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Powers MA, Bardsley JK, Cypress M, Funnell MM, Harms D, Hess-Fischl A, Hooks B, Isaacs D, Mandel ED, Maryniuk MD, Norton A, Rinker J, Siminerio LM, Uelmen S. Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Sci Diabetes Self Manag Care 2021; 47:54-73. [PMID: 34078207 DOI: 10.1177/0145721720987936] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Joan K Bardsley
- Medstar Health Research Institute, MedStar Diabetes Institute and MedStar Health System Nursing, Hyattsville, Maryland
| | | | | | - Dixie Harms
- MercyOne Clive Internal Medicine, Clive, Iowa
| | - Amy Hess-Fischl
- Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, University of Chicago, Chicago, Illinois
| | | | - Diana Isaacs
- Cleveland Clinic Diabetes Center, Cleveland, Ohio
| | | | | | | | - Joanne Rinker
- Association of Diabetes Care & Education Specialists, Chicago, Illinois
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Pascual Fuster V, Pérez Pérez A, Carretero Gómez J, Caixàs Pedragós A, Gómez-Huelgas R, Pérez-Martínez P. Executive summary: Updates to the dietary treatment of prediabetes and type 2 diabetes mellitus. Rev Clin Esp 2021; 221:169-179. [PMID: 33998467 DOI: 10.1016/j.rceng.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/26/2020] [Indexed: 11/26/2022]
Abstract
Adequate lifestyle changes significantly reduce the cardiovascular risk factors associated with prediabetes and type 2 diabetes mellitus. Therefore, healthy eating habits, regular physical activity, abstaining from using tobacco, and good sleep hygiene are recommended for managing these conditions. There is solid evidence that diets that are plant-based; low in saturated fatty acids, cholesterol, and sodium; and high in fiber, potassium, and unsaturated fatty acids are beneficial and reduce the expression of cardiovascular risk factors in these subjects. In view of the foregoing, the Mediterranean diet, the DASH diet, a low-carbohydrate diet, and a vegan-vegetarian diet are of note. Additionally, the relationship between nutrition and these metabolic pathologies is fundamental in targeting efforts to prevent weight gain, reducing excess weight in the case of individuals with overweight or obesity; and personalizing treatment to promote patient empowerment. This document is the executive summary of an updated review that includes the main recommendations for improving dietary nutritional quality in people with prediabetes or type 2 diabetes mellitus. The full review is available on the webpages of the Spanish Society of Arteriosclerosis (SEA, for its initials in Spanish), the Spanish Diabetes Society (SED, for its initials in Spanish), and the Spanish Society of Internal Medicine (SEMI, for its initials in Spanish).
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Affiliation(s)
- V Pascual Fuster
- Centro de Salud Palleter, Universidad CEU-Cardenal Herrera, Castellón, Grupo de Trabajo Nutrición y Estilo de Vida, Sociedad Española de Arteriosclerosis (SEA), Spain
| | - A Pérez Pérez
- Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Sociedad Española de Diabetes (SED), Spain
| | - J Carretero Gómez
- Servicio Medicina Interna, Hospital Comarcal de Zafra, Badajoz. Grupo de Diabetes, Obesidad y Nutrición, Sociedad Española de Medicina Interna (SEMI), Spain
| | - A Caixàs Pedragós
- Servicio de Endocrinología y Nutrición, Hospital Universitari Parc Taulí. Departament de Medicina, Universitat Autònoma de Barcelona. Institut Investigació Innovació Parc Taulí (I3PT), Sabadell, Sociedad Española de Diabetes (SED), Spain
| | - R Gómez-Huelgas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Grupo de Diabetes, Obesidad y Nutrición, Sociedad Española de Medicina Interna (SEMI), Spain
| | - P Pérez-Martínez
- Unidad de Lípidos y Arterioesclerosis, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Córdoba, Universidad de Córdoba. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Grupo de Trabajo Nutrición y Estilo de Vida, Sociedad Española de Arteriosclerosis (SEA). Grupo de Diabetes, Obesidad y Nutrición, Sociedad Española de Medicina Interna (SEMI), Grupo de Educación para la Salud, Sociedad Española de Medicina Interna (SEMI), Spain.
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103
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Yuan C, Sun X, Liu Y, Wu J. The thyroid hormone levels and glucose and lipid metabolism in children with type 1 diabetes: a correlation analysis. Transl Pediatr 2021; 10:276-282. [PMID: 33708513 PMCID: PMC7944189 DOI: 10.21037/tp-20-204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is common in clinical setting, the relationship between thyroid hormone levels and glucose and lipid metabolism in patients with T1DM remains unclear. We attempted to analyze the correlation of thyroid hormone levels and blood glucose and lipid metabolism in children with normal thyroid function. METHODS Children with T1DM were selected, and 85 healthy children who underwent physical examinations in our hospital as control group. The characteristics and laboratory testing results were compared, the correlation of thyroid hormone levels with blood glucose and blood lipids was analyzed by Pearson correlation analysis. RESULTS A total of 167 participants were included. the low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), fasting blood glucose (FBG), and glycated hemoglobin (HbAlc) in T1DM patients were higher than those in healthy controls, while the high-density lipoprotein-cholesterol (HDL-C), thyroid stimulating hormone (TSH) and free triiodothyronine (FT3) in T1DM patients were lower than that of healthy children (all P<0.05). TSH was positively correlated with LDL-C (r=0.169, P=0.032), TC (r=0.182, P=0.017) and TG (r=0.197, P=0.008), negatively correlated with FBG (r=-0.196, P=0.023) and HbAlc (r=-0.328, P=0.002). FT3 was negatively correlated with TG (r=-0.182, P=0.011), FBG (r=-0.184, P=0.009) and HbAlc (r=-0.223, P=0.005). TG in the high TSH group and the middle TSH group is higher than that of low TSH group. However, FBG and HbAlc were lower than those in the low TSH group (all P<0.05). Compared with the low FT3 group, the TG, FBG and HbAlc decreased in the high and middle FT3 group (all P<0.05). CONCLUSIONS The serum TSH are closely associated with FT3 and glycolipid metabolism in children with T1DM, which may be the useful indicators to assess the severity of T1DM in clinical settings to provide insights into the management of T1DM.
