The first of its kind Endocrine Premier League was conducted at this year’s ESICON with refrees Dr R Santosh and Dr Awadhesh Singh and umpires Dr Anirban Majumdar (East), Dr Shanmugasundar (South), Dr Rakesh Prasad (North), and Dr. Parag Shah (West). Four teams, one from each zone participated in the matches/debates. The teams were given a topic and were asked to present their views about it with the audience giving their scores on the talks. Scores were also given by the umpires.

The North and East teams went into the finals by finishing first and second in the league stage, respectively. East Zone came out as a winner of the final debate.

Here is a synopsis of the debates:

HbA1c vs. OGTT for diagnosing DM – HbA1c is a much more stable marker due to its better stability, reliability and patient compliance. However, it can’t be performed in pregnancy, iron-deficiency anemia and other blood dyscrasias, the latter two being common issues among Indian population.

Are CV safety trials required? – CV safety trials are important for discovering new classes of antidiabetic drugs, given the fact that a major cause of death in diabetics is CV diseases. However, these trials are costly, increase the cost of drugs and make them out of reach for low-income population. So, we can consider the trials only when a drug actually poses a potential CV risk.

Insulin resistance vs. β-cell dysfunction as a pathogenesis of DM – Insulin resistance is more important, since type 2 is more prevalent than type 1, given obesity as a major cause of diabetes in India. However, b-cell dysfunction is a genetic as well as an important predisposing factor, which forms a crucial part of its pathophysiology.

Vitamin D deficiency epidemic is a fraud – The entire logic that vitamin D deficiency is the root cause of major morbidities like DM, hypertension, dementia and CV diseases is a fraud, because correcting the vitamin D levels won’t correct or improve the above conditions. Of note, more and more patients are coming up with vitamin D toxicity, due to unchecked prescription of vitamin D supplements. But there is no doubt that our population faces a huge deficiency of vitamin D due to lack of sun exposure, deficient diet, menstrual problems, lack of activity, etc. And ignoring it would lead to serious complications.

Estrogen replacement in menopausal women – Estrogen is very important in the overall maintenance of a woman’s health. There’s no doubt that estrogen replacement in a very early phase after menopause can reduce the CV risks posed when given at a later date. However, a lack of concrete evidence from studies and proper guidelines question the potential of such a venture.

Andropause is in the mind – Andropause is a proper disease and a common complaint in a growing number of people. It has a definite clinical presentation, has proper treatment guidelines, and can be controlled. So, considering it as a mind problem is no less of a blunder. However, prevalence in a low number of people is definitely a reason why it’s put away as more of a mental problem.

Type 1.5 diabetes exists – Type 1.5 differs from type 1 as well as from type 2 diabetes. Type 1.5 diabetes is often referred to as latent autoimmune diabetes in adults. When it comes to comparison with type 2, the age group confuses the diagnosis and type 2 patients are often misdiagnosed. However, giving it a different classification, and introducing additional categories like type 3 and type 3C is all the more confusing. So, some suggest that categorizing it as a subtype of type 2 may be a more viable option.