Vol 2 Issue 1

Blog, Vol 2 Issue 1

An Epidemiology study of Socio-demographic-economic & Gestational Profile of Women with Early Gestational Glucose Intolerance at 8-10 weeks of Pregnancy

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Diabetes accounts for nearly 10% of global deaths among people aged 20 to 99 and is the fourteenth leading cause of Disability-Adjusted Life Years (DALYs) worldwide. The prevalence of diabetes is increasing worldwide due to factors like urbanization, nutrition, the elderly population, genetics, and lifestyle changes.1 An often-overlooked factor is gestational diabetes mellitus, which leads to glucose intolerance during pregnancy.2 Women with gestational diabetes often develop diabetes within three to six years after delivery, perpetuating a cycle of obesity, insulin resistance, diabetes, and NCDs across generations. Breaking this cycle is now more crucial than ever.3 Gestational diabetes mellitus (GDM), according to the World Health Organization, is characterized by carbohydrate intolerance leading to elevated blood sugar levels, with variable severity, first recognized during pregnancy. It is a very common metabolic disorder in pregnancy. Insulin resistance increases during pregnancy due to the development of carbohydrate intolerance.4 Adiponectin, which has antidiabetic and anti-inflammatory effects, is present in low levels in pregnant women with gestational diabetes mellitus (GDM). This decrease is associated with increased insulin resistance during pregnancy, playing a role in the onset of GDM. Insulin resistance, resulting from the β-cells’ failure to secrete insulin properly, may also be affected by maternal adiposity.5 The rising prevalence of GDM is primarily driven by modifiable risk factors like obesity, poor diet, sedentary lifestyle, and pre-existing insulin resistance, which can be reduced through early interventions. GDM has long-term effects on both the mother and offspring, influencing health outcomes across generations.

Blog, Vol 2 Issue 1

Gestational Diabetes Diagnosis by DIPSI & IADPSG Criteria in observational study in Italian Population

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Sanjev Dave, Submitted: 12 April 2025; Accepted: 21 April 2025; Published: 28 April 2025 Corresponding Author: 1Prof Dr Sanjev Dave, HOD Community Medicine, Autonomous State Medical College, Auraiya (UP-206244). [email protected] There is non-universal consensus for Diagnosis of Gestational Diabetes Mellitus around the Globe, even in same country two guidelines are followed; one observational retrospectively study done in Italy, of the 1015 pregnant women who studied, 80% were (811) Italian [1]. Gestational diabetes mellitus (GDM) was identified in 113 cases (11.1%) using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, while the Indian Diabetes in Pregnancy Study Group (DIPSI) criteria diagnosed 105 patients (10.3%).

Blog, Vol 2 Issue 1

The effect of dried camel milk on blood parameters in the diabetic cases

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Taherah Mohammadabadi1 *, Rajesh Jain2 1 Professor, Faculty of Animal Science and Food Technology, Agricultural Sciences and Natural Resources University, Iran 2Consultant Diabetes, Jain Hospital, Kanpur, India Submitted: 1 April 2025; Accepted: 10 April 2025; Published: 29 April 2024 1*Corresponding author: Prof Dr Taherah Mohammadabadi, Faculty of Animal Science and Food Technology, Agricultural Sciences and Natural Resources University, Iran. Email: [email protected] Abstract Traditionally, in Africa, Asia, and the Middle East, camel milk is consumed regularly for diabetes, and a lower incidence of diabetes occurs by drinking camel milk. Since fresh camel milk is not available for all people globally, this study aimed to evaluate the antidiabetic effects of camel milk powder in diabetic patients. About 15 grams/day of camel milk powder was used in 6 type 1 diabetic cases injected with insulin, for 3 months in two groups. The results showed a significant decrease in fasting blood glucose in camel milk powder patients. Blood sugar reduced from 113 to 98 mg /dL, and LDL decreased significantly from 95 to 73 mg/dL. The results showed that the average dose of required insulin before consuming camel’s milk powder was 42±5 u/day, gradually decreasing to 30 ± 6 u/day, three months after taking camel milk powder. After 3 months, consuming 15 g camel milk powder, two times daily, decreased fasting blood glucose, required insulin dose, total cholesterol, and LDL. Thus, camel milk powder may exhibit antidiabetic activity in diabetic patients and improve cardiovascular disorders and other complications. Keywords: camel milk, diabetes, blood glucose, health

Blog, Vol 2 Issue 1

Can Yoga help in Preventive & Therapeutic Practice?