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Affiliation(s)
- Chuanjie Yuan
- Department of Pediatric Endocrinology and Metabolism, West China Second Hospital of Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Xiaomei Sun
- Department of Pediatric Endocrinology and Metabolism, West China Second Hospital of Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Yin Liu
- Department of Pediatric Endocrinology and Metabolism, West China Second Hospital of Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Jin Wu
- Department of Pediatric Endocrinology and Metabolism, West China Second Hospital of Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
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104
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5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes-2021. Diabetes Care 2021; 44:S53-S72. [PMID: 33298416 DOI: 10.2337/dc21-s005] [Citation(s) in RCA: 169] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc21-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc21-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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105
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Martín-Payo R, Papín-Cano C, Fernández-Raigada RI, Santos-Granda MI, Cuesta M, González-Méndez X. Motiva.DM2 project. A pilot behavioral intervention on diet and exercise for individuals with type 2 diabetes mellitus. Diabetes Res Clin Pract 2021; 171:108579. [PMID: 33307132 DOI: 10.1016/j.diabres.2020.108579] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/28/2020] [Accepted: 11/20/2020] [Indexed: 02/08/2023]
Abstract
AIM The purpose of this study was to assess the efficacy of an educational intervention based on the Behavior Change Wheel (BCW) framework for individuals with type 2 diabetes mellitus (DM2) on dietary and exercise behavior in a Spanish region. METHODS A two-arm pilot research was developed. The intervention consisted of a 6-month period with guidelines and 4 in-person interventions. The outcome was changes in behaviors, motivation, competence, autonomy, social support to implement the recommendations, HbA1c, and body composition. RESULTS n = 111 patients were recruited. Individuals in the intervention experienced a significative improvement on adherence to dietary recommendations (+1.23; p = 0.026), exercise (+0.86; p = 0.001), and a decrease in HbA1c levels (-0.6%; p = 0.002) and BMI (-0.73; p < 0.001). CONCLUSION The intervention for DM2 individuals, based on the BCW framework, developed, and implemented by primary care nurses has been effective in improving the adherence to healthy eating, exercise, HbA1c levels, and body composition.
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Affiliation(s)
- R Martín-Payo
- Faculty of Medicine and Health Sciences, University of Oviedo, Spain; PRECAM Research Team, Health Research Institute of the Principality of Asturias, Spain.
| | - C Papín-Cano
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Spain; Health Service of the Principality of Asturias (Area 3), Spain
| | | | | | - M Cuesta
- Faculty of Psychology, University of Oviedo, Spain
| | - X González-Méndez
- Faculty of Medicine and Health Sciences, University of Oviedo, Spain; PRECAM Research Team, Health Research Institute of the Principality of Asturias, Spain; Health Service of the Principality of Asturias (Area 3), Spain
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106
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Sousa AA, Renke G, Leal A, Rassi MMB, Feuser CS, Cunha H, Silva FM, Arbex A. Current Evidence Regarding Low-carb Diets for The Metabolic Control of Type-2 Diabetes. Curr Diabetes Rev 2021; 17:e112220188254. [PMID: 33231159 DOI: 10.2174/1573399816666201123104358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 11/22/2022]
Abstract
The management of diabetes requires a medical nutrition therapy as an essential part of this treatment. There should be no "one-size-fits-all" eating pattern for different patient´s profiles with diabetes. It is clinically complex to suggest an ideal percentage of calories from carbohydrates, protein and lipids recommended for all patients with diabetes. Among the eating patterns that have shown beneficial effects on metabolic control of patients with type 2 diabetes is the lowcarb diet, since the carbohydrate ingestion is viewed as the most important determinant of postprandial glucose and insulin response. In this context, theoretically, it could make sense to reduce the daily amount of carbohydrates ingested, to achieve lower levels of HbA1c. There could be risks associated to this approach. The adherence to a low-carb diet is here also discussed. This narrative review shows on the current evidence for answering these questions regarding low-carb diet as a possible alternative eating pattern for type 2 diabetes.
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Affiliation(s)
- Adriana Andrade Sousa
- Department of Endocrinology IPEMED Medical School / AFYA Educational, São Paulo, Brazil
| | - Guilherme Renke
- Department of Endocrinology IPEMED Medical School / AFYA Educational, São Paulo, Brazil
| | - Aluysio Leal
- Department of Endocrinology IPEMED Medical School / AFYA Educational, São Paulo, Brazil
| | | | | | - Heber Cunha
- Department of Endocrinology IPEMED Medical School / AFYA Educational, São Paulo, Brazil
| | - Flávia Moraes Silva
- Department of Nutrition and Postgraduate Program in Nutrition Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Alberto Arbex
- Department of Endocrinology IPEMED Medical School / AFYA Educational, São Paulo, Brazil
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107
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Schiff R, Freill H, Hardy CN. Understanding Barriers to Implementing and Managing Therapeutic Diets for People Living with Chronic Kidney Disease in Remote Indigenous Communities. Curr Dev Nutr 2021; 5:nzaa175. [PMID: 33501402 PMCID: PMC7809360 DOI: 10.1093/cdn/nzaa175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/18/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022] Open
Abstract
Indigenous peoples in Canada, and globally, experience a disproportionate burden of chronic kidney disease (CKD) and end-stage renal disease (ESRD) ESRD patients in remote Indigenous communities might experience significant challenges in adhering to dietary guidelines. Much research has documented the poor quality, high cost, and limited availability of healthy foods in remote, Indigenous communities. Food quality and availability are poor in remote communities, indicating that persons with ESRD and CKD might have limited ability to adhere to dietary guidelines. This article reports on research designed to understand food-access barriers in remote First Nations for persons living with stage 4 and 5 CKD/ESRD. The study involved semi-structured interviews with 38 patients in remote communities. It concludes with some reflections on the significance of this issue in the context of dietetic practice.
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Affiliation(s)
- Rebecca Schiff
- Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | - Holly Freill
- Renal Department, Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Crystal N Hardy
- Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
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108
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Valenzuela Zamudio F, Segura Campos MR. Amaranth, quinoa and chia bioactive peptides: a comprehensive review on three ancient grains and their potential role in management and prevention of Type 2 diabetes. Crit Rev Food Sci Nutr 2020; 62:2707-2721. [PMID: 33305588 DOI: 10.1080/10408398.2020.1857683] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Worldwide prevalence of Type 2 Diabetes (T2D) has become a major concern with several implications for public health, economy, and social well-being, especially in developing countries. Conventional pharmacological management of T2D have proved effective, but possess underlying side effects, leading the scientific community to research alternative compounds that exert beneficial effects on current therapeutic targets of T2D. Bioactive peptides (BAPs) from food sources, have shown relative advantages in this matter, moreover, BAPs have proved to impart anti-diabetic activity through one or more mechanisms such as enzymatic inhibition of α-glucosidase, α-amylase and DPP-IV. Several plants and animal have been used as protein sources of anti-diabetic BAPs, in the sense of this matter, the pseudo-cereals amaranth and quinoa, along with the ancestral grain chia, have gained attention. Due, to their high protein content and balanced amino-acid composition, along with proved anti-diabetic features, the three seeds are top choices for the obtention of anti-diabetic BAPs. With a comprehensive overview of the most recent reported in silico and in vitro anti-diabetic studies in relation to biomarkers α-glucosidase, α-amylase and DPP-IV, the present review aims to examine the current knowledge of amaranth, quinoa and chia derived anti-diabetic BAPs and their effects on T2D therapeutic markers.
