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Comparison of gliclazide vs linagliptin on hypoglycemia and cardiovascular events in type 2 diabetes mellitus: A systematic review

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World Journal of Diabetes 2022年第12期13卷 1168-1183页

作者： viswanathan mohan Subhash Wangnoo Sambit Das Rajnish Dhediya Kumar Gaurav Department of Diabetes Madras Diabetes Research Foundation&Dr Mohan’s Diabetes Specialties CentreChennai 600086Tamil NaduIndia Department of Diabetes Apollo Hospital Education and Research FoundationNew Delhi 110001India Department of Endocrinology Endeavour ClinicsBhubaneswar 750017India Medical Affairs Dr.Reddy’s Laboratories LtdHyderabad 500016India

BACKGROUND Cardiovascular outcome trials have demonstrated cardiovascular safety of glimepiride(a sulfonylureas) against dipeptidyl peptidase-4 inhibitor ***(another newer sulfonylureas) has shown similar glycemic efficacy and 50% decreased risk of hypoglycemia compared to *** Considering the absence of cardiovascular outcome trials for gliclazide, we decided to conduct a systematic review of the literature to assess the cardiovascular(CV) safety by assessing the risk for major adverse CV events and hypoglycemia risk of gliclazide vs linagliptin in patients with type 2 diabetes(T2D).METHODS This systematic review followed the current Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to analyze all the clinical studies published from 2008 that compared the two drugs in patients with T2D with no risk of CV disease(CVD). We included only evidence designated high quality by the Oxford Center for Evidence-based Medicine-Levels of *** Eight clinical studies were included in the narrative descriptive analysis(gliclazide: 5 and linagliptin: 3). The CV safety of gliclazide in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation trial and of linagliptin in the Cardiovascular and Renal Microvascular Outcome Study With Linagliptin(CARMELINA) and CARdiovascular Outcome study of LINAgliptin vs glimepiride in patients with T2D(CAROLINA)trials were excluded from the comparative analysis as these trials demonstrated CV and hypoglycemia benefits in patients at high risk of CVD. However, since these are landmark trials,they were discussed in brief to show the CV benefits and low hypoglycemia risk of gliclazide and linagliptin. We did not find any study comparing gliclazide with linagliptin. Hence, direct comparison of their major adverse CV events and hypoglycemia risk could not be carried ***, the literature meeting the inclusion criteria showed that b

关键词： Linagliptin Gliclazide Hypoglycemia Major cardiovascular adverse events Type 2 diabetes

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预防和管理2型糖尿病的饮食和营养干预策略

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英国医学杂志中文版 2019年第9期22卷 500-506页

作者： Nita G Forouhi Anoop Misra viswanathan mohan Roy Taylor William Yancy 黄融(译) 竹萍(校) Forouhi Nita G MRC Epidemiology Unit University of Cambridge School of Clinical Medicine Cambridge UK Fortis-C-DOC Centre of Excellence for Diabetes Metabolic Diseases and Endocrinology and National Diabetes Obesity and Cholesterol Foundation New Delhi India Dr mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation Chennai India Magnetic Resonance Centre Institute of Cellular Medicine Newcastle University Newcastle UK Duke University Diet and Fitness Center Durham North Carolina USA Department of Medicine Duke University School of Medicine Durham North Carolina USA Center for Health Services Research in Primary Care Department of Veterans Affairs Durham North Carolina USA 上海交通大学仁济医院健康保健科

Nita G Forouhi和同事们认为,我们可以找到预防、管理和可能缓解2型糖尿病的饮食方法基本要点。饮食因素在2型糖尿病的预防和管理中至关重要。尽管在制定循证饮食指南方面取得了进展,但争议和困惑依然存在。在本文中,我们研究了现有证据... 详细信息

Nita G Forouhi和同事们认为,我们可以找到预防、管理和可能缓解2型糖尿病的饮食方法基本要点。饮食因素在2型糖尿病的预防和管理中至关重要。尽管在制定循证饮食指南方面取得了进展,但争议和困惑依然存在。在本文中,我们研究了现有证据,确定2型糖尿病饮食指南中哪些领域取得了共识,哪些还存在不确定性或争议。

