New guidelines on diabetes self-management education and support

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Management of diabetes is multidisciplinary and a team approach is the basis of care of the patient with diabetes, who is at the center of this team.

Diabetes self-management education (DSME) is a very important aspect of management in all patients with diabetes, including those with prediabetes. Optimal control of blood sugar is important; but, it is also important to control other risk factors such as hypertension, dyslipidemia in order to prevent the macrovascular and microvascular complications of diabetes. Because of the need for lifestyle modifications, patients with diabetes are themselves responsible for the day to day management of diabetes, but with the support of the doctor.

For the first time, the American Diabetes Association (ADA) and American Association of Diabetes Educators (AADE) have combined education and support (DSMES) and released new standards to help diabetes educators and medical providers establish and sustain patient care models, programs and teams for people with diabetes and their caregivers. These guidelines will be published in the September 2017 issues of Diabetes Care and The Diabetes Educator.

These standards relate to organizational structure, participation of community stakeholders, access, program coordination, instructional staff, individualizing diabetes education to the need of each patient, monitoring of patient progress and quality improvement. An up-to-date, evidence-based, and flexible curriculum provides education.

These standards emphasize that DSME alone does not translate into effective self care. Ongoing support is very important to improve patient outcomes.

The standards defined in these recommendations can be applied to both small solo practices, as well as large, multicenter facilities.

(ADA Press Release, July 28, 2017)
Dr KK Aggarwal
National President IMA & HCFI

Recipient of Padma Shri, Dr BC Roy National Award, Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award
Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO)
Past Honorary Secretary General IMA
Past Senior National Vice President IMA
President Heart Care Foundation of India
Gold Medalist Nagpur University
Limca Book of Record Holder in CPR 10
Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre
Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand
Editor in Chief IJCP Group of Publications & eMedinewS
Member Ethics Committee Medical Council of India (2013-14)
Chairman Ethics Committee Delhi Medical Council (2009-15)
Elected Member Delhi Medical Council (2004-2009)
Chairman IMSA Delhi Chapter (March 10- March 13)
Director IMA AKN Sinha Institute (08-09)
Finance Secretary IMA (07-08)
Chairman IMAAMS (06-07)
President Delhi Medical Association (05-06)

Gift a Tulsi plant: Live in harmony with nature

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Plants and trees are vital to life and are an integral part of our environment. They provide oxygen, conserve water, improve air quality, reduce noise pollution and help control climate, to name a few. Nature is not called ‘Mother Nature’ for nothing. Nature is life-giving; it nurtures. Nature provides us with food, water and medicines. And, we need to look after it and live in harmony with it.

The green cover in the country is fast disappearing in the name of development. Ongoing construction activities clear land and forests of trees. Deforestation is a major contributor to climate change, which directly affects five components of the environment: water, air, weather, oceans, and ecosystems and adversely affects human health. Hence, the disturbed ecological balance needs to be restored.
One way to do this is by planting more trees. Another way to create awareness about preserve and protect our environment is by gifting plants. Choose medicinal plants such as Tulsi.

We often hear of tree plantation drives in the country. So why not a campaign to gift a tulsi plant?
Tulsi is a plant, which is common to most households. There is a saying in Sanskrit: “Tulanaa naasti athaiva tulsi” meaning that which is incomparable in its qualities is the tulsi. It has both spiritual and health significance.
The health benefits of Tulsi are known to all since ancient times. It has a multitude of beneficial actions in the body such as antimicrobial, antioxidant, anti-inflammatory, anti-pyretic, anti-allergic, immunomodulatory, diaphoretic, adaptogenic, anti-stress, neuro-protective, cardio-protective, anti-diabetic, anti-hypercholesterolemia, anti-hypertensive, anti-carcinogenic, chemopreventive, radioprotective, to name a few.
Gifting plants is environment-friendly. It is a gift for many occasions, be it housewarming, birthdays, weddings, etc. You can also give plant saplings as a return gift for birthdays of your children. This is one way by which you can instill in them the need to look after the environment right from an early age.
Gift potted plants instead of gifting flower bouquets or other gifts. Choose Tulsi plant or any other medicinal plant such as Stevia. These are long-lasting gifts.

