Priya Hiteshi - Academia.edu (original) (raw)

Papers by Priya Hiteshi

PLOS ONE, 2021

Aims Limb and patient outcomes in people with diabetic foot complications including diabetic foot... more Aims Limb and patient outcomes in people with diabetic foot complications including diabetic foot ulcer (DFU) provided virtual triage and personalized video consultations during COVID-19 pandemic are not known. Methods Patients with foot complications attending the diabetic foot clinic prior to lockdown who sought teleconsultations during COVID-19 lockdown underwent virtual triage to include clinical history, visual inspection of feet, domiciliary wound care (community nurse assisted dressings) and offloading instructions. The subsequent ulcer, limb and mortality outcomes during the following 24 weeks of COVID-19 lockdown (April-September 2020, group 1) were assessed and compared with those who attended foot clinic during the same period in 2019 (April-September, group 2). Results Group 1 included 561 participants with foot complications provided with teleconsultations, median age 57 (51 to 63) years and diabetes duration of 10 (5 to 16) years. Twelve patients with severe DFU were e...

International Journal of Diabetes in Developing Countries, 2021

Type 2 diabetes is a chronic metabolic disease characterized by vascular complications, the preva... more Type 2 diabetes is a chronic metabolic disease characterized by vascular complications, the prevalence of which varies widely. Determine the prevalence of microvascular and macrovascular complications in type-2 diabetes in North India and their correlation with various risk factors. Prospective observational study Tertiary referral centres A total of 6400 patients attending diabetes clinic were screened, out of which 6105 patients were enrolled during April 2018 to February 2021. Data were collected using a standardized electronic case record form. Prevalence estimates of microvascular and macrovascular complications were performed, and multivariate regression was applied for the analysis of correlation with known modifiable and non-modifiable risk factors. ROC analysis was done to find the best cut-offs for predictors of diabetic vascular complications. The mean age of the participants was 58.3 ± 9.1 years (57% males). The mean duration of diabetes was 11.3 ± 7 years and HbA1c was 8.4 ± 4%. Prevalent diabetic neuropathy was observed in 30.1%, nephropathy in 18.8% and retinopathy in 13.7%. Coronary artery disease (CAD) was prevalent in 15.7%, cerebrovascular accident (CVA) in 3.6% and foot complications in 2.9%. In the multivariate regression model, all microvascular complications significantly correlated with the longer duration of diabetes but the same was not observed for macrovascular complications. Obesity [BMI cut-off>26.4 kg/m2 (AUC 0.51, p=0.04) and waist circumference>94 cm (male) and >98 cm (female)] significantly predicted prevalent diabetic neuropathy and nephropathy. A BMI of >25.7 kg/m2 had a sensitivity of 55.2% (AUC 0.57), p<0.001 for predicting foot complications. There is a strong association of obesity and longer diabetes duration with the prevalent microvascular and foot complications irrespective of the glycemic control but not for macrovascular complications.

International Journal of Diabetes in Developing Countries, 2020

Background and aims COVID-19 is likely to affect the lives of individuals with type 2 diabetes. H... more Background and aims COVID-19 is likely to affect the lives of individuals with type 2 diabetes. However, the effect of COVID-19 lockdown on physical activity and glycemic control in such individuals is not known. We studied the physical activity and glycemic control during lockdown in comparison to pre-lockdown parameters in individuals with long-standing type 2 diabetes. Methods This prospective, observational study includes 2240 people with T2DM regularly attending diabetes clinic prior to lockdown. Glycemic record, HbA1c, and physical activity assessed with Global Physical Activity Questionnaire (GPAQ) as metabolic equivalents (MetS min/week) were obtained during lockdown (minimum duration of 3 months). Results A total of 422 out of 750 participants (nest) responded. The median (IQR) for age was 58 (52 to 64) years, duration of diabetes 11 (6 to 16) years, prevalent foot complications in 59.7%, and atherosclerotic cardiovascular disease in 21.3% of participants. There was a decrease in HbA1c from 7.8% (6.9 to 9.4) prior lockdown to 7.4% (6.6 to8.7) during lockdown [ΔHbA1c − 0.41 ± 0.27% (p = 0.005)] and postprandial blood glucose 200.0 mg/dl (152.0 to 252.0) to 158.0 (140.0 to 200.0) mg/dl (p < 0.001). The physical activity increased during lockdown from a GPAQ score 140 (0.0 to 1260) MetS to 840 (0.0 to 1680) MetS (p = 0.014). The improvement of glycemic control was observed in either gender and independent of the presence of foot complications or increase in physical activity. Conclusions There is an overall improvement of glycemic control during COVID-19 lockdown independent of increase in physical activity in people with long duration of diabetes.

