Browsing by Author "Bavuma, Charlotte"

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    Classifying a distinct form of diabetes in lean individuals with a history of undernutrition: an international consensus statement
    (The Lancet Group, 2025-10) Wadivkar, Pradnyashree; Jebasingh, Felix; Thomas, Nihal; Yajnik, S Chittaranjan; Vaag, Arthur Allan; Kibirige, Davis; Bahendeka, Silver; Bajaj, Mandeep; Boyne, S Michael; Bavuma, Charlotte; Abodo, Jacko; Wild, Sarah; Kolthur-Seetharam, Ullas; Mukhopadhyay, Satinath; Somasundaram, P Noel; Schwarz, Peter; Christensen, L Dirk; Pathan, Faruque; Jones, G Angus; Mathur, Sandeep; Kehlenbrink, Sylvia; Hawkins, Meredith; on behalf of the Vellore Declaration Signatories
    Since 1955, a form of diabetes in lean, young (BMI < 18·5 kg/m2, age < 30 years) individuals with a history suggestive of undernutrition from before birth and throughout childhood has been described in the literature. In 1985, WHO formally classified it as malnutrition-related diabetes, but subsequently removed the classification in 1999 over a disagreement as to whether undernutrition was a sufficient risk factor to cause this type of diabetes. Emerging evidence now strongly supports the distinct classification of this unique diabetes phenotype, which is characterised by substantial impairment of pancreatic insulin secretion, with normal hepatic and peripheral insulin sensitivity, an absence of ketoacidosis, and no islet cell autoantibodies. In this consensus statement, we synthesise this evidence to produce a set of common features of the disease, proposed pathogenetic mechanisms, and suggested management and prevention strategies. During a consensus meeting in Vellore, India, in January, 2025, type 5 diabetes was proposed as the nomenclature for this distinct form of diabetes, subsequently formalised at the International Diabetes Federation (IDF) World Diabetes Congress in April, 2025. We call upon the international diabetes community to recognise this distinct form of the disease, and to support the IDF's Type 5 Diabetes Working Group and its goals to promote more research into its phenotype, pathophysiology, and treatment, which will benefit millions of patients worldwide, particularly in low-income and middle-income countries.
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    Euthymia in Diabetes
    (Springer Nature, 2019-04-22) Kalra, Sanjay; Das, A.K; Baruah, M. P.; Unnikrishnan, A. G.; Dasgupta, Arundhati; Shah, Parag; Sahay, Rakesh; Shukla, Rishi; Das, Sambit; Tiwaskar, Mangesh; Vijayakumar, G.; Chawla, Manoj; Eliana, Fatimah; Suastika, Ketut; Orabi, Abbas; Abdul Rahim, Aly Ahmed; Uloko, Andrew; Lamptey, Roberta; Ngugi, Nancy; Bahendeka, Silver; Abdela, Abdurezak Ahmed; Mohammed, Fariduddin; Pathan, Mohammed Faruque; Rahman, Muhammed Hafizur; Afsana, Faria; Selim, Shajada; Moosa, Muaz; Murad, Moosa; Shreshtha, Pradeep Krishna; Shreshtha, Dina; Giri, Mimi; Hussain, Wiam; Al-Ani, Ahmed; Ramaiya, Kaushik; Singh, Surender; Raza, Syed Abbas; Aye, Than Than; Garusinghe, Chaminda; Muthukuda, Dimuthu; Weerakkody, Muditha; Kahandawa, Shyaminda; Bavuma, Charlotte; Ruder, Sundeep; Vanny, Koy; Khanolkar, Manish; Czupryniak, Leszek
    Aim: To develop an evidence-based expert group opinion on various types of euthymia associated with diabetes mellitus (DM) and its management. Background: Diabetes mellitus is a metabolic syndrome characterized by diverse biomedical and psychosocial features. Emotional health disturbances may lead to psychological and psychiatric dysfunction and may negatively influence glycemic control. Patients with DM may experience diabetes distress (DD) associated with burden of self-care, interpersonal issues, and emotional worries regarding the ability to cope with the illness. Euthymia or a state of positive mental health and psychological well-being should be considered a key outcome of diabetes care. Therefore, to achieve optimal outcomes, the consideration and measurement of psychological and psychiatric aspects along with glycemic levels are very important. A group of multidisciplinary clinical experts came together in an international meeting held in India to develop a workable concept for euthymia in diabetes care. A multidisciplinary approach was suggested to enhance the clinical outcomes and facilitate patient-centered care. During the meeting emphasis was given to the concept of a euthymia model in diabetes care. This model focuses on enhancement of self-care skills in diabetic patients and preventative health awareness among diabetes care providers. Euthymia also encompasses patient–provider communication to aid enhancement of coping skills. Results: After due discussions and extensive deliberations, the expert group provided several recommendations on implementing the concept of euthymia in DM care. Conclusions: Introduction of the concept of euthymia in routine clinical practice is important to improve the quality of life and coping skills in patients with DM. A timely clinical assessment of psychological and psychiatric aspects along with patient-reported outcomes of diabetes contributes to overall health and wellbeing of affected individuals.