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Bigdeli M, Jacobs B, Men CR, Nilsen K, Van Damme W, Dujardin B. Access to Treatment for Diabetes and Hypertension in Rural Cambodia: Performance of Existing Social Health Protection Schemes. PLoS One 2016; 11:e0146147. [PMID: 26815916 PMCID: PMC4729435 DOI: 10.1371/journal.pone.0146147] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 12/13/2015] [Indexed: 12/25/2022] Open
Abstract
Background Non-communicable diseases (NCD) pose challenges to Cambodia’s health system. Medicines for NCD are on the National Essential Medicines List but no clinical guidelines support their utilization. Two social health protection schemes aimed at the informal sector population exist (Health Equity Funds and Insurance) together with two disease-specific interventions (a Peer Educator Network and Chronic Diseases Clinics) targeted at NCD patients. This study examines performance of these various schemes in relation to NCD. Methods Cross-sectional household survey among 709 individuals self-reporting diabetes and/or hypertension in three geographical locations in rural Cambodia using a structured questionnaire investigating diagnostic and treatment pathways, health seeking behaviour, health expenditures, and financial coping mechanisms. Results Two third of respondents with NCD were female and 55% did not belong to any scheme. The majority (59%) were diagnosed in the private sector and only 56% were on allopathic treatment that was mainly sought in the private sector (49%). Outpatient treatment cost was higher in the private sector and when using multiple providers of care. The majority were indebted, 11% due to health-related expenses. Contrary to social health protection schemes, disease-specific interventions offered better access to allopathic treatment and provided medicines in accordance with NEML. Conclusion The benefit packages of existing social health protection schemes and services in the public health sector should be adjusted to cater for the needs of people living with NCD in rural Cambodia. Initiatives that offer active disease management strategies and promote patients and community participation appear more successful in increasing treatment adherence and decreasing the risk of financial hardship.
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Affiliation(s)
- Maryam Bigdeli
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
- * E-mail:
| | - Bart Jacobs
- Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Phnom Penh, Cambodia
| | | | - Kristine Nilsen
- Department of Social Statistics and Demography, University of Southampton, Southampton, United Kingdom
| | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bruno Dujardin
- Centre de Recherches en Politiques et Systèmes de Santé, Santé Internationale, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
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Hilliard ME, Oser SM, Close KL, Liu NF, Hood KK, Anderson BJ. From Individuals to International Policy: Achievements and Ongoing Needs in Diabetes Advocacy. Curr Diab Rep 2015; 15:59. [PMID: 26194156 PMCID: PMC4581582 DOI: 10.1007/s11892-015-0636-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Diabetes impacts tens of millions of people in the United States of America and 9 % of the worldwide population. Given the public health implications and economic burden of diabetes, the needs of people with diabetes must be addressed through strategic and effective advocacy efforts. Diabetes advocacy aims to increase public awareness about diabetes, raise funds for research and care, influence policy impacting people with diabetes, and promote optimal individual outcomes. We present a framework for diabetes advocacy activities by individuals and at the community, national, and international levels and identify challenges and gaps in current diabetes advocacy. Various groups have organized successful diabetes advocacy campaigns toward these goals, and lessons for further advancing diabetes advocacy can be learned from other health-related populations. Finally, we discuss the role of healthcare providers and mental/behavioral health professionals in advocacy efforts that can benefit their patients and the broader population of people with diabetes.
