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Sweet news ahead of World Diabetes Day

On new guidelines for diabetes treatment, mpox research, making healthcare systems workable and safe, RNA editing and more

Updated - November 13, 2024 08:38 am IST

With over a 100 million diabetics said to be from the Indian subcontinent, it makes sense that a day marked out for diabetes would be of key significance for the nation

With over a 100 million diabetics said to be from the Indian subcontinent, it makes sense that a day marked out for diabetes would be of key significance for the nation | Photo Credit: Getty Images/iStockphoto

(In the weekly Health Matters newsletter, Ramya Kannan writes about getting to good health, and staying there. You can subscribe here to get the newsletter in your inbox.)

Among the more important health days, at least for India, one is coming up later this week -- World Diabetes Day. With over a 100 million diabetics said to be from the Indian subcontinent, it makes sense that a day marked out for diabetes would be of key significance for the nation. While prevention is the eternal slogan, this year’s World Diabetes Day theme is, ‘Breaking Barriers, Bridging Gaps’. This includes: activities to reduce the risk of diabetes; ensuring that people with diabetes have access to quality care; and improving people’s quality of life through effective diabetes management. Nations will have to do well to focus on this theme because increasingly, inequities in access to both prevention and treatment for diabetes and its complications are being debated. 

In this context, the International Diabetes Federation’s announcement that it is working on a new set of guidelines for treatment of Type 2 diabetes is significant. It comes as a balm, particularly because IDF president Peter Schwarz and the chairman of the guidelines committee Antonio Cereillo are committed to the affordability and rights perspective. In a recent chat with me, they spoke about evolving a set of rights that will not be the best accessible only to those in Europe or America, but a set of basic guidelines, that will be more than the minimum. Anything less than this will be inadequate, Dr. Cereillo said. As an international organisation comprising 240 organisations of diabetologists from various countries, the IDF has a mandate to ensure that the best practices from across the world are incorporated into the new guidelines. For the full text of the interview, scroll right down on the link above. 

Dr. Schwarz and Dr. Cereillo also spoke at length about the value of the now-popular lines of treatment in terms of GLP-1 receptor agonists, including semaglutide. While this is a great drug, there are specific criteria to be deployed before it is recommended for a patient. Meanwhile, in The Hindu, we had a full page on the Indian context and the availability, prescriptions, costs, and weight-loss and glycaemic control in the population in the subcontinent. Do read it here: Has semaglutide transformed treatment of diabetes and obesity in India?

A lifestyle approach -- with a regulated diet, exercise and drugs/insulin if necessary -- is recommended for both prevention and blood sugar control. All of last year, we heard about the benefits of millets. But there’s a key factor a recent study pointed out: Keep the bran on millets to retain health benefits. Debranning erodes many of the essential nutrients and fibres we get from millets, the researchers pointed out. 

Not forgetting infectious diseases, which are always just one outbreak away, continuing research on the current rash of mpox cases across the world, shows that the Mpox clade Ia has evolved to jump from humans to humans, says Arun Panchapakesan. A preprint posted on Virologica reported evidence that the DNA of clade Ia, reportedly the oldest clade causing mpox infection, with viruses sequenced from the present outbreak bears clear signs of human-to-human transmission. More research on this is clearly warranted. More and more, it is clear that it is a broad-based One Health approach to managing infectious diseases that will create a measure of safety for humans from the threat of diseases that pathogens cause. 

Meanwhile, the WHO has identified 17 pathogens in urgent need of vaccines. This list reconfirms longstanding priorities for vaccine research and development: HIV, malaria, and tuberculosis -- three diseases that collectively kill nearly 2.5 million people each year.

Evaluating the adequacy of health resources in the country periodically is something we at the health desk take very seriously. In this context, we present Afshan Yasmeen’s very significant article: Can mid-level healthcare providers compensate for physician shortages in rural India? To make up for doctor shortages, several countries around the world have introduced a cadre of MLHPs into their health systems; however, in India, mainstreaming of MLHPs has time and again been met with resistance from organised medicine, who remain wary of the threat from quackery if this were to come through. 

