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My Journey in Diabetology

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Dr Sarita Bajaj, President    31 January 2018

With my team, I have covered various aspects of diabetes including epidemiology, regional disparities in care, public education, diet (maize, starch), metabolic syndrome, prevalence of type 2 diabetes and hypertension, fatty liver, HIV, fasts and feasts in diabetes, psychosocial aspects, insulin, complications, H. pylori with type 2 diabetes, oral manifestations, vitamin D,  diabetic kidney disease, thyroid disorder. In 2013, the South Asian Federation of Endocrine Societies (SAFES) was established. We worked on a noninvasive method of mass screening for patients using easy scan to look into peripheral neuropathy. and are working on the RSSDI digital diabetes collaboration. We have also worked in the field of women’s health and diabetes with emphasis on GDM. In the SAFES Dhaka Declaration 2015, GDM was identified as the focus of attention for the term  2015-17. GDM: SAFES Recommendations and Action Plan will be released in Lahore this month.

In the study - Prevalence of GDM and associated risk factors in UP, we determined the prevalence of GDM and risk factors associated with it in 2417 women attending an antenatal care clinic in UP. About 11.37% women had GDM. Gestational glucose intolerance was observed in 23.4% women. Average BMI in GDM patients was 23.58 kg/m2. Risk factors found to be associated with GDM were: age; socioeconomic status; educational level; pre-pregnancy weight and BMI; weight gain; family history of diabetes or hypertension, past history of GDM.

I feel that the healthcare system should consider custom-designed prevention and control programs tailored for women based on local and regional attitudes on healthcare, cultural beliefs, and available social support systems. Apart from health issues of universal concern in relation to Ramadan fasting, issues pertaining exclusively to women which need to be addressed include: Menstruation; sexual obligations of married life; pregnancy; lactation/breastfeeding. Insulin, glibenclamide and metformin are safe and effective therapies for GDM during 2nd and 3rd trimesters, and may be initiated as first-line treatment after failing to achieve glucose control with lifestyle medication. Among OADs, metformin may be a better choice than glibenclamide.

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