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Keeping HbA1c levels below 7% is necessary for individuals with diabetes due to its significant impact on long-term health outcomes. HbA1c, or glycated hemoglobin, suggests average blood sugar levels over the past two to three months. Maintaining HbA1c levels within the target range, typically below 7%, individuals can reduce the risk of developing diabetes-related complications such as cardiovascular disease, kidney disease, nerve damage, and vision problems.

The notion that diabetes exclusively impacts individuals who consume junk food is a common misconception. While poor dietary habits can contribute to the development of type 2 diabetes, the disease can affect individuals regardless of their dietary choices. Type 1 diabetes, for instance, is an autoimmune condition that typically develops in childhood or adolescence and is not linked to dietary factors. Moreover, genetic predisposition, sedentary lifestyle, obesity, and other health factors also play significant roles in the onset of diabetes. Therefore, it’s essential to recognize that diabetes can affect individuals from various backgrounds and dietary preferences.

In this video, Dr (Prof) DG Jain from Delhi explains why it is important for people with diabetes to keep their HbA1c below 7%. Additionally, he addresses the common misconception that diabetes only affects individuals who consume junk food.

Understanding diabetes is crucial for maintaining good health. Diabetes is a chronic condition characterized by elevated blood sugar levels due to the body’s inability to produce or effectively use insulin. It can lead to serious complications such as heart disease, kidney failure, and nerve damage if not managed properly. Therefore, it’s essential to monitor blood sugar levels regularly, follow a healthy diet, engage in regular physical activity, and take prescribed medications as directed by healthcare professionals.

Having borderline diabetes, also known as prediabetes, doesn’t mean one should dismiss concerns about their health. Prediabetes indicates that blood sugar levels are higher than normal but not high enough to be classified as diabetes. However, individuals with prediabetes are at increased risk of developing type 2 diabetes, heart disease, and stroke. Therefore, it’s crucial to take proactive steps such as adopting a healthy lifestyle, maintaining a balanced diet, and engaging in regular exercise to prevent or delay the progression of diabetes. Ignoring prediabetes can lead to more serious health issues down the line, emphasizing the importance of taking preventive measures and seeking medical advice for optimal health management.

In this video, Dr. Usha Subramanian from Delhi explains what diabetes is and why it is a cause for concern. Additionally, she addresses the misconception that having borderline diabetes means there’s no need to worry.

Mumbai: Alkem Labs has announced that the U.S. Food and Drug Administration (USFDA) has issued Form 483 with ten observations at the end of the inspection at the Company’s manufacturing facility located at Baddi.

Read also: Justify inter-subject variability in BE study data: CDSCO Panel Tells Alkem on anticancer drug Relugolix

Alkem Laboratories Ltd is an Indian pharmaceutical company engaged in the development, manufacture, and sale of pharmaceutical and nutraceutical products. The company produces branded generics, generic drugs, active pharmaceutical ingredients (APIs) and nutraceuticals in acute and chronic therapeutic areas, such as anti-infective, pain and analgesics, vitamins/minerals/nutrients, cardiac and Diabetology, Gynecology, Ophthalmology, neuro/central nervous system, dermatology, anti-diabetes, anti-osteoporosis, cardiovascular, and muscle relaxants, which are marketed in Indian and International markets. It operates through the pharmaceutical business segment.

Read also: Alkem Reduces Prices of Denuril, Brand of Denosumab by 30% for the Treatment of Osteoporosis in Postmenopausal Women

Use of Popular obesity drugs may increase risk of aspiration pneumonia following endoscopy, suggests new research from Cedars-Sinai. Therefore patients who are scheduled for certain medical procedures should stop taking popular weight loss drugs in the days or weeks prior to avoid complications.

Investigators found that glucagon-like peptide-1 receptor agonists (GLP-1RAs)-medications like Ozempic and Wegovy that are used to treat diabetes and obesity-are associated with an increased risk of aspiration pneumonia following endoscopy. The large, population-based study is published in the leading peer-reviewed journal Gastroenterology.

Aspiration pneumonia is caused by inhaling foreign materials-including food in the stomach, or secretions from the mouth and nose-into the lungs. Endoscopy is a medical procedure in which a physician puts a tube-like scope down a patient’s throat and into the body to look inside.

One way the new obesity medications work is by slowing digestion, so people feel full longer, causing them to eat less. This also means that food sits in the stomach longer. As a result, the stomach may not empty completely during the usual duration of fasting that is recommended ahead of a surgical procedure to decrease risk of aspiration, explained the study’s corresponding author, Ali Rezaie, MD, medical director of the GI Motility Program and director of bioinformatics at the MAST Program at Cedars-Sinai.

“Aspiration during or after endoscopy can be devastating,” Rezaie said. “If significant, it can lead to respiratory failure, ICU admission and even death. Even mild cases may require close monitoring, respiratory support and medications including antibiotics. It is important we take all possible precautions to prevent aspiration from occurring.”