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Affiliation(s)
- Marisa E. Hilliard
- Baylor College of Medicine, 1102 Bates Avenue, Suite 940, Houston, TX 77030, USA
| | - Sean M. Oser
- Pennsylvania State University College of Medicine, 500 University Drive, HP-21, Hershey, PA 17033, USA
| | - Kelly L. Close
- The diaTribe Foundation, 804 Haight Street, San Francisco, CA 94117, USA
| | - Nancy F. Liu
- The diaTribe Foundation, 804 Haight Street, San Francisco, CA 94117, USA
| | - Korey K. Hood
- Stanford University School of Medicine, 780 Welch Road, MC 5208, Palo Alto, CA 94305-5208, USA
| | - Barbara J. Anderson
- Baylor College of Medicine, 1102 Bates Avenue, Suite 940, Houston, TX 77030, USA
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Seuring T, Archangelidi O, Suhrcke M. The Economic Costs of Type 2 Diabetes: A Global Systematic Review. PHARMACOECONOMICS 2015; 33:811-31. [PMID: 25787932 PMCID: PMC4519633 DOI: 10.1007/s40273-015-0268-9] [Citation(s) in RCA: 480] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND There has been a widely documented and recognized increase in diabetes prevalence, not only in high-income countries (HICs) but also in low- and middle-income countries (LMICs), over recent decades. The economic burden associated with diabetes, especially in LMICs, is less clear. OBJECTIVE We provide a systematic review of the global evidence on the costs of type 2 diabetes. Our review seeks to update and considerably expand the previous major review of the costs of diabetes by capturing the evidence on overall, direct and indirect costs of type 2 diabetes worldwide that has been published since 2001. In addition, we include a body of economic evidence that has hitherto been distinct from the cost-of-illness (COI) work, i.e. studies on the labour market impact of diabetes. METHODS We searched PubMed, EMBASE, EconLit and IBSS (without language restrictions) for studies assessing the economic burden of type 2 diabetes published from January 2001 to October 2014. Costs reported in the included studies were converted to international dollars ($) adjusted for 2011 values. Alongside the narrative synthesis and methodological review of the studies, we conduct an exploratory linear regression analysis, examining the factors behind the considerable heterogeneity in existing cost estimates between and within countries. RESULTS We identified 86 COI and 23 labour market studies. COI studies varied considerably both in methods and in cost estimates, with most studies not using a control group, though the use of either regression analysis or matching has increased. Direct costs were generally found to be higher than indirect costs. Direct costs ranged from $242 for a study on out-of-pocket expenditures in Mexico to $11,917 for a study on the cost of diabetes in the USA, while indirect costs ranged from $45 for Pakistan to $16,914 for the Bahamas. In LMICs-in stark contrast to HICs-a substantial part of the cost burden was attributed to patients via out-of-pocket treatment costs. Our regression analysis revealed that direct diabetes costs are closely and positively associated with a country's gross domestic product (GDP) per capita, and that the USA stood out as having particularly high costs, even after controlling for GDP per capita. Studies on the labour market impact of diabetes were almost exclusively confined to HICs and found strong adverse effects, particularly for male employment chances. Many of these studies also took into account the possible endogeneity of diabetes, which was not the case for COI studies. CONCLUSIONS The reviewed studies indicate a large economic burden of diabetes, most directly affecting patients in LMICs. The magnitude of the cost estimates differs considerably between and within countries, calling for the contextualization of the study results. Scope remains large for adding to the evidence base on labour market effects of diabetes in LMICs. Further, there is a need for future COI studies to incorporate more advanced statistical methods in their analysis to account for possible biases in the estimated costs.
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Affiliation(s)
- Till Seuring
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK,
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Van Olmen J, Marie KG, Christian D, Clovis KJ, Emery B, Maurits VP, Heang H, Kristien VA, Natalie E, François S, Guy K. Content, participants and outcomes of three diabetes care programmes in three low and middle income countries. Prim Care Diabetes 2015; 9:196-202. [PMID: 25281167 DOI: 10.1016/j.pcd.2014.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 08/13/2014] [Accepted: 09/08/2014] [Indexed: 01/02/2023]
Abstract
AIMS To improve access and quality of diabetes care for people in low-income countries, it is important to understand which elements of diabetes care are effective. This paper analyses three diabetes care programmes in the DR Congo, Cambodia and the Philippines. METHODS Three programmes offering diabetes care and self-management were selected. Programme information was collected through document review and interviews. Data about participants' characteristics, health outcomes, care utilisation, expenditures, care perception and self-management were extracted from a study database. Comparative univariate analyses were performed. RESULTS Kin-réseau (DR Congo) is an urban primary care network with 8000 patients. MoPoTsyo (Cambodia) is a community-based peer educator network, covering 7000 patients. FiLDCare (Philippines) is a programme in which 1000 patients receive care in a health facility and self-management support from a community health worker. Content of care of the programmes is comparable, the focus on self-management largest in MoPoTsyo. On average, Kin-réseau patients have a higher age, longer diabetes history and more overweight. MoPoTsyo includes most female, most illiterate and most lean patients. Health outcomes (HbA1C level, systolic blood pressure, diabetes foot lesions) were most favourable for MoPoTsyo patients. Diabetes-related health care expenditure was highest for FiLDCare patients. CONCLUSIONS This study shows it possible to maintain a diabetes programme with minimal external resources, offering care and self-management support. It also illustrates that health outcomes of persons with diabetes are determined by their bio-psycho-social characteristics and behaviour, which are each subject to the content of care and the approach to chronic illness and self-management of the programme, in turn influenced by the larger context.
