JPEF Abstracts 2022

1. PREVALENCE OF TYPE 2 DIABETES PRECURSORS IN SOUTH INDIAN YOUTH OF 18-30 YEARS AGE- A COMMUNITY-BASED CROSS-SECTIONAL STUDY Abilash Nair1, P. K. Jabbar1, C. Jayakumari1, Jeena Ramesh1, Ramesh Gomez1, G. Giri Vishnu2, Syamji Voise2 1Government Medical College, Thiruvananthapuram, Kerala, India 2Kerala Health Services Department, Kerala, India Background: The ICMR-INDIAB study has shown a high prevalence of type 2 diabetes mellitus (T2DM) (24%) and prediabetes in Kerala (23%). There is no community-based study from India showing the prevalence of T2DM or its precursors in the young adult population. Objective: The study was done to find the prevalence of T2DM and its precursors in South Indian youth of 18-30 years of age in Trivandrum, Kerala. Methodology: Multistage cluster sampling was used to enrol community-dwelling youth of 18 to 30 years, residing at Trivandrum district in Kerala. Six panchayat wards from rural and urban regions and 4 from coastal areas were randomly selected as the primary sampling units. Trained staff nurses conducted the survey with the help of accredited social health activists (ASHA). Socio-demographic data, anthropometry, clinical features of insulin resistance, and random capillary glucose (CG) were assessed and recorded. Oral glucose tolerance test (OGTT) or Glycated hemoglobin (HbA1c) was done for participants with a CG ≥130 mg/dL for diagnosis of diabetes and prediabetes. Results: A total of 1031 participants were included from the rural (n=394), coastal (n=269), and urban (n=368) areas. Prevalence of hyperglycemia i.e., T2DM and pre-diabetes was 0.48% (n=5) and 2.8% (n=30) respectively. Family history of T2DM was present in 35.1% of subjects. Prevalence of overweight, obesity and abdominal obesity was 28.2%, 16.1%, and, 28.4% respectively. Clinical features of insulin resistance (CFIR) were present in 27.1% subjects (acanthosis [17.7%], skin tags [1.7%], and PCOS phenotype [10.7%]). Among various anthropometric measurements and their derivatives, CFIR correlated best (r=0.24, p<0.01) with the product of BMI and the sum of abdominal circumference and hip circumference (Trivandrum Medical College [TMC]-adiposity-index). Hyperglycemia was more common in males, did not correlate with waist-hip ratio, and correlated best again with TMC-adiposity-index ((r=0.13, p<0.01) [Figure 1.1].FigureConclusions: The burden of insulin resistance in the young South Indian population, hitherto unknown in any community-based study from India has been studied for the first time. The prevalence of precursors of T2DM is high in this population. Early identification of 'at risk' individuals could provide a window of opportunity for preventing or delaying future diabetes and its long-term complications. TMC adiposity index could become a valuable tool in the anthropometric assessment for predicting future T2DM. 2. EFFICACY AND SAFETY OF ORAL SEMAGLUTIDE BY BASELINE AGE IN THE PIONEER CLINICAL TRIAL PROGRAM D. Shabeer1, Sue D. Pedersen2, Vanita R. Aroda3, Robert Bauer4, Christin L. Hertz4, Eduard Montanya5, Mark L. Warren6, Bertrand Cariou7 1Novo Nordisk, Bengaluru, Karnataka, India 2C-endo Diabetes and Endocrinology Clinic, Calgary, Canada 3Brigham and Women's Hospital, Harvard Medical School, Boston, USA 4Novo Nordisk A/S, Søborg, Denmark 5Hospital Universitari Bellvitge-IDIBELL, CIBERDEM, and University of Barcelona, Barcelona, Spain 6Physicians East, Greenville, USA 7L'Institut du Thorax, CIC INSERM 1413, CHU Nantes, Université de Nantes, Nantes, France Background: The efficacy and safety of oral semaglutide in patients with type 2 diabetes mellitus (T2DM) was investigated in the global PIONEER program. Objective: In an exploratory analysis of 7 global phase 3a trials (PIONEER 1-5, 7, and 8), we evaluated the effect of age at baseline on efficacy (<45, ≥45-<65, or ≥65 years) and safety (<65 or ≥65 years) for oral semaglutide (3, 7, 14 mg once daily) vs. comparators in patients with T2DM. Methodology: Data were included from all participants of the PIONEER 1-5, 7, and 8 trials who had been randomized to once-daily oral semaglutide (3, 7, or 14 mg or flexibly dosed) or a comparator (placebo, empagliflozin 25 mg, sitagliptin 100 mg, or liraglutide 1.8 mg) (N=5,657). Efficacy endpoints were change from baseline in Glycated hemoglobin (HbA1c) and body weight. Results: Across all trials, there were 582,3392 participants and 1683 patients aged <45, ≥45-<65, and ≥65 years, respectively. Baseline HbA1c was similar across age groups, whereas baseline body weight tends to be higher in younger patients. Overall, reduction in HbA1c was comparable across age groups for all trials and was generally larger with oral semaglutide than comparators, irrespective of age [Table 2.1]. Body weight reductions were greater for oral semaglutide vs. comparators but without association between age and reductions in body weight. In general, the proportions of patients with adverse events (AEs) and AEs leading to treatment discontinuation were greater in the ≥65 vs. the <65 age group for oral semaglutide and comparators [Table 2.1].FigureConclusion: The greater effects of oral semaglutide vs. comparators on Glycated hemoglobin (HbA1c) and body weight were seen for patients regardless of age group in the global PIONEER trials. For the <65 and ≥65 age groups, the safety profile of oral semaglutide was in line with other GLP-1RAs. Overall, there was a generally higher discontinuation rate in older patients. 