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Introduction: Despite the numerous advances achieved in diabetes control and evaluation, the management of this complex disease remains challenging. This study was conducted with the aim of determining the level of glycaemic control among adult patients with type 2 Diabetes mellitus. Method: The cross-sectional study was conducted in the diabetes care centers of the outpatient departments in Bangladesh. Adult patients with at least 2 years documented history of type 2 diabetes mellitus (T2DM) were recruited and data regarding the demographics, treatment they received and the level of glycaemic control was assessed. Result: A total of 5140 diabetic patients fulfilling the inclusions criteria were recruited for the study. 9.90% of the patients were below 40 years of age and the majority (64.05%) of the respondents were from urban communities. Based on HbA1c levels, only 18.8% of the patients had good glycaemic control. Gender, educational level and the income seem to have a relationship with the level of glycaemic control. Conclusion: Despite the medical advances in the management of diabetes, the glycaemic control of the majority (81.2%) of the T2DM patients are still very poor.

Aim In Bangladesh, there is a large population of Muslims with type 2 diabetes mellitus (T2DM) who fast during Ramadan. Changes in the pattern of meal and fluid intake during this long-fasting hours may increase the risk of hypoglycaemia, hyperglycaemia, and dehydration. Our key point of focus was to evaluate the efficacy and safety of Empagliflozin, a sodium-glucose co transporter 2 inhibitor (SGLT2i), in patients with T2DM while fasting during Ramadan. Methods This was a 24-weeks, multi-centre, open-label, two-arm parallel-group study. In this prospective type of observational study, we enrolled patients taking Empagliflozin and Metformin with or without a DPP-4 inhibitor in one group (n = 274) and a parallel group (n = 219) who were treated with Metformin with or without a DPP-4 inhibitor. The primary endpoint of this study was HbA1c reduction, weight loss and the number of reported or symptomatic hypoglycemic events. In secondary endpoints, we evaluated the changes from baseline in blood pressure, estimated glomerular filtration rate (eGFR), serum creatinine, and serum electrolyte, the proportion of volume depletion (≥1 event) and incidence of other adverse events (AEs) of interest potentially related to SGLT2 inhibitor. Results During Ramadan, HbA1c reduction was significant in Empagliflozin arm (−0.49% vs −0.12%); [p < 0.001]. From before to the end of the study, significant weight reduction was seen in the Empagliflozin arm (−1.4 kg vs −0.09 kg); [p < 0.001]. We observed no significant increase in the incidence of hypoglycemia (0.7% vs 0.4%, p = 0.267) and volume depletion (2.6% vs 1.8%; p = 0.55) in both arm. All these milder forms events did not require any hospital admission. There was no report of serious adverse events or any discontinuation, or reduction of prescribed doses of empagliflozin during Ramadan. Conclusion Empagliflozin is efficacious and safe for treating adults with T2DM during Ramadan.

The covid-19 pandemic caused the elimination of all activities that are usually carried out by almost everyone in the world, especially learning activities at various levels.  Based on the Higher Education Law number 12 of 2012, article 31 concerning Distance Education (PJJ) is a learning process that is carried out remotely through the use of various communication and information media.  Therefore, since the covid outbreak, distance education is now widely applied in the learning process almost all over the world.  This study aims to determine the application of distance education in SIDH Netherlands and SIKL Malaysia during the pandemic, and to find out the obstacles in the application of distance education in SIDH Netherlands and SIKL Malaysia during the pandemic.  The method used in this research is descriptive qualitative method.  Data collection techniques in this study using interview techniques.  The results of the study state that SIDH in the Netherlands and SIKL Malaysia have implemented the PJJ (Distance Education) system since 2008, with Distance Learning being used to do this, automatically during this pandemic, students are not surprised by the online learning provided.  teachers (educators), but there are also some obstacles faced during the teaching and learning process during the pandemic.  Whereas in SIKL Malaysia, distance education was implemented when there was covid-19, so all students study at their respective homes.  In its application, there are several obstacles in the learning process, one of which is signal constraints. The teachers from the two scools have coshen the best method for their students so that learning can be carried out optimally. And it is hoped that in learning to apply health protocols so that students and teacherscan carry out learning activities comfortably.

Background:The year 2020 witnessed a largely unprecedented pandemic of coronavirus disease , caused by SARS COV-2. Many people with COVID-19 have comorbidities, including diabetes, hypertension and cardiovascular diseases, which are significantly associated with worse outcomes. Moreover, COVID-19 itself is allied with deteriorating hyperglycemia. Therefore, Bangladesh Endocrine Society has formulated some practical recommendations for management of diabetes and other endocrine diseases in patients with COVID-19 for use in both primary and specialist care settings. Objective: The objective of the article is to develop a guideline to protect the vulnerable group with utmost preference -the elderly and those with comorbid conditions. Therefore, to ensure the adequate protective measures and timely treatment for COVID-19 patients with diabetes, other endocrine diseases or any other comorbidities. Considering and Monitoring Issues:• The risk of a fatal outcome from COVID-19 may be up to 50% higher in patients with diabetes than in non-diabetics. • Patients with diabetes and COVID had CFR 7.3-9.2%, compared with 0.9-1.4% in patients without comorbidities. • Diabetic ketoacidosis may be one of the causes of mortality in COVID-19.• There is wide fluctuation of blood glucose in these patients, probably due to irregular diet, reduced exercise, increased glucocorticoids secretion, and use of glucocorticoids. • HbA1c should be <7.0% for the majority of the patients, this target may be relaxed in appropriate clinical settings. • More emphasis should be given on day-to-day blood glucose levels. Hypoglycemia (<3.9 mmol/l) must be avoided. • Frequent monitoring of blood glucose is needed in critically ill patients. Conclusion:The fight against COVID-19 has been proven to be a challenging one. Therefore, all healthcare personnel should make the best use of updated knowledge and skills to ensure adequate protective measures and timely treatment for COVID-19 patients with diabetes, other endocrine diseases or any other comorbidities.