K.R. Antony calls out the situation as it is. He makes a rather bold prescription: no more AIIMS or CHCs. “We do not need any more AIIMS. We do not need any more CHCs. Look at whatever is available now. Make them work first and then build new ones. Deliver on your promises, make them complete and then make new promises in the Budget.” From the outside, 11 of the 18 All India Institutes of Medical Sciences (AIIMS) built recently are impressive to look at. They are gigantic structures built in the cities of various States as a Centrally Sponsored Scheme (CSS) under the Ayushman Bharat Health Infrastructure Mission. But what lies inside is hollow and a disappointment for patients. These academic institutions have 40% vacancies in teaching and research faculties. Pointing to the high vacancy rate in staff strength in these institutions of higher learning, he calls for a rehaul of the entire healthcare system in order to make it a viable workable model that will be able to handle the oncoming threats we need to be prepared for.

It is also important, simultaneously, to ensure the safety of healthcare personnel employed at these institutions. The National Task Force, set up in accordance with a Supreme Court ruling, on Thursday (November 7, 2024) submitted its recommendations for safety measures at hospitals across the country. We will keep tabs on this story in future.

Do also read this story by Bindu Shajan Perappadan: Medical device sector welcomes Centre’s ₹500 crore outlay. “The comprehensive scheme targets critical areas of the medical device industry covering manufacturing of key components and accessories, skill development, support for clinical studies, development of common infrastructure, and industry promotion,’’ the Ministry said.

She also writes on the demand of patient representatives and rare disease treatment activists: Stop abuse of patent monopolies in rare diseases

Manjeera Gowravaram writes on the promise that RNA holds out: RNA editing promises to go where DNA editing can’t

Here is an article that certainly needs to get the alarm bells ringing if it has not already. Food companies sell products that are less healthy in poorer countries, according to a report. It may be recalled that earlier, there was the charge that manufacturers of infant formula add sugar in the product that is marketed in India and a few other Asian countries.

In the tailpiece segment for the week, regulars Sridhar Sivasubbu and Vinod Scaria take us back to the tardigrades to take us forward. If tardigrades crowd-sourced their remarkable genes, can humans? In case you have not seen one before, Tardigrades are one of the most resilient as well as enigmatic life forms on earth. These organisms, also called water bears and moss piglets, are microscopic eight-legged creatures without a backbone. They inspire awe with their remarkable ability to survive in extreme environments, including areas so very radioactive that they are easily lethal to humans. They can also survive starvation, lack of air and water, and subzero temperatures. The question though is, are there lessons here for humans?

Our explainers for the week focus on a range of subjects: 

Ting Zhang, Jianying Zhang (The Conversation) Osteoporosis can shorten your life − here’s how to prevent fractures and keep bones healthy

C. Aravinda on Lassa fever: Understanding the risk, response and global threat

If numbers speak to you, do check out The Hindu Data Team’s work Assessing India’s tuberculosis burden: Data

Mohua Chakraborty Choudhury and Liz Maria Kuriakose write an elaborate piece on Taking newborn screening, as a birth right, ahead in Karnataka 

Why should emotional support be part of the pedagogy for those with autism spectrum disorder, explains Rohini Karandikar

If you have a few moments, do also read

U.S. FDA proposes ending use of popular decongestant present in cold medicines

WHO, 50 countries warn United Nations of increasing ransomware attacks against hospitals

Shilpa Elizabeth writes on a Bengaluru start-up that strives to bridge India’s genomics data gap to aid precision oncology

The Hindu’s edit on Tamil Nadu declaring heat waves as a State disaster: Sun signs

FSSAI asks States to issue SoPs for delivery personnel to ensure safe food to consumers

For many more health stories, head to our health page and subscribe to the health newsletter here.

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