Jay H. Shubrook, DO: Hi. I'm Jay Shubrook, family physician and professor at Touro University California. We're here at the American Diabetes Association (ADA) 78th Scientific Sessions and continuing our discussions on diabetes guidelines around the world. Today I'm happy to have with me Dr Rucha Mehta, who is from the Apollo Hospital in Gujarat, India. Tell me a little bit about the guidelines in India for diabetes.
Rucha J. Mehta, MD: Thank you, Jay. It's great to be here. The guidelines in India are very similar to the ADA/European Association for the Study of Diabetes (EASD) guidelines in terms of the targets for glycemic control. We have similar targets for diagnosis and treatment purposes: fasting plasma glucose ≥ 125, the 2-hour oral glucose tolerance test > 200, or a random plasma glucose > 200. When we treat, we also try to keep the [glucose] levels < 140-180, depending on the patient's tolerability.
The [ADA/EASD and Indian] guidelines are similar in terms of those treatment recommendations. Where we differ is in terms of the lifestyle changes. We all forget to look at the lifestyle changes. The Indian diet is largely—80%—a carbohydrate-based diet. When patients come to my clinic, we spend a lot of time focusing on lifestyle changes and trying to bring that down to 50% carbohydrates.
