Background and Objectives: Hypertension (HT) is a leading risk factor for blood vessel diseases w... more Background and Objectives: Hypertension (HT) is a leading risk factor for blood vessel diseases worldwide and its prevalence is increasing among adolescents. Lifestyle changes cause increased obesity, thereby increasing the risk of developing HT. In this study, the prevalence of HT and associated risk factors were assessed in adolescents in Gujarat, India. Methodology: Each of the urban and rural cohorts included 400 subjects, aged 14-18 years, with similar gender distributions. Physiological parameters, including body mass index (BMI) and blood pressure, were recorded, and a questionnaire was used to evaluate medical history and lifestyle patterns with an emphasis on food habits. The association between the recorded parameters and obesity and HT was evaluated. Results: The prevalence of HT was higher in the urban cohort than in the rural cohort (20% vs. 17%), and a weak association with a family history of HT was observed in both cohorts. Obesity and high-fat diet had a moderate to relatively strong association with HT in both cohorts. More than 35% of the participants who regularly consumed junk food were hypertensive. Conclusion: The changing lifestyle with less physical activity and increased consumption of high-fat and high-sugar diets may have been responsible for the increasing obesity among adolescents, thereby increasing the prevalence of HT. A systematic approach to the recognition, monitoring, prevention, and treatment of obesity is crucial for addressing this global health issue. Disclosure D.Hasnani: None. S.Jha: None. B.D.Saboo: None. S.Hasnani: None. S.Jamalpure: None. V.Chavda: None.
Rationale: Drug prescribing studies can suggest modifications in the current prescribing practice... more Rationale: Drug prescribing studies can suggest modifications in the current prescribing practices, which in turn will reduce the treatment cost, non-compliance and complications. Purpose: To identify the prescription patterns in patients with type 2 diabetes mellitus with respect to the duration of the disease. Methods: Patients with type 2 diabetes mellitus seeking regular care at twelve of the locations in Western India were included in the study. Using MEDEVA (EMR), an integrated research platform, information on medical history, laboratory values and medications was recorded. Data collected from 1st December 2022 to February 25th 2023 was considered for the analysis. Results: Of the 920 patients enrolled in the study, 607 had a duration of diabetes and prescribed medications recorded. Patients with a duration ≤ 5 years are about 53.0%, 5-10 years are 28.8% and >10 years are 18.1%. Biguanides and Sulfonylureas, followed by DPP-4, are the most common drug classes prescribed in patients with ≤ 5 years duration and Insulins in patients with a duration of more than 10 years. Conclusion: This study offers valuable information on the trends in oral antidiabetic medications and insulins in diabetic patients. As the duration of the disease increases insulin is the most prescribed medication. Disclosure V. Chavda: None. B. D. Saboo: None. V. Abhichandani: None. S. Desai: None. V. Patadia: None. B. S. Mori: None. S. Patel: None. A. M. Prajapati: None. M. N. Parekh: None. F. Vora: None. T. Vora: None. D. Hasnani: None.
The outbreak of COVID-19 had created a significant impact on the medical community and has result... more The outbreak of COVID-19 had created a significant impact on the medical community and has resulted in novel challenges to all the physicians. It is estimated by the International Diabetes Federation (IDF) that in 2019 there were 95,600 cases of type 1 diabetes (0 and 14 years of age) in India. Type 1 diabetes was identified to be an independent risk factor associated with in-hospital death in COVID-19. During the pandemic, due to fear of visiting the hospitals, there was an underrepresentation of new cases and due to delay in the diagnosis, there was a spike in the number of cases of diabetic ketoacidosis. The objective of the current review is to summarize the role of telemedicine in the management of pediatric diabetes. Various organizations such as the Research Society of Study of Diabetes in India (RSSDI), CDiC, and IFAC came forward to support the pediatric diabetes community through the supply of insulin, glucose strips and syringes. The efficiency of telehealth visits was enhanced by using diabetes technologies like insulin pumps, CGMs, and bluetooth glucose meters. As children got ample time to spend with their parents and perform the in-home physical activity, they had good glycemic control during the pandemic period in some cases.
