Browsing by Author "Das, A.K."
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Item BE-SMART (Basal Early Strategies to Maximize HbA1c Reduction with Oral Therapy): Expert Opinion(Diabetes Therapy, 2019-03-19) Lamptey, R.; Bajaj, S.; Das, A.K.; Kalra, S.; Sahay, R.; Saboo, B.; Das, S.; Shunmugavelu, M.; Jacob, J.; Priya, G.; Khandelwal, D.; Dutta, D.; Chawla, M.; Surana, V.; Tiwaskar, M.; Joshi, A.; Shrestha, P.K.; Bhattarai, J.; Bhowmik, B.; Latt, T.S.; Aye, T.T.; Vijayakumar, G.; Baruah, M.; Jawad, F.; Unnikrishnan, A.G.; Chowdhury, S.; Pathan, M.F.; Somasundaram, N.; Sumanathilaka, M.; Raza, A.; Bahendeka, S.K.; Coetzee, A.; Ruder, S.; Ramaiya, K.; Bavuma, C.; Shaikh, K.; Uloko, A.; Chaudhary, S.; Abdela, A.A.; Akanov, Z.; Rodrı`guez-Saldan˜a, J.; Faradji, R.; Tiago, A.; Reja, A.; Czupryniak, L.The past three decades have seen a quadruple rise in the number of people affected by diabetes mellitus worldwide, with the disease being the ninth major cause of mortality. Type 2 diabetes mellitus (T2DM) often remains undiagnosed for several years due to its asymptomatic nature during the initial stages. In India, 70% of diagnosed diabetes cases remain uncontrolled. Current guidelines endorse the initiation of insulin early in the course of the disease, specifically in patients with HbA1c > 10%, as the use of oral agents alone is unlikely to achieve glycemic targets. Early insulin initiation and optimization of glycemic control using insulin titration algorithms and patient empowerment can facilitate the effective management of uncontrolled diabetes. Early glucose control has sustained benefits in people with diabetes. However, insulin initiation, dose adjustment, and the need to repeatedly assess blood glucose levels are often perplexing for both physicians and patients, and there are misconceptions and concerns regarding its use. Hence, an early transition to insulin and ideal intensification of treatment may aid in delaying the onset of diabetes complications. This opinion statement was formulated by an expert panel on the basis of existing guidelines, clinical experience, and economic and cultural contexts. The statement stresses the timely and appropriate use of basal insulin in T2DM. It focuses on the seven vital Ts-treatment initiation, timing of administration, transportation and storage, technique of administration, targets for titration, tablets, and tools for monitoringItem Euthymia in Diabetes: Clinical Evidence and Practice-Based Opinion from an International Expert Group(Diabetes Therapy, 2019-04) Kalra, S.; Das, A.K.; Baruah, M.P.; Unnikrishnan, A.G.; Dasgupta, A.; Shah, P.; Sahay, R.; Shukla, R.; Tiwaskar, M.; Das, S.et.alTo develop an evidence-based expert group opinion on various types of euthymia associated with diabetes mellitus (DM) and its management. Diabetes mellitus is a metabolic syndrome characterized by diverse biomedical and psychosocial features. Emotional health disturbances may lead to psychological and psychiatric dysfunction and may negatively influence glycemic control. Patients with DM may experience diabetes distress (DD) associated with burden of self-care, interpersonal issues, and emotional worries regarding the ability to cope with the illness. Euthymia or a state of positive mental health and psychological well-being should be considered a key outcome of diabetes care. Therefore, to achieve optimal outcomes, the consideration and measurement of psychological and psychiatric aspects along with glycemic levels are very important. A group of multidisciplinary clinical experts came together in an international meeting held in India to develop a workable concept for euthymia in diabetes care. A multidisciplinary approach was suggested to enhance the clinical outcomes and facilitate patient-centered care. During the meeting emphasis was given to the concept of a euthymia model in diabetes care. This model focuses on enhancement of self-care skills in diabetic patients and preventative health awareness among diabetes care providers. Euthymia also encompasses patient–provider communication to aid enhancement of coping skills. After due discussions and extensive deliberations, the expert group provided several recommendations on implementing the concept of euthymia in DM care. Introduction of the concept of euthymia in routine clinical practice is important to improve the quality of life and coping skills in patients with DM. A timely clinical assessment of psychological and psychiatric aspects along with patient-reported outcomes of diabetes contributes to overall health and well-being of affected individuals. Sanofi India.