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Affiliation(s)
- Josefien Van Olmen
- Institute of Tropical Medicine, Department of Public Health Antwerp, Belgium; Department of General Practice & Elderly Medicine, EMGO, Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Ku Grace Marie
- Institute of Tropical Medicine, Department of Public Health Antwerp, Belgium
| | | | | | - Bewa Emery
- Memisa, Kinshasa, People's Republic of Congo
| | | | | | - Van Acker Kristien
- Algemeen Ziekenhuis Heilige Familie, Reet & Centre de Santé des Fagnes, Chimay, Belgium
| | | | - Schellevis François
- Department of General Practice & Elderly Medicine, EMGO, Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; NIVEL (Netherlands Institute for Health Services Research), The Netherlands
| | - Kegels Guy
- Institute of Tropical Medicine, Department of Public Health Antwerp, Belgium
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Zhang X, Wang S, Li Y, Zhao D, An N, Wu J, Zhang T, Wu C, Li Y. Tadehaginoside modulates lipogenesis and glucose consumption in HepG2 cells. Nat Prod Res 2015; 29:2287-90. [DOI: 10.1080/14786419.2014.1001387] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Xiaopo Zhang
- School of Pharmaceutical Science, Hainan Medical University, Haikou 571101, P.R. China
| | - Shuai Wang
- Research Center on Life Sciences and Environmental Sciences, Harbin University of Commerce, Harbin 150076, P.R. China
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, P.R. China
| | - Yonghui Li
- School of Pharmaceutical Science, Hainan Medical University, Haikou 571101, P.R. China
| | - Dan Zhao
- School of Pharmaceutical Science, Hainan Medical University, Haikou 571101, P.R. China
- Research Center on Life Sciences and Environmental Sciences, Harbin University of Commerce, Harbin 150076, P.R. China
| | - Ni An
- School of Pharmaceutical Science, Hainan Medical University, Haikou 571101, P.R. China
- Research Center on Life Sciences and Environmental Sciences, Harbin University of Commerce, Harbin 150076, P.R. China
| | - Jiani Wu
- School of Pharmaceutical Science, Hainan Medical University, Haikou 571101, P.R. China
- Research Center on Life Sciences and Environmental Sciences, Harbin University of Commerce, Harbin 150076, P.R. China
| | - Tingting Zhang
- School of Pharmaceutical Science, Hainan Medical University, Haikou 571101, P.R. China
| | - Chongming Wu
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, P.R. China
| | - Youbin Li
- School of Pharmaceutical Science, Hainan Medical University, Haikou 571101, P.R. China
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Zhang JX, Lee JU, Meltzer DO. Risk factors for cost-related medication non-adherence among older patients with diabetes. World J Diabetes 2014; 5:945-950. [PMID: 25512801 PMCID: PMC4265885 DOI: 10.4239/wjd.v5.i6.945] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 06/23/2014] [Accepted: 09/10/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To assess the risk factors for cost-related medication non-adherence (CRN) among older patients with diabetes in the United States.
METHODS: We used data from the 2010 Health and Retirement Study to assess risk factors for CRN including age, drug insurance coverage, nursing home residence, functional limitations, and frequency of hospitalization. CRN was self-reported. We conducted multivariate regression analysis to assess the effect of each risk factor.
RESULTS: Eight hundred and seventy-five (18%) of 4880 diabetes patients reported CRN. Age less than 65 years, lack of drug insurance coverage, and frequent hospitalization significantly increased risk for CRN. Limitation in both activities of daily living and instrumental activities of daily living were also generally associated with increased risk of CRN. Residence in a nursing home and Medicaid coverage significantly reduced risk.
CONCLUSION: These results suggest that expanding prescription coverage to uninsured, sicker, and community-dwelling individuals is likely to produce the largest decreases in CRN.