Introduction: Diabetes treatment requires the involvement of people with diabetes in the form of ... more Introduction: Diabetes treatment requires the involvement of people with diabetes in the form of regular clinical follow-up for good Glycaemic control and Metabolic health. Newer Communication techniques, such as mobile messaging are now finding their way into diabetes care and treatment. It can assist diabetes patients to maintain a regular follow-up routine and can assist in glycemic control. Materials and Methods: A total of 326 patients were selected by random sampling. They were of age 15-65 years with T1DM and T2DM. Inclusion Criteria: 1. Known case of DM 2. Consent to receive messages Exclusion criteria: 1. Not consenting for messaging 2. Reading Disability. Randomly allocated to two groups of 163 persons each. In the first group, the participants were sent regular messages to remind them of their follow-up dates. The other group was treated as usual and was allowed to come for follow-up on their own. The participants were monitored for follow-up frequency, meeting testing deadlines and resultant glycemic control measured by Hba1c at 3 months and 6 months. The results were tabulated and analysed using SPSS. Result: 17 patients each dropped out from the messaging group and 16 patients dropped out from routine care groups, out of the remaining 297 patients the analysis of data shows: in the messaging group, 63 % maintained their follow-up dates as compared to 42 % in the other group. The number of patients achieving the target goal of 7% HBA1C was better in the messaging group (54%) as compared to the routine group (31%). Blood sugar testing frequency was better in the messaging group as compared to other group. Discussion: With the advent of newer modalities of communication, the ways and means to communicate with patients has improved. These tools if used correctly can not only improve follow-ups but at the same time increase the connection between caregivers and patients. This also can result in better patient outcomes and will lead to reduced complications and financial implications. Disclosure B.Saboo: None. S.Saboo: None. V.Chavda: None. D.Hasnani: None.
To study worldwide differences in childhood diabetes, comparing relevant indicators among five re... more To study worldwide differences in childhood diabetes, comparing relevant indicators among five regions within the SWEET initiative.
Many recommendations provided in this guideline are based on work performed in adults, thus raisi... more Many recommendations provided in this guideline are based on work performed in adults, thus raising the possibility that some of these
This article is available in open access under Creative Common Attribution-Non-Commercial-No Deri... more This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
Background: India is predicted to have over 27 million children with obesity, representing over h... more Background: India is predicted to have over 27 million children with obesity, representing over half of the children with obesity in the region and 1 in 10 of all children globally. Aim: To study Obesity prevalence in Adolescents and making timely interventions for healthier lifestyle adoption in urban and rural Ahmedabad. Methodology: A team of physician, nurse, pediatrician, educator took up the task of collecting data from schools in the rural and urban areas of Ahmedabad and periphery of 50kms during months of March-May 2022 with prior consent from guardians at 4 schools. Data including height, weight, abdominal girth, neck circumference was collected along with survey on food intake, type, exercise and habits. Adolescents of age category 14-18 yrs were included. Menstrual history was taken. Obesity was defined using the National Center for Disease Control definitions. We used the NHANES proposed cutoff of ≥90th percentile of Waist Circumference for identifying central obesity and Neck Circumference ≥ 50th percentile for identifying obesity. BP measurement and acanthosis assessment was also done. We conducted seminars on healthy eating and physical activity for all kids irrespective of their health status. Results: Total Cohort: 800, 14-18 years with a 1:1 ratio of girls:boys and same in rural and urban areas. There was higher prevalence of overweight in girls compared with boys (16%vs 12%), but the prevalence of obesity is higher in boys than girls (8%vs6%), the prevalence of underweight is slightly higher in boys than girls (21%vs9.5%). Underweight is more prevalent in rural areas vs obesity in urban areas. Conclusion: Screening adolescents for obesity, and making timely interventions for the prevention of disorders through education and appropriate lifestyle interventions can be one step towards a healthy future of the country. There lies necessity for expanding these screening and education programs through ROOTS ie Recognition, Obesity monitoring, Obesity prevention, Treatment and System based approach. Disclosure V.Chavda: None. D.Hasnani: None. S.Hasnani: None. B.Saboo: None. V.Abichandani: None. A.Shrivastava: None. S.Jha: None. B.D.Saboo: None.
