Is it enough to have just one dose of insulin at night to control the glucose level through the day or do Indians need a different kind of therapy?
At a session in the seventh edition of the international diabetes conference in the city, panellists discussed whether insulin helped control blood sugar levels.
Marc Evans, a consultant diabetologist from Cardiff University, who spoke on the benefits of using insulin, said clinicians should optimise treatment by introducing insulin therapy as better HbA1c control reduced complications in the patient. It also reduced cost of care to the patient besides improving quality of life, he added.
By the time of diagnosis, diabetes patients would have lost approximately 80% of their beta cell function. Dr. Evans said clinical inertia, where effective therapies and interventions are underused despite sufficient evidence, therapeutic inertia, that is, not identifying early the need to adjust treatment regimen and clinical myopia – the failure to give preference to long-term benefits – led to higher treatment cost for the patient. Good glucose control meant that the cost of treatment fell by more than 20% for the patient, he added.
While the western diabetologists believed that one dose of insulin at night was sufficient to take care of the blood glucose level through the day, the carb-rich Indian diet required a different treatment method, said Ajay Kumar, of Diabetes Care and Research, Patna. He felt there has to be a mix of basal insulin at night and during daytime too, given the diet pattern of Indians.
V. Mohan, chairman of the Dr. Mohan’s group of diabetes institutions, chaired the session on insulin usage. He said the question was whether a single dose of insulin at night would bring down the post-prandial sugar levels. The western concept may not work in Indian population since the western population took very little carbs.
Earlier in the day, at the inauguration of the seventh annual international conference on diabetes update, B. A. Muruganathan, Governor of the India chapter of American College of Physicians, urged diabetologists to adopt a village and educate the families on diabetes.
Mumbai-based endocrinologist Shashank R. Joshi spoke about deaths due to non-communicable diseases (NCD) during the current COVID-19 pandemic. While in May 2019, as many as 6,000 persons with diabetes had died, the number stood at 12,000 this year. “Of this 8,000 people died of diabetes,” he added.
The three-day virtual conference had as many as 7,500 attendees. “There are two exclusive sessions on COVID and its relationship with diabetes,” Dr. Mohan said.