A consensus of key opinion leaders on the management of pre-diabetes in the Asia-Pacific region / Journal of the ASEAN Federation of Endocrine Societies

@#<p>The Asia-Pacific region carries a high disease burden, with over half of the global diabetic population residing in this region. Increasing evidence shows that without targeted intervention, the progression from impaired glucose tolerance (IGT) to type 2 diabetes occurs more frequently in Asians compared with Caucasians. Furthermore, IGT is independently associated with an increased risk of cardiovascular disease, and should be managed as early as possible. Because diabetes is now a major public health issue, strategies aimed at prevention and treatment are urgently required. Lifestyle modification, including weight loss, dietary changes and increased physical activity, play a major role in controlling the disease. Significant evidence also supports the effectiveness of a combination of lifestyle modification and pharmacologic therapy, such as metformin, in delaying the onset of diabetes. Although the importance of lifestyle interventions is well recognized throughout Asia, many countries do not have formal recommendations to guide the diagnosis and management of individuals at risk of progression to diabetes. At a recent regional meeting, experts from the Asian region convened to develop consensus recommendations to guide clinicians in the management of Asian patients with pre-diabetes. These consensus recommendations provide a clear and concise approach to the management of individuals with IGT based on the available evidence and current best clinical practice.</p>

A consensus of key opinion leaders on the management of pre-diabetes in the Asia-Pacific Region / Journal of the ASEAN Federation of Endocrine Societies

@#The Asia-Pacific region carries a high disease burden, with over half of the global diabetic population residing in thisregion. Increasing evidence shows that without targeted intervention, the progression from impaired glucose tolerance(IGT) to type 2 diabetes occurs more frequently in Asians compared with Caucasians. Furthermore, IGT is independently associated with an increased risk of cardiovascular disease, and should be managed as early as possible. Because diabetes is now a major public health issue, strategies aimed at prevention and treatment areurgently required. Lifestyle modification, including weight loss, dietary changes and increased physical activity, play a major role in controlling the disease. Significant evidence also supports the effectiveness of a combination of lifestylemodification and pharmacologic therapy, such as metformin, in delaying the onset of diabetes. Although the importanceof lifestyle interventions is well recognized throughout Asia, many countries do not have formal recommendations to guide the diagnosis and management of individuals at risk of progression to diabetes. At a recent regional meeting,experts from the Asian region convened to develop consensus recommendations to guide clinicians in themanagement of Asian patientswith pre-diabetes. These consensus recommendations provide a clear and conciseapproach to the management of individuals with IGT based on the available evidence and current best clinical practice.

Development and management of a geographic information system for health research in a developing-country setting: a case study from Bangladesh.

In the last decade, geographic information systems (GIS) have become accessible to researchers in developing countries, yet guidance remains sparse for developing a GIS. Drawing on experience in developing a GIS for a large community trial in rural Bangladesh, six stages for constructing, maintaining, and using a GIS for health research purposes were outlined. The system contains 0.25 million landmarks, including 150,000 houses, in an area of 435 sq km with over 650,000 people. Assuming access to reasonably accurate paper boundary maps of the intended working area and the absence of pre-existing digital local-area maps, the six stages are: to (a) digitize and update existing paper maps, (b) join the digitized maps into a large-area map, (c) reference this large-area map to a geographic coordinate system, (d) insert location landmarks of interest, (e) maintain the GIS, and (f) link it to other research databases. These basic steps can produce a household-level, updated, scaleable GIS that can both enhance field efficiency and support epidemiologic analyses of demographic patterns, diseases, and health outcomes.

A low-cost method to identify tubewells for longitudinal research on arsenic in groundwater.

Exposure to high concentrations of arsenic in tubewell groundwater from the shallow aquifers of Bangladesh could result in up to 300,000 arsenic-related cancer cases over the next four decades. Understanding the magnitude and temporal dynamics of this exposure, via longitudinal studies, is imperative for planning effective mitigation and management strategies. Appropriate methods are needed to identify tubewells for longitudinal sampling. A plastic band marked with a unique identification number was developed, and various methods for attaching the band to the tubewell were tested, resulting in the choice of a galvanized-iron split-rivet. Two follow-up surveys at two and 14 months post-banding assessed the durability and longevity under field conditions in the JiVitA Project area in rural, northwestern Bangladesh. After two months, approximately 96.0% of the original bands on 1,063 tubewells were functional, although the rivets were partially corroded. After 14 months, approximately 65% of a subsample of the bands were functional. With further improvements to the rivets, these bands offer an inexpensive, durable, enumeration technology for longitudinal studies on groundwater arsenic.

Effect of Emblica officinalis (Gaertn) on CCl4 induced hepatic toxicity and DNA synthesis in Wistar rats.

A single dose of CCl4 (1 ml/kg body weight, po in corn oil) increased the levels of SGOT (serum glutamate oxaloacetate transaminase), SGPT (serum glutamate pyruvate transaminase), LDH (lactate dehydrogenase), glutathione-S-transferase and depletion in reduced glutathione, glutathione peroxidase and glutathione reductase. It also caused enhancement in the levels of lipid peroxidation (LPO) and DNA synthesis. There was also pathological deterioration of hepatic tissue as evident from multivacuolated hepatocytes containing fat globules around central vein. The pretreatment of E. officinalis for 7 consecutive days showed a profound pathological protection to liver cell as depicted by univacuolated hepatocytes. Pretreatment with E. officinalis at doses of 100 and 200 mg/kg body weight, prior to CCl4 intoxication showed significant reduction in the levels of SGOT, SGPT, LDH, glutathione-S-transferase, LPO and DNA synthesis. There was also increase in reduced glutathione, glutathione peroxidase and glutathione reductase. The results suggest that E. officinalis inhibits hepatic toxicity in Wistar rats.