Journal of Diabetology : Official Journal of Diabetes in Asia Study Group, 2018
India has been a prey to rising tide of non-communicable diseases. It is becoming increasingly im... more India has been a prey to rising tide of non-communicable diseases. It is becoming increasingly important to evolve strategies to ensure effective prevention, diagnosis and treatment of this rising burden. Available Indian data reveal different opinions regarding type 1 diabetes (T1D). Such variation in data leads to uncertainty in healthcare planning and management. This ununiformity in data and the absence of protocol make a task challenging. Many patients consult non-specialists and even doctors from different streams. On the part of the patients, the diagnostic and screening testing are a great burden. T1D registry is of great relevance to India. It helps in ensuring good clinical practice and errors. Endocrinologists and paediatricians can audit themselves using such a registry. The overall goal is to improve population health. The objective is to reduce morbidity and mortality while maximising the cost-effectiveness. Such a registry helps in fund allocation and healthcare planning and contributes to the formulation of pragmatic management guidelines. However, healthcare professionals are reluctant to share their data. This may be due to fear of being audited by peers or regulators and record maintenance. We must work towards creating a national registry of T1D. This should involve multiple centres across the country, as it will help enhance awareness about T1D and improve standard of care. The results of which can be used to advocate for greater allocation of resources to T1D care. An effective registry will help children claim their rightful place under the sun.
T his article describes the importance of the family in diabetes care. It lists the multiple ways... more T his article describes the importance of the family in diabetes care. It lists the multiple ways in which the family is related to diabetes: as a cause or culprit of diabetes, as a tool or technique for delivering diabetes care and as a target of diabetes or diabetes-care-related complications. The authors suggest an alliterative 'Five-I' approach to guide diabetes care professionals in addressing needs, and utilising strengths, of the family of a person with diabetes. The five 'I's stand for: involved independence, iterative information, interactive interviews, inspired introspection and integrated incorporation. This strategy, based upon evidence and experience, is supported by pragmatism and practicality.
Aim: To find out Efficacy of a basal plus regimen. Objectives: 1. To find out the efficacy of bas... more Aim: To find out Efficacy of a basal plus regimen. Objectives: 1. To find out the efficacy of basal plus regime by evaluating the changes in HbA1c at 24 weeks. 2. To find out changes in weight and frequency of hypoglycemia after initiation of the basal plus regime. Method: The study was a prospective analysis of 24 weeks after initiation of basal plus regime. Inclusion criteria: T2DM>5 Years; On 3OAD + basal insulin, HbA1c- 7.5-8.5%. Exclusion Criteria: critically ill patients, acute infection, pregnant, T1D. All patients matching the inclusion criteria were analyzed on the basis of SMBG chart to find out their highest glycemic excursion of post prandial and fasting readings. Based on the diet recall and sugar reading charts these patients were initiated on bolus insulin with the largest meal of the day where their post prandial corresponded to the highest reading. They were educated on proper insulin injection techniques and SMBG and asked to follow-up with their sugar readings using telemedicine application every day. Result: We studied 220 patients (F=124 M=96) with HbA1c at baseline 7.5-8.5% (avg-8.0). After addition of bolus insulin at 12 weeks target HbA1c <7% was achieved in 55.9% (n=123) patients with minor dose titrations. Average HbA1c at 12 Weeks was 7.3%. At 24Weeks target HbA1c was achieved in 88.18% (n=194) of patients after uptitration of bolus dose. Average HbA1c at 24Weeks was 6.9%. 5 patients experienced severe hypoglycemic episode. Cases of 15 average mild to moderate hypoglycemic episodes were reported. Regular SMBG and follow-up of the patients through telemedicine applications is continued for insulin dose titration. Fasting sugar target of below 110 mg/dl was achieved through titration of basal insulin in all 220 patients at the end of 12 weeks. Post prandial glycemic readings at the end of 12 weeks were achieved below 160 mg/dl in 167 patients and at 24 weeks in 198 patients. Conclusion: After failure of OADS and basal insulin a basal plus regime with addition of 1 bolus insulin with the largest meal of the day helped achieve the target HbA1c of <7% effectively. Disclosure B.D.J. Saboo: None. D. Hasnani: None. H. Chandarana: None. S. Bhandari: None. S. Joshi: None. J. Kesavadev: Advisory Panel; Self; Novo Nordisk India Private Limited. Speaker's Bureau; Self; Novo Nordisk India Private Limited. Advisory Panel; Self; Medtronic. Speaker's Bureau; Self; Medtronic. Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; MSD. Speaker's Bureau; Self; MSD. Advisory Panel; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. A. Maheshwari: None. H. Thacker: Research Support; Self; Wockhardt LTD.