Diabetes & Metabolic Syndrome: Clinical Research & Reviews

Int J DiabetesDevCtriesOct , 2020

Background and aims COVID-19 is likely to affect the lives of individuals with type 2 diabetes. H... more Background and aims COVID-19 is likely to affect the lives of individuals with type 2 diabetes. However, the effect of COVID-
19 lockdown on physical activity and glycemic control in such individuals is not known. We studied the physical activity and
glycemic control during lockdown in comparison to pre-lockdown parameters in individuals with long-standing type 2 diabetes.
Methods This prospective, observational study includes 2240 people with T2DM regularly attending diabetes clinic prior to
lockdown. Glycemic record, HbA1c, and physical activity assessed with Global Physical Activity Questionnaire (GPAQ) as
metabolic equivalents (MetS min/week) were obtained during lockdown (minimum duration of 3 months).
Results A total of 422 out of 750 participants (nest) responded. The median (IQR) for age was 58 (52 to 64) years, duration of
diabetes 11 (6 to 16) years, prevalent foot complications in 59.7%, and atherosclerotic cardiovascular disease in 21.3% of
participants. There was a decrease in HbA1c from 7.8% (6.9 to 9.4) prior lockdown to 7.4% (6.6 to8.7) during lockdown
[ΔHbA1c − 0.41 ± 0.27% (p = 0.005)] and postprandial blood glucose 200.0 mg/dl (152.0 to 252.0) to 158.0 (140.0 to 200.0)
mg/dl (p < 0.001). The physical activity increased during lockdown from a GPAQ score 140 (0.0 to 1260) MetS to 840 (0.0 to
1680)MetS (p = 0.014). The improvement of glycemic control was observed in either gender and independent of the presence of
foot complications or increase in physical activity.
Conclusions There is an overall improvement of glycemic control during COVID-19 lockdown independent of increase in
physical activity in people with long duration of diabetes.
Keywords COVID-19 . Glycemic control . HbA1c . Global Physical Activity Questionnaire (GPAQ) . Physical activity

PLOS ONE, 2021

Aims Limb and patient outcomes in people with diabetic foot complications including diabetic foot... more Aims Limb and patient outcomes in people with diabetic foot complications including diabetic foot ulcer (DFU) provided virtual triage and personalized video consultations during COVID-19 pandemic are not known. Methods Patients with foot complications attending the diabetic foot clinic prior to lockdown who sought teleconsultations during COVID-19 lockdown underwent virtual triage to include clinical history, visual inspection of feet, domiciliary wound care (community nurse assisted dressings) and offloading instructions. The subsequent ulcer, limb and mortality outcomes during the following 24 weeks of COVID-19 lockdown (April-September 2020, group 1) were assessed and compared with those who attended foot clinic during the same period in 2019 (April-September, group 2). Results Group 1 included 561 participants with foot complications provided with teleconsultations, median age 57 (51 to 63) years and diabetes duration of 10 (5 to 16) years. Twelve patients with severe DFU were e...

International Journal of Diabetes in Developing Countries, 2021

Type 2 diabetes is a chronic metabolic disease characterized by vascular complications, the preva... more Type 2 diabetes is a chronic metabolic disease characterized by vascular complications, the prevalence of which varies widely. Determine the prevalence of microvascular and macrovascular complications in type-2 diabetes in North India and their correlation with various risk factors. Prospective observational study Tertiary referral centres A total of 6400 patients attending diabetes clinic were screened, out of which 6105 patients were enrolled during April 2018 to February 2021. Data were collected using a standardized electronic case record form. Prevalence estimates of microvascular and macrovascular complications were performed, and multivariate regression was applied for the analysis of correlation with known modifiable and non-modifiable risk factors. ROC analysis was done to find the best cut-offs for predictors of diabetic vascular complications. The mean age of the participants was 58.3 ± 9.1 years (57% males). The mean duration of diabetes was 11.3 ± 7 years and HbA1c was 8.4 ± 4%. Prevalent diabetic neuropathy was observed in 30.1%, nephropathy in 18.8% and retinopathy in 13.7%. Coronary artery disease (CAD) was prevalent in 15.7%, cerebrovascular accident (CVA) in 3.6% and foot complications in 2.9%. In the multivariate regression model, all microvascular complications significantly correlated with the longer duration of diabetes but the same was not observed for macrovascular complications. Obesity [BMI cut-off>26.4 kg/m2 (AUC 0.51, p=0.04) and waist circumference>94 cm (male) and >98 cm (female)] significantly predicted prevalent diabetic neuropathy and nephropathy. A BMI of >25.7 kg/m2 had a sensitivity of 55.2% (AUC 0.57), p<0.001 for predicting foot complications. There is a strong association of obesity and longer diabetes duration with the prevalent microvascular and foot complications irrespective of the glycemic control but not for macrovascular complications.