To control the alarming increases in non-communicable diseases, it is important to change our lifestyle and live in harmony with nature by protecting the environment. The proximity with nature helps in the inward spiritual journey and shifts one from the sympathetic (disturbed) to parasympathetic (relaxed) mode described by lowering of blood pressure and pulse rate and rise in skin resistance. A balance between the sympathetic and the parasympathetic modes is required for optimum health and well-being.

Dr KK Aggarwal
National President IMA & HCFI

Recipient of Padma Shri, Dr BC Roy National Award, Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award
Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO)
Past Honorary Secretary General IMA
Past Senior National Vice President IMA
President Heart Care Foundation of India
Gold Medalist Nagpur University
Limca Book of Record Holder in CPR 10
Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre
Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand
Editor in Chief IJCP Group of Publications & eMedinewS
Member Ethics Committee Medical Council of India (2013-14)
Chairman Ethics Committee Delhi Medical Council (2009-15)
Elected Member Delhi Medical Council (2004-2009)
Chairman IMSA Delhi Chapter (March 10- March 13)
Director IMA AKN Sinha Institute (08-09)
Finance Secretary IMA (07-08)
Chairman IMAAMS (06-07)
President Delhi Medical Association (05-06)

Universal screening for alcohol misuse at hospitalization is a feasible strategy

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A study published online July 27, 2017 in the Journal of Hepatology has demonstrated that universal screening for alcohol misuse at the time of hospitalization to identify patients at risk of developing alcohol-related liver disease, is a feasible strategy.

Researchers from the UK screened all admissions to the Acute Medical Unit of a large acute hospital using an electronic data capture system. At the time of admission, information about the amount of alcohol consumed, previous visits and or admissions and whether they were alcohol-related was recorded.

Around 91% patients completed the screening; of these, around 3% of the patients were grouped as “increasing”, and 4% as “high” risk of alcohol harm. The high risk group had more frequent emergency room (ER) visits and higher re-admission rates; gastrointestinal bleeding, mental health disorders, poisoning and liver disease were the most common diagnoses for hospitalization.

What this study showed was that it is possible to screen patients for alcohol misuse at hospitalization, identify patients with a very high unit consumption and then to refer them for appropriate intervention, potentially reducing the burden of alcohol-related harm. While, lower risk patients can be given brief advice by any trained healthcare professional

This study assumes all the more importance because alcohol misuse is a major cause of preventable death. It also offers a solution to the unmet need to identify patients with alcohol-related liver disease at an earlier stage.

According to the WHO, 3.3 million deaths (~6% of all deaths) globally every year are due to alcohol-related harm. It is all the more worrisome because alcohol consumption causes death and disability relatively early in life, particularly in the younger age group. Alcohol has been linked to many noncommunicable diseases, including alcohol-related liver disease and injuries. Overall 5.1 % of the global burden of disease and injury is attributable to alcohol, as measured in disability-adjusted life years (DALYs).

Source

1. Westwood G, et al. Universal screening for alcohol misuse in acute medical admissions is feasible and identifies patients at high risk of liver disease. Journal of Hepatology, published 27 July 2017.

Dr KK Aggarwal
National President IMA & HCFI

Recipient of Padma Shri, Dr BC Roy National Award, Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award
Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO)
Past Honorary Secretary General IMA
Past Senior National Vice President IMA
President Heart Care Foundation of India
Gold Medalist Nagpur University
Limca Book of Record Holder in CPR 10
Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre
Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand
Editor in Chief IJCP Group of Publications & eMedinewS
Member Ethics Committee Medical Council of India (2013-14)
Chairman Ethics Committee Delhi Medical Council (2009-15)
Elected Member Delhi Medical Council (2004-2009)
Chairman IMSA Delhi Chapter (March 10- March 13)
Director IMA AKN Sinha Institute (08-09)
Finance Secretary IMA (07-08)
Chairman IMAAMS (06-07)
President Delhi Medical Association (05-06)

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