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109
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Outcomes of Culturally Tailored Dietary Intervention in the North African and Bangladeshi Diabetic Patients in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238932. [PMID: 33271775 PMCID: PMC7730264 DOI: 10.3390/ijerph17238932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 02/08/2023]
Abstract
Immigrants show higher adjusted diabetes prevalence than Italians, especially among South-East Asians followed by North and Sub-Saharan Africans. Diabetes progression is influenced by food behaviors, and diet control is a critical aspect in disease management. Food habits have many cultural and symbolic implications. Guidelines recommend that every patient should receive appropriate self-management education according to cultural and socioeconomic characteristics. This study aims to test whether a customized diet and transcultural mediator’s support can improve immigrants’ food habits. A pre-post quali-quantitative study was conducted among 20–79-year-old Bangladeshi and North African diabetic immigrants. The INMP transcultural mediator, an expert in the social and health care field, actively participates in clinical activity by decoding linguistic and cultural needs expressed by the foreigner patient. Five culturally tailored dietary profiles were designed according to international diabetes guidelines and adjusted to traditional food habits. Data were collected with two different semi-structured questionnaires. Changes in food consumption were assessed through McNemar’s test, while paired Wilcoxon Signed-Rank test was used to analyze pre and post intervention. Fifty-five patients were enrolled. At follow-up, cereals, meat, and potatoes intake significantly improved, and the number of adequate dietary habits for each patient increased significantly. Transcultural mediator support was 90% positively evaluated. Adherence to dietary control is favorably influenced by a transcultural intervention, which is based on clinical and socio-cultural criteria, in compliance with patient’s lifestyles.
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110
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Sikand G, Severson T. Top 10 dietary strategies for atherosclerotic cardiovascular risk reduction. Am J Prev Cardiol 2020; 4:100106. [PMID: 34327475 PMCID: PMC8315554 DOI: 10.1016/j.ajpc.2020.100106] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 01/30/2023] Open
Abstract
Poor dietary quality has surpassed all other mortality risk factors, accounting for 11 million deaths and half of CVD deaths globally. Implementation of current nutrition recommendations from the American Heart Association (AHA), American College of Cardiology (ACC) and the National Lipid Association (NLA) can markedly benefit the primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD). These include: 1) incorporate nutrition screening into medical visits; 2) refer patients to a registered dietitian nutritionist (RDN) for medical nutrition therapy, when appropriate, for prevention of ASCVD; 3) follow ACC/AHA Nutrition and Diet Recommendations for ASCVD prevention and management of overweight/obesity, type 2 diabetes and hypertension; 4) include NLA nutrition goals for optimizing low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) and reducing ASCVD risk; 5) utilize evidence-based heart-healthy eating patterns for improving cardiometabolic risk factors, dyslipidemia and ASCVD risk; 6) implement ACC/AHA/NLA nutrition and lifestyle recommendations for optimizing triglyceride levels; 7) understand the impact of saturated fats, trans fats, omega-3 and omega-6 polyunsaturated fats and monounsaturated fats on ASCVD risk; 8) limit excessive intake of dietary cholesterol for those with dyslipidemia, diabetes and at risk for heart failure; 9) include dietary adjuncts such as viscous fiber, plant sterols/stanols and probiotics; and 10) implement AHA/ACC and NLA physical activity recommendations for the optimization of lipids and prevention of ASCVD. Evidence on controversies pertaining to saturated fat, processed meat, red meat, intermittent fasting, low-carbohydrate/very-low-carbohydrate diets and caffeine are discussed.
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111
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Kim H, Son H. A Moderated-Mediation Model of the Relationship between Dietary Satisfaction and Fatigue in Older Adults with Diabetes: The Role of Meal Planning and Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8823. [PMID: 33261015 PMCID: PMC7729502 DOI: 10.3390/ijerph17238823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 01/12/2023]
Abstract
Little research has examined the pathways between psychological factors and fatigue in older adults with diabetes. This study explored the pathways between diet-related quality of life and depressive symptoms in predicting fatigue using a moderated-mediation model. A convenience sample of adults ≥65 years (n = 127) with diabetes completed a cross-sectional survey including measures of fatigue severity, diet-related quality of life, and depressive symptoms, and a moderated-mediation analysis assessed the relationships between them. Diet satisfaction was negatively related to fatigue, which was mediated by depressive symptoms. In the moderated-mediation model, diet satisfaction had a conditional effect on fatigue through the mediating effect of depressive symptoms, moderated by meal planning difficulty. At higher levels of perceived meal planning difficulty, lower diet satisfaction was indirectly associated with higher fatigue through depressive symptoms, but this pathway was non-significant at lower levels. Findings suggest that supportive care for diet therapy might improve psychological outcomes in older adults with diabetes, especially for those having difficulties with daily dietary practice. Meal planning difficulties in the dietary management of diabetes accompanied by low diet satisfaction may lead to negative psychological outcomes. Monitoring satisfaction and burdens associated with dietary practices could improve fatigue in this population.