关键词： 2型糖尿病饮食方法营养干预管理预防饮食因素饮食指南

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Glycemic Index and Response of a Plant Based Nutritional Supplement and Its Subjective Satiety Following Its Use in Indian Adults

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Food and Nutrition Sciences 2019年第8期10卷 937-946页

作者： Bhoite Rachana Parthasarthy Vijayalakshmi Raman Jeevan Ganesh viswanathan Gopinath Karthikeyan Parkavi Vasudevan Kavitha Nagamuthu Gayathri Rajagopal Gayathri Shanmugam Shobana Ranjit mohan Anjana Ranjit Unnikrishnan Vasudevan Sudha Mehta Suyog Archana Toppo Panda Acharya Shivani viswanathan mohan Dr. Reddy’s Laboratories Hyderabad India Department of Foods Nutrition & Dietetics Research Madras Diabetes Research Foundation Chennai India Department of Diabetology Dr. Mohan’s Diabetes Specialities Centre Chennai India

Background: Diet plays a vital role in managing diabetes. Foods with a low glycemic index provide lower postprandial glucose spikes and induce satiety. The objective of this study was to assess the Glycemic index (GI) without milk and Glycemic response (GR) with milk of two different flavours of a plant-based supplement which is high in protein and fibre, along with a subjective assessment of satiety. Methods: Fifteen overweight/obese subjects aged 18 - 45 years were recruited. After overnight fasting, blood samples were drawn at 5 mins before food consumption (-5), 0, 15, 30, 45, 60, 90 and 120 minutes. Participants underwent 3 days of reference food testing and 1 day of test food in random order with 2 days of wash-out period. The GI was assessed using a validated protocol recognized by FAO/WHO, as well as the guidelines by the International Dietary Carbohydrate Task Force for GI Methodology. The satiety index was measured using the Visual Analog Scale (VAS). The dietary intake of the subjects was measured by 24-hour dietary recall. The Incremental Area Under the Curve (IAUC) was calculated using the trapezoid rule. Results: Both the flavours of the supplement had low GI & GR. The GI and GR of Flavour 1 were 27.3 ± 4.8 & 16.4 ± 2.6 (Mean ± SEM) respectively. For Flavour 2 the GI and GR were 36.7 ± 4.4 & 25.7 ± 2.3 (Mean ± SEM). For Flavour 1, 60% and for flavour 2 66.7% of subjects reported feeling hungry only after 3 hours, showing good satiety. Conclusion: The plant-based high fibre high protein supplement in both flavours showed a low glycemic index and hence may be useful to include in the diets to reduce the postprandial glycemic response and could improve satiety.

关键词： Glycemic Index High Protein High Fiber Satiety Visual Analog Scale

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A Novel Approach for Groundwater Budgeting Using GIS in a Part of Pondicherry Region, India

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Journal of Water Resource and Protection 2010年第6期2卷 585-591页

作者： Sivaraman Pethaperumal Sabarathinam Chidambaram Kandasamy Vijayaragavan mohan viswanathan Prasanna Kannan Anandavel Ulaganathan Karmegam Ramachandran Manivannan Paluchamy Anandhan Kesari Tirumalesh 不详

The over extraction of groundwater from the coastal aquifers, result in reduction of groundwater resource and lowering of water level. In general, the depletion of groundwater level enhances the landward migration of saltwater wedge. Pondicherry is one such region with recent alluvium as the major formation. Since the study area forms a part of the coastal aquifer system this behaves as a fragile ecosystem. The present study has been attempted to calculate the extraction of water and to estimate the amount of recharge into this alluvial aquifer by using groundwater level variations. The monthly water level fluctuation was observed during the study period (2000-2002) in eighteen locations. The maximum rise in groundwater level observed during 2000 was considered as the initial water level for the study and the subsequent decline in water level (draw down) was monitored monthly until the rising trend was noted. This indicates the fall in water level due to extraction. Later keeping the deepest draw down as the initial value increasing water level trend was studied until there was a notice of decline in groundwater level. This indicates as the rise in water level due to recharge. This method of observation carried out at a single location was adopted for all eighteen locations. The spatial representation of these data for eighteen locations were carried out by using GIS and the area occupied by different groundwater level contours were calculated and the amount of water withdrawn/re- charged was estimated. The maximum recharge was noted in the central and the northern part of the study area when compared to the other regions. Similarly, the maximum discharge was noted in the northern and the southern part of the study area during the study period.