International Journal of Diabetes in Developing Countries, 2020

Background and aims COVID-19 is likely to affect the lives of individuals with type 2 diabetes. H... more Background and aims COVID-19 is likely to affect the lives of individuals with type 2 diabetes. However, the effect of COVID-19 lockdown on physical activity and glycemic control in such individuals is not known. We studied the physical activity and glycemic control during lockdown in comparison to pre-lockdown parameters in individuals with long-standing type 2 diabetes. Methods This prospective, observational study includes 2240 people with T2DM regularly attending diabetes clinic prior to lockdown. Glycemic record, HbA1c, and physical activity assessed with Global Physical Activity Questionnaire (GPAQ) as metabolic equivalents (MetS min/week) were obtained during lockdown (minimum duration of 3 months). Results A total of 422 out of 750 participants (nest) responded. The median (IQR) for age was 58 (52 to 64) years, duration of diabetes 11 (6 to 16) years, prevalent foot complications in 59.7%, and atherosclerotic cardiovascular disease in 21.3% of participants. There was a decrease in HbA1c from 7.8% (6.9 to 9.4) prior lockdown to 7.4% (6.6 to8.7) during lockdown [ΔHbA1c − 0.41 ± 0.27% (p = 0.005)] and postprandial blood glucose 200.0 mg/dl (152.0 to 252.0) to 158.0 (140.0 to 200.0) mg/dl (p < 0.001). The physical activity increased during lockdown from a GPAQ score 140 (0.0 to 1260) MetS to 840 (0.0 to 1680) MetS (p = 0.014). The improvement of glycemic control was observed in either gender and independent of the presence of foot complications or increase in physical activity. Conclusions There is an overall improvement of glycemic control during COVID-19 lockdown independent of increase in physical activity in people with long duration of diabetes.

Diabetes & Metabolic Syndrome: Clinical Research & Reviews

Int J DiabetesDevCtriesOct , 2020

Background and aims COVID-19 is likely to affect the lives of individuals with type 2 diabetes. H... more Background and aims COVID-19 is likely to affect the lives of individuals with type 2 diabetes. However, the effect of COVID-
19 lockdown on physical activity and glycemic control in such individuals is not known. We studied the physical activity and
glycemic control during lockdown in comparison to pre-lockdown parameters in individuals with long-standing type 2 diabetes.
Methods This prospective, observational study includes 2240 people with T2DM regularly attending diabetes clinic prior to
lockdown. Glycemic record, HbA1c, and physical activity assessed with Global Physical Activity Questionnaire (GPAQ) as
metabolic equivalents (MetS min/week) were obtained during lockdown (minimum duration of 3 months).
Results A total of 422 out of 750 participants (nest) responded. The median (IQR) for age was 58 (52 to 64) years, duration of
diabetes 11 (6 to 16) years, prevalent foot complications in 59.7%, and atherosclerotic cardiovascular disease in 21.3% of
participants. There was a decrease in HbA1c from 7.8% (6.9 to 9.4) prior lockdown to 7.4% (6.6 to8.7) during lockdown
[ΔHbA1c − 0.41 ± 0.27% (p = 0.005)] and postprandial blood glucose 200.0 mg/dl (152.0 to 252.0) to 158.0 (140.0 to 200.0)
mg/dl (p < 0.001). The physical activity increased during lockdown from a GPAQ score 140 (0.0 to 1260) MetS to 840 (0.0 to
1680)MetS (p = 0.014). The improvement of glycemic control was observed in either gender and independent of the presence of
foot complications or increase in physical activity.
Conclusions There is an overall improvement of glycemic control during COVID-19 lockdown independent of increase in
physical activity in people with long duration of diabetes.
Keywords COVID-19 . Glycemic control . HbA1c . Global Physical Activity Questionnaire (GPAQ) . Physical activity