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Affiliation(s)
- Hyerang Kim
- Department of Nursing Science, Howon University, 64 Howondae 3gil, Impi, Gunsan 54058, Jeollabuk-do, Korea;
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
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112
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Jacobsen SS, Vistisen D, Vilsbøll T, Bruun JM, Ewers B. The quality of dietary carbohydrate and fat is associated with better metabolic control in persons with type 1 and type 2 diabetes. Nutr J 2020; 19:125. [PMID: 33213464 PMCID: PMC7678058 DOI: 10.1186/s12937-020-00645-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 11/13/2020] [Indexed: 01/15/2023] Open
Abstract
Background Diet quality is generally poor in persons with diabetes and it is unknown whether this is associated with worse glycaemic control and atherogenic lipid profile. The aim was to examine diet quality in relation to important markers of metabolic control in adults with type 1 diabetes (T1D) and type 2 diabetes (T2D). Methods The study was cross-sectional and included 423 (49% females) persons with T1D and 339 (29% females) persons with T2D recruited from an outpatient diabetes clinic in Denmark. Data were collected from July 2014 to January 2015. Diet quality was assessed with a food frequency questionnaire to examine eight key dietary components (carbohydrates, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, added sugar, dietary fibre, fruit and vegetables). Clinical data assessing metabolic control (haemoglobin A1c (HbA1c), total cholesterol (total C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), systolic and diastolic blood pressure and body mass index were extracted from the electronic medical records. Results In T1D, higher intake of carbohydrates and added sugar was associated with higher HbA1c; higher fruit intake was associated with lower total C and LDL-C; and higher intake of carbohydrates and dietary fibre was associated with lower HDL-C. In T2D, higher intake of saturated fat was associated with higher total C; higher intake of added sugar was associated with higher LDL-C; and higher intake of polyunsaturated fat was associated with higher diastolic blood pressure. Conclusions In Danish adults with T1D and T2D, both the total intake and the quality of carbohydrates and fat were associated with an unfavourable glucose regulation and lipid profile. Thus, our findings support a constant focus on diet and emphasise the need for dietary support in people with diabetes to improve diet quality, metabolic control and possibly reduce cardiovascular risk.
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Affiliation(s)
- Sabine S Jacobsen
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 4, DK-2820, Gentofte, Denmark
| | - Dorte Vistisen
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 4, DK-2820, Gentofte, Denmark
| | - Tina Vilsbøll
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 4, DK-2820, Gentofte, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens M Bruun
- Steno Diabetes Center Aarhus, Aarhus, Denmark.,Department of Clinical Medicine, University of Aarhus, Aarhus, Denmark.,Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Bettina Ewers
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 4, DK-2820, Gentofte, Denmark.
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113
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Hawley JA, Sassone-Corsi P, Zierath JR. Chrono-nutrition for the prevention and treatment of obesity and type 2 diabetes: from mice to men. Diabetologia 2020; 63:2253-2259. [PMID: 32761356 DOI: 10.1007/s00125-020-05238-w] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022]
Abstract
The proliferation in the rate of diagnosis of obesity and type 2 diabetes mellitus continues unabated, with current recommendations for primary lifestyle changes (i.e. modification to dietary patterns) having a limited impact in reducing the incidence of these metabolic diseases. Part of the reason for the failure to alter nutritional practices is that current dietary recommendations may be unrealistic for the majority of adults. Indeed, round-the-clock access to energy-dense, nutrient-poor food makes long-term changes to dietary habits challenging. Hence, there is urgent need for innovations in the delivery of evidence-based diet interventions to rescue some of the deleterious effects on circadian biology induced by our modern-day lifestyle. With the growing appreciation that the duration over which food is consumed during a day has profound effects on numerous physiological and metabolic processes, we discuss dietary protocols that modify the timing of food intake to deliberately alter the feeding-fasting cycle. Such chrono-nutrition functions to optimise metabolism by timing nutrient intake to the acrophases of metabolic rhythms to improve whole-body insulin sensitivity and glycaemic control, and thereby positively impact metabolic health. Graphical abstract.
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Affiliation(s)
- John A Hawley
- Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, 3000, Australia.
| | - Paolo Sassone-Corsi
- INSERM U1233-Department of Biological Chemistry, Center for Epigenetics and Metabolism, School of Medicine, University of California, Irvine, CA, 92697, USA
| | - Juleen R Zierath
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
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Lower nocturnal blood glucose response to a potato-based mixed evening meal compared to rice in individuals with type 2 diabetes. Clin Nutr 2020; 40:2200-2209. [PMID: 33069511 DOI: 10.1016/j.clnu.2020.09.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/26/2020] [Accepted: 09/29/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND & AIMS Guidelines for reducing postprandial blood glucose concentrations include avoiding high glycemic index (GI) foods, such as white potatoes. However, GI testing is often undertaken in the morning with foods consumed in isolation by non-clinical cohorts. We investigated the impact of potato preparation and consumption as part of a mixed-evening meal on postprandial and nocturnal glycemic responses, and postprandial insulin response, in individuals with Type 2 Diabetes Mellitus (T2DM). METHODS In a randomized, cross-over design, 24 males and females (age 58.3 ± 9.3 y; BMI: 31.7 ± 6.8 kg/m2) with T2DM (diet or metformin controlled) completed four experimental trials after consuming a standardized breakfast (25% daily energy intake (EI)) and lunch (35% EI). Dinner (40% EI) was consumed at 1800 h being either: 1) boiled potato (BOIL); 2) roasted potato (ROAST); 3) boiled potato cooled for 24 h (COOLED); or 4) basmati rice (CONTROL). Each meal contained 50% carbohydrate, 30% fat and 20% protein. Blood samples were collected prior to, immediately post meal and at 30-min intervals for a further 120 min. A continuous glucose monitor was worn to assess nocturnal interstitial glucose concentrations. RESULTS No differences were detected in postprandial venous glucose area under the curve (iAUC) between CONTROL and all three potato conditions. Postprandial insulin iAUC was greater following COOLED compared to CONTROL (P = 0.003; 95% CI: 18.9-111.72 miU/mL). No significant differences between CONTROL and BOIL or ROAST were detected for postprandial insulin concentrations. All potato meals resulted in lower nocturnal glucose AUC than CONTROL (P < 0.001; 95% CI 4.15-15.67 mmol/L x h). CONCLUSION Compared to an isoenergetic rice meal, boiled, roasted or boiled then cooled potato-based meals were not associated with unfavourable postprandial glucose responses or nocturnal glycemic control, and can be considered suitable for individuals with T2DM when consumed as part of a mixed-evening meal. CLINICAL TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry https://www.anzctr.org.au/, ACTRN 12618000480280.