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Goryakin Y, Suhrcke M. The prevalence and determinants of catastrophic health expenditures attributable to non-communicable diseases in low- and middle-income countries: a methodological commentary. Int J Equity Health 2014; 13:107. [PMID: 25376485 PMCID: PMC4228103 DOI: 10.1186/s12939-014-0107-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 10/20/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs), while traditionally considered a "rich world"-problem, have been spreading fast in low and middle income countries and by now account for a large share of mortality and ill-health in these countries, too. In addition to the disease burden, NCDs may also impose a substantial economic cost. One way in which NCDs might impact people's economic well-being may be via the out-of-pocket expenditures required to cover treatment and other costs associated with suffering from an NCD. METHODS In this commentary, we identify and discuss the methodological challenges related to cross-country comparison of-out-of-pocket and catastrophic out-of-pocket health care expenditures, attributable to NCDs, focussing on low and middle income countries. RESULTS There is significant evidence of substantial cost burden placed by NCDs on patients living in low and middle income countries, with most of it being heavily concentrated among low socioeconomic status groups. However, a large variation in definition of COOPE between studies prevents cross-country comparison. In addition, as most studies tend to be observational, causal inferences are often not possible. This is further complicated by the cross-sectional nature of studies, small sample sizes, and/or limited duration of follow-up of patients. Most evidence for certain conditions (e.g., cancer) tends to be collected in high-income countries only. CONCLUSIONS The definitions for COOPEs should be standardized as much as possible, to enable comparison of COOPE prevalence between countries. Prospective study design using larger samples representative of broader sections of local population, collecting better data on both direct and indirect treatment costs is also needed.
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Affiliation(s)
- Yevgeniy Goryakin
- Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK. .,UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, Cambridge, UK.
| | - Marc Suhrcke
- Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK. .,UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, Cambridge, UK. .,Centre for Health Economics, University of York, York, UK.
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Saito E, Gilmour S, Rahman MM, Gautam GS, Shrestha PK, Shibuya K. Catastrophic household expenditure on health in Nepal: a cross-sectional survey. Bull World Health Organ 2014; 92:760-7. [PMID: 25378730 PMCID: PMC4208475 DOI: 10.2471/blt.13.126615] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 06/01/2014] [Accepted: 06/18/2014] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine the incidence of - and illnesses commonly associated with - catastrophic household expenditure on health in Nepal. METHODS We did a cross-sectional population-based survey in five municipalities of Kathmandu Valley between November 2011 and January 2012. For each household surveyed, out-of-pocket spending on health in the previous 30 days that exceeded 10% of the household's total expenditure over the same period was considered to be catastrophic. We estimated the incidence and intensity of catastrophic health expenditure. We identified the illnesses most commonly associated with such expenditure using a Poisson regression model and assessed the distribution of expenditure by economic quintile of households using the concentration index. FINDINGS Overall, 284 of the 1997 households studied in Kathmandu, i.e. 13.8% after adjustment by sampling weight, reported catastrophic health expenditure in the 30 days before the survey. After adjusting for confounders, this expenditure was found to be associated with injuries, particularly those resulting from road traffic accidents. Catastrophic expenditure by households in the poorest quintile were associated with at least one episode of diabetes, asthma or heart disease. CONCLUSION In an urban area of Nepal, catastrophic household expenditure on health was mostly associated with injuries and noncommunicable diseases such as diabetes and asthma. Throughout Nepal, interventions for the control and management of noncommunicable diseases and the prevention of road traffic accidents should be promoted. A phased introduction of health insurance should also reduce the incidence of catastrophic household expenditure.
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Affiliation(s)
- Eiko Saito
- Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Stuart Gilmour
- Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Md Mizanur Rahman
- Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Ghan Shyam Gautam
- Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH, Kathmandu, Nepal
| | | | - Kenji Shibuya
- Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
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Santos MABD, Ceretta LB, Réus GZ, Abelaira HM, Jornada LK, Schwalm MT, Neotti MV, Tomazzi CD, Gulbis KG, Ceretta RA, Quevedo J. Anxiety disorders are associated with quality of life impairment in patients with insulin-dependent type 2 diabetes: a case-control study. ACTA ACUST UNITED AC 2014; 36:298-304. [PMID: 25003555 DOI: 10.1590/1516-4446-2013-1230] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 01/23/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assess the presence of anxiety disorders and quality of life in patients with insulin-dependent type 2 diabetes. METHODS Case-control study of 996 patients with type 2 diabetes and 2,145 individuals without diabetes. The sole inclusion criterion for the case group was insulin-dependent type 2 diabetes. We compared the case and control groups for sociodemographic variables, laboratory and clinical data, and presence of anxiety disorders. Quality of life was evaluated using the WHOQOL-BREF instrument, and the prevalence of anxiety disorder was evaluated by the Mini International Neuropsychiatric Interview (MINI). RESULTS Patients with diabetes had a higher prevalence of generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder. The presence of these disorders in combination with type 2 diabetes was associated with worse quality of life in the physical, social, psychological, and environmental domains. CONCLUSIONS This study demonstrates the importance of diagnosing and treating anxiety disorders in patients with diabetes, so as to prevent more serious complications associated with these comorbidities.
