better beings by building bridges - ahmedabad...
TRANSCRIPT
NOVEMBER - 2015 7Vol.10
Yoga ShibirNational Healing SeminarSeminar on Financial AwarenessMedico's Listeners' Club ProgrammeLadies Club ProgrammeIMA Young Doctors ConventionLadies Club Programme (Yogasan)MMACON - 2015
Yoga ShibirNational Healing SeminarSeminar on Financial AwarenessMedico's Listeners' Club ProgrammeLadies Club ProgrammeIMA Young Doctors ConventionLadies Club Programme (Yogasan)MMACON - 2015
01-12-2015 to 10-12-201506-12-201513-12-201513-12-201518-12-201520-12-201525-12-2015 & 26-12-201526-12-2015 & 27-12-2015
01-12-2015 to 10-12-201506-12-201513-12-201513-12-201518-12-201520-12-201525-12-2015 & 26-12-201526-12-2015 & 27-12-2015
Imm. Past President - DR. SMITABEN B. SHAH
BETTER BEINGS BY BUILDING BRIDGES
DR. ASHOK D. KANODIAHon. Secretary - AMA
DR. BRIJAN H. CHOKSIPresident - AMA
DR. ASHOK D. KANODIA,
HIGHLIGHTS
9
27-11-2015
A.M.A. BULLETIN INDEXContent Page No.
10
27-11-2015
Ahmedabad Medical AssociationAMA House, First Floor, Opp. H. K. College, Ashram Road, Ahd-009 Ph : (079) 26588775
Fax : 079-2658 74 98, e-mail : [email protected] website : www.ahmedabadmedicalassociation.com
AHMEDABAD MEDICO NEWS
PRESIDENT
DR. CHOKSI BRIJAN H.
C. : 2539 6568 M.: 9824265642
VICE PRESIDENTS
DR. SHETH PANKAJ KANTILAL
C. : 2764 3738 M.: 9824195362
DR. PATEL PARTH NAVINCHANDRA
C. : 2764 2001 M.: 9913363762
HON. FINANCE SEC.
DR. PANCHAL DIVYESHKUMAR N.
M.: 9714632100
MANAGING COMMITTEE MEMBERS
OTHER THAN P.G.P.G.
BULLETIN COMMITTEE
DR. BHOJAK ASHISH ASHOKBHAI
9909904571 GHATLODIA
DR. DESAI PARTH MAHENDRABHAI
9898797963 MEMNAGAR
DR. GAJJAR MAITREY DAMODARDAS
9723814598 SOLA ROAD
DR. KALYANI AMITKUMAR MOHANLAL
9898244366 SABARMATI
DR. MODI NIRAV VINODCHANDRA
9825887812 GURUKUL ROAD
DR. PATEL GAURANGKUMAR JAGDISHCHANDRA
9724319934 SOLA CIVIL
DR. PATEL JAYESH DINESHBHAI
9825037891 SHAHIBAUG
DR. PATEL MITESH KALIDAS
9426585877 SABARMATI
DR. PATEL SAUMIL BHIKHABHAI
9825606501 NARANPURA
DR. ROHIT PINAKIN PURUSHOTTAM
9925113323 SHAHIBAUG
DR. SHAH PRATIK JASHWANTILAL
9825010972 SHAHPUR
DR. VAGHELA SHIVPALSINH DHARMENDRASINH
9879048687 NARANPURA
DR. DESAI GOPAL ARJUNBHAI
9925467838 SATELLITE
DR. MEHTA DHIREN RAMNIKLAL
9898854158 MANINAGAR
DR. MISTRY AMIT KALIDAS
9825331266 MANINAGAR
DR. MODI ASHOK BABUBHAI
9825347657 NAVA VADAJ
DR. PANDYA SATISH MADHUSUDAN
9825956928 SHAHIBAUG
DR. PATEL RAMESH ISHWARLAL
9426495264 PALDI
DR. PATEL VASANT B.
9428018840 ODHAV
DR. PATEL VISHNUBHAI N.
9825165294 GHATLODIA
DR. RAJGOR JAGDISH BHANABHAI
9998461904 MANINAGAR
DR. SHAH JAYESH C.
9426274536 NARANPURA
DR. SHAH RAKESH NAVANITLAL
9879450450 NARANPURA
DR. VARMA KUNDAN KUBERDAS
9825689093 VEJALPUR
HON. SECRETARY
DR. KANODIA ASHOK D.
