ABSTRACT:
Definition of control as a reduction in the incidence, prevalence, morbidity or mortality of an disease to a locally acceptable level.
Type 2 Diabetes is a simple and Chronic disorder rather than a Serious disease(To me if Controlled).Common diseases like Heart Diseases, Type 2 Disease, Obesity do not have a genetic cause rather than multiple genetic cause in combination of life style modification and environmental factors. My slogan is Control diabetes is not a disease but Uncontrolled diabetes is a Disease.
Definition of Simple Disease is " Disease may apply generally to any deviation of the body from its normal or healthy state, or it may refer to a particular disorder with a specific cause and characteristic symptoms; , malady usually refers to a deep-seated chronic disease, frequently one that is ultimately fatal; , ailment refers to a mild, chronic disorder.
simple definition: 1. easy to understand or do; not difficult, presenting no difficulty, uncomplicated in form, nature (If kept Under Controlled).There are 40Pathies in Diabetes. I declare that No Pathy if Blood sugar kept under Control. I have given
my Idea No Retinopathy, Neuropathy etc if Blood sugar kept under Control with "Nutritious diet". No cure has yet been found for the disease; however, treatment modalities include lifestyle modifications, treatment of obesity, oral hypoglycaemic agents, and insulin sensitizers like metformin, a biguanide that reduces insulin resistance, is still the recommended first line medication especially for obese patients. Other effective medications include non-sulfonylurea secretagogues, thiazolidinediones, alpha glucosidase inhibitors, and insulin.
I do not agree with ADA-EASD Guideline. I have tried with Insulin Degludec,SGLT-2,GLP analogue due to Very Cost effective ,serious side effects like Hypoglycemia,Serious Mycotic Infection with Gangrene, developing cancer.
Keywords: Type 2 diabetes mellitus, Diagnosis, Management, Newer drugs Vs Older simple drugs.
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INTRODUCTION:
Diabetes mellitus (DM) is probably one of the oldest diseases known to man. Type 2 DM (formerly known as non-insulin dependent DM) is the most common form of DM characterized by hyperglycemias, insulin resistance, and relative insulin deficiency. Type 2 DM results from interaction between genetic, environmental, Nutritional and behavioural risk factors. living with type 2 DM are more vulnerable to various forms of both short- and long-term complications, Insidious onset and late recognition, especially in resource-poor developing countries, Wrong diet plan(My View) example advising Mango, Orange which I differed rather Even I used advise "Stop sugar based Fruits even Apple,Pumpgrnate,grapes,Banana,Orange,Jagery" .I used to compare Apple Vs Tomato. Even I am having 21 Years of Diabetes Even I have never taken "one Apple "But I am Physically ,Mentally and Sexually sound. My HBA1C is always 5.7 to 5.9.I used advice One Guava weekly once, Avocado Regularly,8(4+4)Almonds,Walnuts,Strawberry. Treatment for type 2 diabetes includes monitoring your blood sugar levels and using medications or insulin when needed .I recommend losing weight through diet and exercise that is VLCD(Very Low Calorie Diet) with My Diet Plan. All of My Patient having HBA1C between 5.7 to 6.2.With my diet plan all patient to come first 3month.If FBS,PPBS,HBA1C,Lipid Profile,LFT,KFT and Eye Test (Fundoscopy) is within normal. I used to tell them come Every two Consecutive 6 Months. If it is Normal. Then I used to Do the test in Their Place with those test if It is normal or HBA1C Less than 5.5.I used to reduce my drugs.
EARLY INSULIN THERAPY I DIFFERED IN TYPE II DIABETESI am requesting all the physician of the world not to start insulin initially in type ii diabetes as EIT I deferred as because:-(1)Insulin Word makes a patient panic(2)Hypoglycaemia(3)Obesity(4)Insulin Resistance(5)All most 90% Patients are under OHD. Even i am taking for last 17years with triple combination. My HBA1C 5.7 to 5.8(6)INCREASE IN TG LEVEL(7)INSULIN VS OHD BETA CELL FAILURE NO EFFECT.(8) Insulin may increase ESRD risk in type 2 diabetes, study finds(VERY IMPORTANT)Type 2 diabetes patients who were insulin users had an increased risk of end-stage renal disease, regardless of their A1C levels, compared with those not taking the drug, according to a study presented at an American Society of study shows.
I do not agree about life expectancy 10-20years. I used to advice a Controlled Type 2 Diabetes will live longer than a Non-Diabetic. Thus I do not agree with It is a Progressive Disease rather than a Nutritional and Environmental Disorder.