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Affiliation(s)
- Maria Augusta B dos Santos
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Luciane B Ceretta
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Gislaine Z Réus
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Helena M Abelaira
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Luciano K Jornada
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | | | | | - Cristiane D Tomazzi
- Laboratory of Experimental Pathophysiology and National Science and Technology Institute for Translational Medicine (INCT-TM), UNESC, Criciúma, SC, Brazil
| | | | | | - João Quevedo
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
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Effect of fenugreek (Trigonella foenum-graecum L.) intake on glycemia: a meta-analysis of clinical trials. Nutr J 2014; 13:7. [PMID: 24438170 PMCID: PMC3901758 DOI: 10.1186/1475-2891-13-7] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 01/16/2014] [Indexed: 11/10/2022] Open
Abstract
Background and aim Fenugreek is a herb that is widely used in cooking and as a traditional medicine for diabetes in Asia. It has been shown to acutely lower postprandial glucose levels, but the long-term effect on glycemia remains uncertain. We systematically reviewed clinical trials of the effect of fenugreek intake on markers of glucose homeostasis. Methods PubMed, SCOPUS, the Cochrane Trials Registry, Web of Science, and BIOSIS were searched up to 29 Nov 2013 for trials of at least 1 week duration comparing intake of fenugreek seeds with a control intervention. Data on change in fasting blood glucose, 2 hour postload glucose, and HbA1c were pooled using random-effects models. Results A total of 10 trials were identified. Fenugreek significantly changed fasting blood glucose by -0.96 mmol/l (95% CI: -1.52, -0.40; I2 = 80%; 10 trials), 2 hour postload glucose by -2.19 mmol/l (95% CI: -3.19, -1.19; I2 = 71%; 7 trials) and HbA1c by -0.85% (95% CI: -1.49%, -0.22%; I2 = 0%; 3 trials) as compared with control interventions. The considerable heterogeneity in study results was partly explained by diabetes status and dose: significant effects on fasting and 2 hr glucose were only found for studies that administered medium or high doses of fenugreek in persons with diabetes. Most of the trials were of low methodological quality. Conclusions Results from clinical trials support beneficial effects of fenugreek seeds on glycemic control in persons with diabetes. However, trials with higher methodology quality using a well characterized fenugreek preparation of sufficient dose are needed to provide more conclusive evidence.
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Modulation of lipogenesis and glucose consumption in HepG2 cells and C2C12 myotubes by sophoricoside. Molecules 2013; 18:15624-35. [PMID: 24352018 PMCID: PMC6270613 DOI: 10.3390/molecules181215624] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 12/05/2013] [Accepted: 12/06/2013] [Indexed: 12/28/2022] Open
Abstract
Sophoricoside, an isoflavone glycoside isolated from Sophora japonica (Leguminosae), has been widely reported as an immunomodulator. In this study, the effects of sophoricoside on lipogenesis and glucose consumption in HepG2 cells and C2C12 myotubes were investigated. Treatment with sophoricoside at concentrations of 1-10 μM inhibited lipid accumulation in HepG2 cells in a dose-dependent manner. At the same concentration range, no effect on cell viability was observed in the MTT assay. Inhibition of lipogenesis was associated with the downregulation of SREBP-1a, SREBP-1c, SREBP-2 and their downstream target genes (FAS, ACC, HMGR) as revealed by realtime quantitative PCR. The lipid-lowering effect was mediated via the phosphorylation of AMPK. Further investigation of the activities of this isoflavone showed that sophoricoside has the capability to increase glucose uptake by C2C12 myotubes. It also effectively inhibited the activities of α-glucosidase and α-amylase in vitro and remarkably lowered postprandial hyperglycaemia in starch-loaded C57BL6/J mice. These results suggest that sophoricoside is an effective regulator of lipogenesis and glucose consumption and may find utility in the treatment of obesity and type 2 diabetes.