关键词： Water Level Recharge Groundwater Budget GIS

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Efficacy of a Diabetes Specific Nutrition Supplement on Glycemic, Anthropometric, Dietary and Gut Health Markers in Adults with Type 2 Diabetes: An RCT

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Food and Nutrition Sciences 2024年第8期15卷 846-867页

作者： Deepti Khanna Hema S. Gopalan Kuzhandaivelu Abirami Vasudevan Sudha Rajagopal Gayatri Kejal Joshi-Reddy Jaladhi Bhatt Raman Ganesh Jeevan Karthikeyan Parkavi Vadivel Deepika Manoj Pareek Ranjit mohan Anjana viswanathan mohan R&D Department Hindustan Unilever Limited Gurugram India Department of Foods Nutrition & Dietetics Research Madras Diabetes Research Foundation Chennai India Department of Diabetology Dr. Mohans Diabetes Specialities Centre Chennai India

With increasing incidence of diabetes, use of diabetes specific nutrition supplements (DSNS) is common for better management of the disease. To study effect of 12-week DSNS supplementation on glycemic markers, anthropometry, lipid profile, SCFAs, and gut microbiome in individuals with diabetes. Markers studied were glycemic [Fasting Blood Glucose (FBG), Post Prandial Glucose (PPG), HbA1c, Incremental Area under curve (iAUC), Mean Amplitude of Glycemic Excursions (MAGE), Time in/above Range (TIR/TAR)], anthropometry [weight, Body Mass Index (BMI), waist circumference (WC)], lipid profile, diet and gut health [plasma short chain fatty acids (SCFAs)]. N = 210 adults were randomized to receive either DSNS with standard care (DSNS + SC;n = 105) or standard care alone (SC alone;n = 105). After 12 weeks, significant differences between DSNS + SC versus SC alone was observed in FBG [−3 ± 6 vs 14 ± 6 mg/dl;p = 0.03], PPG [−35 ± 9 vs −3 ± 9 mg/dl;p = 0.01], weight [−0.6 ± 0.1 vs 0.2 ± 0.1 kg;p = 0.0001], BMI [−0.3 ± 0.1 vs 0.1 ± 0.1 kg/m2;p = 0.0001] and WC [−0.3 ± 0.2 vs 0.2 ± 0.2 cm;p = 0.01]. HbA1C and low-density lipoprotein (LDL) were significantly reduced in DSNS + SC [−0.2 ± 0.9;p = 0.04 and −5 mg/dl;p = 0.03] respectively with no change in control. Continuous Glucose Monitoring (CGM) reported significant differences between DSNS + SC versus SC alone for mean glucose [−12 ± 65 vs 28 ± 93 mg/dl;p < 0.01], TAR 180 [−9 ± 42 vs 7 ± 45 mg/dl;p = 0.04], TAR 250 [−3 ± 27 vs 9 ± 38 mg/dl;p = 0.05], iAUC [−192 (1.1) vs −48 (1.1) mg/dl;p = 0.03]. MAGE was significantly reduced for both DSNS + SC (−19 ± 67;p < 0.001) and SC alone (−8 ± 70;p = 0.04), with reduction being more pronounced for DSNS + SC. DSNS + SC reported a decrease in carbohydrate energy % [−9.4 (−11.3, −7.6) %;p < 0.0001] and amount [−47.4 (−67.1, −27.7) g;p < 0.0001], increased dietary fiber [9.5 (7.2, 11.8) g;p < 0.0001] and protein energy % [0.9 (0.5, 1.3) %;p < 0.0001] versus SC alone. DSNS + SC reported signi

关键词： Diabetes Specific Nutrition Supplement Standard of Care Diabetes Glycemic Markers HbA1C

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利格列汀应用于血糖水平未获充分控制的2型糖尿病亚洲患者有效且具有良好的耐受性

利格列汀应用于血糖水平未获充分控制的2型糖尿病亚洲患者有效且...