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Martínez MLR, Gómez-Díaz RA, González ALV, González RM, Becerra MCS, Rio SLGD, Cruz M, Wacher-Rodarte NH, Pacheco RAR, Aburto VHB. Association between glycemic control and dietary patterns in patients with type 2 diabetes in a Mexican institute. Nutrition 2020; 78:110901. [DOI: 10.1016/j.nut.2020.110901] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/02/2020] [Accepted: 05/27/2020] [Indexed: 01/30/2023]
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Abstract
Aims/Introduction Amid the coronavirus disease (COVID-19) pandemic, the Japanese government declared a state of emergency and urged people to stay at home to prevent disease transmission. Herein, we investigated this emergency situation’s effect on diabetes patients’ lifestyle and glycemic control Materials and methods Diabetes patients who visited our hospital between April 1 and June 13, 2020, for a regular consultation were asked about changes in their physical activities and dietary habits during the state of emergency period. Results Among 168 patients, 26 (15.5%) gained > 2 kg; HbA1c levels were elevated or decreased by > 0.2% compared to that at the last visit in 57 and 51 patients (Groups D and I), respectively. Group D patients were affected to a larger extent by changes in commuting (transition to teleworking) and closures of sport gyms than Group I patients. Increased snacks, sweets, total diet, and alcohol intake could have contributed to worsening of glucose control in Group D, whereas a healthy diet and less alcohol intake could have led to better glucose control in Group I. Conclusion During the state of emergency period, decreased physical activity levels negatively affected glycemic control. However, despite changes in physical activity level, maintaining or improving dietary habits could lead to better glycemic control in diabetes patients. During this COVID-19 pandemic, more diabetes patients are likely to shift to teleworking and stay home for longer periods. Therefore, we should develop effective and feasible measures to promote exercise and dietary therapy, especially for those who engage in teleworking.
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Berkowitz SA, Chang Y, Porneala B, Cromer SJ, Wexler DJ, Delahanty LM. Does the effect of lifestyle intervention for individuals with diabetes vary by food insecurity status? A preplanned subgroup analysis of the REAL HEALTH randomized clinical trial. BMJ Open Diabetes Res Care 2020; 8:8/1/e001514. [PMID: 32978121 PMCID: PMC7520816 DOI: 10.1136/bmjdrc-2020-001514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/21/2020] [Accepted: 08/13/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION We aimed to test the effectiveness of a lifestyle intervention (LI) for individuals with food insecurity and type 2 diabetes. RESEARCH DESIGN AND METHODS Adults with type 2 diabetes, body mass index ≥25 kg/m2 (or ≥23 kg/m2 if Asian), hemoglobin A1c of 6.5%-11.5% (48-97 mmol/mol) and who were willing to lose 5%-7% bodyweight were enrolled in REAL HEALTH-Diabetes. This practice-based randomized clinical trial compared LI (delivered inperson or by telephone) with medical nutrition therapy (MNT) on weight loss at 6 and 12 months. Two or more affirmative responses on the six-item US Department of Agriculture Food Security Survey Module indicated food insecurity. In this prespecified subgroup analysis, we tested using linear mixed effects models whether the intervention effect varied by food security status. RESULTS Of 208 participants, 13% were food insecure. Those with food insecurity were more likely to be racial/ethnic minorities (p<0.001) and have lower education (p<0.001). LI, versus MNT, led to greater weight loss at 6 months (5.1% lost vs 1.1% lost; p<0.0001) and 12 months (4.7% lost vs 2.0% lost; p=0.0005). The intervention effect was similar regardless of food security status (5.1% bodyweight lost vs 1.1% in food secure participants and 5.1% bodyweight lost vs 1.3% in food insecure participants at 6 months; 4.7% bodyweight lost vs 2.1% in food secure participants and 4.5% bodyweight lost vs 0.9% in food insecure participants at 12 months; p for interaction=0.99). CONCLUSIONS The REAL HEALTH-Diabetes lifestyle intervention led to meaningful weight loss for individuals with food insecurity and type 2 diabetes. TRIAL REGISTRATION NUMBER NCT02320253.
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Affiliation(s)
- Seth A Berkowitz
- Division of General Medicine & Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Yuchiao Chang
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Bianca Porneala
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sara J Cromer
- Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Deborah J Wexler
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Linda M Delahanty
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
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Effectiveness of Lifestyle Intervention for Type 2 Diabetes in Primary Care: the REAL HEALTH-Diabetes Randomized Clinical Trial. J Gen Intern Med 2020; 35:2637-2646. [PMID: 31965526 PMCID: PMC7458982 DOI: 10.1007/s11606-019-05629-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 12/20/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Intensive lifestyle interventions (LI) improve outcomes in obesity and type 2 diabetes but are not currently available in usual care. OBJECTIVE To compare the effectiveness and costs of two group LI programs, in-person LI and telephone conference call (telephone LI), to medical nutrition therapy (MNT) on weight loss in primary care patients with type 2 diabetes. DESIGN A randomized, assessor-blinded, practice-based clinical trial in three community health centers and one hospital-based practice affiliated with a single health system. PARTICIPANTS A total of 208 primary care patients with type 2 diabetes, HbA1c 6.5 to < 11.5, and BMI > 25 kg/m2 (> 23 kg/m2 in Asians). INTERVENTIONS Dietitian-delivered in-person or telephone group LI programs with medication management or MNT referral. MAIN MEASURES Primary outcome: mean percent weight change. SECONDARY OUTCOMES 5% and 10% weight loss, change in HbA1c, and cost per kilogram lost. KEY RESULTS Participants' mean age was 62 (SD 10) years, 45% were male, and 77% were White, with BMI 35 (SD 5) kg/m2 and HbA1c 7.7 (SD 1.2). Seventy were assigned to in-person LI, 72 to telephone LI, and 69 to MNT. The mean percent weight loss (95% CI) at 6 and 12 months was 5.6% (4.4-6.8%) and 4.6% (3.1-6.1%) for in-person LI, 4.6% (3.3-6.0%) and 4.8% (3.3-6.2%) for telephone LI, and 1.1% (0.2-2.0%) and 2.0% (0.9-3.0%) for MNT, with statistically significant differences between each LI arm and MNT (P < 0.001) but not between LI arms (P = 0.63). HbA1c improved in all participants. Compared with MNT, the incremental cost per kilogram lost was $789 for in-person LI and $1223 for telephone LI. CONCLUSIONS In-person LI or telephone group LI can achieve good weight loss outcomes in primary care type 2 diabetes patients at a reasonable cost. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02320253.
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Vitale R, Kim Y. The Effects of Intermittent Fasting on Glycemic Control and Body Composition in Adults with Obesity and Type 2 Diabetes: A Systematic Review. Metab Syndr Relat Disord 2020; 18:450-461. [PMID: 32780629 DOI: 10.1089/met.2020.0048] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The purpose of this study was to evaluate the effects of intermittent fasting on glycemic control and body composition in adults with obesity and type 2 diabetes. Although intermittent fasting has shown some promise in improving glucoregulatory indicators and body composition in adults with obesity, there is currently no systematic review evaluating these effects in adults with obesity and type 2 diabetes. A database search of PubMed, CINHAL, and MEDLINE identified five studies that met inclusion criterion. All studies were randomized controlled trials in adult subjects (n = 46-137) with type 2 diabetes and a body mass index of ≥30 kg/m2. Four different intermittent fasting regimens were reviewed. All fasting regimens revealed strong evidence to support intermittent fasting as a feasible diet to improve glycemia and body composition measures within 12-24 weeks. Follow-up 12-18 months after intermittent fasting did not show promising results for continued weight loss and improved glycemic control. The majority of the studies demonstrated insignificant differences between intermittent fasting and continuous energy restriction for measures of glycated hemoglobin a1c and body composition. More data on intermittent fasting in adults with obesity and type 2 diabetes are needed to determine its benefits within this patient population. Future research should include consistent fasting regimens and larger sample sizes to improve the reliability and generalizability of the data. Also, consistent follow-up after a fasting intervention may enhance long-term benefits and should be considered in future research.
