Publications by authors named "Rakesh Kumar Sahay"

Evidence is lacking for guiding optimal combination hypertension therapy in South Asian patients. Here we investigated the blood pressure (BP)-lowering efficacy and safety of three commonly recommended antihypertensive dual combinations in a multicenter, single-blinded trial conducted in India. We randomized Indians aged 30-79 years (mean age, 52 years) with mean sitting systolic blood pressure (SBP) of 150-179 mmHg on no treatment or an SBP of 140-159 mmHg on monotherapy 1:1:1 to a single-pill combination of amlodipine-perindopril, perindopril-indapamide or amlodipine-indapamide.

View Article and Find Full Text PDF

Background: Managing osteoporosis (OP) in chronic kidney disease (CKD) presents significant challenges due to altered bone metabolism. Given the lack of robust clinical trial data and a notable knowledge gap exists among nephrologists regarding an optimal management in this population, an expert consensus is crucial for developing tailored management strategies. This study aimed to gather an expert opinion to bridge this gap and establish consensus recommendations on the diagnosis and management of osteoporosis in CKD patients.

View Article and Find Full Text PDF

Type 2 diabetes mellitus is a heterogeneous disease with broader metabolic perturbation beyond hyperglycemia, resulting in varied prognoses. Additionally, patients are at risk of complications, such as diabetic kidney disease (DKD), which often remains asymptomatic in early stages. Metabolomics offers a comprehensive assessment of metabolic dysregulation, surpassing conventional biomarkers such as glucose and creatinine.

View Article and Find Full Text PDF

Introduction: The morbidity of type 2 diabetes mellitus (T2DM) is rising dramatically both at the national and international levels. In recent years, many novel medications are developed or in development for better management of hyperglycemia in people with T2DM. Focusing on the new promising molecules, here we aim to present the opinion of experts and their consensus on the use of imeglimin for the treatment of T2DM in India.

View Article and Find Full Text PDF

In India, the increasing prevalence of diabetes and obesity poses a significant threat towards a surge in the incidence of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD). Concomitant with the evolving guidelines, there is a need to direct and spread awareness among practicing diabetologists to identify and screen high-risk individuals for MASLD for timely management. Its asymptomatic nature and the evolving guidelines on diagnosis have hindered the precise estimates of MASLD in the high-risk group of individuals in a clinical setting.

View Article and Find Full Text PDF

A 13-year-old girl was referred to the endocrinology outpatient clinic with chief complaints of significant hair loss leading to balding and poor height gain noted since the age of 5 years. She was born full term with a normal birth weight and had achieved all appropriate developmental milestones. Physical examination (Fig.

View Article and Find Full Text PDF

Introduction: The aim of this work was to assess the safety and effectiveness of concomitant iGlarLixi and sodium-glucose co-transporter-2 inhibitors (SGLT-2i) use in adults with type 2 diabetes (T2D) who fasted during Ramadan.

Methods: Of the 420 eligible participants from the SoliRam study, 174 were using SGLT-2i in addition to iGlarLixi and 246 were not using SGLT-2i, referred to as SGLT-2i user and non-user, respectively. The primary endpoint was the proportion of participants experiencing ≥ 1 severe and/or symptomatic documented (< 70 mg/dl [< 3.

View Article and Find Full Text PDF
Article Synopsis
  • A national study titled "Save the Feet and Keep Walking" assessed the prevalence of high-risk feet among diabetics in India, involving over 33,000 participants from July to August 2022.
  • The research revealed that about 25.2% of participants exhibited high-risk feet conditions, with significant associations found for heel fissures and calluses.
  • The study highlights the urgent need for regular screening and foot care among the diabetic population, as many also faced other serious complications like kidney and retinal issues.
View Article and Find Full Text PDF

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders largely affecting women of reproductive age group.

Objectives: This study aimed to understand the Indian public health-care systems' preparedness in addressing PCOS.

Materials And Methods: A multicentric rapid assessment cross-sectional study was undertaken among 173 health-care providers serving across various public health-care facilities in India.

View Article and Find Full Text PDF
Article Synopsis
  • - The study analyzed the effectiveness of a quality improvement strategy in managing poorly controlled type 2 diabetes in India and Pakistan, comparing it to standard care over 6.5 years.
  • - Participants receiving the quality improvement strategy had better control of multiple diabetes risk factors compared to those receiving usual care, particularly after 2.5 years.
  • - The analysis also looked at various health outcomes, including macrovascular and microvascular events, and found notable differences between the two treatment approaches, with some clinics discontinuing the quality improvement strategy during the follow-up period.
View Article and Find Full Text PDF

Vildagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor is effective in reducing HbA1c levels in patients with type 2 diabetes (T2DM) when administered as monotherapy, dual or triple combination therapy. In India, Vildagliptin is commonly prescribed in T2DM patients because it reduces mean amplitude of glycemic excursion (MAGE), has lower risk of hypoglycemia and is weight neutral. Early combination therapy with vildagliptin and metformin is effective and well-tolerated in patients with T2DM, regardless of age or ethnicity.

View Article and Find Full Text PDF

Inadequate glycaemic control post-discharge is the root cause of readmission in people with diabetes mellitus (DM) and is often linked to improper discharge planning (DP). A structured DP plays a crucial role in ensuring continuing home care and avoiding readmissions. DP should help patients in self-care and provide appropriate guidance to maintain optimal glycaemic control.

View Article and Find Full Text PDF

Objectives: To assess the cost-effectiveness of a multicomponent strategy versus usual care in people with type 2 diabetes in South Asia.

Design: Economic evaluation from healthcare system and societal perspectives.

Setting: Ten diverse urban clinics in India and Pakistan.

View Article and Find Full Text PDF

Background And Aims: To evaluate the safety and effectiveness of iGlarLixi in adults with type 2 diabetes (T2D) fasting during Ramadan.

Methods: SoliRam was a multinational, prospective, single-arm, real-world observational study conducted during Ramadan 2020 and 2021 in adults with T2D treated with iGlarLixi ≥3 months at study entry. The primary endpoint was the percentage of participants experiencing ≥1 episode of severe and/or symptomatic documented hypoglycemia (<70 mg/dL [<3.

View Article and Find Full Text PDF

Background And Aims: Hypoglycemia and insulin-related adverse events are crucial barriers to effective diabetes management, particularly in the elderly, people with renal impairment, people with diabetes fasting during Ramadan, or people with type 1 diabetes mellitus (T1DM). There is a scarcity of clinical and real-world evidence assessing the effectiveness and safety of insulin glargine 300 U/mL (Gla-300) in these special populations. To understand the entirety of evidence, this mini-review elaborates on the use of Gla-300 in diabetes management among special populations.

View Article and Find Full Text PDF

Diabetes is a global public health concern. Vigilant monitoring and effective management of glycaemic variations are essential to prevent complications of diabetes. Effectively incorporating monitoring strategies in management of diabetes is a serious challenge.

View Article and Find Full Text PDF

Objective To evaluate the usage of various strengths of glimepiride and metformin fixed-dose combinations in the management of type 2 diabetes mellitus (T2DM) patients with comorbidities and complications. Methods A retrospective, non-randomized, non-comparative, multi-centric real-world study included T2DM patients (age > 18 years) taking glimepiride and metformin fixed-dose combinations. Age, duration of diabetes, diabetes complications, comorbidities (hypertension and dyslipidemia), dosage frequency, and concomitant medications were analyzed from medical charts.

View Article and Find Full Text PDF