Letters to the Editor

Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India Sir, This letter is with regard to our study, the details of which are below. We would like to point out to an error that has arisen in the printed table. Indian J Endocrinol Metab July-August 2013/Vol 17/ Issue 4, Titled: Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India on Pages: 647-52. In the results section it was mentioned that 598 (11.15%) participants gave history of thyroid dysfunction including thyroid surgery- however in Table 1 only 581 patients who gave positive history of thyroid disease were listed. Seventeen patients who gave positive history of benign Table 1: Demographic characteristics and thyroid related history of the study population Total subjects Gender, n (%) Female Male Age (years) Mean ±SD Min- Max (years) Age-group, n (%) 18-35 years 36-45 years 46-54 years 55 and above Common concurrent conditions, n (%) Diabetes mellitus Hypertension History of thyroid dysfunction, n (%) Hypothyroid Hyperthyroid Goitre Thyroid malignancy Subacute viral thyroiditis History of thyroid surgery, n (%) Current or past thyroid medications, n (%) Levothyroxine Thyroid supplements Carbimazole Methimazole

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5360 2932 (54.70) 2428 (45.30) 45.85±14.68 18-100 1447 (27.00) 1244 (23.21) 1068 (19.93) 1601 (29.87) 866 (16.16) 1095 (20.43) 427 (7.97) 17 (0.34) 116 (2.25)* 6 (0.11) 2 (0.04) 13 (0.24) 379 (7.07) 15 (0.27) 13 (0.24) 1 (0.02)

thyroid nodules were not mentioned in the table due to an error. Thus, while considering the table, readers are advised to consider that the total number of people who gave a history of thyroid disease is 598. Regards Neeraj Tewari Neeraj Tewari Medical Affairs, Metabolism and Endocrinology Abbott India Limited, Goregaon East Mumbai, India Address for correspondence: Dr. Neeraj Tewari, 271, Business Park, Goregaon East Mumbai - 400 061, Maharashtra, India. E-mail: [email protected] Access this article online Quick Response Code: Website: www.ijem.in DOI: 10.4103/2230-8210.126590

Improving diabetes care for children with type 1 diabetes from poor families: Changing diabetes® in children program, India Sir, The “Changing Diabetes® in Children” program is part of Novo Nordisk’s Access to the Diabetes Care Strategy and builds on the UN-defined cornerstones in the right to health. The aim of the program is to contribute to meet the fourth UN millennium goal, to reduce child mortality by breaking down the barriers that prevent children with type 1 diabetes in developing countries from receiving proper care. India has an estimated 61.3 million[1] people with diabetes. Out

Indian Journal of Endocrinology and Metabolism / Jan-Feb 2014 / Vol 18 | Issue 1

Letters to the Editor

of this population, 95%[2] have type 2 diabetes. In front of this huge pandemic, problems faced by children with type 1 diabetes are often overlooked. To address the critical gap in the management of type 1 diabetes in India, the Changing Diabetes in Children (CDiC) program was launched by Novo Nordisk Education Foundation in September 2011. The objective of the program is giving children, who are below the poverty line, access to comprehensive diabetes care.

and knowledge gained in coping with this chronic disease in children with other healthcare professionals. The current phase of this program will continue up to December 2014.

The changing diabetes in the children program is operational in nine countries in the world, which includes Bangladesh, Cameroon, Democratic Republic of the Congo (DRC), Guinea, Tanzania, Ethiopia, Kenya, and Uganda. Until now, 4026 children have been enlisted in this program in India and over 10,000 children across the nine countries. To reach out to every corner of our country, there are 21 centers across India. Additionally, there are 25 satellite centers which are attached to these main centers, which serve the purpose of penetration into the smaller towns to reach out to those children with type 1 diabetes who cannot come to the main centers on a regular basis. Each child with type 1 diabetes participating in this program is provided comprehensive diabetes care, which includes free insulin and syringes, glucometer, test strips, diagnostic tests, namely, HbA1c, CBC, microalbuminuria, and fundus.

REFERENCES

Insulin is no doubt the lifeline for these children with type 1 diabetes, but it cannot be managed only by taking insulin, it is very important that the children also learn more about the disorder and its management since it has to be managed 24 × 7. Hence, so far more than 200 patient education camps have been held in partnership with the CDIC centers to help children manage their diabetes and live better. Each camp has three components, namely, diabetes education, experience sharing, and fun activities. In addition, several innovative child friendly patient education tools, which include toys to teach basics of diabetes and comic books on diabetes education, have been created to help them understand how to self-manage their diabetes. Apart from the primary objectives of improving access to proper medication, monitoring, diagnostics, consulting, and patient education, the CDiC program also incorporates other elements of diabetes management. This includes training of healthcare professionals (HCPs) to enhance their capabilities in diagnosis and treatment of children with type 1 diabetes and setting up of a registry for children from poor families with type 1 diabetes. So far, more than 1500 HCP s including diabetes educators have been trained. A training manual prepared by ISPAD on Diabetes Management in children and the adolescents has been distributed to more than 1700 HCPs. The CDiC program also envisages sharing best practices

Kanakatte Mylariah Prasanna Kumar Consultant Endocrinologist, Bangalore Diabetes Hospital, India Address for correspondence: Dr. KM Prasanna Kumar, Bangalore Diabetes Hospital, 16/M, Miller Tank Bed Area, Thimmaiah Road, Vasanth Nagar, Bangalore - 560 002, India. E-mail: [email protected]

1. 2.

Available from: http://www.idf.org/diabetesatlas/5e/south-east-asia. Last accessed on 2013 Aug 07. Available from: http://www.apiindia.org/medicine_update_2013/ chap40.pdf. Last accessed on 2013 Aug 07. Access this article online Quick Response Code: Website: www.ijem.in DOI: 10.4103/2230-8210.126591

Depression and type 2 diabetes in developed and developing countries Sir, Diabetes patients are more exposed to depression. This association might yield higher rates of mortality, morbidity and costs of health-care. [1] The world evaluation of depression prevalence in diabetes patients seems to vary according to the prosperity and health-care system of each country.[2] Hence, what are the factors of impact on the gap of depression rate within type 2 diabetes (T2D) in developing and developed countries? What are the care possibilities to reduce the depression rate in developing countries compared with developed countries? To answer this question, we achieved a transversal study in the University Hospital of Fez, Morocco. The study included 142 T2D patients. The average age of patients was 56.68-year-old, without significant difference in gender ration. The depression

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Improving diabetes care for children with type 1 diabetes from poor families: Changing diabetes(®) in children program, India.

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