Publications by authors named "Joshi Shashank"

Primary prevention of diabetes still remains as an unmet challenge in a real world setting. While, translational programmes have been successful in the developed nations, the prevailing social and economic inequities in the low and middle income countries, fail to integrate diabetes prevention into their public health systems. The resulting exponential increase in the prevalence of diabetes and the cost of treatment has put primary prevention in the back seat.

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Obsessive-compulsive disorder (OCD) is a common and potentially debilitating condition affecting approximately 1%-3% of children and adolescents.1,2 It is characterized by obsessions and/or compulsions that are time-consuming or cause clinically significant distress or impairment in school, social, family, or other important areas of functioning. OCD can have a lasting impact on both academic and social functioning.

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Background: Type 2 Diabetes (T2D) is a complex condition marked by insulin resistance and beta-cell dysfunction. Traditional dietary interventions, such as low-calorie or low-carbohydrate diets, typically overlook individual variability in postprandial glycemic responses (PPGRs), which can lead to suboptimal management of the disease. Recent advancements suggest that personalized nutrition, tailored to individual metabolic profiles, may enhance the effectiveness of T2D management.

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This retrospective observational study, building on prior research that demonstrated the efficacy of the Digital Twin (DT) Precision Treatment Program over shorter follow-up periods​​, aimed to examine glycemic control and reduced anti-diabetic medication use after one-year in a DT commercial program. T2D patients enrolled had adequate hepatic and renal function and no recent cardiovascular events. DT intervention powered by artificial intelligence utilizes precision nutrition, activity, sleep, and deep breathing exercises.

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Background: Assessment of diabetes health takes into account metabolic, nonmetabolic, and self-care measures like diet, exercise, follow-up, and habits. On the other hand, the index of complications includes the macro- and microvascular complications of diabetes along with foot complications. The Blue Index (BI) is a composite assessment of both diabetic health-related parameters and systemic complications stemming from diabetes.

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Background: Digital twin (DT)-guided lifestyle changes induce type 2 diabetes (T2D) remission but effects on hypertension (HTN) in this population are unknown.

Objectives: The purpose of this study was to assess effects of DT vs standard of care (SC) on blood pressure (BP), anti-HTN medication, HTN remission, and microalbuminuria in participants with T2D.

Methods: This is a secondary analysis of a randomized controlled trial in India of 319 participants with T2D.

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Article Synopsis
  • An error grid is a tool that helps compare glucose levels measured by devices to see if they are correct and to identify any risks.
  • Experts created a new error grid called the DTS Error Grid that works for both blood glucose monitors (BGMs) and continuous glucose monitors (CGMs), organizing accuracy into five risk zones.
  • The results showed that the DTS Error Grid provides a clearer picture of how accurate these devices are and includes a separate matrix to evaluate how well CGMs track glucose trends over time.
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The Indian Society of Hypertension (InSH) highlights the urgency for India-specific guidelines on hypertension management. Hypertension affects over one billion people worldwide, with India bearing a significant burden due to its population, diversity, and demographics. In India, hypertension affects 21% of women and 24% of men, while pre-hypertension affects 39% of women and 49% of men.

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This study aims to evaluate the dual benefits of dulaglutide in improving glycemic control and reducing knee OA pain. Elderly T2DM patients diagnosed with bilateral knee OA on conventional OA treatment for at least 3 months were studied for their glycemic metrics, OA pain scores and NSAID consumption at baseline, 3 months and 6 months. Significant improvements in glycemic control were observed, HbA1c decreased from 8.

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  • Pandemics create a significant strain on healthcare systems, leading to overwhelmed resources and services.
  • Effective management requires planning and understanding the case definitions during various phases of the pandemic, as illustrated in the recent COVID-19 situation.
  • The article outlines the stages of a pandemic, how it concludes, and specific case definitions relevant to each stage.
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Article Synopsis
  • * There are currently no unified guidelines for using steroids in diabetic patients, leading to inconsistencies among healthcare providers regarding the selection and application of different steroids.
  • * A consensus working group has emphasized the need for careful monitoring and individualized treatment plans to manage steroid-related complications effectively for diabetic patients.
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The management of edema requires a systematic approach to screening, diagnosis, and treatment, with an essential initial assessment to differentiate between generalized and localized edema. The Association of Physicians of India (API) aimed to develop the first Indian Edema Consensus (Edema India), offering tailored recommendations for screening, diagnosing, and managing edema based on the insights from the expert panel. The panel suggested when evaluating edema symptoms, important factors to consider include the patient's current illness, medical history, risk factors, family history, and medications.

