TargetOptimum care a b s t r a c t were estimated at baseline and prevalence of those at target (HbA1c <7%, BP < 130/ 80 mm Hg, LDL < 100 mg/dl) was documented and repeated at three and six months to monitor improvement in the number of patients at target and trend in improvement of individual parameters. Results:The percentage of patients at target at baseline and six months for HbA1c was (45% vs. 55% p ¼ 0.101), BP < 130/80 mm Hg (27% vs. 25%) and LDL <100 mg/dl (37% vs. 40% p ¼ 0.386). All three parameters were at target in one patient and three patients at six months period. Mean values at baseline and six months of HbA1c 7.46% (95% CI 7.17e7.75) vs 7.21% (95% CI 6.9e7.52), Systolic BP 138 mm Hg (95% CI 135e141), Diastolic BP 86 mm Hg (95% CI 84 e86) and LDL 114 mg/dl (95%CI 107e121) vs. 110 mg/dl (95%CI 105e116) did not show significant improvement (p for trend).Conclusion: Standards of care for HbA1c, blood pressure and LDL remains to be achieved in majority of the diabetic patients.

Type 2 diabetes is characterised by a progressive decline in insulin secretion, and sooner or later patients require insulin therapy. However, physicians are reluctant to initiate insulin therapy because of perceived inadequacy in managing insulin therapy, cost and lack of benefits. Experts from across the country met at a workshop during 12th National Insulin Summit which was held in September at Hyderabad and came up with key recommendations to build capacity and confidence in general practitioners for insulin usage. Barriers can be overcome through self-education and training; effective patient education; imparting coping skill training to patients; and bridging gaps to improve adherence. Moreover, optimum insulinization requires knowledge about the available options for initiation and intensification of insulin therapy; various insulin regimens; dosing and titration; and choosing effective and simple insulin therapy as per patient characteristics. Hence, the objective of this review article is to help build capacity and confidence among general practitioners on optimising insulin therapy.

Despite the availability of multiple therapeutic options and strategies, patients with type 2 diabetes mellitus (T2DM) the world over have inadequate glycaemic control and India is no exception. Patients with T2DM in India have benefitted from glucagon-like peptide-1 analogues similar to that of patients from other parts of the world. However, subcutaneous treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is limited by their injectable mode of administration. The present review highlights barriers to incretinisation with GLP-1RAs and the role of first-in-class oral semaglutide in the Indian context and provides guidance to physicians on its initiation and uses.

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secondary care health delivery system is well developed and regular follow up is well ensured, we can design a larger study with an inbuilt system to assess the achievement of treatment goals periodically. This mechanism to audit comprehensive healthcare delivery in a condition like Type 2 DM which has such a significant impact on cardiovascular morbidity and mortality will be a huge step towards achieving improved health for our clientele.