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Sanjev Dave , Mukesh Vir Singh2, Rashmi Pandey3, Anuradha Dave4, Rajesh Jain5 , Ridima Kamal6. 1Prof Dr Sanjev Dave, HOD Community Medicine, Autonomous State Medical College, Auraiya (UP-206244) 2Principal & Professor- Paediatrics, Autonomous State Medical College, Auraiya (UP-206244) 3Assistant Professor Biochemistry, Govt Medical College, Haridwar, Uttarakhand, India, Uttar Pradesh)- India 4Prof Dr Department of Community Medicine, Subharti Medical College, Meerut (Uttar Pradesh)- India-250005 5Professor, Director, Jain Medical Centre, Kanpur (Uttar Pradesh)- India 6 Public Health Consultant, Department of Community Medicine, All India Institute of Medical Sciences, New Delhi.  Submitted: 10 April 2025; Accepted: 25 April 2025; Published: 29 April 2025 Corresponding Author: Prof. Dr Sanjev Dave, HOD Community Medicine, Autonomous State Medical College, Auraiya (UP-206244). [email protected] Introduction An old practice rooted in Indian philosophy, yoga integrates physical posture (asana), breathing techniques (pranayama), meditation (dhyana), and ethical fields to promote a general well. For thousands of years, yoga has been rooted partly in Indian philosophy and traditional Indian spiritual practices [1]. The role of yoga has recently expanded. Yoga is currently a popular physical and mental health method, adapted to international complementary and integrative medicine [2]. In the latter environment, yoga often includes physical posture, breath control, deep relaxation, and meditation/mindfulness techniques. In Western society, yoga is increasingly popular as a preventive and therapeutic practice, and is one of the treatments with the fastest increase in prevalence [3], as seen in a study [4]. Over the years, yoga has gained global recognition for improving flexibility and relaxation, but also a powerful preventive and therapeutic device for various health conditions. Therefore, health service providers are increasingly presented with patients who use yoga to treat health conditions and those of interest [4]. Yoga-based initiatives are becoming popular in promoting wellness in communities, businesses, and schools, and now, primary health care integration via AYUSH programs (India) is underway [5-7]. Let’s look at the important Preventive and therapeutic functions of Yoga as seen from studies [5-7]. Numerous positive advantages are also linked to yoga.

Blog, Vol 2 Issue 1

Review of spot Test and significance of Post Prandial Blood Glucose (PPBG) ≥110 mg/dl in 8-10 weeks of Pregnancy

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Abstract: Metformin & MNT are used from 8 to 10 weeks of pregnancy to prevent gestational diabetes. According to Dr. Seshiah, significant changes occur in maternal metabolism when fetal insulin secretion begins. Hyperglycemia can lead to non-communicable diseases later in life, which is why gestational diabetes is often referred to as a precursor to these conditions. It is important to avoid the transgenerational transmission of diabetes. Spot Test was discovered by the V Seshiah group 40 years ago, with 105 mg/dl by plasma lab value and 110 mg/dl by plasma calibrated Glucometer, which are equal values.

