Dr.Jothydev A cardiodiabetes CME was conducted last evening at Muthoot Plaza, Trivandrum. More than 50 doctors participated. Chair: Dr.Madhusudanan (Rtd.Prof. of Medicine) Speakers: Dr.Bahulayen C.G (Cardiologist), Dr.Jothydev Kesavadev - Changing perceptions on Insulin therapy: The era of analogue insulins (Diabetologist) Some points of Public interest: Heart attacks have become the major cause of premature death in diabetics. Many a time a silent heart attack is diagnosed during the time a routine ECG is taken.The patient despite the fact he has no symptoms has to undergo further tests like angiogram so as to prevent sudden deaths, cautioned Dr.Bahulayen. Not only diabetes, even subjects with prediabetes are now recognized as having a higher chance for death due to heart attacks and strokes, said Dr.Jothydev. Prediabetes subjects are apparently healthy individuals with so called 'normal' sugars.In such subjects correction of excess body weight, blood pressure and lipids helps a lot to prevent further progression to diabetes.In treatment of diabetes there are three major components: correction of raised blood pressure even if minimally raised, correction of cholesterol with drugs even when it is minimal elevation because of potential benefits. The third component is blood sugar normalisation, which is the most difficult part because of the phenomenon of glucose "excursions". Even in USA more than 50% on regular medications fail to achieve sugar control but blood pressure and cholesterol targets are more easily achieved!! Jothydev Kesavadev pointed out that average A1c levels(average of 3 months blood sugar) have no normal cut off limits, because even in healthy subjects with no diabetes, minimal elevations of A1c predicts future occurrence of heart diseases and strokes.Newer insulins helps sustain normal sugars without fear of low sugars.Jothydev said that globally inhaled route of administration of insulins met with commercial failure due to difficulties using this equipment ; though found to be absolutely safe and effective and hence research in this direction has stopped.Basal insulins should be started early enough in diabetes with an aim to prevent devastating future complications of diabetes. The CME was followed by active interaction by audience.Prof.Dr.K A Kumar stressed the importance of metabolic memory and its realization by both physicians and patients. Seen in the pictures are Dr.KSS Nair, Dr.Ramesan Pillai, Dr.Chacko Varghese, Dr.Titus,Dr.Murukesan, Dr.Balachandran, Dr.Devin Prabhakar, Dr.Vivekkrishnan, Dr.Lekha, Dr.Ajith kumar, Dr.Abraham Philip, Dr.Hari etc., The program was organised by Aventis.