Objective: To study worldwide differences in childhood diabetes, comparing relevant indicators am... more Objective: To study worldwide differences in childhood diabetes, comparing relevant indicators among five regions within the SWEET initiative. Subjects: We investigated 26 726 individuals with type 1 diabetes (T1D) from 54 centers in the European region; 7768 individuals from 30 centers in the Asia/Middle East/Africa region; 2642 people from five centers in Australia/New Zealand; 10 839 individuals from seven centers in North America, and 1114 patients from five centers in South America. Methods: The SWEET database was analyzed based on the following inclusion criteria: T1D, time period 2015-2019, and age < 21 years, with analysis of the most recent documented year of therapy. For the statistical analysis, we used multivariable linear and logistic regression models to adjust for age (<6 years, 6-< 12 years, 12-< 18 years, 18-< 21 years), gender, and duration of diabetes (<2 years, 2-< 5 years, 5-< 10 years, ≥10 years).
Background and Objectives: Hypertension (HT) is a leading risk factor for blood vessel diseases w... more Background and Objectives: Hypertension (HT) is a leading risk factor for blood vessel diseases worldwide and its prevalence is increasing among adolescents. Lifestyle changes cause increased obesity, thereby increasing the risk of developing HT. In this study, the prevalence of HT and associated risk factors were assessed in adolescents in Gujarat, India. Methodology: Each of the urban and rural cohorts included 400 subjects, aged 14-18 years, with similar gender distributions. Physiological parameters, including body mass index (BMI) and blood pressure, were recorded, and a questionnaire was used to evaluate medical history and lifestyle patterns with an emphasis on food habits. The association between the recorded parameters and obesity and HT was evaluated. Results: The prevalence of HT was higher in the urban cohort than in the rural cohort (20% vs. 17%), and a weak association with a family history of HT was observed in both cohorts. Obesity and high-fat diet had a moderate to relatively strong association with HT in both cohorts. More than 35% of the participants who regularly consumed junk food were hypertensive. Conclusion: The changing lifestyle with less physical activity and increased consumption of high-fat and high-sugar diets may have been responsible for the increasing obesity among adolescents, thereby increasing the prevalence of HT. A systematic approach to the recognition, monitoring, prevention, and treatment of obesity is crucial for addressing this global health issue. Disclosure D.Hasnani: None. S.Jha: None. B.D.Saboo: None. S.Hasnani: None. S.Jamalpure: None. V.Chavda: None.
