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Current Issues in Understanding of Diabetes

Ravishankar Polisetty, Purna Divya Singanamala, Teja Sree Bitla


Diabetes mellitus is a significant metabolic disorder that poses a major health concern, particularly in India. India harbours the world's highest number of diabetic patients, totalling around 130 million, with an additional 40 million categorised as prediabetic. In the global context, the number of adults suffering from diabetes was roughly 150 million in 2000, but this number is projected to significantly increase by 2030. The global prevalence of prediabetes is alarming, projected to rise from 430 million adults in 2019 to approximately 700 million by 2045. This surge underscores the growing importance of addressing diabetes as a paramount health issue. Following an extensive literature review and over 130 years of combined translational research, we provide a comprehensive overview of numerous aspects related to diabetes. Our focus encompasses the complexities of prediabetes, insights, and controversies from pivotal clinical trials such as VADT, ACCORD, ADVANCE, and UKPDS, issues with oral hypoglycaemic agents and insulin therapy, debates surrounding dietary strategies, as well as the role of alternative health practices. We further delve into the implications of alternative sweeteners, particularly fructose. Given the subject's intricacy, our findings will be published across 9–16 papers, each dedicated to specific subtopics, to allow a comprehensive understanding of diabetes management. One significant area of exploration in the first of the articles is the intricacies surrounding the diagnosis of prediabetes. Prediabetes, a stage characterised by higher-than-normal glycaemic parameters, indicates a heightened risk for diabetes. Despite the critical importance of early identification and intervention, the diagnostic criteria for prediabetes have been a subject of debate. The present review was aimed to scrutinise these criteria, assess their strengths and limitations, and offer insights into clinical management strategies. We aspire to contribute valuable perspectives to the scientific community and healthcare practitioners.


Prediabetic, hyperglycaemia, homeostasis, impaired fasting glucose, impaired glucose tolerance, metabolic variability, poly scientific Ayurveda.

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