3. STUDY OF SERUM MAGNESIUM LEVELS IN TYPE 2 DIABETES MELLITUS PATIENTS Mohammed Khaleef Musliar, Prakash Rao KVG Medical College and Hospital, Sullia, Karnataka, India Background: Hypomagnesaemia has been reported to occur at an increased frequency among people with type 2 diabetes mellitus (T2DM) compared with their counterparts without diabetes. Hypomagnesaemia occurs at an incidence of 13.5% to 47.7% among T2DM. Objective: The main objective of the study was to determine the serum magnesium levels, along with the incidence of hypomagnesaemia in people with T2DM and to study if magnesium level is associated with diabetic retinopathy, nephropathy, and neuropathy. Methodology: A cross-sectional study was conducted among 70 patients with T2DM admitted at KVG Medical College and Hospital, Sullia, Karnataka, between December 2021 and April 2022. Data was collected in terms of history, clinical findings & laboratory parameters and then analysed using standard statistical tests. Results: The proportion of people with T2DM and hypomagnesemia is 32%. A negative correlation was observed between increased fasting blood glucose and serum levels of magnesium. There was no statistically significant relationship between hypomagnesemia and age, gender, and type of treatment in the present study. There was no significant association between hypomagnesemia and ischemic heart disease or hypomagnesemia and hypertension. The prevalence of hypomagnesemia was higher in patients with microvascular complications. Conclusion: In the present study, a statistically significant association was observed between hypomagnesemia and hyperglycemia and the incidence of diabetic complications. Patients with microvascular complications such as diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy had a significant association with hypomagnesemia. 4. A NOVEL SCORING SYSTEM FOR PREDICTING ADVERSE OUTCOMES IN PEOPLE WITH DIABETES HOSPITALIZED WITH SARS COV-2 VIRUS Shravanthi Naidu S. Woodayagiri, Swathy Moorthy Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India Objective: To develop a clinical risk score to predict adverse outcomes among hospitalized COVID-19 patients with diabetes. Methodology: After obtaining ethical clearance, the data of patients hospitalized with SARS COV-2 virus at Sri Ramachandra Institute of Higher education and were collected such as age, and was a and the score was as a sum of all the [Table The score was then compared with outcomes and any clinical in a to an or was as an adverse The patients were from and a score of greater than was as at greater risk for Higher blood glucose levels and and been associated with a higher risk of complications to SARS 2 the of a study of had a score of of 4 patients had a score of of and 2 patients were Conclusion: clinical risk score has been with data to help predict adverse outcomes in people with diabetes hospitalized with THE OF AND IN DIABETES A S. Medical College and Hospital, Tamil Nadu, India Naidu Hospital, Tamil Nadu, India Background: in an in and associated with of the and the of Objective: and their from to the this study to the of and associated in with diabetes mellitus Methodology: A of the was to in with The were used in the Diabetes AND and was conducted to in were were not in the not to the study, and were [Figure The with increased and increased their compared to without fasting glucose was and correlated with and is associated with in the of more than the and in the an increased risk for Conclusion: study is in compared to and in the is not and with standard and on at the is the risk of T2DM in and the of obesity and its complications in the OF AND IN AND WITH AND TYPE 2 DIABETES MELLITUS D. K. S. Medical Karnataka, India Background: The from to is associated with risk such as abdominal and insulin at increased risk of type 2 diabetes mellitus (T2DM) and T2DM a among and has as of the to the of T2DM. The study to find the association of of with and levels among and with and without T2DM. Objective: To determine the serum levels of among the study population. To determine the levels among the subjects. To of among the study population. Methodology: of was a of was using was from the blood a was a was was using the Results: The level of between the in and Conclusion: The of common of the levels of associated with the of T2DM in and AND OF IN WITH FOR OF IN WITH TYPE 2 DIABETES India Hospital, India Background: The used and for the diagnosis of to determine the levels of and Objective: The study to the of with for of of the with in with T2DM. Methodology: assessed using with in with T2DM of were 