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Kengne AP, June-Rose McHiza Z, Amoah AGB, Mbanya JC. Cardiovascular diseases and diabetes as economic and developmental challenges in Africa. Prog Cardiovasc Dis 2013; 56:302-13. [PMID: 24267437 DOI: 10.1016/j.pcad.2013.10.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Current estimates and projections suggest that the burden of cardiovascular diseases (CVDs), diabetes and related risk factors in African countries is important, somewhat unique and rapidly growing. Various segments of the population are affected; however, the group mostly affected is young adults residing in urban areas, and increasingly those in the low socioeconomic strata. The African milieu/environment is compounded by weak health systems, which are unable to cope with the looming double burden of communicable and chronic non-communicable diseases. This review discusses the economic and developmental challenges posed by CVDs and diabetes in countries in Africa. Using several lines of evidence, we demonstrate that the cost of care for major CVDs and diabetes is beyond the coping capacities of individuals, households, families and governments in most African countries. We have reviewed modeling studies by the International Diabetes Federation (IDF) and other major international agencies on the current and projected impact that CVDs and diabetes have on the economy and development of countries in the region. Locally, appropriate strategies to limit the impact of the conditions on the economies and development of countries in Africa are suggested and discussed. These include monitoring diseases and risk factors, and primordial, primary and secondary preventions implemented following a life-course perspective. Structural, logistic, human capacity and organizational challenges to be surmounted during the implementations of these strategies will be reviewed.
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Affiliation(s)
- Andre Pascal Kengne
- South African Medical Research Council & University of Cape Town, Cape Town, South Africa; The George Institute for Global Health, Sydney, Australia; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
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Dyer SJ, Sherwood K, McIntyre D, Ataguba JE. Catastrophic payment for assisted reproduction techniques with conventional ovarian stimulation in the public health sector of South Africa: frequency and coping strategies. Hum Reprod 2013; 28:2755-64. [DOI: 10.1093/humrep/det290] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Liu Y, Cao DL, Guo LB, Guo SN, Xu JK, Zhuang HF. Amniotic stem cell transplantation therapy for type 1 diabetes: A case report. J Int Med Res 2013; 41:1370-7. [PMID: 23828649 DOI: 10.1177/0300060513487640] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
This case report presents an evaluation of the clinical effects of an allogeneic amniotic cell transplant for the treatment of type 1 diabetes mellitus. A 26-year-old man with type 1 diabetes was treated with stem cells isolated from his neonatal son’s amniotic membrane, collected at birth (2 × 107 cells). The cells, which expressed high levels of cluster of differentiation (CD) 133 and CD34 as assessed by flow cytometry, were infused into the pancreatic dorsal artery through the left femoral artery. The main study outcome was the change in exogenous insulin requirements, which began to decrease 3 days after transplantation. At 3 months post-transplantation, the patient was insulin independent and remained so for 6.2 months. During a 36-month follow-up, the patient’s blood glucose remained under control and insulin treatment was readjusted to a dosage of 8 IU/day. These preliminary data suggest that amniotic membrane stem cell transplantation can improve islet-cell function in response to glucose in vivo, although an alternative explanation (such as a honeymoon period due to reduced glucose toxicity) also has to be considered.
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Affiliation(s)
- Ying Liu
- Stem Cell Clinical Application Centre, Siping Central Hospital, Siping, Jilin Province, China
- Jilin Zhongke Bioengineering Company Ltd, Changchun, Jilin Province, China
| | - Dong-Lin Cao
- Department of Laboratory Medicine, Provincial People’s Hospital, Guangzhou, Guangdong Province, China
| | - Li-Bin Guo
- Stem Cell Clinical Application Centre, Siping Central Hospital, Siping, Jilin Province, China
| | - Sheng-Nan Guo
- Stem Cell Clinical Application Centre, Siping Central Hospital, Siping, Jilin Province, China
| | - Jin-Kai Xu
- Stem Cell Clinical Application Centre, Siping Central Hospital, Siping, Jilin Province, China
| | - Hong-Feng Zhuang
- Stem Cell Clinical Application Centre, Siping Central Hospital, Siping, Jilin Province, China
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Lipska KJ, Beran D. WITHDRAWN: Promoting the use of DPP-4 inhibitors in Asia. Diabetes Res Clin Pract 2012:S0168-8227(12)00141-6. [PMID: 22572104 DOI: 10.1016/j.diabres.2012.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 04/16/2012] [Indexed: 11/30/2022]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
- Kasia J Lipska
- Fogarty International Clinical Research Fellow, Public Health Foundation of India (PHFI), New Delhi, India; Section of Endocrinology, Yale University School of Medicine, New Haven, CT, USA.
| | - David Beran
- University of Geneva, Faculty of Medicine, Division of International and Humanitarian Medicine, Rue Gabrielle-Perret-Gentil 6, 1211 Geneva 14, Switzerland
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