Clinicians' view on non-adherence: sharing expert opinion.

Introduction: Medication non-adherence (NA) remains a persistent challenge across all medical specialties, contributing to adverse patient outcomes and increased healthcare burdens. While numerous studies have explored patient-related factors influencing adherence, the perspectives of healthcare professionals remain underrepresented in literature. This study aims to document the individual experiences of seven international physicians across diverse medical fields, highlighting barriers, detection methods, and strategies employed to address NA in their daily practice.

High prevalence of metabolic obesity in India: The ICMR-INDIAB national study (ICMR-INDIAB-23).

Background & objectives While obesity usually produces cardio-metabolic dysfunction, some obese individuals are metabolically healthy, and conversely, some nonobese individuals have significant metabolic dysfunction. This study aims to assess the national prevalence of various obesity subtypes and their association with type 2 diabetes (T2D), coronary artery disease (CAD), and chronic kidney disease (CKD) in the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. Methods The ICMR-INDIAB study is a nationally representative cross-sectional survey of 1,13,043 individuals aged ≥20 yr from urban and rural areas across 31 Indian States and Union Territories.

Effect of Neoadjuvant Chemotherapy on Immunohistochemistry in Breast Cancer.

Background Neoadjuvant chemotherapy (NACT) is a key treatment strategy for locally advanced or high-risk early-stage breast cancer. This study aims to evaluate the effects of NACT on estrogen receptor (ER), progesterone receptor (PR), HER2 status, and Ki67 index, which are crucial markers for breast cancer prognosis and treatment decisions. Methods A cohort of 62 female breast cancer patients underwent NACT with varied regimens.

Revisiting Diabetes Classification: Insights Challenges and Clinical Relevance of the ANDIS Framework in the Indian Context.

Diabetes mellitus exhibits significant heterogeneity in clinical presentation, progression, and treatment response, rendering the traditional binary classification into type 1 and type 2 diabetes increasingly inadequate. The All New Diabetics in Scania (ANDIS) framework, introduced in 2018, proposed a novel data-driven classification system that stratifies adult-onset diabetes into five distinct subgroups based on clinical and biochemical characteristics. This manuscript critically examines the scientific rationale, methodology, and clinical implications of the ANDIS classification, while evaluating its utility through evidence drawn from Indian (INSPIRED and WellGen) and global validation studies (DEVOTE, LEADER, DD2, NHANES, and FoCus cohorts).

Malnutrition-related diabetes mellitus: Rushing toward "type 5" amid unresolved questions and limited evidence.

Aim: To critically evaluate the historical context, diagnostic ambiguity, epidemiological relevance, and recent proposals to reclassify malnutrition-related diabetes mellitus (MRDM) amid changing nutritional landscapes and existing metabolic data.

Methods: This review synthesizes data from early clinical reports, WHO documents, epidemiological studies, and recent literature on malnutrition and diabetes. Emphasis is placed on diagnostic inconsistencies, the overuse of low BMI as a surrogate for malnutrition, and evolving nutrition trends in India and low- and middle-income countries (LMICs).

An Overview of Currently Available Injectable Therapies in Diabetes: A Guide to Practitioners.

The management of diabetes has seen significant advancements with the introduction of various injectable therapies. Being a common chronic disorder, it is managed by doctors across all specialties worldwide. Despite the availability of new medications, healthcare professionals continue to face ambiguity due to differing terminologies and variations in regional practices.

Management of metabolic dysfunction-associated steatotic liver disease (MASLD)-An expert consensus statement from Indian diabetologists' perspective.

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.

Prevalence of Metabolic Dysfunction-Associated Steatotic Liver Disease: Mapping Across Different Indian Populations (MAP Study).

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern. MASLD is strongly linked to obesity, sedentary lifestyles, and metabolic syndrome. In India, the prevalence of MASLD exhibits regional variations because of genetic, dietary, and socioeconomic factors.

Allergen Immunotherapy in Autoimmune Terrain: A Case Study.

Allergen immunotherapy (AIT), or specific immunotherapy (SIT), is an effective treatment for inducing immune tolerance to specific allergens. It is widely used for allergic rhinitis, conjunctivitis, asthma, and Hymenoptera venom allergies, with recent applications to food allergies and atopic dermatitis. Despite its benefits, the use of SIT in patients with autoimmune diseases is controversial due to concerns about its potential to induce or exacerbate autoimmune conditions.

Ahmedabad declaration: A framework to combat growing epidemic of young-onset type 2 diabetes in Asia.

Aim: Rising prevalence of Type 2 Diabetes (T2D) among young Asians has emerged as a public health crisis that threatens the long-term health, economic stability, and productivity of nations across Asia (1). Early-onset T2D poses unique challenges, including higher rates of undiagnosed cases, more aggressive disease progression, an increased risk of chronic complications and higher mortality (2). Hyperglycemia during the reproductive age especially among the female population can potentially have transgenerational impact through epigenetic changes.