Rationale: Drug prescribing studies can suggest modifications in the current prescribing practice... more Rationale: Drug prescribing studies can suggest modifications in the current prescribing practices, which in turn will reduce the treatment cost, non-compliance and complications. Purpose: To identify the prescription patterns in patients with type 2 diabetes mellitus with respect to the duration of the disease. Methods: Patients with type 2 diabetes mellitus seeking regular care at twelve of the locations in Western India were included in the study. Using MEDEVA (EMR), an integrated research platform, information on medical history, laboratory values and medications was recorded. Data collected from 1st December 2022 to February 25th 2023 was considered for the analysis. Results: Of the 920 patients enrolled in the study, 607 had a duration of diabetes and prescribed medications recorded. Patients with a duration ≤ 5 years are about 53.0%, 5-10 years are 28.8% and &gt;10 years are 18.1%. Biguanides and Sulfonylureas, followed by DPP-4, are the most common drug classes prescribed in patients with ≤ 5 years duration and Insulins in patients with a duration of more than 10 years. Conclusion: This study offers valuable information on the trends in oral antidiabetic medications and insulins in diabetic patients. As the duration of the disease increases insulin is the most prescribed medication. Disclosure V. Chavda: None. B. D. Saboo: None. V. Abhichandani: None. S. Desai: None. V. Patadia: None. B. S. Mori: None. S. Patel: None. A. M. Prajapati: None. M. N. Parekh: None. F. Vora: None. T. Vora: None. D. Hasnani: None.
The outbreak of COVID-19 had created a significant impact on the medical community and has result... more The outbreak of COVID-19 had created a significant impact on the medical community and has resulted in novel challenges to all the physicians. It is estimated by the International Diabetes Federation (IDF) that in 2019 there were 95,600 cases of type 1 diabetes (0 and 14 years of age) in India. Type 1 diabetes was identified to be an independent risk factor associated with in-hospital death in COVID-19. During the pandemic, due to fear of visiting the hospitals, there was an underrepresentation of new cases and due to delay in the diagnosis, there was a spike in the number of cases of diabetic ketoacidosis. The objective of the current review is to summarize the role of telemedicine in the management of pediatric diabetes. Various organizations such as the Research Society of Study of Diabetes in India (RSSDI), CDiC, and IFAC came forward to support the pediatric diabetes community through the supply of insulin, glucose strips and syringes. The efficiency of telehealth visits was enhanced by using diabetes technologies like insulin pumps, CGMs, and bluetooth glucose meters. As children got ample time to spend with their parents and perform the in-home physical activity, they had good glycemic control during the pandemic period in some cases.
Introduction: Diabetes treatment requires the involvement of people with diabetes in the form of ... more Introduction: Diabetes treatment requires the involvement of people with diabetes in the form of regular clinical follow-up for good Glycaemic control and Metabolic health. Newer Communication techniques, such as mobile messaging are now finding their way into diabetes care and treatment. It can assist diabetes patients to maintain a regular follow-up routine and can assist in glycemic control. Materials and Methods: A total of 326 patients were selected by random sampling. They were of age 15-65 years with T1DM and T2DM. Inclusion Criteria: 1. Known case of DM 2. Consent to receive messages Exclusion criteria: 1. Not consenting for messaging 2. Reading Disability. Randomly allocated to two groups of 163 persons each. In the first group, the participants were sent regular messages to remind them of their follow-up dates. The other group was treated as usual and was allowed to come for follow-up on their own. The participants were monitored for follow-up frequency, meeting testing deadlines and resultant glycemic control measured by Hba1c at 3 months and 6 months. The results were tabulated and analysed using SPSS. Result: 17 patients each dropped out from the messaging group and 16 patients dropped out from routine care groups, out of the remaining 297 patients the analysis of data shows: in the messaging group, 63 % maintained their follow-up dates as compared to 42 % in the other group. The number of patients achieving the target goal of 7% HBA1C was better in the messaging group (54%) as compared to the routine group (31%). Blood sugar testing frequency was better in the messaging group as compared to other group. Discussion: With the advent of newer modalities of communication, the ways and means to communicate with patients has improved. These tools if used correctly can not only improve follow-ups but at the same time increase the connection between caregivers and patients. This also can result in better patient outcomes and will lead to reduced complications and financial implications. Disclosure B.Saboo: None. S.Saboo: None. V.Chavda: None. D.Hasnani: None.
To study worldwide differences in childhood diabetes, comparing relevant indicators among five re... more To study worldwide differences in childhood diabetes, comparing relevant indicators among five regions within the SWEET initiative.