7, and Results: The age and of diabetes were years and years, respectively. The score and score were and respectively. had serum 18 and serum were There was significant correlation between age and score to in score was significant in or of diabetes was higher in or Conclusion: with to be for and the for The high prevalence of for in with T2DM is A STUDY SAFETY AND OF OF PEOPLE WITH DIABETES MELLITUS WITH India Background: A of mg and mg was to for type 2 diabetes is to be used as the to the of and compared with Objective: To the safety and of of mg mg in a study. Methodology: study was conducted on T2DM years of mg with mg from laboratory were for safety and on and The incidence of adverse the study was the primary whereas the of adverse were the safety in Glycated hemoglobin fasting blood glucose and blood glucose levels from baseline to were evaluated for Results: patients were for the study. The common adverse events were and of the adverse events any of the reported adverse events treatment the study had any or adverse the study. The reduction in HbA1c was and at and from of patients had reduction in HbA1c of There was mg/dL and mg/dL reduction in fasting and blood of Conclusion: of mg mg the and The was and There were no or observed in the study. The adverse events profile in this study is in line with of on in Indian patients. WITH ORAL SEMAGLUTIDE BY ADVERSE Eduard Montanya5, 1Novo Nordisk, Bengaluru, Karnataka, India Clinic, Nordisk A/S, Søborg, Denmark Hospital, University of Canada 5Hospital Universitari Bellvitge-IDIBELL, CIBERDEM, and University of Barcelona, Barcelona, Spain Health USA Background: body weight and associated with adverse events to and Objective: to the observed in phase clinical trials with oral semaglutide was to effects as and or effects Methodology: Data from PIONEER 1-5, 7, and 8 were assessed and a analysis a the relationship between other and was to the of and effects to in Results: total treatment in were observed vs. all comparators with oral semaglutide 7 mg vs. vs. and 14 mg vs. vs. In the AEs for of the across oral semaglutide vs. all comparators [Figure In AEs to no on total observed with oral semaglutide vs. and PREVALENCE AND OF IN Diabetes and Diabetes Chennai, Tamil Nadu, India College Institute of and Tamil Nadu, India Background: and diabetes to be the in a between obesity and diabetes. in South India is an in diabetes and Objective: To determine the prevalence of and risk for diabetes and obesity among in Methodology: is a community-based cross-sectional survey done as of a at and of of wards studied in Chennai, selected wards on and using an A random sampling was used to were selected using a sampling was as fasting glucose levels or Glycated hemoglobin (HbA1c) levels and obesity or abdominal obesity circumference in and in Results: of participants studied in the 2 the prevalence of was the study had had abdominal had HbA1c and had levels age increased the risk increased from years to years there was a in diabetes risk years and were associated with Conclusion: The study the prevalence of is for future and OF FOR IN WITH TYPE 2 DIABETES MELLITUS IN India Hospital, India Background: for in 2 Diabetes is an risk for diabetes with increased risk in is a to and negative and of and for associated with a in clinical outcomes in is to be an Objective: To study the of score for in with T2DM in a Methodology: A analysis of with who diabetes between and was Patients with or other of disease were The score was used to the of in a study conducted with the ethical of the of The study was conducted with and was used for statistical Results: The 4 score was to and was statistically not significant in the group hemoglobin (HbA1c) and group of diabetes and were and respectively. were on the group group group and analysed for of diabetes and age [Table The in the age groups was statistically significant with the participants years) the the score was a tool to T2DM at risk of disease without or Patients with in the of were and of and and patients with higher to the for to the OF ORAL SEMAGLUTIDE WITH IN PATIENTS WITH TYPE 2 DIABETES OF PIONEER 4 Nair1, Robert 1Novo Nordisk, Bengaluru, Karnataka, India USA Nordisk A/S, Søborg, Denmark University of USA University of Background: and 2 used to type 2 diabetes (T2DM) but data on their Objective: To the first data on efficacy and of oral semaglutide in subjects with or without Methodology: was a analysis of the PIONEER 4 in people with T2DM on with or without were randomized to once-daily oral semaglutide 14 mg, liraglutide 1.8 mg or Glycated hemoglobin (HbA1c) and body weight data for the product product without Results: Overall, of patients were treatment at baseline the of patients had a of T2DM and higher in HbA1c and were similar in patients oral semaglutide or liraglutide with or without The of adverse events was similar in patients on with and without [Table In in HbA1c and as as safety were similar in patients on with or without OF PEOPLE WITH DIABETES AND PEOPLE A STUDY Medical College and