Background and Aims: Lockdown during the COVID-19 pandemic imposed many restrictions on the public. Loss of continuum of care along with improper lifestyle was expected to worsen glycemic control in people with type 2 diabetes (T2D). We aimed to identify the effects of lockdown on their glycemic status, lifestyle changes and psychosocial health. Methods: The pre- and post-lockdown data of 110 adults with T2D who were under regular follow up was collected by direct interview during their visit to the diabetes clinic. The variables analyzed included demographic data, HbA1c, body weight, lifestyle changes, psychosocial factors and use of technology. Result: The overall physical activity had dipped significantly accounting to lockdown restrictions and fear. Dietary adherence was better with participants exhibiting increased consumption of vegetables (80.9%), fruits (42.7%), and decreased unhealthy snacking (63%). 90% of them had access to medications during lockdown. There was significant change noted in the mean HbA1c (0.9- 1.45%) and body weight (1–3.5kgs) before and after lockdown. There was a great increase in Screen time attributing to Work from home and restrictions to move out. 63.6% of them spent time with their family members. Those with prior mental stress,poor sleep and unhealthy dietary habits had worsening glycemic control as seen in those with less physical activity and an unhealthy diet. An increasing trend of utilisation of health related mobile internet technology apps were noted. Conclusion: Lockdown did cause a major change in the overall glycemic control. Measures to promote healthy lifestyle practices along with ways to reduce psychosocial stress must be implemented for better T2D management during such restricted times. Telemedicine paved a greater way and scope of continuum of Diabetes care.

Background: Type 2 diabetes mellitus (T2DM), a metabolic disorder with high levels of glucose due to absolute insulin deficiency or relative insulin deficiency (insulin resistance) affects about 20 percent of adults in South Asia (SA) in the United Kingdom (UK). This is similar to that of urban Indian population, where the incidence is about 15 percent. Despite this, there is a scarcity of data comparing SA with that of the Indian urban community in the UK. Objective: The aim of the present study was to study the prevalence and differences of undiagnosed diabetes and associated risk factors between the urban adult Indian populations living in Bangalore and in South Asians residing in the UK. Materials and Methods: The general publics above age of 30 (adult) were encouraged to come for general checkup including capillary blood glucose test during public health events held at various town halls in UK. In the UK, nearly 230 SA adults were screened at 3 separate events held in Preston, Bolton and London. While in Bangalore, at 4 events were held at mosques and the community centres and 412 adult subjects were tested. Subjects known to have diabetes (DM) were analyzed separately from those that were not known to have diabetes (non-DM. Clinical monitoring of anthropometric data and random levels of capillary blood glucose were analyzed. Results: We found that 14.6 % and 42.7% of subjects had previously documented diabetes in the UK and India, respectively (P<0.001). No characteristic differences in age and BMI were found between the subjects of SA in the UK and those in India. In Bangalore, more men (69%) attended screening programme compared to the UK (14.6 percent). Of people without history of diabetes 30.1% of Indians in urban Bangalore had elevated blood sugar in comparison to SA in the UK (10.8%). Conclusion:There is an urgent need to perform screening of adult population for diabetes in urban India, where almost 20% people have impaired glucose tolerance.

Background and aims: The burden of diabetes in India is increasing, especially in cities. We conducted a cross- sectional survey of the prevalence of diabetes and a measure of prediabetes in an urban population in Bangalore, India.Methods: Screening was conducted free of charge and without need for a prior appointment in 32 screening sites throughout Bangalore. Diabetes was defined either on the basis of a self-reported prior diagnosis or as undiagnosed diabetes on the basis of a random blood glucose measurement of >11.1 mmol/L (200 mg/dL). A second index of dysglycaemia, termed prediabetes, was defined as a random blood glucose measurement of >7.8 mmol/L (140 mg/dL) but less than 11.1 mmol/L.Results: The study population comprised 3,691 subjects, screened over a period of 15 months. Previously diagnosed diabetes was present in 818 patients (22.2%), previously undiagnosed diabetes in 67 patients (1.8%) and the additional measure of prediabetes in 221 patients (6%). Accordingly, almost one-third of subjects (30%) had diabetes or prediabetes by our criteria. Diabetes (diagnosed or undiagnosed) and prediabetes were more common in older subjects than younger subjects, as would be expected.Conclusions: We observed high rates of dysglycaemia in a large urban population in Bangalore. Our data add to previous reports of a substantial burden of abnormal glucose regulation in this setting. Additional public health initiatives are required to protect the citizens of Bangalore from diabetes and its future complications.

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T2DM (type 2 diabetes mellitus) is a chronic and progressive illness with high morbidity and death rates. Oral semaglutide (Rybelsus®) is a combination of semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), and sodium N- (8- [2-hydroxybenzoyl] amino) caprylate (SNAC), an absorption enhancer that facilitates semaglutide absorption across the gastric epithelium in a concentration-dependent manner. This family of drugs apart from glucose lowering effects causes significant weight loss with lower risk of hypoglycemia, and some of them have been linked to a significant reduced major adverse cardiovascular events. GLP-1 RAs may assist persons with T2DM and chronic kidney disease (CKD), a major microvascular consequence of T2DM, in ways other than lowering blood sugar. Several large clinical studies, the bulk of which are cardiovascular outcome trials, show that GLP-1 RA treatment is safe and tolerated for persons with T2DM and impaired renal function and that it may potentially have renoprotective characteristics. This article focuses on the advances of oral GLP1-RA and describes the key milestones and predicted advantages.