Diabetes in Asia

Ramachandran, Ambady; Wan, Ronald Ching; Snehalatha, Chamukuttan

doi:10.1016/s0140-6736(09)60937-5

Cited by 711 publications

(598 citation statements)

References 118 publications

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“…The contribution of these components is within a spectrum ranging from predominant insulin resistance to a predominant insulin secretory defect [1]. There is a growing body of evidence that the pathophysiology of type 2 diabetes differs by ethnic group [2][3][4]. Comparing Asian and white patients with type 2 diabetes, Asian patients are characterised by a relatively lower BMI [4], higher amounts of visceral fat with a given BMI or waist circumference [5,6] and a predominant insulin secretory defect [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…In patients with type 2 diabetes, the insulin secretory defect is more prominent in Asian than in white individuals [7,10,11]. The reasons for decreased insulin secretion in Asian patients with type 2 diabetes are yet to be determined but may be explained by lower beta cell mass, impaired beta cell function and genetic differences [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

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Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis

et al. 2013

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Aims/hypothesis The aim of this work was to compare the glucose-lowering efficacy of dipeptidyl peptidase-4 (DPP-4) inhibitors between Asian and non-Asian patients with type 2 diabetes. Methods We searched MEDLINE, EMBASE, LILACS, CENTRAL, ClinicalTrials.gov and conference proceedings. Studies were eligible if they were randomised controlled trials with a treatment duration of at least 12 weeks, compared a DPP-4 inhibitor with a placebo as either monotherapy or oral combination therapy, had information on ethnicity and HbA 1c values and were published or described in English. A systematic review and meta-analysis with a meta-regression analysis was conducted. Results Among 809 potentially relevant studies, 55 trials were included. A meta-analysis revealed that DPP-4 inhibitors lowered HbA 1c to a greater extent in studies with ≥50% Asian participants (weighted mean difference [WMD] −0.92%; 95% CI −1.03, −0.82) than in studies with <50% Asian participants (WMD −0.65%; 95% CI −0.69, −0.60). The between-group difference was −0.26% (95% CI −0.36, −0.17, p<0.001). The baseline BMI significantly correlated with the HbA 1c -lowering efficacy of DPP-4 inhibitors. The RR of achieving the goal of HbA 1c <7.0% (53.0 mmol/mol) was higher in studies with ≥50% Asian participants (3.4 [95% CI 2.6, 4.7] vs 1.9 [95% CI 1.8, 2.0]). The fasting plasma glucose-lowering efficacy was higher with monotherapy in the Asiandominant studies, but the postprandial glucose-lowering efficacy and changes in body weight were comparable between the two groups. Conclusions/interpretation DPP-4 inhibitors exhibit a better glucose-lowering efficacy in Asians than in other ethnic groups; this requires further investigation to understand the underlying mechanism, particularly in relation to BMI.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis

et al. 2013

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“…The greatest increases are being seen in developing countries such as those in South East Asia (International Diabetes Federation, 2003;Ramachandran et al, 2010). There are many reasons for this increase in prevalence but it is generally thought that increasing rates of obesity and lack of exercise predicated upon a pre-existing genetic tendency towards diabetes are fuelling the epidemic (Stumvoll et al, 2005).…”

Section: The Rationale For Preventing Type 2 Diabetes and Its Complicmentioning

confidence: 99%

“…Hence, one profound implication is that population screening may well be too costly to be undertaken in developing countries and this is doubly serious as many Asian countries have some of the highest levels of prevalence of Type 2 Diabetes in the world, e.g. 10% in China (Ramachandran et al, 2010).…”

Section: Population Screeningmentioning

confidence: 99%

Type 2 Diabetes Mellitus in Family Practice: Prevention and Screening

Evans¹,

Wright²,

Gray³

et al. 2011

Topics in the Prevention, Treatment and Complications of Type 2 Diabetes

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“…The Bepidemic^of diabetes mellitus (DM) is a global phenomenon, and India holds the dubious distinction of being the Bdiabetic capital of the world^ [1][2][3][4]. Among all the complications, the most common is the diabetic foot ulcer (DFU) which often becomes the most devastating, culminating in unexpected consequences like amputation [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Effective and Economic Offloading of Diabetic Foot Ulcers in India with the Bohler Iron Plaster Cast

Saikia¹,

Hariharan

Shankar

et al. 2015

Indian J Surg

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Economic constraints are a major obstacle to the implementation of offloading casts in India. The aim of this study is to monitor the healing and activity limitations related to Bohler iron plaster cast (BIPC) when used for offloading diabetic neuropathic plantar foot ulcers. Thirty patients were cast for 1 month and evaluated for healing using the Pressure Ulcer Scale for Healing (PUSH), and for activity limitation using the Lower Extremity Functional Scale (LEFS). The change in the scores after intervention was the outcome measure. There was good healing as evidenced by a statistical difference in mean PUSH scores. The baseline PUSH score of 9.76-0.41 (T1-SEM) was greater than follow-up PUSH score of 6.32+0.41 (T2+SEM) and the p value <0.0001. Improvement was seen in ulcer area, exudate, and tissue type. There was no mobility effect as there was no significant difference in LEFS. Significant negative correlation was there between PUSH and LEFS. The r value was less than −0.7 both at baseline and after intervention. The combined benefits of good healing, lack of affect on lower extremity function, the ease of application and dressing, and relative affordability make BIPC a commendable offloading modality for the management of diabetic plantar ulcers.

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Diabetes in Asia

Cited by 711 publications

References 118 publications

Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis

Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis

Type 2 Diabetes Mellitus in Family Practice: Prevention and Screening

Effective and Economic Offloading of Diabetic Foot Ulcers in India with the Bohler Iron Plaster Cast

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