Description
Recent advancements in drug discovery have led to the emergence of innovative therapeutics for diabetes treatment. Promising classes of drugs, including Incretin mimetics, Amylin analogues, GIP analogs, Peroxisome proliferator-activated receptors, and dipeptidyl peptidase-4 inhibitors, have been identified as potential targets. Moreover, the exploration of bioactive compounds from plants has revolutionized the search for effective treatments in diabetes management. Exciting technologies such as infrared radiation, Raman spectroscopy, thermal imaging, photoacoustic spectroscopy, and millimeter waves offer the possibility of non-invasive and continuous monitoring of blood glucose levels, eliminating the need for painful finger pricks. Additionally, ongoing research on immunotherapy shows promise in preventing or delaying the onset of Type 1 diabetes, particularly for individuals with a genetic predisposition to the disease. Multiple approaches are being developed, including the utilization of the tuberculosis vaccine, monoclonal antibody development, and synthetic peptide modification. With an increasing number of clinical studies, the future looks promising for diabetic patients.
Résumé
- The Research Society for the Study of Diabetes of India (RSSDI) has issued guidelines for diabetes management, but ultimately, treatment should be individualized based on patient needs. Type 2 diabetes is diagnosed with a fasting blood glucose level exceeding 126 mg/dL, or a post-glucose level above 200 mg/dL. Lifestyle modifications, including diet, physical activity, adequate sleep, stress reduction, and avoiding smoking and excessive alcohol consumption, are crucial in managing diabetes.
- Medication decisions should consider the patient's age, weight (BMI), presence of complications, duration of diabetes, cardiovascular disease status, and current blood glucose levels. Hypoglycemia is a significant concern, particularly in elderly patients. Financial considerations also play a role in drug selection to ensure long-term adherence.
- Effective diabetes management involves regular blood glucose monitoring (frequency depends on the individual), adherence to prescribed medications (oral or insulin), and tailored physical activity recommendations. Dietary advice is also critical, focusing on calorie restriction (if overweight), carbohydrate management (restricting to approximately 50% of intake, prioritizing unrefined sources), adequate protein intake, and healthy fats.
- When providing dietary recommendations, consider factors like calorie restriction, carbohydrate intake type, protein sources, fat type, and consumption of vegetables and fruits. Unrefined carbohydrates with high fiber content, such as brown rice, whole wheat flour, and millets, are preferred over refined carbohydrates. Lean meats and plant-based sources should be prioritized for protein intake.
- In terms of pharmacological interventions, Metformin is often the first-line choice for managing diabetes. SGLT2 inhibitors are increasingly used due to their kidney and cardiovascular benefits. GLP-1 analogs, including oral semaglutide, can effectively reduce body weight. When prescribing any medication, it's crucial to know its mechanism of action, efficacy, side effects, precautions, and contraindications.
- In the Indian context, type 2 diabetes often starts at a younger age and can occur in individuals with lower BMIs. Indian patients tend to have insulin resistance, rapid decline of beta cell function, dislipidemia, and vitamin deficiencies. Considering these peculiarities is essential when managing diabetes in Indian patients.
- Different subtypes of type 2 diabetes exist, necessitating individualized management strategies. Newer technologies, such as continuous glucose monitoring (CGM), are valuable for young type 2 diabetics, those requiring multiple medications, and those with complications. Insulin pumps offer another advanced option, especially for individuals needing higher insulin doses or those with type 1 diabetes.
- Effective communication and management also entail understanding technologies. While technologies are important, affordability for the patient is a critical consideration. Home blood glucose monitoring using glucometers is an empowering and cost-effective approach. Healthcare professionals must stay informed about emerging technologies and their application in diabetes management.
Exemple de certificat
À propos des intervenants
Dr Vasanth Kumar
Senior General Physician Apollo Hospitals, Hyderabad President of RSSDI Founder and President Diabetes and You Society (DAY Society)
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