C. : 2545 3267 M.: 9428405746
HON. JT. SECRETARY
DR. SHAH MANISH G.
C. : 2532 8249 M.: 9099962094
DR. GANDHI ATUL J.
C. : 2660 4009 M.: 9824047636
HON. LIBRARY SECRETARY
DR. SACHDE JAYESH P.
M.: 9824018848
IMM. PAST PRESIDENT
DR. SHAH SMITABEN B.
C. : 2754 1859 M.: 9898219859
DR. K. R. SANGHAVIDR. BANKIM SHAHDR. PRANAV SHAH
DR. ASHUTOSH DAVEDR. PURVI BHAGATDR. ALPESH SHAH
DR. NEEL BHAVSARDR. SURESH K. ZAVERIDR. JITENDRA H. PARIKH
YEAR : 2015-2016
11
27-8-2015
BETTER BEINGS BY BUILDING BRIDGES
From President's & Hon. Secretary's Desk
11
27-8-2015
Dear Friends,
Just as these words ring true under all circumstances, we are
humble enough to accept the fact that we have just embarked on this
erstwhile journey and are taking fledgling steps to take this association
to newer heights.
Our aim is primarily to bridge the gap between the medical
fraternity and the common man and alleviate the misconceptions and
fear regarding the illnesses that have gripped the society in today's fast
paced world.
We are truly overwhelmed by the response of the members of
the association as well as of the society whenever we have extended a
helping hand to serve them to the best of our capacity.
Programmes like the on Swine flu and Dengue
was well attended and the orators made sure that the attendees were
properly briefed on the nitty gritty of the disease and its effects.
The diwali festival is a period of enjoyment, entertainment and
celebrations for one and all but with a few exceptions. Our salutations
to all doctors who took upon them the onus to respond to all
emergency calls during those days and really brought light into the
lives of those who received treatment.
CME update
In this day, when all doctors are hard pressed for time and are
always on the run responding to the call of duty day in and day out, it
becomes imperative for them to spare a few hours to enjoy their life
and spend a few fruitful and joyous moments with family and friends.
So AMA leaves no stone unturned to organize such programmes for the
doctors. No doubt such events are well received. The annual
celebrations and programmes were very
successful in their own right and the medical fraternity enjoyed
themselves to the hilt and let their hair down and grooved to the latest
beats in town. Both the events were a spectacle to behold.
Every year the is religiously held at AMA.
A lecture by Sadhu Vivekjivandas under the aegis of was the
highlight of this event. The event witnessed a considerable turnout.
This was the first time that such a lecture was initiated at AMA during
the pujan ceremony.
One important thing happened in last month was
call given by I.M.A. Headquater for 16 November in relation to many
demands you all know about it. We all as usual, shown solidarity for
that and we are thankful to all of you for your wholeheartly support for
that and expect same type of unity in future.
In the pipeline ahead are two programmes that will be of
immense help to all members. This includes the by st thprominent yoga gurus from the 1 December to the 10 December as
well as a spiritual lecture by for the thbenefit of the members on 6 December, 2015.
th thOn 27 & 28 December there is Annual Conference of
at New Delhi
Long Live AMA….
Jai AMA….
Navratri
Diwali get together
Dhanvantari Pujan
“G” speaks
"Satyagrah"
Yoga Shibir
Avdhoot Baba Shivanandji
IMA NATCON
BETTER BEINGS BY BUILDING BRIDGES
"Coming together is a beginning. Keeping together is progress.
Working together is success."
- Henry Ford
DR. BRIJAN H. CHOKSIPRESIDENT
HON. SECRETARY
Dr. ASHOK D. KANODIA
11
27-11-2015
Ahmedabad Medical Association(Branch of Indian Medical Association)
in association with Shivyog Foundation, DelhiCordially invites you to
Program will be followed by Amrutasya Bhojanam- THE LUNCH -
For Registration Contact AMA Office (26588775) or 75729 05046
Registration is free. But for better management please Register
yourself at AMA office on or before 05, December. 12.00 p.m.
AMA OFFICIALS :
thDate : 06 December, 2015 SUNDAYTime : 09.00 a.m. to 12.30 p.m.Venue : R. M. Fozdar Hall, AMA Building,
B/h. Handloom House, Ashram Road, Ahmedabad.