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中华医学会糖尿病学分会第十六次全国学术会议

作者： ZHENG PEI ZENG DONG SEOP CHOI viswanathan mohan ANGELA EMSER KAMRAN SIDDIQUI YAN GONG SAN JAY PATEL HANS-JUERGEN WOERLE

已有一系列的随机、双盲、安慰剂对照、多国试验针对DPP-4抑制剂利格列汀单药治疗方案、利格列汀与二甲双胍的联合治疗方案、利格列汀与二甲双胍加磺脲类药物的联合治疗方案、利格列汀与吡格列酮的联合治疗方案应用于2型糖尿病(T2D)患...

已有一系列的随机、双盲、安慰剂对照、多国试验针对DPP-4抑制剂利格列汀单药治疗方案、利格列汀与二甲双胍的联合治疗方案、利格列汀与二甲双胍加磺脲类药物的联合治疗方案、利格列汀与吡格列酮的联合治疗方案应用于2型糖尿病(T2D)患者血糖控制的安全性和疗效进行了评估。鉴于对新型降糖药物在不同种族人群中进行评估的必要性,我们对利格列汀应用于T2D亚洲患者的疗效和安全

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Need for operational simplicity and timely disbursal of benefits—a qualitative exploration of the implementation of a direct benefit transfer scheme for persons with tuberculosis in India

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Infectious Diseases of Poverty 2024年第3期13卷 58-72页

作者： Malu mohan Jeromie W.V.Thangaraj Sumit Pandey G.Sri Lakshmi Priya Sivavallinathan Arunachalam Rahul Sharma Hemant Deepak Shewade B.Aishwarya K.Afeeq Afsana Khatoon B.Gokulvijay Gude Sireesha Kavita Chandra S.Nandhakumar Prince Samuel C.Nanditha viswanathan Devika Shanmugasundaram Raghuram Rao Manoj V.Murhekar Kathiresan Jeyashree Indian Council of Medical Research-National Institute of Epidemiology R-127TNHBAyapakkamChennaiTamil Nadu 600077India TB Support Network WHO Country Office for IndiaNew DelhiIndia Central Tuberculosis Division Government of IndiaNew DelhiIndia

Background Ni-kshay Poshan Yojana(NPY)is a direct benefit transfer scheme of the Government of India introduced in 2018 to support the additional nutritional requirements of persons with TB(PwTB).Our recent nationwide evaluation of implementation and utilization of NPY using programmatic data of PwTB from nine randomly selected Indian states,reported a 70%coverage and high median delay in benefit *** undertook a qualitative study between January and July 2023,to understand the detailed implementation process of NPY and explore the enablers and barriers to effective implementation and utilization of the NPY *** We followed a grounded theory approach to inductively develop theoretical explanations for social phenomena through data generated from multiple *** conducted 36 in-depth interviews of national,district and field-level staff of the National Tuberculosis Elimination Programme(NTEP)and NPY beneficiaries from 30 districts across nine states of India,selected using theoretical *** analytical framework developed through inductive coding of a set of six interviews,guided the coding of the subsequent *** and themes emerged through constant comparison and the data collection continued until theoretical *** Stakeholders perceived NPY as a beneficial *** political commitment from the state administration,mainstreaming of NTEP work with the district public healthcare delivery system,availability of good geographic and internet connectivity and state-specific grievance redressal mechanisms and innovations were identified as enablers of ***,the complex,multi-level benefit approval process,difficulties in accessing banking services,perceived inadequacy of benefits and overworked human resources in the NTEP were identified as barriers to implementation and *** The optimal utilization of NPY is enabled by strong political commitment and challenged by its length

关键词： National Tuberculosis Elimination Programme Nutritional status Direct benefit transfer Implementation Cash transfer scheme Grounded theory India

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