The study analyzed data from nearly 1 million de-identified U.S. patients who underwent upper or lower endoscopy procedures between January 2018 and December 2020. Patients who were prescribed GLP-1RA medications had a 33% higher chance of experiencing aspiration pneumonia than those who did not take these medications before the procedure. This comparison also considered other variables that could influence the outcome to ensure a fair comparison between the two groups.

“When we apply this risk to the more than 20 million endoscopies that are performed in the U.S. each year, there may actually be a large number of cases where aspiration could be avoided if the patient safely stops their GLP-1RA medication in advance,” Rezaie said.

“The results of this study could change clinical practice,” said Yee Hui Yeo, MD, first author of the study and a clinical fellow in the Karsh Division of Gastroenterology and Hepatology at Cedars-Sinai. “Patients taking these medications who are scheduled to undergo a procedure should communicate with their healthcare team well in advance to avoid unnecessary and unwanted complications.”

Reference:

Yee Hui Yeo, Srinivas Gaddam, Wee Han Ng, Pin-Chia Huang, Ghada Mohamed, Jamil Samaan, Tina Yi-Jin Hsieh, Gin Yi Lee, Rabindra Watson, Ruchi Mathur, Kevin Sheng-Kai Ma, Ali Rezaie. Increased risk of aspiration pneumonia associated with endoscopic procedures among patients with Glucagon-like peptide-1 receptor agonist use. Gastroenterology, 2024; DOI: 10.1053/j.gastro.2024.03.015.

Prolonged use of certain progestogen hormone drugs is associated with an increased risk of developing a type of brain tumour known as an intracranial meningioma, finds a study from France published by The BMJ today.

The researchers say this study is the first to assess the risk associated with progestogens used by millions of women worldwide, and further studies are urgently needed to gain a better understanding of this risk.

Progestogens are similar to the natural hormone progesterone, which are widely used for gynaecological conditions such as endometriosis and polycystic ovary syndrome, and in menopausal hormone therapy and contraceptives.

Meningiomas are mostly non-cancerous tumours in the layers of tissue (meninges) that cover the brain and spinal cord. Factors such as older age, female sex, and exposure to three high-dose progestogens (nomegestrol, chlormadinone, and cyproterone acetate) are already known to increase the risk of meningioma.

But there are many other progestogens for which the risk of meningioma associated with their use has not been estimated individually.

To address this knowledge gap, researchers set out to evaluate the real life risk of intracranial meningioma requiring surgery in women associated with use of several progestogens with different routes of administration.

They used data from the French national health data system (SNDS) for 18,061 women (average age 58) who underwent intracranial meningioma surgery from 2009-18.

Each case was matched to five control women without intracranial meningioma (total 90,305) by year of birth and area of residence.

The progestogens examined were progesterone, hydroxyprogesterone, dydrogesterone, medrogestone, medroxyprogesterone acetate, promegestone, dienogest, and levonorgestrel intrauterine systems.

For each progestogen, use was defined as at least one prescription in the year before hospital admission or within 3-5 years for levonorgestrel intrauterine systems.

Use of at least one of the three high-dose progestogens known to increase the risk of meningioma in the 3 years before hospital admission was also recorded to minimise bias.

After taking account of other potentially influential factors, prolonged use (a year or more) of medrogestone was associated with a 4.1-fold increased risk of intracranial meningioma requiring surgery. Prolonged use of medroxyprogesterone acetate injection was associated with a 5.6-fold increased risk, and prolonged use of promegestone was linked to a 2.7-fold increased risk.

There appeared to be no such risk for less than one year of use of these progestogens.

As expected, there was also an excess risk of meningioma for women exposed to chlormadinone acetate, nomegestrol acetate, and cyproterone acetate, all of which are known to increase the risk of meningioma.

However, results showed no excess risk of meningioma for progesterone, dydrogesterone, or the widely used hormonal intrauterine systems, regardless of the dose of levonorgestrel they contained.

No conclusions could be drawn about dienogest or hydroxyprogesterone as the number of exposed individuals was too small.

This is an observational study so can’t establish cause and effect, and the authors acknowledge that the SNDS database lacked information on all the clinical details and medical indications for which progestogens are prescribed. Nor were they able to account for genetic predisposition and exposure to high dose radiation.

However, they say, given that medroxyprogesterone acetate is estimated to be used for birth control by 74 million women worldwide, the number of attributable meningiomas may be potentially high.

Further studies using other sources of data are urgently needed to gain a better understanding of this risk, they conclude.

Reference:

Roland N, Neumann A, Haszard L, Duranteau L, Froelich S, Zureik M et al. Use of progestogens and the risk of intracranial meningioma: national case-control study BMJ 2024; 384 :e078078 doi:10.1136/bmj-2023-078078.