Contact Us
Dr. BRIJAN H. CHOKSI, President98242 65642 [email protected]
Dr. ASHOK D. KANODIA, Hon. Secretary94284 05746 [email protected]
CO-ORDINATORS FOR PROGRAM
MR. JITENDRA AWASTHIDR. HETAL PANDYA
DR. DEENA SUTARIA 7572905046eMail : [email protected]
Ms. SANGITA MUKESH 9924684643ONLINE REGISTRATION www.webnx.in/ama
"Cure Is Possible" - National healing
Seminar
for Doctors : Revolutionary healing
science seminar presented by his
Holiness Avdhoot Baba Shivanandji
12
27-11-2015
Date : 13-12-2015, Sunday
9.45 am to 10.00 am Registration & Tea-Coffee
Time : 10:00 am to 12:30 pm
Venue : AMA Premises, Opp. H.K. College, Ahmedabad.
SEMINAR ON FINANCIAL AWARENESS
Registration Fee : Rs. 50/-
Please register on or before 11-12-2015, 05:00 PM
Speaker : Mr. Vinay Vaidya, Course Director : Ekkalavya
Academy of Wealth Creation.
Subject : Become an entrepreneur and create wealth
Speaker : Mrs. Komal Kanzaria, Reg. Head Guj. MCX
Subject : Awareness Programme on Commodity Market
Speaker : Mr. Ashwinbhai C. Shah, CA
Former Central Council Member ICAI
Subject : Post retirement financial Planning
Programme will be followed by L U N C H
You are requested to register your name at our
AMA office on Tel. No. : 079-26588775.
Co-Ordinators : Dr. Devendra Patel, Dr. Piyush Bhansali
PROGRAMME DETAILS
13
27-11-2015
AHMEDABAD MEDICAL ASSOCIATIONMEDICO'S LISTENERS' CLUB
(Festival songs of films)
Presentation : Dr. Gurudatt Thakkar
Anchor : Respected Dr. G.G. Oza
Concluding Remarks : Dr. Ashok Patel
Place : A.M.A. Hall
Date : 13-12-2015, Sunday Time : 5.00 p.m. onwards
Courtesy : Eris Life Sciences
Entry : For Registered Members only. (No spot entry)
AMA CULTURAL BOARD
[Kindly note the changes in timing and day of programme]
AMA SENIOR CITIZEN CLUB
Date : 13-12-2015, Sunday
Time : 10.00 am to 12.30 pm
Venue : AMA Premises, Opp. H.K. College, Ahmedabad.
Subject : Retirement Planning
All senior members of the club with their spouse are cordially
Invited to attend this very useful programme.
Please register at AMA office between 2.00 pm to 6.00 pm
This programme is arrange with Ahmedabad Medical Association.
CO-ORDINATORS
Dr. K. R. Sanghavi Dr. Abhay S. Dikshit Dr. Ramesh C. Shah
Dr. Brijan H. ChoksiPresident, AMA
Dr. Ashok D. KanodiaHon. Secretary, AMA
14
27-11-2015
15
27-11-2015
Important Daysst 1 December World AIDS Dayrd 3 December International Handicapped Day
16
27-11-2015
AMA FAMILY BENEFIT SCHEME
OFFICE BEARERS & EXECUTIVE COMMITTEE MEMBERS
Dr. Mehul J. Shah
Chairman
Dr. Pragnesh M. Vachharajani
Hon. Secretary
Dr. K. C. Gadhavi
Vice Chairman
Dr. J. P. Darbar
Hon. Treasurer
Dr. Jitendra N. Patel
Hon. Jt. Secretary
Following are the Executive Committee Members
Dr. Monaben Desai
Dr. Rupande Patel
Dr. Alpa Gandhi
Dr. Pratik Shah
Dr. Mehul Shelat
Dr. Jignesh Shah
Dr. Kamlesh Saini
Dr. Dhiren Mehta
Dr. Vijay Bhavsar
Dr. Piyush Bhansali
YOGA SHIBIR
Late Dr. C. C. Raval - Divya Jivan Sangh
For Doctors and their Family Members
Date : 1-12-2015 to 10-12-2015
Time : 7.00 a.m. to 8.00 a.m.