Blog, Vol 1 Issue 2

Review of TOBOGM Study

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Editorial Review: Rajesh Jain1 1Corresponding Author: Dr. Rajesh Jain, MD Chair (Diabetes Asia under JHRC); 108 B Gandhi gram, Vinobha Nagar, Kanpur-208007, India. Email: [email protected]; Rajesh Jain1. Review of TOGOBM study. Diabetes Asia Journal.2024; 1(2):35-37. https://doi.org/10.62996/daj.30112024 Simmons D, Immanuel J, Hague WM, Teede H, Nolan CJ, Peek MJ, Flack JR, McLean M, Wong V, Hibbert E, Kautzky-Willer A, Harreiter J, Backman H, Gianatti E, Sweeting A, Mohan V, Enticott J, Cheung NW; TOBOGM Research Group. Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy. N Engl J Med. 2023 May 5. doi: 10.1056/NEJMoa2214956 In the TOBGM study, Intervention started very late, with OGTT performed an average of 15.6 weeks. This is why it results in a modest reduction in primary outcome in the immediate treatment arm (24.9% Vs. The control group (30.5%) adjusted risk reduction by 5.6%. OGTT was performed in less than 14 weeks in 23.2% of Women only, and most of the women were beyond the 14th week at entry level in both the Intervention and control groups. Insulin and Metformin use was more in the Treatment arm than in the control arm, 58.1% vs. 41.4% and 23.6% Vs. 10.4%, respectively. Interestingly, more benefits were seen in less than the 14th week of pregnancy. Our theory says that if a Diagnosis could have been made in the 8th week by a Postprandial Blood Glucose value threshold of 110 mg/dl and treatment with MNT and Metformin 250 mg Two times to maintain Postprandial Blood glucose at 2 hours with less than 110 mg/dl would have resulted in a more robust reduction in Neonatal and Maternal outcomes. This theory is based on Dr. V Seshiah’s” Path Breaking Concept for Primordial Prevention of Gestational Diabetes and its sequelae. Prof Seshiah is a well-known Expert on Gestational Diabetes and received the IDF lifetime achievement award and Padmashri from Govt of India for his work in GDM. Diabetes mellitus in recent years has become a relentlessly evolving pandemic. Measures for the screening and early detection of diabetes are practiced worldwide. However, considering the ever-increasing magnitude of the problem, the current efforts should primarily focus on primordial diabetes prevention. A ray of hope for preventing the development of diabetes in an individual arises from the concept that many adult-onset diseases have already been programmed while the individual is still in utero. In women with hyperglycemia in pregnancy, maternal hyperglycemia results in fetal hyperinsulinemia, leading to increased fetal adiposity insulin resistance and diabetes in adulthood. We have pointed out that the fetal beta-cells start secreting insulin at 10-11 weeks of pregnancy, and fetal hyperinsulinemia persists with maternal hyperglycemia in a pregnant woman who would develop gestational diabetes. Considering the fetal glucose-steal phenomenon and the fetal renal threshold for glucose, we have suggested a two-hour post-prandial blood-glucose (PPBG) value of >110 mg/dL as the cut-off for predicting gestational diabetes in the early weeks of pregnancy. Furthermore, we have emphasized using metformin in addition to medical nutrition therapy in the early weeks to maintain PPBG around 110 mg/dL to prevent gestational diabetes. We recommend universal screening of all pregnant women during the early weeks of the first trimester. We put forward that a two-hour PPBG of >110 mg/dl during the 10th-11th week of pregnancy would predict the risk of gestational diabetes in the pregnant woman. We suggest early testing and intervention to prevent the development of fetal hyperinsulinemia as a primordial prevention approach for diabetes1 Figure 1. The pattern of glycemia in normal pregnancies and recommended therapeutic targets for post-prandial blood glucose in hyperglycemia-in-pregnancy (HIP). Adapted from Hernandez et al., 2011 [9], under the Creative Commons License http://creativecommons.org/licenses/by-nc-nd/3.0/) A blood test conducted as early as the 10th week of pregnancy may help identify women at risk for gestational diabetes; if> 110 mg/dl, MNT and metformin 250 mg/bd must be started and continued. The target glycemia to be obtained is PPBS 99 ± 10 mg/dl. Metformin is Safe as the Embryonic stage is over by the 8th week. 2To use metformin as an adjunct or alternative to insulin in the preconception period and during pregnancy, when the likely benefit from improved blood glucose control outweighs the potential for harm. Figure 2 Glycemic level at Gestational Weeks for Prediction of GDM 3Administration of metformin after the 12th week will not prevent GDM.   PPBS >110 mg/dl at the first-week Insulin resistance physiologically plays a vital role in the changes in carbohydrate, lipid, and amino acid metabolism that facilitate the fetus’s anabolism and nutrition. The idea is to test for glucose tolerance in the 8th week (2 months). Why? Prediction of GDM is 2hr PPBS > 110mg/dl at 10th week. Hence, in the 8th week, PPBS has to be estimated.  Because…If PPBS is > 110 mg/dl in the 8th week, a grace period of 2 weeks is available to attain PPBS < 110 mg/dl in the 10th week. The aim is to maintain Maternal 2-hr Plasma Glucose 99 ± 10 mg/dl throughout pregnancy from Conception to Confinement to Prevent the Transgenerational Transmission of Diabetes. The preliminary data from India show the benefit of early treatment of GDM, as per the RCT conducted in 8 centers across different states by the DIPSI Diabetes in Pregnancy Study Group in India. 1. Seshiah V, Bronson SC, Balaji V, Jain R, Anjalakshi C. Prediction and Prevention of Gestational Diabetes Mellitus and Its Sequelae by Administering Metformin in the Early Weeks of Pregnancy. Cureus. 2022 Nov 15;14(11):e31532. doi: 10.7759/cureus.31532. PMID: 36540507; PMCID: PMC9754731. 2. NICE Guidelines. 2nd February 2015 3. Valdés E, Sepúlveda-Martínez A, Candia P, Abusada N, Orellana R, Manukian B, Cuellar E. Metformin as a prophylactic treatment of gestational diabetes in pregnant patients with pregestational insulin resistance: A randomized study. J Obstet Gynaecol Res. 2018 Jan;44(1):81-86. Doi: 10.1111/jog.13477 4. Hernandez TL, Friedman JE, Van Pelt RE, Barbour LA. Patterns of Glycemia in Normal Pregnancy: Should the current therapeutic targets be challenged? Diabetes Care. 2011 Jul;34(7):1660-8 Not applicable Not applicable Not applicable All the authors declared “No Conflict of Interest” with this publication. The article

