eg. blood glucose levels, diet, exercise, lifestyle, treatment, self-monitoring of blood glucose, sick day, complications, annual medical checkups; 4 multiple choice questions for subjects taking oral medication and/ or insulin only, eg. monitoring, hypoglycemia, traveling precautions, precautions for adverse drug / drug-drug reactions and 1 multiple choice question (sick day) for subjects with type 1 diabetes only.Conclusion: Modified DKQ can be utilized for evaluating diabetes knowledge outcome of subjects with diabetes of the South Asian region. Rigorous re-validation of modified DKQ will be carried out

Glucometric Guardianship

This communication conceptualizes, defines and describes glucometric guardianship, as a means of ensuring optimal glycemic management. We define glucometric guardianship as the process of ensuring appropriate measurement, monitoring and analysis of glucose levels, so as to ensure alertness in glycemic management, and agility in anticipating and detecting suboptimal glycemic parameters, and responding to them. This paper hopes to draw attention to the need for glucometric science, encourage debate and discussion and facilitate research on the topic

Vitamin D Deficiency Eradication: A National Priority

Vitamin D Deficiency Eradication: A National Priorit

Vitamin D in Clinical Practice: Current Perspectives

India is a heliophobic country; despite ample sunshine, almost 490 million people are vitamin D deficient in the country. Additionally, the Indian diet has not been successful in providing the daily need for vitamin D, leading to a vitamin D deficiency. The need to fortifying food with vitamin D has been raised several times. Besides, there have been discussions about whether vitamin D is a hormone or a vitamin? In this review, the authors have reviewed vitamin D deficiency and its status in India, assessment and screening, the role of vitamin D in various disease conditions, dosage recommendation and regimen