Place : AMA Premises
# Registration fee Rs. 50/- per Person
# This Shibir will be Conducted by
Dr. Puspa P. Multani (Qualified Yoga Teacher)
17
27-11-2015
NEW LIFE MEMBERS
8662 LC DR. SHAH GEET M.
8663 LC DR. SHAH EKTA GEET
8664 L DR. SACHORA WASIMAHED M.
8665 L DR. THAKER ROHIT ANILBHAI
8666 LC DR. GAADHE RAVINDRA L.
8667 LC DR. GAADHE PARUL R.
8668 L DR. DOSHI BINAL HARESH
8669 L DR. SHAILENDRA KUMAR
8670 L DR. KUBAVAT ASHKA VISHWAS
8671 LC DR. PATEL RUTUL PRAVINBHAI
8672 LC DR. PATEL NIRMIKA RUTUL
8673 L DR. SOLANKI RAJENDRAKUMAR N.
8674 L DR. SHAH HARSH JAYANTKUMAR
8675 L DR. SHAH JAYUNKUMAR M.
8676 L DR. TALUJA AMITKUMAR HARBANSLAL
8677 L DR. SHAH KAIRAV SHIRISHKUMAR
8678 L DR. PATEL PIYUSH VALJIBHAI
8679 L DR. MEHTA RUCHA J.
8680 L DR. PARMAR SANDEEP MADHAVLAL
8681 L DR. KAPADIYA HARESH LAXMANBHAI
8682 L DR. JOSHI DEEP RAGESHBHAI
8683 L DR. SHAH ANKIT ANILBHAI
8684 LC DR. BANSAL MUDIT JITENDRA
8685 LC DR. BANSAL SUSHMA MUDIT
CONGRATULATION
TIRTH S/o. Dr. Pragnesh & Mayuri Vachharajani for winning
Bronze Medal in "Kata & Karate" @ International Shitoryu competition
@ Jaipur.
Dr. Amar Shah has been elected as Member of the National Academy
of Medical Sciences (India) in recognition of significant contribution
for the advancement of Medical Sciences. He has been awarded the
degree of MAMS for the same.
18
27-11-2015
19
27-11-2015
20
27-11-2015
ANNUAL CONFERENCE OFMANINAGAR MEDICAL ASSOCIATION MMACON – 2015
HighlightsHighlights
Kindly contact ..
Dr. Vipul shah9426533707
Dr. Urvesh Shah9228233441
Dr. Hiren Shah9824045683
Pre-conference session :Date & Time : 26th December, Saturday;
8.30 pm onwardsat Ahmedabad Medical Association Hall,Ashram Road.
Conference :thDate : 27 December, 2015 Sunday
Time : 8.30 am onwardsVenue : J.B. Auditorium,
Ahmedabad Management Association,Nr. Atira.
Coffee table book
We are planning to launch Coffee table book, which includes
> delegates' names/mobile no. & Email .
> super-specialist faculties names & contact no.
> Corporate hospitals contacts
All the doctors /Group of doctors/ hospitals are invited to give their advertisement in this ready recknor coffee table book.
Kindly forward your data on [email protected] with CDR file.
Draw your cheque on the name of “MMACON-2015”
Registration fees - IMA qualified Doctors – Rs. 800/-
*Last date of registration -15/12/2015
*Full page 4 colour - Rs. 4000/- per page.( A-5 size ).
37
27-11-2015
AHMEDABAD MEDICAL ASSOCIATION
SHARADOTSAVth
SUNDAY, 25 OCTOBER, 2015 at SINDUR PARTY PLOT
PRIZE WINNERS
UPTO 12 YEARS
FROM 13 to 25 YEARS
FROM 26 to 45 YEARS
45 YEARS ONWARDS
BEST TRADITIONAL DRESS
BEST PERFORMANCE COUPLE
MALE
FEMALE
MALE
FEMALE
MALE
FEMALE
MALE
FEMALE
MALE
FEMALE
TEJAL SHAHKEVAL SHAHKATHAN SALVIHELLY GOVANIVEDANGI TRIVEDIYASHVI SHAHDIRGH SHAHVISHWA PATELNAMRA PATELFORUM MEHTAANVI PARIKHDR. NILAMBHAI PATELDR. MAULIK KINARIWALAKRIMA SHAHDR. MITA PATELDR. ARVINDBHAI PANCHALDR. ANILBHAI SONIBINA PARIKHMITA SHAHPRIYANSH SHAHPRITAV SHAHDR. VYOMA SHAHNIMISHA PATELDR. JYOTI DESAIDR. BHARAT MAKWANAMRS. & DR. HARSHAD SHAH
We are thanks to our Judges : Dr. Geetaben Mehta and Ketki Rohit Modi
We are thanks to our sponsors
Punjab National BankUco BankBank of IndiaBank of MaharashtraRelief DevelopersTanishq Jewellery - C. G. RoadEmerald Honda
38
27-11-2015
AMA FAMILY BENEFIT SCHEME
FEE SCHEDULE :
Member's AGE AF.C. ADM Total
Up to 35
36 to 40
41 to 45
46 to 50
51 to 55
3000
3000
3000
3000
3000
3850
4400
5500
6600
7700
6850
7400
8500
9600
10700
I Eligibility of the members :
Any Life Member of A.M.A. and his/her spouse are eligible to become member of this
scheme,
Provided that :
(1) A member below the age of 55 years
(2) Life members of A.M.A. will be known as Member of the scheme and their Spouse
will be associate member of the scheme (The couple members will be considered
Members of the Scheme). Spouse cannot join alone.