wdd2024
Blog, Vol 1 Issue 2

World Diabetes Day 2024

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 World Diabetes Day 2024 Rajesh Jain1, Veeraswamy Seshiah2 Sadhana Tiwari3, Shweta Verma4 Corresponding Author: Dr Rajesh Jain, MD chair, Diabetes Asia, Jain Hospital & Research Centre, Kanpur-208007, India. Email: [email protected] World Diabetes Day (WDD) is the main global awareness campaign dedicated to Diabetes mellitus, held annually on November 14 [1] World Diabetes Day, initiated by the International Diabetes Federation (IDF) and WHO, is a testament to our ongoing commitment to the fight against Diabetes. Each World Diabetes Day focuses on a diabetes-related theme. Type 2 diabetes, a noncommunicable disease rapidly increasing in numbers worldwide, can be prevented. Type 1 diabetes, unfortunately, is not preventable but can be managed with insulin injections[2]. The day also includes discussions on human rights, NCDs and lifestyle, obesity, Diabetes in the LMIC and the vulnerable, and Diabetes in children and adolescents. The campaigns, which run year-round, ensure that we are constantly engaged in the fight against Diabetes, not just on November 14 but every day of the year. The day marks the birthday of Frederick Banting, who, along with Charles Best, first conceived the idea that led to insulin’s discovery in 1922[3] History Figure 1: World Diabetes Day on November 14, 2024, at Vimla Group, Kanpur Himeji Castle lit up for WDD on World Diabetes Day on November 14, 2008 World Diabetes Day, a global initiative started in 1991 by the International Diabetes Federation and the World Health Organization (WHO), responded to the alarming rise in diabetes cases worldwide. This initiative has since united people from all corners of the globe, fostering a sense of global unity in the fight against Diabetes. The General Assembly’s resolution, A/61/L.39/Rev.1 / Add.1, adopted at the UN on December 20, 2006, was a significant step in establishing World Diabetes Day. This resolution, numbered 61/225, officially established World Diabetes Day, further highlighting the global concern about the rapid increase in diabetes cases. It’s important to be aware of these international initiatives and resolutions to understand the severity of the issue. By 2016, over 230 IDF Member Associations in more than 160 countries and territories actively participated in World Diabetes Day. This global movement is a testament to the widespread support for the cause, with diverse participants, from international organizations and companies to healthcare professionals, politicians, celebrities, and, most importantly, people with Diabetes and their loved ones. Around the world, 536.66 million adults were living with Diabetes in 2021, Which will be 592 million by 2035, which was 108 million in 1980. The global prevalence of Diabetes has twice risen from 4.7% to 8.5% in the adult population, which indicates increased risk factors: overweight, obesity, and other risk factors for NCDs. Over the past two decades, diabetes prevalence growth has been twice that of low- and middle-income countries compared to high-income nations. Diabetes major complications of blindness, kidney failure, heart attack, stroke, and lower limb amputation are well recognized. A healthy diet low in carbohydrates, physical activity, and avoiding tobacco consumption can help prevent or delay type 2 diabetes. Moreover, Diabetes can be treated, and its complications may be delayed or delayed with medication, regular screening, and treatment for complications. The General Assembly adopted resolution 61-225 in 2007, fixing November 14 as WDD World Diabetes Day. The statement recognized the “organized ” need to follow multilateral efforts to prevent, promote, and protect human health and provide access to treatment and healthcare education.” The resolution also motivates Nations and states to develop national health policies for the prevention/control, treatment, and health management of Diabetes in line with the sustainable development SDGs of their healthcare systems. Diabetes and well-being Diabetes and well-being are the theme for World Diabetes Day 2024-26. With appropriate access to diabetes care and support for their well-being, everyone with Diabetes can live well. Millions of people with Diabetes face daily challenges managing their condition at home, work, and school. They must be resilient, organized, and responsible, which impacts their physical and mental well-being. Diabetes care often focuses only on blood sugar, leaving many overwhelmed. This World Diabetes Day, November, let’s put well-being at the heart of diabetes care and start the change for a better diabetes life. Background Diabetes is an NCD/chronic disease that occurs when insulin resistance develops, the pancreas does not produce enough insulin, or the body does not effectively use it, which leads to an increased glucose concentration in the blood (hyperglycemia). Type 1 diabetes/ previously known as IDDM insulin-dependent or childhood-onset diabetes, is due to a lack of insulin secretion. Type 2 diabetes (formerly called NIDDM, non-insulin-dependent, or adult-onset diabetes) is caused by the body’s dysfunctional utilization of insulin. It results from increased body weight and physical inactivity. Gestational Diabetes is hyperglycemia that is first recognized during pregnancy. Global Diabetes Walk from World Diabetes Foundation As per IDF Atlas 2021, With over 537 million adults living with Diabetes worldwide, a number predicted to rise to 783 million bit’s45, it’s more important than ever to spread awareness about this disease. Diabetes affects people from all walks of life. However, it is particularly prevalent in low- and middle-income countries (LMICs), where more than 75% of people living with Diabetes reside and where access to healthcare and health education may be limited.  The Global Diabetes Walk is organized by the World Diabetes Foundation, a leading funder of diabetes prevention and care projects in LMICs, which aligns with its primary prevention intervention area. The Walk contributes to the annual International Diabetes Federation campaign for World Diabetes Day on November 14. In 2024, we celebrate 20 years of raising awareness together.  Since 2004, more than 6 million people have joined the Walk, making it a powerful force for change in the fight against Diabetes. We aim to inspire people worldwide to act and get walking for diabetes awareness. We believe that everyone has a role to play. Whether you are an individual, a family, a community, or an organization, you can make a difference by getting involved in the Global Diabetes Walk. Figure 2 The theme for World Diabetes Day 2024-2026 is Diabetes and well-being. As a result, the Walk campaign this year will highlight the benefits of exercise for the physical, societal, and mental well-being of people