Digital Twin Technology in Resolving Polycystic Ovary Syndrome and Improving Metabolic Health: A Comprehensive Case Study.

Background: Clinical manifestations of polycystic ovary syndrome (PCOS) are heterogeneous, with hallmarks including anovulation, androgen excess, and insulin resistance.

Case Report: A 38-year-old female with typical PCOS features presented with hypertension, obesity, and elevated fasting and postprandial insulin levels. She was enrolled in the Digital Twin (DT) platform, which uses artificial intelligence and Internet of Things to deliver personalized nutrition by predicting postprandial glucose responses and suggesting alternative foods with lower postprandial glucose response through a mobile app.

Two Concerns and A Single Solution in Managing Type 2 Diabetes: A Narrative Review on Imeglimin.

Type 2 diabetes (T2D) presents a formidable challenge to healthcare, with rising prevalence and complex pathogenesis involving beta-cell dysfunction and insulin resistance. Imeglimin, the progenitor of the "glimins" class, emerges as a multifaceted agent capable of attenuating beta-cell apoptosis, reducing hepatic gluconeogenesis, and augmenting muscular glucose uptake. This positions it as a promising solution for T2D management, especially for patients inadequately controlled by current therapies.

Call to action for clinicians in the South-East Asian regions on primary prevention of diabetes in people with prediabetes- A consensus statement.

Primary prevention of diabetes still remains as an unmet challenge in a real world setting. While, translational programmes have been successful in the developed nations, the prevailing social and economic inequities in the low and middle income countries, fail to integrate diabetes prevention into their public health systems. The resulting exponential increase in the prevalence of diabetes and the cost of treatment has put primary prevention in the back seat.

Obsessive-Compulsive Disorder in Children and Adolescents: Early Detection in Primary Care Settings.

Obsessive-compulsive disorder (OCD) is a common and potentially debilitating condition affecting approximately 1%-3% of children and adolescents.1,2 It is characterized by obsessions and/or compulsions that are time-consuming or cause clinically significant distress or impairment in school, social, family, or other important areas of functioning. OCD can have a lasting impact on both academic and social functioning.

Personalized nutrition in type 2 diabetes remission: application of digital twin technology for predictive glycemic control.

Background: Type 2 Diabetes (T2D) is a complex condition marked by insulin resistance and beta-cell dysfunction. Traditional dietary interventions, such as low-calorie or low-carbohydrate diets, typically overlook individual variability in postprandial glycemic responses (PPGRs), which can lead to suboptimal management of the disease. Recent advancements suggest that personalized nutrition, tailored to individual metabolic profiles, may enhance the effectiveness of T2D management.

One-year outcomes of a digital twin intervention for type 2 diabetes: a retrospective real-world study.

This retrospective observational study, building on prior research that demonstrated the efficacy of the Digital Twin (DT) Precision Treatment Program over shorter follow-up periods​​, aimed to examine glycemic control and reduced anti-diabetic medication use after one-year in a DT commercial program. T2D patients enrolled had adequate hepatic and renal function and no recent cardiovascular events. DT intervention powered by artificial intelligence utilizes precision nutrition, activity, sleep, and deep breathing exercises.

Blue Index as a Comprehensive, Patient-centered Assessment of Care in Diabetic Patients.

Background: Assessment of diabetes health takes into account metabolic, nonmetabolic, and self-care measures like diet, exercise, follow-up, and habits. On the other hand, the index of complications includes the macro- and microvascular complications of diabetes along with foot complications. The Blue Index (BI) is a composite assessment of both diabetic health-related parameters and systemic complications stemming from diabetes.

Digital Twin in Managing Hypertension Among People With Type 2 Diabetes: 1-Year Randomized Controlled Trial.

Background: Digital twin (DT)-guided lifestyle changes induce type 2 diabetes (T2D) remission but effects on hypertension (HTN) in this population are unknown.

Objectives: The purpose of this study was to assess effects of DT vs standard of care (SC) on blood pressure (BP), anti-HTN medication, HTN remission, and microalbuminuria in participants with T2D.

Methods: This is a secondary analysis of a randomized controlled trial in India of 319 participants with T2D.

Position statement on hypertension by Indian Society of Hypertension, 2023.

The Indian Society of Hypertension (InSH) highlights the urgency for India-specific guidelines on hypertension management. Hypertension affects over one billion people worldwide, with India bearing a significant burden due to its population, diversity, and demographics. In India, hypertension affects 21% of women and 24% of men, while pre-hypertension affects 39% of women and 49% of men.

Dual effects of dulaglutide on glycemic control and knee osteoarthritis pain in elderly patients with Type 2 diabetes.

This study aims to evaluate the dual benefits of dulaglutide in improving glycemic control and reducing knee OA pain. Elderly T2DM patients diagnosed with bilateral knee OA on conventional OA treatment for at least 3 months were studied for their glycemic metrics, OA pain scores and NSAID consumption at baseline, 3 months and 6 months. Significant improvements in glycemic control were observed, HbA1c decreased from 8.