II. Procedure For enrollment :
A. Member who want s to join the scheme has to apply in the prescribed application form
meant for the purpose along with necessary documents & scheduled fees.
B. Associate member who wants to join has to fill separate form, endorsed by his or her
spouse along with necessary documents & scheduled fees.
C. A member need to submit certified copy of (1) standard age proof (A) Driving
Licence, (B) School Leaving Certificate (C) Valid Passport (D) PAN Card (2) Life-
membership certificate of A.M.A. (3) Valid Photo I.D. (4) 2 Passport Size
Photographs along with application form.
In case of associate member: Additionally Marriage Certificate / Valid Passport /
Election Card is mandatory.
D. All eligible members mentioned above shall submit their application along with
admission fees as per age & AFC by D.D. or cheque in name of A.M.A., Family
Benefit Scheme, payable at Ahmedabad (no cash transaction).
E. Nominee : A member will have to give name of 2 nominees along with their
photograph and specimen signature.
III. Fee Schedule :
A. Any eligible member of A.M.A. willing to become member of this scheme can do so
on payment of admission fees as stated below
AFC : Advanced Fraternity Contribution
ADM : Admission Fee
39
27-11-2015
B. Admission fee is Non-refundable.
C. Advanced Fraternity Contribution (AFC) will remain as security deposit against the death fraternity contribution payable by the member.
IV Benefits to Members :
1. Fraternity Benefits : Rs. 500/ member in event of death of member.
2. Permanent Disability Benefit :
In case of an unfortunate event if a member becomes permanently disabled, can claim Rs. 500/ member as benefit amount, after that he will be retired from the scheme and no longer will avail any benefit.
N.B. : > The disability must not be there at the time of membership and in the next one year after membership.
> In case of claim / dispute the expert panel will decide the admissibility of claim. The decision of executive committee in such case will be final.
> The conditions covered under permanent disability are as per the list mentioned :
1. Loss of both eyes 2. Loss of both either upper limb or lower limb 3. Irrversible Coma 4. Irreversible Hemiplegia 5. Irreversible Paraplegia
3. Voluntary Retirement Benefit :
A. Any member who has completed 21 years in scheme or 70 years of age, which ever is later can withdraw a sum of rupees Rs. 350/member any time after that, then he ceases to be a member of scheme.
B. Any member who has completed 25 years in scheme or 75 years of age whichever is later can withdraw a sum of rupees Rs. 450/member and he ceased to be member of the scheme.
C. Any member who has completed 15 years in scheme or 80 years of age, which ever is later can withdraw a sum of rupees Rs. 150/member any time after that, then he ceases to be a member of scheme.
The Fraternity benefits will be available to members as follows.
Any member who has completed 1 year in scheme will be eligible to make claim in the event of Death or Permanent Disability.
N.B. : In case of Accidental Death no restrictions apply.
V. Claim Procedure :
1. In the event of death of a member the nominee will inform the same to the secretary A.M.A., F.B.S. and will make a claim by submitting prescribed claim forms available with the office with the necessary documents.
2. The claim amount will be paid to first nominee only. In case of death of the first nominee the claim amount will be paid to the second nominee (submission of death certificate of first nominee mandatory)
3. Computation of Fraternity contribution Payment : The fraternity contribution is calculated according the membership strength of the last day of the previous month in which the event has occurred.
Dear Member,
The Family Benefit Scheme is unique, one of its kind scheme launched
by Ahmedabad Medical Association for its Life Members & their spouse.
Scheme started operation from 1st, July 2013. As per the constitution, the
members can claim after completion of one year of membership.
