1. A mix gathering of core prescribers and non-prescribers

2. Clearing of doubts and concepts through a mutual discussion method

3. Each and Every doctor should share his clinical experience and opinion

A mix of Core prescribers and potential non-prescribers

Gathering consisting of Endocrinologist , Cardiologist and Consulting Physicians

Consultant Endocrinologist Has served the forces for more than 25 years

Got the best of Knowledge and Command over Situations

Dr. R.S.K SinhaDr. R.S.K Sinha Ex HOD Safdurjung Hospital Consulting Doctor to the Prime Minister and President of India

Dr.Arun Mukherjee

M.D Physician and M.D PharmacologyEx Medical advisor Ranbaxy Pharmaceuticals Has got experience of both Industry and Clinical Practice

D.M Cardiology Has got more than 30 years of Clinical

experience Owns 3 Hospital In South Delhi and NCR

Dr.Ravi PaulDr.Ravi Paul

Pass out of AFMC Has own clinic in GK-1 a posh colony in South Delhi Clinic of more than 50 patients per day

Dr.Adarsh Kumar Dr.Adarsh Kumar

Consultant Physician in South Delhi Has got good number of Cardio Diabetic patients

Consutant Physician with more than 35 years of Clinical Experience

Has got a policy that it’s not the Has got a policy that it’s not the Pharmaceutical Companies that will decide Pharmaceutical Companies that will decide that they are going to meet me or not It’s I that they are going to meet me or not It’s I

who decides which company and which who decides which company and which representative to meet representative to meet

Dr.Manju BharadwajDr.Manju Bharadwaj

Incharge of purchase in NDMC which is a government institution

Dr.Sunil WadhwaDr.Sunil Wadhwa

Got own clinic in South Delhi Has an OPD of 40-50 patients with good number of Cardio-Diabetic patients

Consultant Physician Having an excellent clientage with good number of Cardio Diabetic Patients

The only consultant physician in the area of Nizzamuddin

1.Doctor’s were invited for the meeting as a speaker and not as

audience

2.Every doctor was requested to share his clinical experience and add

value to other’s

Dr.Sanjiv Bhambani was requested to be the moderator for the session

A consultant Endocrinologist who has served the forces

An Endocrinologist was made a part of the meeting so as to validate other’s opinion

Dr.Sanjiv Bhambani Dr.Sanjiv Bhambani

Topic Chosen : DPP-4 inhibitor’s , newer treatment modalities in the management of T2DM

The Topic chosen provided a vast scope for discussion

Date :- Saturday , 29th August 2009

Venue :- Hotel Parkland , Safdurjung Enclave , South Delhi

Time :- Meeting Started :- 9.30 PM Meeting Ended :- 11.00 PM

First time a scientific session lasted for One

and half hours

1.Prevelance of Diabetes

2.Complication’s of Diabetes

3.Pathophisology

4.SU v/s Vildagliptin

5.Treatment Pathway Followed

6.Guideline’s Recommendation’s

DOCTOR’S COMMENTSDOCTOR’S COMMENTS

Cases of Diabetes have increased tremendously over a period of time

Complication’s arise because life expectance have increased and patients

now spend more year’s living with Diabetes

DPP-4 inhibitor’s give results more than expected

Certain New Reports have shown that they can be safely given to patients with

cardiovascular diseases

Lesser incidence of Side Effects , so should be used in priority in Elderly Population

Lifestyle management is of utmost importance in patients with Diabetes

Incidence of complications have also increased

Incretin Effect has a very long history and good evidence

DPP-4 inhibitors have proven themselves as a better substitutes for Sulphonyl Ureas

There is mis-balance between the diet and exercise of the patients giving rise to more number of Diabetic cases

Introduction of Plastics and Chemicals in food , has also served as a reason for early beta cell failure in patients

The defects should be identified first in the patients

Based on the defects which have been identified the treatment guidelines should be designed

DPP-4 inhibitors have less evidence as compared to Sulphonyl Ureas so they cannot replace them Its more advisable to use a combination of drugs rather than hammering around with a single drugDPP-4 inhibitors should not be used in patients with beta cell failure Metformin with Vildagliptin cover’s many unmet need

There is always a deficiency of GLP-1 in patients who are T2DM Therefore DPP-4 inhibitors should be considered in the treatment of any diabetic individual

Patients have become more latharic and are having a sedentary lifestyle

After metformin failure Sulphonyl Ureas are a better choice

DPP-4 inhibitors have provided a new dimension to the management of Diabetes

They give us an option that we should not go to the maximum permissible doses of Sulphonyl

Ureas and thus can reduce the incidence of side effects with SU

After 1980 more food is available to an average Indian and with the introduction of modern living exercise has been reduced tremendously

Hence the incidence of Diabetes are on the rise The treatment of any diabetic individual should

depend upon the weight of the patient A lean patient can be initiated with DPP-4

inhibitor’s or SU In case of Obese patients Metformin +

Vildagliptin make’s a good choice

Presence of Heavy Metals in water cause interference in the genetic structure hence their have been an increase in incidence of Metabolic Disorders

Metformin is the best drug to initiate but after Metformin failure its more advisable to add DPP-4 inhibitors so as not to trouble the beta cells which are already facing a crises situation

Glitazone’s can also be used but only under strict supervision

Diet and Lifestyle without any doubts play an undisputed role in the management of T2DM

After metformin failure addtion of SU is the next best alternative and if SU fail’s to response DPP-4 inhibitors have now come up as an option

Patients are now less resistant to the usage of Insulin

Lifestyle management utmost priority After glitazone controversy we should be

more careful to form any firm opinion about DPP-4 inhibitors

Their future looks bright and more data is awaited

Patients are still hesitant to use Insulin hence role of DPP-4 inhibitors is present in current therapy

Apart from Diabetes treatment hypertension treatment is also of prime importance in prevention of complications of T2DM

DPP-4 inhibitors have given results which were not expected by them

SU are still remains as the seconds option after Metformin failure

Cardio Vascular safety profile of the drug is showing good signs as an option to treat cardiomyopathy patients

Less risk of Hypo-glycemmia hence a good option for elderly population

More evidence awaited but initial reports are positive

Some Serious Discussion’s going on after the meeting

Every doctor who attended the meeting was satisfied with the content of the meeting and the direction which it took , but most important was the participation from every individual

The exact thought process of the doctors is now clear and will give a good direction to us

The doctors were most satisfied that they now have an idea as to the application of concepts by other’s in their clinical practice , as they hardly get any chance to interact with each other over academics

A Word of Thanks to Dr.Sanjiv Bhambani

Doctors who are using Galvus would now think in a different perspective as the usage is concerned Potential Non-Prescribers got a complete exposure to the product along with the points they were lacking

Core prescribers will now prescribe the product with more confidence and has helped to further enhance my business from them

A Complete Team EffortA Complete Team Effort

Time to PARTY