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Affiliation(s)
- Rosemarie Vitale
- Nutrition and Dietetics, Central Michigan University, Mount Pleasant, Michigan, USA
| | - Yeonsoo Kim
- Nutrition and Dietetics, Central Michigan University, Mount Pleasant, Michigan, USA
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Medical nutrition therapy and dietary counseling for patients with diabetes-energy, carbohydrates, protein intake and dietary counseling. Diabetol Int 2020; 11:224-239. [PMID: 32802703 DOI: 10.1007/s13340-020-00437-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Indexed: 12/11/2022]
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Burgermaster M, Son JH, Davidson PG, Smaldone AM, Kuperman G, Feller DJ, Burt KG, Levine ME, Albers DJ, Weng C, Mamykina L. A new approach to integrating patient-generated data with expert knowledge for personalized goal setting: A pilot study. Int J Med Inform 2020; 139:104158. [PMID: 32388157 PMCID: PMC7332366 DOI: 10.1016/j.ijmedinf.2020.104158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/19/2020] [Accepted: 04/23/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Self-monitoring technologies produce patient-generated data that could be leveraged to personalize nutritional goal setting to improve population health; however, most computational approaches are limited when applied to individual-level personalization with sparse and irregular self-monitoring data. We applied informatics methods from expert suggestion systems to a challenging clinical problem: generating personalized nutrition goals from patient-generated diet and blood glucose data. MATERIALS AND METHODS We applied qualitative process coding and decision tree modeling to understand how registered dietitians translate patient-generated data into recommendations for dietary self-management of diabetes (i.e., knowledge model). We encoded this process in a set of functions that take diet and blood glucose data as an input and output diet recommendations (i.e., inference engine). Dietitians assessed face validity. Using four patient datasets, we compared our inference engine's output to clinical narratives and gold standards developed by expert clinicians. RESULTS To dietitians, the knowledge model represented how recommendations from patient data are made. Inference engine recommendations were 63 % consistent with the gold standard (range = 42 %-75 %) and 74 % consistent with narrative clinical observations (range = 63 %-83 %). DISCUSSION Qualitative modeling and automating how dietitians reason over patient data resulted in a knowledge model representing clinical knowledge. However, our knowledge model was less consistent with gold standard than narrative clinical recommendations, raising questions about how best to evaluate approaches that integrate patient-generated data with expert knowledge. CONCLUSION New informatics approaches that integrate data-driven methods with expert decision making for personalized goal setting, such as the knowledge base and inference engine presented here, demonstrate the potential to extend the reach of patient-generated data by synthesizing it with clinical knowledge. However, important questions remain about the strengths and weaknesses of computer algorithms developed to discern signal from patient-generated data compared to human experts.
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Affiliation(s)
- Marissa Burgermaster
- Nutritional Sciences & Population Health, University of Texas at Austin, Austin, TX, USA; Biomedical Informatics, Columbia University, New York, NY, USA.
| | - Jung H Son
- Biomedical Informatics, Columbia University, New York, NY, USA
| | | | - Arlene M Smaldone
- School of Nursing & College of Dental Medicine, Columbia University, New York, NY, USA
| | - Gilad Kuperman
- Biomedical Informatics, Columbia University, New York, NY, USA; Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Daniel J Feller
- Biomedical Informatics, Columbia University, New York, NY, USA
| | | | | | - David J Albers
- Biomedical Informatics, Columbia University, New York, NY, USA; Pediatrics & Informatics, University of Colorado, Aurora, CO, USA
| | - Chunhua Weng
- Biomedical Informatics, Columbia University, New York, NY, USA
| | - Lena Mamykina
- Biomedical Informatics, Columbia University, New York, NY, USA
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Powers MA, Bardsley JK, Cypress M, Funnell MM, Harms D, Hess-Fischl A, Hooks B, Isaacs D, Mandel ED, Maryniuk MD, Norton A, Rinker J, Siminerio LM, Uelmen S. Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care 2020; 43:1636-1649. [PMID: 32513817 DOI: 10.2337/dci20-0023] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
| | - Joan K Bardsley
- Medstar Health Research Institute, MedStar Diabetes Institute, and MedStar Health System Nursing, Hyattsville, MD
| | | | | | | | - Amy Hess-Fischl
- Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, University of Chicago, Chicago, IL
| | | | | | | | | | | | - Joanne Rinker
- Association of Diabetes Care & Education Specialists, Chicago, IL
| | | | - Sacha Uelmen
- Association of Diabetes Care & Education Specialists, Chicago, IL
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Dedov II, Shestakova MV, Mayorov AY, Shamkhalova MS, Sukhareva OY, Galstyan GR, Tokmakova AY, Nikonova TV, Surkova EV, Kononenko IV, Egorova DN, Ibragimova LI, Shestakova EA, Klefortova II, Sklyanik IA, Yarek-Martynova IY, Severina AS, Martynov SA, Vikulova OK, Kalashnikov VY, Bondarenko IZ, Gomova IS, Starostina EG, Ametov AS, Antsiferov MB, Bardymova TP, Bondar IA, Valeeva FV, Demidova TY, Mkrtumyan AM, Petunina NA, Ruyatkina LA, Suplotova LA, Ushakova OV, Khalimov YS. Diabetes mellitus type 2 in adults. DIABETES MELLITUS 2020. [DOI: 10.14341/dm12507] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Tatiana P. Bardymova
- Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education
| | | | | | | | - Ashot M. Mkrtumyan
- Moscow State University of Medicine and Dentistry named after A.I. Evdokimov
| | - Nina A. Petunina
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. J Am Pharm Assoc (2003) 2020; 60:e1-e18. [PMID: 32527704 DOI: 10.1016/j.japh.2020.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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125
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Diabetes self-management education and support in adults with type 2 diabetes: A consensus report of the American Diabetes Association, the Association of Diabetes Care and Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. JAAPA 2020; 33:1-20. [PMID: 32516163 DOI: 10.1097/01.jaa.0000668828.47294.2a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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126
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Diabetes Self-management Education and Support in Adults with Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care and Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. J Am Assoc Nurse Pract 2020; 33:1314-1331. [PMID: 32530872 DOI: 10.1097/jxx.0000000000000473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 11/26/2022]
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127
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Powers MA, Bardsley JK, Cypress M, Funnell MM, Harms D, Hess-Fischl A, Hooks B, Isaacs D, Mandel ED, Maryniuk MD, Norton A, Rinker J, Siminerio LM, Uelmen S. Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. DIABETES EDUCATOR 2020; 46:350-369. [PMID: 32510275 DOI: 10.1177/0145721720930959] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Joan K Bardsley
- Medstar Health Research Institute, MedStar Diabetes Institute and MedStar Health System Nursing, Hyattsville, Maryland
