title: Barriers and solutions to diabetes management: An Indian perspective.
abstract: India, with one of the largest and most diverse populations of people living with diabetes, experiences significant barriers in successful diabetes care. Limitations in appropriate and timely use of insulin impede the achievement of good glycemic control. The current article aims to identify solutions to barriers in the effective use of insulin therapy viz. its efficacy and safety, impact on convenience and life-style and lack of awareness and education. Therapeutic modalities, which avoid placing an undue burden on patients' life-style, must be built. These should incorporate patient-centric paradigms of diabetes care, team-based approach for life-style modification and monitoring of patients' adherence to therapy. To address the issues in efficacy and safety, long-acting, flat profile basal insulin, which mimics physiological insulin and show fewer hypoglycemic events is needed. In addition, therapy must be linked to monitoring of blood glucose to enable effective use of insulin therapy. In conjunction, wide-ranging efforts must be made to remove negative perception of insulin therapy in the community. Patient- and physician - targeted programs to enhance awareness in various aspects of diabetes care must be initiated across all levels of health-care ensuring uniformity of information. To successfully address the challenges in facing diabetes care, partnerships between various stakeholders in the care process must be explored.
authors: Department of Endocrinology, Indraprastha Apollo Hospital, New Delhi, India.
authors: Subhash K
authors: SK
authors: Wangnoo
authors: Debasish
authors: D
authors: Maji
authors: Ashok Kumar
authors: AK
authors: Das
authors: P V
authors: PV
authors: Rao
authors: Anand
authors: A
authors: Moses
authors: Bipin
authors: B
authors: Sethi
authors: Ambika Gopalakrishnan
authors: AG
authors: Unnikrishnan
authors: Sanjay
authors: S
authors: Kalra
authors: V
authors: V
authors: Balaji
authors: Ganapathi
authors: G
authors: Bantwal
authors: Jothydev
authors: J
authors: Kesavadev
authors: Sunil M
authors: SM
authors: Jain
authors: Mala
authors: M
authors: Dharmalingam
keywords: Delivery of health-care; diabetes mellitus; health-care disparities; insulin; life-style; medication adherence; patient compliance; patient-centered care; physician-patient relations; safety
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