At present, the membership strength of our scheme is 1835
HIGHLIGHTS of the SCHEME
(1) Life member of Ahmedabad Medical Association & their spouse below
55 years can become the member.
(2) Rs. 500/- per member will be disbursed to the nominee of the member
after the death of the member of scheme.
(3) Member of the scheme can Retire Voluntarily from the scheme after
15,21,25 years of the membership of the scheme.
Rs. 150/-, Rs. 350/- & Rs. 450/- respectively per member will be
disbursed to the member.
(4) It's a unique scheme of its kind. Please enroll with your spouse as early
as possible.
(5) For more details contact our office.
Dr. J. P. DarbarHon. Treasurer
Dr. Mehul J. ShahChairman
Dr. Pragnesh M. VachharajaniHon. Secretary
Dr. Brijan H. ChoksiPresident - AMA
Dr. Ashok D. KanodiaHon. Secretary - AMA
40
27-11-2015
42
27-11-2015
DIABETES MELLITUSDIABETES MELLITUS1 INTRODUCTION
Diabetes mellitus is an important non communicable disease affects all individuals irrespective of age , sex, ethnicity , geographical area or socioeconomic status. It’s prevalence has remarkably increased in recent times and has reached to an epidemic proportion.
The tsunami of diabetes has altered the health budget of an individual in particular and society in general.
It affects the person with acute complications like DKA ( Diabetic Keto Acidosis) and chronic microvascular and macrovascular complication leading to death and disability.
2 DEFINITION AND PATHOPHYSIOLOGY
Diabetes is a metabolic disease characterized by Hyperglycemia (Increased blood sugar levels) which may result from increased insulin resistance or decreased insulin production or release which could result from B cell apoptosis or incretin deficiency.
Besides the eight pathophysiological mechanism described by D Alfrenzo there are four more mechanism leading to “Dirty Dozens”
They are (1) Catecholamines (2) Vitamin D (3) RAS System and (4) Testosterone
There is one more addition to this which is known “Treacherous Thirteen “ is Iron Deficiency.
In short many pathophysiological factors are responsible for hyperglycemia.
However the diabetic epidemic is because of genetic predisposition and life style changes. The genes which were dormant during famine has become expressive because of abundance of calories and available nutrition. Urbanization, maternal nutrition, small birth weight baby, maternal hyperglycemia are few more factors responsible for the same.
41
27-11-2015
OBITUARY
We send our sympathy & condolence to the bereaved family.
May his/her soul rest in eternal peace.
Dr. Naresh N. Shah
Date of Birth
Date of Death
: 10-5-1933
: 15-8-2015
DISCLAIMER
Opinions in the various articles are those of the authors and do not reflect the views of Ahmedabad Medical Association. The appearance of Advertisement is not a guarantee or endorsement of the product or the claims made for the product by the manufacturer.
43
27-11-2015
44
27-11-2015
Urbanization has not only lead to change in diet composition and high calorie intake but has also become responsible for inactivity. We can presume that increased calorie intake coupled with inactivity are two important lifestyle changes working on genetic susceptible individuals to produce Type 2 Diabetes Mellitus.
CRITERIA FOR THE DIAGNOSIS OF DIABETES
A1C =6.5%.
(THE TEST SHOULD BE PERFORMED IN A LABORATORY USING A METHOD THAT IS NGSP CERTIFIED AND STANDARDIZED TO THE DCCT ASSAY.)*
OR
FPG =126 MG/DL (7.0 MMOL/L).
FASTING IS DEFINED AS NO CALORIC INTAKE FOR AT LEAST 8 H.*
OR
2-H PG =200 MG/DL (11.1 MMOL/L) DURING AN OGTT.
(THE TEST SHOULD BE PERFORMED AS DESCRIBED BY THE WHO, USING A GLUCOSE LOAD CONTAINING THE EQUIVALENT OF 75 G ANHYDROUS GLUCOSE DISSOLVED IN WATER.)*
OR
IN A PATIENT WITH CLASSIC SYMPTOMS OF HYPERGLYCEMIA OR HYPERGLYCEMIC CRISIS, A RANDOM PLASMA GLUCOSE =200 MG/DL (11.1 MMOL/L). *
(IN THE ABSENCE OF UNEQUIVOCAL HYPERGLYCEMIA, RESULTS SHOULD BE CONFIRMED BY REPEAT TESTING)
PREVALENCE
According to statistics from the International Diabetes Federation (IDF), India has more diabetics than any other nation of the world. Current estimates peg the number of diabetics in the country at about 62 million – an increase of over 10 million from 2011 when estimates suggested that about 50.8 million people in the country were suffering from the disease. If you think the disease has already reached endemic proportions in the country, consider this. By the year 2030, over 100 million people in India are likely to suffer from diabetes, say researchers.