Many recommendations provided in this guideline are based on work performed in adults, thus raisi... more Many recommendations provided in this guideline are based on work performed in adults, thus raising the possibility that some of these
This article is available in open access under Creative Common Attribution-Non-Commercial-No Deri... more This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
Background: India is predicted to have over 27 million children with obesity, representing over h... more Background: India is predicted to have over 27 million children with obesity, representing over half of the children with obesity in the region and 1 in 10 of all children globally. Aim: To study Obesity prevalence in Adolescents and making timely interventions for healthier lifestyle adoption in urban and rural Ahmedabad. Methodology: A team of physician, nurse, pediatrician, educator took up the task of collecting data from schools in the rural and urban areas of Ahmedabad and periphery of 50kms during months of March-May 2022 with prior consent from guardians at 4 schools. Data including height, weight, abdominal girth, neck circumference was collected along with survey on food intake, type, exercise and habits. Adolescents of age category 14-18 yrs were included. Menstrual history was taken. Obesity was defined using the National Center for Disease Control definitions. We used the NHANES proposed cutoff of ≥90th percentile of Waist Circumference for identifying central obesity and Neck Circumference ≥ 50th percentile for identifying obesity. BP measurement and acanthosis assessment was also done. We conducted seminars on healthy eating and physical activity for all kids irrespective of their health status. Results: Total Cohort: 800, 14-18 years with a 1:1 ratio of girls:boys and same in rural and urban areas. There was higher prevalence of overweight in girls compared with boys (16%vs 12%), but the prevalence of obesity is higher in boys than girls (8%vs6%), the prevalence of underweight is slightly higher in boys than girls (21%vs9.5%). Underweight is more prevalent in rural areas vs obesity in urban areas. Conclusion: Screening adolescents for obesity, and making timely interventions for the prevention of disorders through education and appropriate lifestyle interventions can be one step towards a healthy future of the country. There lies necessity for expanding these screening and education programs through ROOTS ie Recognition, Obesity monitoring, Obesity prevention, Treatment and System based approach. Disclosure V.Chavda: None. D.Hasnani: None. S.Hasnani: None. B.Saboo: None. V.Abichandani: None. A.Shrivastava: None. S.Jha: None. B.D.Saboo: None.
Journal of Diabetology : Official Journal of Diabetes in Asia Study Group, 2018
India has been a prey to rising tide of non-communicable diseases. It is becoming increasingly im... more India has been a prey to rising tide of non-communicable diseases. It is becoming increasingly important to evolve strategies to ensure effective prevention, diagnosis and treatment of this rising burden. Available Indian data reveal different opinions regarding type 1 diabetes (T1D). Such variation in data leads to uncertainty in healthcare planning and management. This ununiformity in data and the absence of protocol make a task challenging. Many patients consult non-specialists and even doctors from different streams. On the part of the patients, the diagnostic and screening testing are a great burden. T1D registry is of great relevance to India. It helps in ensuring good clinical practice and errors. Endocrinologists and paediatricians can audit themselves using such a registry. The overall goal is to improve population health. The objective is to reduce morbidity and mortality while maximising the cost-effectiveness. Such a registry helps in fund allocation and healthcare planning and contributes to the formulation of pragmatic management guidelines. However, healthcare professionals are reluctant to share their data. This may be due to fear of being audited by peers or regulators and record maintenance. We must work towards creating a national registry of T1D. This should involve multiple centres across the country, as it will help enhance awareness about T1D and improve standard of care. The results of which can be used to advocate for greater allocation of resources to T1D care. An effective registry will help children claim their rightful place under the sun.
T his article describes the importance of the family in diabetes care. It lists the multiple ways... more T his article describes the importance of the family in diabetes care. It lists the multiple ways in which the family is related to diabetes: as a cause or culprit of diabetes, as a tool or technique for delivering diabetes care and as a target of diabetes or diabetes-care-related complications. The authors suggest an alliterative 'Five-I' approach to guide diabetes care professionals in addressing needs, and utilising strengths, of the family of a person with diabetes. The five 'I's stand for: involved independence, iterative information, interactive interviews, inspired introspection and integrated incorporation. This strategy, based upon evidence and experience, is supported by pragmatism and practicality.