| | | | | | - Dixie Harms
- MercyOne Clive Internal Medicine, Clive, Iowa
| | - Amy Hess-Fischl
- Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, University of Chicago, Chicago, Illinois
| | | | - Diana Isaacs
- Cleveland Clinic Diabetes Center, Cleveland, Ohio
| | | | | | | | - Joanne Rinker
- Association of Diabetes Care & Education Specialists, Chicago, Illinois
| | | | - Sacha Uelmen
- Association of Diabetes Care & Education Specialists, Chicago, Illinois
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Esteghamati A, Ismail-Beigi F, Khaloo P, Moosaie F, Alemi H, Mansournia MA, Afarideh M, Janbabaei Molla G, Ghadimi T, Shadnoush M, Kermanchi J, Ghaemi F. Determinants of glycemic control: Phase 2 analysis from nationwide diabetes report of National Program for Prevention and Control of Diabetes (NPPCD-2018). Prim Care Diabetes 2020; 14:222-231. [PMID: 31402326 DOI: 10.1016/j.pcd.2019.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/29/2019] [Accepted: 07/16/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Diabetes is one of the leading causes of morbidity and mortality worldwide, especially among middle and low income nations. Many diabetic complications and comorbidities are attributable to poor glycemic control. The aim of this study was to update and extend the national diabetes reports on the status of comorbidities, diabetes care and complications in Iran. Moreover, we investigated the risk factors of poor glycemic control in the Iranian population. METHODS National database of 99,651 patients with diabetes who attended university-affiliated clinics between April 1, 2017 and February 30, 2018 was used to carry out a cross-sectional study. Stepwise backward selection logistic regression model was used to examine the associated factors of glycemic control. RESULTS In this study 73.0% and 56.5% of the enrolled population with diabetes, had hypertension and hyperlipidemia, respectively. The prevalence of patients who received education for nutrition therapy or diabetes self-management was 16.3% and 23.3% respectively. Poor glycemic control was associated with male gender (OR=1.06, p=0.001), obesity (OR=1.03, p=0.05), duration of diabetes (OR=1.018, p<0.001), smoking (OR=1.08, p=0.041), hypertension (OR=1.53, p<0.001), hyperlipidemia (OR=1.15, p<0.001), insulin therapy (OR=1.26, p<0.001) and combination of insulin and oral anti-diabetic agents compared to oral anti-diabetic agents alone (OR=2.36, p<0.001). CONCLUSION We demonstrated that the prevalence of diabetes comorbidities is high in Iranian population and that a great proportion of Iranian patients with diabetes had not reached the goal of glycemic control. Our findings provide a starting point from which to investigate the obstacles that prevent patients with diabetes from reaching metabolic targets.
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Affiliation(s)
- Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Faramarz Ismail-Beigi
- Department of Medicine, Biochemistry, Physiology and Biophysics, Division of Clinical and Molecular Endocrinology, Case Western Reserve University, Cleveland, OH, United States
| | - Pegah Khaloo
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Moosaie
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Alemi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Afarideh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghasem Janbabaei Molla
- Department of Deputy of Curative Affaires of Ministry of Health & Medical Education, Tehran, Iran
| | - Teyyeb Ghadimi
- Department of Surgery, Iran Medical University, Tehran, Iran
| | - Mehdi Shadnoush
- Department of Clinical Nutrition, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Jamshid Kermanchi
- Disease Management Advisor-Curative Affair Deputy-Ministry of Health and Medical Education, Tehran, Iran
| | - Fatemeh Ghaemi
- Department of Transplantation and Disease, Ministry of Health & Medical Education, Tehran, Iran.
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Merrill JD, Soliman D, Kumar N, Lim S, Shariff AI, Yancy WS. Low-Carbohydrate and Very-Low-Carbohydrate Diets in Patients With Diabetes. Diabetes Spectr 2020; 33:133-142. [PMID: 32425450 PMCID: PMC7228825 DOI: 10.2337/ds19-0070] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Low-carbohydrate diets have been advocated as an effective method for promoting weight loss in overweight and obese individuals and preventing and treating type 2 diabetes. This article reviews the differences between various low-carbohydrate eating plans and discusses the benefits and drawbacks of such a diet based on available evidence. It also offers practical pointers for clinicians.
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Affiliation(s)
- Jennifer D. Merrill
- Division of Endocrinology, Diabetes and Metabolism, Duke University School of Medicine, Durham, NC
| | - Diana Soliman
- Division of Endocrinology, Diabetes and Metabolism, Duke University School of Medicine, Durham, NC
| | - Nitya Kumar
- Division of Endocrinology, Diabetes and Metabolism, Duke University School of Medicine, Durham, NC
| | - Sooyoung Lim
- Department of Internal Medicine, Duke University School of Medicine, Durham, NC
| | - Afreen I. Shariff
- Division of Endocrinology, Diabetes and Metabolism, Duke University School of Medicine, Durham, NC
| | - William S. Yancy
- Duke Diet and Fitness Center, Department of Medicine, Duke University Health System, Durham, NC
- Durham Veterans Affairs Medical Center, Durham, NC
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130
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Rozga M, Latulippe ME, Steiber A. Advancements in Personalized Nutrition Technologies: Guiding Principles for Registered Dietitian Nutritionists. J Acad Nutr Diet 2020; 120:1074-1085. [PMID: 32299678 DOI: 10.1016/j.jand.2020.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Indexed: 01/12/2023]
Abstract
Individualized nutrition counseling and care is a cornerstone of practice for registered dietitian nutritionists (RDNs). The term personalized nutrition (PN) refers to "individual-specific information founded in evidence-based science to promote dietary behavior change that may result in measurable health benefits." PN technologies, which include the "omics" approaches, may offer the potential to improve specificity of nutrition care through assessment of molecular-level data, such as genes or the microbiome, in order to determine the course for nutrition intervention. These technologies are evolving rapidly, and for many RDNs, it is unclear whether, when, or how these technologies should be incorporated into the nutrition care process. In order to provide guidance in these developing PN fields, International Life Sciences Institute North America convened a multidisciplinary panel to develop guiding principles for PN approaches. The objective of this article is to inform RDN practice decisions related to the implementation of PN technologies by examining the alignment of proposed PN guiding principles with the Code of Ethics for the Nutrition and Dietetics Profession, as well as Scope and Standards of Practice. Guiding principles are described as they apply to each stage of the nutrition care process and include identifying potential beneficiaries, communicating effects transparently, and protecting individual privacy. Guiding principles for PN augment standard guidance for RDNs to pose relevant questions, raise potential concerns, and guide evaluation of supporting evidence for specific PN technologies. RDNs have a responsibility to think critically about the application of PN technologies, including appropriateness and potential effectiveness, for the individual served.