Thiruvananthapuram, Kerala, India Background: The of COVID-19 is in a high proportion of patients. the of and in we similar be in study to determine the association between and diabetes in patients. the prevalence of in diabetes and groups the association between and in patients with 2 Diabetes mellitus (T2DM) Methodology: conducted a data study among 30 participants who were admitted to Medical College, Trivandrum, Kerala. The study was 30 COVID-19 patients years of age were included in the study. were group with diabetes and group without diabetes Patients years of age and COVID-19 patients were from the study. The study were age, Glycated hemoglobin and of were Results: In study, was levels were high in of patients. Among the diabetes had compared to the group without diabetes has a correlation with increased Conclusion: the for be in and has for the clinical of patients. study the of diabetes in patients. be conducted a larger to the of HbA1c and IN AND A Health and India of Medical College, and India Background: is a cluster of occur the risk of heart and type 2 diabetes mellitus Objective: The present study to the of on outcomes in Methodology: and clinical were recorded. health were evaluated in the first of were to the Diabetes for were used to the risk for diabetes mellitus for age for age and with of the for and as a as the Results: The age of the participants was years, with age at of A total of were and had with were at an increased risk for a of to and for to of was not associated with increased risk for or BMI in with increased the of Conclusion: than of the who had in a IN WITH TYPE 2 DIABETES AND WITH Health and Medical and India Medical College, and India Hospital, and India Background: is common in patients with type 2 diabetes more in and the of Objective: To study the prevalence of in with T2DM and with Methodology: was a study of adult T2DM patients aged The study 100 with T2DM clinical and parameters were T2DM were evaluated for and diabetic complications. participants without diabetes were included for used the to the of and the to the of A was Results: The age of the participants was years, of was The hemoglobin (HbA1c) of the participants was with a of diabetes of with T2DM as compared to had to score Prevalence of was as compared to in T2DM and The of was in and and in and on analysis for in with T2DM was to the of neuropathy, and Conclusion: is a common in with T2DM. complications of of and of CLINICAL AND OF PATIENTS WITH AND Medical College and Thiruvananthapuram, Kerala, India Background: is of the common complications of diabetes mellitus as as of and is associated with increased and is the common a associated with weight is a and and ischemic and is to be the of Objective: patients present with a and is diabetic or To the study was Methodology: studied subjects with diabetes with and without who and compared with patients the The age groups of the subjects were in the of to and diabetes mellitus for a of 8 history their and and study was done in all subjects. Results: subjects had type 2 of insulin and on oral Body index was higher among the group compared to to gender, age, type of weight or associated complications there was no significant between the a with with a of greater than in patients had was present in of the patients. and and without or with of and of and findings were similar to of Conclusion: findings the more more at and more in the diabetic as compared to OF AND IN India Background: obesity has levels in and and in is to and and to and more to develop diabetes and at a younger a and obesity on the in and in urban Objective: A study was conducted to determine the prevalence of and obesity among in the Methodology: The statistical for the social was used for the study of 100 The test was to determine the relationship between and For all statistical was the for statistical Results: to the study, the of evaluated were of the were The assessment of the of the of had in between of The test was used to find the association between and and was there is a relationship between The study and significant risk for The study in and their the of a A STUDY THE PREVALENCE OF IN DIABETES MELLITUS AND IN S. Medical College, Tamil Nadu, India Background: is of the common and complications of diabetes of the complications develop and Objective: The main objective of the study was to find the prevalence of in diabetes mellitus and its Methodology: people with diabetes mellitus of gender, age years and to were included in this study. with diabetes with or on treatment or and and other of were from the study. participants were a diabetes and and history of hypertension. was and fasting were score was and with a and The was from on the of using a Results: with diabetes were The age was The prevalence of diabetic in the study was and were the common Conclusion: The prevalence of diabetic in the study was and its prevalence increased with the of diabetes and blood glucose and OF WITH AND IN PATIENTS WITH DIABETES MELLITUS Clinic, India Hospital, India Background: and obesity associated with high and for heart disease with of the global burden of to is an risk for with more than of global to is to with their common with and insulin resistance and Objective: The of this study was to at the correlation of body index with profile in people with diabetes Methodology: patients with diabetes were Diabetes mellitus was in with the Diabetes BMI was as weight measurements were from serum in a fasting were groups group of patients with BMI group 2 of patients with BMI analysis was using the and Results: in group and group 2 were mg/dL and mg/dL respectively. in group and group 2 were mg/dL and respectively. was and in groups and 2. and were higher in patients with BMI with of and respectively. study a higher BMI is associated with higher and in people with diabetes with type 2 diabetes mellitus with higher BMI higher and than with reduction to effects on reduction and in diabetes mellitus patients to and OF OF IN A WITH TYPE 2 DIABETES MELLITUS and Diabetes Clinic, India Diabetes and its in the The various with of for diabetes as as of insulin and is a study the of the of such glucose in diabetes used the in a with type 2 diabetes mellitus (T2DM) and disease as a tool to help the diabetes and treatment to in The had a history with in for had in the The was on insulin and of glucose of and to the the the in the to and of we were to glucose levels, insulin and on oral from to was to the as Overall, the in using the to glucose levels and observed reductions in the of the and of the of the for diabetes The the and the to diabetes to glucose and to be an glucose and of and of OF COVID-19 PATIENTS WITH DIABETES India Background: is of the for COVID-19 is a for patients with to COVID-19 Objective: To study the safety and efficacy of on people with diabetes. Methodology: study was conducted on people with diabetes admitted with to COVID-19 The participants were 2 people with diabetes were with 100 of were with standard treatment for their and on the a from the safety of the was assessed in all patients who to the test Results: of the patients who was an of the patients who in the study were and the to of was in the group and to of were for patients who were but was not statistically and to were for patients who were not statistically was not to be in people with diabetes with with higher to the clinical of THE WITH TYPE 2 A FOR Background: Diabetes mellitus is a health is as of the with people with diabetes. the of the is to there is a of data the among people with type 2 diabetes Objective: The primary objective of the study was to the between and data the of the and its associated risk Methodology: The study is a cross-sectional study conducted on people with T2DM aged years and and collected the from the & A assessment was done and laboratory data were collected from the participants of other of diabetes. Results: The age of the participants was years & participants were of the participants were to and were on were first to be data of the group blood than of the participants hemoglobin than the other participants were and 7 had than 70 Conclusion: The conducted study has a between the and the the and among and the health burden on the health in a education is for the and patients. 100 PATIENTS WITH TYPE 2 DIABETES Background: of the main of is In from to of the used to people with type 2 diabetes mellitus (T2DM) is the oral is in to and has a of The main of insulin among the and patients with T2DM is Objective: The objective of the study is to the safety and efficacy of among patients fasting Methodology: The study is a study conducted on 100 with T2DM aged years and and The was collected from the and A assessment was hemoglobin (HbA1c) & & 2 was the of and of were Results: The age of the patients was years & participants were There was no statistical between the groups was more among the group in group in of among the group groups had no statistical weight & and Conclusion: The study has shown could be a than among patients with T2DM fasting with reported and OF WITH OF ORAL OF PIONEER Vanita R. C. 1Novo Nordisk, Bengaluru, Karnataka, India and Women's Hospital, Harvard Medical School, Boston, USA Nordisk A/S, Søborg, Denmark Diabetes at Medical USA Hospital, University of and Background: Early of hemoglobin (HbA1c) is associated with a risk of future complications in type 2 diabetes (T2DM) and help patients to Objective: conducted a analysis of the PIONEER study to the of of oral semaglutide on body weight and of Methodology: Patients on and were randomized to oral semaglutide 7, or 14 mg once or HbA1c and reduction and of HbA1c were assessed at in with T2DM and for Results: HbA1c and reductions were seen for oral semaglutide 14 mg vs. for vs. vs. and vs. vs. the vs. was significant for HbA1c but not A high proportion of oral semaglutide of T2DM diagnosis HbA1c in of on oral semaglutide 14 mg in the were not In of oral semaglutide in of T2DM diagnosis in HbA1c and reductions and of the of and study.

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