Metabolic Diseases

Type-2 diabetes mellitus is a chronic progressive disease, which has assumed the status of a global pandemic. At-present, diabetes affects 415 million people globally, and the number is predicted to rise to 642 million by 2040.¹ In simpler terms, 1 in every 11^th adult individual globally, is a patient of diabetes. Moreover, every 6 seconds, 1 person dies of diabetes.¹

India houses 72.9 million patients of diabetes, with >50% of the cases remaining undiagnosed.² Indian patients are inherently prone to develop diabetes and its complications, because of the ‘Asian Indian phenotype’, and influence of certain cultural practices. Asian-Indian phenotype includes certain unique clinical and biochemical abnormalities, like increased insulin resistance, greater abdominal adiposity i.e., higher waist circumference despite lower body mass index, lower adiponectin levels, and higher high sensitive C-reactive protein levels.³ The risk of vascular complications, like coronary artery disease, cardiovascular events (myocardial infarction, stroke), and chronic kidney disease is significantly increased in the Indian patients of diabetes.^4-6 In fact, the prevalence of diabetic kidney disease is relatively higher in the patients from India, as compared to other Asian countries, indicative of poorer healthcare delivery.⁷

To optimize clinical management of T2DM, a proactive approach aimed to achieve the therapeutic goal of HbA1c within 6-months of diagnosis, has been recommended.⁸ However, at present, only about a third of the Indian patients are optimally controlled for blood glucose levels.⁹ An essential consideration is to address the comorbidities of T2DM, which contribute to the severe complications associated with this disease. As a holistic approach, management of hypertension and dyslipidemia should receive equal priority. The approach should be tailored according to the phenotype of the patient, including HbA1c level, duration of diabetes, presence of complications, and risk of hypoglycemia. Weight-reduction should be encouraged in obese patients.⁸

As Boehringer-Ingelheim, we continually strive for excellence in research and development, to bring innovative therapies for improving diabetes care across the world.

References

1. ​IDF Diabetes Atlas, 7th edition, 2015. http://www.idf.org/about-diabetes/facts-figures. Accessed 28th Nov, 2016.
2. IDF. https://www.idf.org/our-network/regions-members/south-east-asia/members/94-india.html. Accessed 4th Apr, 2018.
3. Mohan V et al. Indian J Med Res. 2007 Mar;125:217-30.
4. Mohan V et al. J Diabetes Sci Technol. 2010 Jan 1;4(1):158-70.
5. Joshi SR et al. Diabetes Technol Ther. 2012 Jan;14(1):8-15.
6. Singh AK et al. BMC Nephrol. 2013 May 28;14:114.
7. Luk AO et al. Diabet Med. 2015 Oct 29. doi: 10.1111/dme.13014.
8. Del Prato S et al. Int J Clin Pract Suppl. 2007 Dec;(157):47-57.
9. Unnikrishnan R et al. Diabetes Technology & Therapeutics. 2014;16(9):596-603.