Consensus Statement on Management of Post-Prandial Hyperglycemia in Clinical Practice in India.

Postprandial hyperglycemia (PPHG) is a detrimental factor in the evolution of diabetes related complications. Numerous studies have established the role of PPHG in development of atherosclerosis and associated cardiovascular conditions. It is seen that management of PPHG can be more troublesome than fasting plasma glucose (FPG). Currently, there are various strategies both monitoring as well as therapeutic to control PPHG but there is no uniformity in practicing these strategies. In the absence of any standard guidelines, widespread variations in the management of PPHG are observed among physicians and diabetologists. The objective of this document is to set forth uniform guidelines to manage PPHG. This will not only result in optimal management and prevention of long term complications of diabetes but also better co-ordination and collaboration among the care providers. Moreover, an Indian perspective that can take into consideration the issues relevant to Indian patient pool will be effective. An expert committee comprising of prominent physicians and researchers associated with diabetes care provided their inputs to provide a basic platform for the formulations of guidelines. Their inputs were supplemented by extensive literature search to collect the relevant evidences. An initial draft was prepared which was reviewed by the core committee. Inputs from other experts were also sought and an initial guideline version was formulated that was presented in a conference, discussed and debated among experts. The guidelines on PPHG were then finalized and published.

Consensus guidelines for glycemic monitoring in type 1/type 2 & GDM.

Stringent monitoring of blood glucose in diabetes plays an important role as the treatment of the disease itself. Blood glucose monitoring (BGM) strategies such as measurement of Hb1Ac, Self-Monitoring of Blood Glucose (SMBG) and Continuous Glucose Monitoring (CGM) plays a vital role in achieving the important goal of preventing long term complications of diabetes. Although the use of BGM is recommended by various international guidelines in T1DM and T2DM, there is no consensus on the utility of BGM in India. So, there is a need to develop a guidance for uniform monitoring mechanism among the care givers taking into account the variations and challenges that are unique to Indian population. A committee was established that comprised of physicians, researchers and other healthcare professionals having expertise in diabetes treatment to oversee the formulation of guidelines on different monitoring and treatment aspects of diabetes. Extensive literature searches were conducted to identify and analyze the evidence available on BGM. An initial draft of BGM guidelines was presented to core members who discussed the subject matter and presented their opinion. This was then taken to wider expert audience to invite their comments that were incorporated in the initial draft. The first compilation was presented at a conference attended by nearly 200 experts. Again, their opinion was sought and the next version was prepared which was sent to core committee members for the final inputs. The Indian consensus guideline on BGM using Hb1Ac, SMBG and CGM as the primary tools was then finalized.

Prevalence of oral pre-malignant lesions and its risk factors in an Indian subcontinent low income migrant group in Qatar.

BACKGROUND: The expatriate population in Qatar largely comprises workers from the Indian subcontinent which has a very high rate of oral malignancy. Social and cultural habits and as well premalignant risk factors in this population remain prevalent even after migration. MATERIALS AND METHODS: This cross sectional study assessed the prevalence of risk factors and occurrence of oral precancerous lesions in a low income group expatriate community from the Indian subcontinent residing in Qatar. RESULTS: Among the 3,946 participants screened for oral premalignant lesions 24.3% (958) were smokers and 4.3 % (169) were pan chewers while 6.3% (248) were users of both smoked and smokeless forms of tobacco. Significantly higher proportion of industrial laborers (49.9%) followed by drivers (24.1%) were found to be smokers (p=0.001). The prevalence of white lesions was higher in smokers versus non-smokers 3.5% versus 2.3% (p=0.111), however this difference was statistically non-significant. Red and white lesions were highly significant (i.e. 1.2 % and 10.9% respectively) in the subjects with pan chewing and smoking habits (p=0.001). A significant proportion (8.9%) of the subjects with pan chewing habit showed evidence of oral precancerous lesions (p=0.001). CONCLUSIONS: Even though smoking and pan chewing were two significant risk factors detected in this population, their prevalence and occurrence of premalignant lesions are low as compared to the studies conducted in their home countries.