Aim: To find out Efficacy of a basal plus regimen. Objectives: 1. To find out the efficacy of bas... more Aim: To find out Efficacy of a basal plus regimen. Objectives: 1. To find out the efficacy of basal plus regime by evaluating the changes in HbA1c at 24 weeks. 2. To find out changes in weight and frequency of hypoglycemia after initiation of the basal plus regime. Method: The study was a prospective analysis of 24 weeks after initiation of basal plus regime. Inclusion criteria: T2DM&gt;5 Years; On 3OAD + basal insulin, HbA1c- 7.5-8.5%. Exclusion Criteria: critically ill patients, acute infection, pregnant, T1D. All patients matching the inclusion criteria were analyzed on the basis of SMBG chart to find out their highest glycemic excursion of post prandial and fasting readings. Based on the diet recall and sugar reading charts these patients were initiated on bolus insulin with the largest meal of the day where their post prandial corresponded to the highest reading. They were educated on proper insulin injection techniques and SMBG and asked to follow-up with their sugar readings using telemedicine application every day. Result: We studied 220 patients (F=124 M=96) with HbA1c at baseline 7.5-8.5% (avg-8.0). After addition of bolus insulin at 12 weeks target HbA1c &lt;7% was achieved in 55.9% (n=123) patients with minor dose titrations. Average HbA1c at 12 Weeks was 7.3%. At 24Weeks target HbA1c was achieved in 88.18% (n=194) of patients after uptitration of bolus dose. Average HbA1c at 24Weeks was 6.9%. 5 patients experienced severe hypoglycemic episode. Cases of 15 average mild to moderate hypoglycemic episodes were reported. Regular SMBG and follow-up of the patients through telemedicine applications is continued for insulin dose titration. Fasting sugar target of below 110 mg/dl was achieved through titration of basal insulin in all 220 patients at the end of 12 weeks. Post prandial glycemic readings at the end of 12 weeks were achieved below 160 mg/dl in 167 patients and at 24 weeks in 198 patients. Conclusion: After failure of OADS and basal insulin a basal plus regime with addition of 1 bolus insulin with the largest meal of the day helped achieve the target HbA1c of &lt;7% effectively. Disclosure B.D.J. Saboo: None. D. Hasnani: None. H. Chandarana: None. S. Bhandari: None. S. Joshi: None. J. Kesavadev: Advisory Panel; Self; Novo Nordisk India Private Limited. Speaker's Bureau; Self; Novo Nordisk India Private Limited. Advisory Panel; Self; Medtronic. Speaker's Bureau; Self; Medtronic. Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; MSD. Speaker's Bureau; Self; MSD. Advisory Panel; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. A. Maheshwari: None. H. Thacker: Research Support; Self; Wockhardt LTD.
Objective: To study worldwide differences in childhood diabetes, comparing relevant indicators am... more Objective: To study worldwide differences in childhood diabetes, comparing relevant indicators among five regions within the SWEET initiative. Subjects: We investigated 26 726 individuals with type 1 diabetes (T1D) from 54 centers in the European region; 7768 individuals from 30 centers in the Asia/Middle East/Africa region; 2642 people from five centers in Australia/New Zealand; 10 839 individuals from seven centers in North America, and 1114 patients from five centers in South America. Methods: The SWEET database was analyzed based on the following inclusion criteria: T1D, time period 2015-2019, and age < 21 years, with analysis of the most recent documented year of therapy. For the statistical analysis, we used multivariable linear and logistic regression models to adjust for age (<6 years, 6-< 12 years, 12-< 18 years, 18-< 21 years), gender, and duration of diabetes (<2 years, 2-< 5 years, 5-< 10 years, ≥10 years).
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