Blog, Vol 1 Issue 2

Can the Management of blood sugar levels in GDM cases can be an indicator of maternal fetal outcomes? The results of a Prospective cohort study from India

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Rajesh Jain, Sanjeev Davey, Anuradha Davey, Santosh Raghav, Jai V Singh Conflict of Interest Statement All the authors declared “No Conflict of Interest” with this publication. The article is Open Access and is licensed under a Creative Commons Attribution 4.0 International License; visit http://creativecommons.org/licenses/by/4.0/. ISSN 3048-8192 Cite this article: Diabetes in Pregnancy Management Reduces Perinatal, Neonatal Mortality in a Large Prospective Cohort from India. Diabetes Asia Journal. 2024; 1(2):25-26  DOI: https://doi.org/10.62996/daj.004102024

Blog, Vol 1 Issue 2

Management of Blood sugar levels in hypreglycemia in pregnancy HIP reduces perinatal, infant morbidity &mortality as a results of large prospective cohort learn from Uttar pradesh

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Swapna Das1, Rajesh Jain2, Shamita3 Conflict of Interest Statement All the authors declared “No Conflict of Interest” with this publication. The article is Open Access and is licensed under a Creative Commons Attribution 4.0 International License; visit http://creativecommons.org/licenses/by/4.0/. ISSN 3048-8192 Cite this article: Diabetes in Pregnancy Management Reduces Perinatal, Neonatal Mortality in a Large Prospective Cohort from India. Diabetes Asia Journal. 2024; 1(2):25-26  DOI: https://doi.org/10.62996/daj.003102024

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