CLASSIFICATION
Diabetes can be classified into the following general categories:
1. Type 1 diabetes (due to b-cell destruction, usually leading to absolute insulin deficiency)
2. Type 2 diabetes (due to a progressive insulin secretory defect on the
background of insulin resistance)
3. Gestational diabetes mellitus (GDM) (diabetes diagnosed in the second or third trimester of pregnancy that is not clearly overt diabetes)
4. Specific types of diabetes due to other causes, e.g., monogenic diabetes syndromes (such as neonatal diabetes and maturity-onset diabetes of the young [MODY]), diseases of the exocrine pancreas (such as cystic fibrosis), and drug- or chemical-induced diabetes (such as in the treatment of HIV/AIDS or after organ transplantation
Source ADA 2015
Criteria for testing for diabetes or prediabetes in asymptomatic adults
1. Testing should be considered in all adults who are overweight (BMI $25 kg/m2 or $23 kg/m2 in Asian Americans) and have additional risk factors:
2. physical inactivity
3. first-degree relative with diabetes c
4. high-risk race/ethnicity (e.g., African American, Latino, Native American, Asian American, Pacific Islander) c
5. Women who delivered a baby weighing .9 lb or were diagnosed with GDM c
6. Hypertension ($140/90 mmHg or on therapy for hypertension) c
7. HDL cholesterol level ,35 mg/dL (0.90 mmol/L) and/or a triglyceride level. 250 mg/dL (2.82 mmol/L)
8. Women with polycystic ovary syndrome c A1C $5.7%, IGT, or IFG on previous testing
9. Other clinical conditions associated with insulin resistance (e.g., severe obesity, acanthosis nigricans)
10. history of CVD
2. For all patients, particularly those who are overweight or obese, testing should begin at age 45 years.
3. If results are normal, testing should be repeated at a minimum of 3-year intervals, with consideration of more frequent testing depending on initial results (e.g., those with prediabetes should be tested yearly) and risk status.
Type 2 diabetes is far most common prevalent variety of diabetes and almost 90 % all diabetes cases are type 2only.
Symptoms
Persons suffering from type 2 diabetes are often asymptomatic and abnormal blood sugar is a chance finding. Many a time’sdiabetes is detected during routine health checkup or during preoperative examination or work up during insurance examination.
45
27-11-2015
46
27-11-2015
Type 1 patient’s symptoms are florid and characterized by polyuria, polydipsia and weight loss. A sizable no of patients with type 1 present as Diabetic Ketoacidosis.
A slight polyuria or nocturia , leg cramps , change in spectacle power and itching around genitalia , vulvovaginitis in females and balanoprostitis in males are often clinch the diagnosis in type 2 Diabetes.
Clinical Examination
The clinicalexamination is unremarkable in persons suffering from Diabetes Mellitus. Hence diabetes cannot be diagnosed with only clinical examination.
Hyperglycemia and Complications
Acute and chronic hyperglycemia are detrimental in a variety ways. Acute hyperglycemia if not treated in time may lead to acute metabolic complications like Diabetic ketoacidosis and hyperosmolar states and coma.
Acute decrease in blood sugar (Hypoglycemia) can also result in coma, seizures, myocardial infarction, arrhythmia etc. and may result in death also. Besides overzealous treatment, poorcompliance, cognitive dysfunction, onset of CKD and onset of CLD and various other causes can be responsible for hypoglycemia.
Chronic hyperglycemia can result in many complications which are predominantly microvascular but can also contribute to macrovascular complications. Endothelial dysfunction, increased AGE increased ROS and micro ischemia are few pathological factors for its development.
Complications of diabetes mellitus
Acute
Diabetic ketoacidosis, Hyperosmolar coma, Hypoglycemic
Chronic
MacrovascularCoronary Artery Disease and IHD, Carotid Artery Disease and Stroke,
Peripheral Vascular Disease
MicrovascularRetinopathy, Nephropathy, Neuropathy,
Miscellaneous
Infection like emphysematous cholecystitis, Pyelonephritis, mucormycosis and Malignant, Otitis externa etc, Recurrent abortions, Premature cataract, Diabetic foot and Amputation, Erectile Dysfunction
Management of Diabetes
Life style changes, Oral antidiabetic agents, Injectables, Insulin, GLP 1RA, Pramilinitide
The Glycemic Control
Life style modification including decrease calorie intake and decreased CHO consumption coupled with increased calorie expenditure with aerobic and muscle strengthening exercise.
