RESUMO
Transgender care needs a multidisciplinary team approach. The awareness about transgender health has increased over the past few years in India. The pyramid of transgender health helps to demystify the care of transgender individuals. The 7 S's of lifestyle modification need to be followed in the routine clinical care of transgender individuals. The individuals also need psychological care and support, metabolic and medical care, endocrine management, and later surgery in some cases. The policy makers can use the pyramid to decide about financial help to the community for their holistic care. The physicians involved in the care of transgender individuals can also take guidance about comprehensive care and management of transgender and gender diverse individuals.
RESUMO
As per current statistics, India accounts for more than 74 million individuals living with diabetes. Many of these individuals have associated cardiovascular disease (CVD) and chronic kidney disease (CKD) comorbidities. Optimal glycemic management is important because uncontrolled glycemia may accelerate the macrovascular and microvascular complications, further aggravating the comorbid conditions. Metformin is used as the first-line therapy in most persons. However, there are some who do not tolerate metformin, are unable to achieve required glycemic targets or require greater efforts for cardiovascular (CV) risk reduction. These patients require an alternative hypoglycemic agent to be used as either monotherapy or as combination treatment with metformin, respectively. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are one such novel class of drugs that can be used as either monotherapy or as part of two drug (dual) or three drug (triple) combinations with other oral hypoglycemic agents or insulin. Dapagliflozin is a promising option for managing type 2 diabetes with CV and renal benefits, weight and blood pressure reducing properties. A low risk of hypoglycemia and drug-drug interactions are the added advantages. In this article, the authors have reviewed the existing clinical evidences on dapagliflozin and highlighted its place in the diabetes management landscape