Epidemiology
It is estimated that 366 million people had DM in 2011; by 2030 this would have risen to 552 million. But my View it can be reduce by My Medications like simple drug like Glimiperide,Metformin,Voglibose,Pioglitazone(Cardio-Reno-Hepato-Neuro protective),and teneligliptin,Vildagliptin. along with my VLCD and My Diet Plan. No newer drug or Insulin I have given Only 1.5% needs Insulin.Not Degludac (ultralong-acting basal insulin analogue ), SGLT2 inhibitors or Glucagon-like peptide-1 receptor agonists Which are cost effective and Produce another disease may be fatal. But in all type II diabetes I used to put on my Diet plan and VLCD.There is tremendous result. Firstly Medicines low cost, No panic for any serious side effects like Hypoglycemia,Serious Mycotic Infection with Gangrene, Pancreatitis or any cancer.
Pathophysiology:
Type 2 DM is characterized by insulin insensitivity as a result of insulin resistance, declining insulin production, and eventual pancreatic beta-cell failure.In my View it can be reversible by Nutrition like taking Nutrition which Changes resistant Insulin to sensitive Insulin like Type 2 Diabetes Can get rid of Cardiovascular Risk not by GLP 1 OR SGLT-2 It can be achieved by Only Nutrition:-
1.Stop Polished rice(Lack of Beta Setosterol)
2.Avoid Oil(Dr Panda Prefers Olive Oil)
3.10Petals of Garlic ,One Onion per day. Garlic contains Allicin is thought to be the principal bioactive compound for prevention of cardiovascular and other metabolic diseases, atherosclerosis, hyperlipidemia, thrombosis, hypertension and diabetes.
4. Red bell peppers are rich in lycopene, thus making them excellent for a healthy heart whereas green bell peppers are a good source of cholesterol lowering fiber. Increased homocysteine levels can lead to a higher risk of heart disease. Bell peppers contain vitamin B6 and folate which help to lower homocysteine levels. In addition to these, the powerful antioxidants vitamins A and C present in these vegetables help to wipe out free radicals. Potassium contained in bell peppers lowers about 162 milligrams of blood pressure which is also beneficial for heart.
5.Curry Leaves (Murreya Koeniigi) Used as Antidiabetic drug and in CAD due to presence of Cinamaldehyde,Carbazole like Mahanimbin and girinimbin which produces Insulin and Converts Resistant Insulin to Sensitive Insulin. It clears the coronary artery blockade even it obliterates Calcification of Coronary artery. I do not agree it is an Progressive disease. How 30% Patients coming after years together with minimising my Drugs. My view it is "Nutritional and Environmental Disease.
Management:
Through lifestyle and diet modification diabetes can be reversed by VLCD,Simple Medications and eating high fibre and unsaturated fat and diet low in saturated and trans-fats and glycemic index, regular exercise, abstinence from smoking and moderate consumption of alcohol.
Summary: Type 2 Diabetes is a Simple Chronic Disease making Panic to Innocent Patient can be treated with simple drug like Glimiperide,Metformin,Voglibose,Pioglitazone(Cardio-Reno-Hepato-Neuro protective),and teneligliptin. Out of more than 1.5 Lakhs Patients I could successful about 98%.No newer drug or Insulin I have given Only 1.5% needs Insulin.
Not Degludac (ultralong-acting basal insulin analogue ), SGLT2 inhibitors or Glucagon-like peptide-1 receptor agonists Which are cost effective and Produce another disease may be fatal. But in all type II diabetes I used to put on my Diet plan and VLCD.There is tremendous result. Firstly Medicines low cost, No panic for any serious side effects like Hypoglycemia,Serious Mycotic Infection with Gangrene, Pancreatitis or any cancer .I do not agree to ADA-EASD Guideline.

Biography:
DR PREMANIDHI PANDA,M.D(MED),HON PhD IN DIABETES,MRCP,FRCP has completed his M.B.B.S at the age of 24 years from Berhampur University, India and postdoctoral studies,M.D(MED) from UTKALUniversity School of Medicine. He is the director of DR PANDA DIABETES INSTITUTE,INDIA, a premier DIABETES HOSPITAL CUM RESEARCH CENTRE,INDIA.He has worked in TISCO HOSPITAL,INDIA,BENGHAZI MEDICAL(LIBYA),MEDWIN HOSPITAL With Repute.He has been awarded as “INDIA’s BEST DOCTOR AWARD:-2013(DIABETES)” BY MEDGATE TODAY SURVEY.He Has been Awarded MRCP,FRCP BY ROYAL COLLEGE OF PHYSICIAN AND SURGEON. He has published more than 20 papers in reputed journals and serving as Director of DR PANDA DIABETES INSTITUTE,INDIA. He has been awarded several National & International awards contribution in diabetes.