Once lifestyle fails to control hyperglycemia then pharmacotherapy comes in to action. The detail of pharmacotherapy is out of scope in this article, however the AACE guideline has beautifully described the availabledrugs in the following algorithm, which itself is self-explanatory.
Glycemic control is an important part of diabetes management, however it is not the sole management. Besides the lifestyle modification and glycemic control, the blood pressure management and lipid management are also important part of management.
The glycemic goals are advised by different organizations which are mentioned in the above slide.
Modern Management of D M
Early diagnosis, Good Glycemic Control, Glycemic monitoring, Target organ damage and monitoring, C V Risk Modification, Prevention and care of foot (to prevent amputation), Prevention of diabetes and education of general population
Patient centric approach
Although good glycemic control is useful and DCCT and UKPDS are trials are the great supportive evidence for the same.
The recent trials like Accord, Advance and Vadt have on the contrary demonstrated contrary to the above mentioned trials.
Hence the goals should be according the patient’s profile.
Use of Insulin
There are various guidelines for use of insulin in D M Type 2.
The indications of insulin therapy in Diabetes Mellitus Type 2 is beyond this article !
Currently available OAD
In recent times we have seen the emergence of various oral antidiabetic agents and newer insulin analogues.
The profiles of various antidiabetic are as follows.
To win the war against Diabetes we should have
1. Healthy Life Style 2. Early diagnosis 3. Good Glycemic Control 4. Target Organ
Monitoring and early institution of preventive changes 5. C V Risk modification
6. Diabetes Foot Care 7. Education for All in General and for Patients in particular
8. Preventive Strategies for Diabetes
Dr. Navin ShahMD
Note : • For One year Advertisement 15% Discount • For Six Month Advertisement 10% Discount• Please Send your Advertisement in CDR / JPG Format only at AMA before the Date.• Please Send your Advertisement Before Dt. of 15th each Month.
47
27-11-2015
48
27-11-2015
REQUIRESHOSPITAL STAFF
UPCOMING MULTISPECIALITY (60 BEDED)
HOSPITAL AT MANSA (GANDHINAGAR)
DOCTORS : Partner / Associate / Full-Time / Part-Time
SPECIALITIES : General Surgeon, Orthopedic, Ophthalmologist, ENT, Dental, Gynecologist, Psychiatric.
VISITING SUPER SPECIALITIES : Onco-Surgeon, Neuro Physician / Surgeon, Nephrologist, Pediatric Surgeon, Cardiologist, Urologist.
INTERESTED CANDIDATES ARE REQUESTED TO SEND
YOUR CV ON THIS
E-MAIL : [email protected]
Contact : Dr. Vedang Acharya M. 99791 69165
MATRIMONIAL
Alliance is invited from Jain
Doctor Parents for their Smart
good Looking Son 1991/64
K g . / 5 ' - 1 1 " L i v i n g i n
California, U.S.A. (H1B Visa)
Looking for a Smart, educated,
Jain Girl.
CONTACT
Dr. Milan J. Shah(M) 85306 60059
Email : [email protected]
27-11-2015 27-11-2015
SHARADOTSAV - 2015 SHARADOTSAV - 2015
27-11-2015
Memorandam hand over to M.P.thregarding Satyagrah of 16 Nov.' 2015
27-11-2015 27-11-2015
AHMEDABAD MEDICAL ASSOCIATIONPAST PRESIDENTS
DR. DEVENDRA R. PATEL
DR. JITENDRA B. PATEL
DR. DILIP VAIDYA
2005-2006
2002-2003
1999-2000
DR. SHAILENDRA N. VORA
DR. BIPIN PATEL
DR. MAHENDRA B. DESAI
2004-2005
2001-2002
1998-1999
DR. YOGENDRA S. MODI
DR. ABHAY S. DIKSHIT
DR. PARIMAL DESAI
2003-2004
2000-2001
1997-1998
GSFPF Homecare Conference
Pillars of strength for AMA, who with their excellent intellectual Skills, Sharp accumen and immense experience have contributed selflessly to make AMA the most premier institution of India.