New treatment norms proposed for diabetes

India may soon come up with a new set of treatment guidelines for patients of diabetes. This means medicines would be prescribed depending on the stage of the disease and kind of patient. Leading endocrinologists and diabetes experts from across the country have proposed a new treatment guideline or algorithm for type-2 diabetes specific to Indian patients. Currently, doctors use the guidelines as prescribed by the American Diabetes Association.

However, doctors say as incidence of diabetes has been increasing in India, there is need for a shift to specific parameters based on the requirements and body types of the Indian population.

"Treatment guidelines or algorithms developed and validated in developed nations may not be relevant or applicable to patients in India. In India, there are several factors such as early age of onset of diabetes, occurrence of diabetes in non-obese and sometimes lean people, differences in the relative contributions of insulin resistance and frequent infections including tuberculosis which impact treatment," says Dr Anoop Misra, chairman, diabetes and allied specialities in Fortis CDOC hospital.

Diabetes has emerged as a serious disease burden for India over the past two decades. While diabetes rate has increased by around 45% globally, it jumped 123% in India between 1990 and 2013, according to latest assessment by the Institute for Health Metrics and Evaluation at the University of Washington.

Estimates by International Diabetes Federation showed nearly 6.9 crore people in India were suffering from diabetes in 2015 and it is expected to swell to 12.5 crore by 2040. According to the new treatment proposal, type-2 diabetes in Asian Indian differs significantly from that found in white Caucasians. Any treatment decision in Indians should take into account not only these differences, but also socio-economic and cultural factors (such as dietary practices), which may render some therapeutic options less suitable in this population.

The proposal also recommends use of some less expensive medicines and more lifestyle based interventions.

The proposal, published in an international journal Diabetics Technology & Therapeutics, contains views from 32 medical experts and endocrinologists from across the country .

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