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Introduction: Type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD) are linked to the global diabetes epidemic, leading to increased disease progression and adverse health outcomes. The renaming of NAFLD to metabolic dysfunction-associated steatotic liver disease (MASLD) at the 2023 European Association for the Study of the Liver Congress highlights the complex relationship between metabolic disorders and liver health. Taking this into consideration, we aimed this study to identify prevalence and risk factors associated with the stages of NAFLD in individuals with T2DM in the Indian population.

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Aim: A retrospective observational study was undertaken to assess the changing trends in the incidence of metabolic syndrome (MetS) in Asian-Indian patients with newly diagnosed type 2 diabetes (T2D) using Adult Treatment Panel III of the National Cholesterol Education Program (NCEP-ATP III), World Health Organization (WHO), and the International Diabetes Federation (IDF) criteria. The overall and gender-wise pattern of MetS and its components were also evaluated.

Materials And Methods: Newly diagnosed T2D patients ( = 10,950)visiting Dr Panikar's Diabetes Care Centre from 2004 to 2019 with retrievable electronic medical records were selected.

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Micronutrients play a key role in human health, being involved in energy metabolism, immunity, cellular functioning, growth, and development. Deficiencies in micronutrients occur in individuals of all ages due to several factors, including inadequate diets, disease states, and overweight/obesity. Guidelines from the Indian Council of Medical Research (ICMR) National Institute of Nutrition (NIN) Expert Group on Nutrient Requirements for Indians (2023) have specified the Recommended Dietary Allowances (RDA) for macronutrients and micronutrients.

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Background: The isometric handgrip (IHG) test is commonly used to detect sympathetic autonomic dysfunction. Tamsulosin, approved for the management of symptomatic benign prostatic hyperplasia (BPH), acts as an antagonist for α1-adrenergic receptors (α1-AR), whereas prazosin, an α receptor blocker, being less selective than tamsulosin, is used as an antihypertensive agent clinically. Our objective was to investigate if there is a distinction in blood pressure (BP) increase during IHG exercise between individuals with essential hypertension taking tamsulosin compared to those taking prazosin.

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  • Gestational hypertension poses risks for both mothers and babies, potentially leading to conditions like preeclampsia; this study investigates sympathetic nervous system function in affected women.
  • The study included 52 women with pregnancy-induced hypertension and 52 without, assessing their blood pressure responses to exercise to determine differences in autonomic function.
  • Results indicated significantly higher blood pressure responses in the hypertensive group, suggesting that the increased sympathetic activity is linked to a higher risk of developing preeclampsia or eclampsia, highlighting a potential area for new treatments.
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The World population doubled from 4 billion humans to 8 billion humans from 1974 to 2022, and it is unlikely to double again. The population of India has now surpassed China, with around 1.4 billion, and we have also already climbed up to become the world's fifth largest economy.

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Background: The efficacy and safety of lobeglitazone sulfate has been reported only in the Korean population, and no study has been conducted in India.

Materials And Methods: In this 16-week randomized, double-blind, and multicenter study, the efficacy and safety of lobeglitazone sulfate 0.5 mg were evaluated with pioglitazone 15 mg.

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Introduction: Hypertension (HTN) remains one of the most important risk factors for cardiovascular (CV) diseases and a leading cause of mortality worldwide. Despite improvement in detection and treatment, poor blood pressure (BP) control rates are observed globally. The situation in India is alarming with only 22.

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β-adrenergic blocker group of medicines has been traditionally used to control high blood pressure since propranolol was discovered by Sir James Black almost 50 years ago. They were the drug of choice in hypertension (HTN) associated with ischemic heart disease, tachyarrhythmias including atrial fibrillation (AF), and anxiety. Congestive cardiac failure was a relative contraindication, but with major advances in science, it became an absolute indication.

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Article Synopsis
  • The Lipid Association of India updated its cardiovascular risk assessment algorithm to address the unique challenges of atherosclerotic cardiovascular disease (ASCVD) in Indians, focusing on early intervention.
  • A series of expert meetings were held to review current evidence and refine treatment guidelines, emphasizing the need for aggressive preventive measures due to the young age of onset for ASCVD in the Indian population.
  • The updated recommendations aim to enhance LDL-C-lowering therapy and improve risk management strategies for individuals at high risk of ASCVD, ultimately striving to reduce its prevalence in India and beyond.
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