Background and aim While diabetes mellitus (DM) is occupying the topmost global epidemic position, India is harboring a challenging number of type 2 DM patients in the world. This devastating picture of the health sector in India requires the availability of more cost-effective, context-specific, and safer drugs for DM management. This study aimed to evaluate the safety and efficacy of teneligliptin in Indian patients with type 2 DM inadequately controlled with diet, exercise, and a maximal dose of metformin treatment. Materials and methods This was a retrospective, observational, and single-center study conducted at a diabetic clinic in India in type 2 DM patients who have been treated with teneligliptin 40 mg once daily as add-on therapy with diet, exercise, and the maximal tolerable dose of metformin for three months. The study was observational, where the data collection was through self-reporting and an observational study conducted over one year (September 2018 to August 2019). A total of 100 patients were enrolled in the study (male 69% and female 31%). Patients with available data for fasting plasma glucose (FPG), postprandial plasma glucose (2h PPG), glycated hemoglobin (HbA1c), renal function parameters, such as urinary albumin to creatinine ratio (UACR), and electrocardiogram (ECG) at baseline and three months after treatment were enrolled in the study. Results There was a significant reduction in fasting blood sugar (P=<0.001), postprandial blood sugar (P=<0.001), and HbA1c (P=<0.001) at the end of the three months treatment in comparison to the baseline level and in the primary outcomes of this study as compared to baseline. The teneligliptin treatment did not cause any significant reduction in body mass index (BMI) before and after treatment. When we compared the secondary outcomes, the indicator of renal function as expressed through the albumin-to-creatinine ratio (ACR; P=0.052), there was a borderline change in ACR from baseline to three months. The mean corrected QT interval at screening baseline was 429.7 ± 8.89 milliseconds while after three months, it was 429.1 ± 8.68 milliseconds, which was statistically insignificant. Conclusion The current results demonstrated a high level of efficacy as an add-on therapy of teneligliptin 1 2

IntroductionDiabetic polyneuropathy (DPN) is a common chronic complication of type 2 diabetes. The pathogenesis of DPN is still debated, but proinflammatory cytokine mediators like interleukin-6 (IL-6) are possibly involved. We conducted this cross-sectional observational study to assess whether IL-6 levels increase in patients with DPN.

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Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and has emerged as a serious public health challenge. About 20% of NAFLD patients may have low titres (<1:320) of antinuclear antibodies (ANA). However, we describe a patient with NAFLD whose ANA titre was high (>1:320) on presentation. After 3 months of diet, exercise and vitamin E supplementation,the patient was symptomatically better but her ANA titre had increased (>1:640). Her liver biopsy showed features of NAFLD with minimal fibrosis. High-titre ANA (>1:320) positivity is rare. Our patient showed a progressive rise in ANA titre from >1:320 to >1:640 within 3 months even though she was improving and histology showed minimal fibrosis.

Introduction. Insulin therapy plays an important role in the management of diabetes mellitus. The primary goal of insulin therapy is to achieve the best possible glycemic control without hypoglycemia. First-generation basal insulin (BI) analogues, such as insulin glargine 100 U/ml (Gla-100) and insulin detemir (IDet), provide more prolonged and stable activity than neutral protamine Hagedorn (NPH) insulin, with a lower risk of hypoglycemia. Insulin glargine 300 U/mL (glargine U 300) is a long acting basal insulin analogue approved for the treatment of diabetes mellitus. Insulin glargine 300 U/mL has a more stable and prolonged pharmacokinetic/ /pharmacodynamics profile than insulin glargine 100 U/mL, with a duration of glucose-lowering activity exceeding 24 h. Although the average daily insulin dose was higher, hypoglycemia episodes were lower in patients treated with Gla-300 compared with those treated with Gla-100. This is due to a more extended time action profile than Gla-100 resulting in a more stable and sustained glycemic control. The formulation of Gla-100 delivers the same amount of Insulin as Gla-300, in a third of the injection volume. It is essential to determine whether the clinical benefits of hypoglycemia reduction observed with insulin glargine in RCTs translate into a real-life clinical practice setting. Materials and methods. Fifty patients diagnosed with type 2 diabetes mellitus with uncontrolled plasma glucose levels (HbA 1c of > 7.5) who were on oral hypoglycemic agents, premix insulin and basal bolus therapy were enrolled into the study and started on glargine U 300 at a dose of 0.2 IU/kg and analysed for glycemic and kidney function parameters. The patients were followed up at 3 and 6 months post treatment. Results. All glycemic control parameters decreased significantly with almost a 50% decline in both FBS and PBS from baseline to 6 months. The HbA 1c decreased significantly from baseline to 3 months and 6 months post treatment by 18% and 29% respectively. All biochemical parameters were found to be statistically significant in both groups. Conclusions. In patients with uncontrolled type 2 diabetes, switching from either OHAs or insulin to Gla-300 improves glycemic control, with a low incidence of hypoglycemia. These results confirm the effectiveness and safety of Gla-300 in a real-world setting and show that Gla-300 is a suitable therapy option for patients with diabetes.