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131
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Dietary Habits of Saharawi Type II Diabetic Women Living in Algerian Refugee Camps: Relationship with Nutritional Status and Glycemic Profile. Nutrients 2020; 12:nu12020568. [PMID: 32098332 PMCID: PMC7071476 DOI: 10.3390/nu12020568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 12/18/2022] Open
Abstract
Diabetes is one of the main health problems among Saharawi refugees living in Algerian camps, especially for women. As is known, diet plays an important role in the management of diabetes. However, the dietary habits of Saharawi diabetic women are unknown. Therefore, we investigated the dietary habits and established their relationship with the nutritional status and glycemic profile of such women. We recruited 65 Saharawi type II diabetic women taking orally glucose-lowering drugs only. Dietary habits were investigated using qualitative 24 h recall carried out over three non-consecutive days. Anthropometric measurements were taken and blood parameters were measured. About 80% of the women were overweight and about three out of four women had uncompensated diabetes and were insulin resistant. The Saharawi diet was found to mainly include cereals, oils, sugars, vegetables (especially onions, tomatoes, and carrots), tea, and meat. Principal component analysis identified two major dietary patterns, the first one “healthy” and the second one “unhealthy”. Women in the higher tertile of adherence to the unhealthy dietary pattern had a higher homeostatic model assessment for insulin resistance (HOMA) index (b = 2.49; 95% CI: 0.41–4.57; p = 0.02) and circulating insulin (b = 4.52; 95% CI: 0.44–8.60; p = 0.03) than the women in the lowest tertile. Food policies should be oriented to improve the quality of diet of Saharawi diabetic women.
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Alawadi F, Abusnana S, Afandi B, Aldahmani K, Alhajeri O, Aljaberi K, Alkaabi J, Almadani A, Bashier A, Beshyah S, bin Belaila B, Fargaly M, Farooqi M, Hafidh K, Hassanein M, Hassoun A, Jabbar A, Ksseiry I, Mustafa H, Saadi H, Suliman S. Emirates Diabetes Society Consensus Guidelines for the Management of Type 2 Diabetes Mellitus – 2020. DUBAI DIABETES AND ENDOCRINOLOGY JOURNAL 2020. [DOI: 10.1159/000506508] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Rapid urbanisation and socioeconomic development in the United Arab Emirates (UAE) have led to the widespread adoption of a sedentary lifestyle and Westernised diet in the local population and consequently a high prevalence of obesity and diabetes. In 2019, International Diabetes Federation statistics reported a diabetes prevalence rate of 16.3% for the adult population in the UAE. In view of the wealth of recent literature on diabetes care and new pharmacotherapeutics, the Emirates Diabetes Society convened a panel of experts to update existing local guidelines with international management recommendations. The goal is to improve the standard of care for people with diabetes through increased awareness of these management practices among healthcare providers licensed by national health authorities. These consensus guidelines address the screening, diagnosis and management of type 2 diabetes mellitus in adults including individuals at risk of developing the disease.
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133
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Yi G, Din JU, Zhao F, Liu X. Effect of soybean peptides against hydrogen peroxide induced oxidative stress in HepG2 cells via Nrf2 signaling. Food Funct 2020; 11:2725-2737. [DOI: 10.1039/c9fo01466g] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this study was to determine the effects of soybean protein hydrolysates against intracellular antioxidant activity.
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Affiliation(s)
- Guofu Yi
- Beijing Advanced Innovation Center for Food Nutrition and Human Health
- Beijing Engineering and Technology Research Center of Food Additives
- Beijing Technology and Business University (BTBU)
- Beijing 100048
- China
| | - Jalal ud Din
- Beijing Advanced Innovation Center for Food Nutrition and Human Health
- Beijing Engineering and Technology Research Center of Food Additives
- Beijing Technology and Business University (BTBU)
- Beijing 100048
- China
| | - Fen Zhao
- Beijing Advanced Innovation Center for Food Nutrition and Human Health
- Beijing Engineering and Technology Research Center of Food Additives
- Beijing Technology and Business University (BTBU)
- Beijing 100048
- China
| | - Xinqi Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health
- Beijing Engineering and Technology Research Center of Food Additives
- Beijing Technology and Business University (BTBU)
- Beijing 100048
- China
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134
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5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020; 43:S48-S65. [PMID: 31862748 DOI: 10.2337/dc20-s005] [Citation(s) in RCA: 213] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc20-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc20-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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135
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García-Molina L, Lewis-Mikhael AM, Riquelme-Gallego B, Cano-Ibáñez N, Oliveras-López MJ, Bueno-Cavanillas A. Improving type 2 diabetes mellitus glycaemic control through lifestyle modification implementing diet intervention: a systematic review and meta-analysis. Eur J Nutr 2019; 59:1313-1328. [PMID: 31781857 DOI: 10.1007/s00394-019-02147-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/18/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Type 2 diabetes mellitus represents a significant health problem. Many studies have reported that intensive nutritional intervention by itself or in addition to medications is the best method to improve glycaemic control in type 2 diabetes mellitus. However, in clinical practice, dietary education is not implemented as an integral part in the management of type 2 diabetes mellitus. The purpose of this systematic review and meta-analysis is to analyse the scientific evidence concerning the role of nutritional intervention in the glycaemic control of type 2 diabetes mellitus. METHODS We searched Pubmed, Scopus, Cochrane Library and Web of Science databases from inception till May 2019 for randomised controlled trials (RCTs) that include dietary interventions in the management of patients with type 2 diabetes mellitus. RESULTS A total of 28 studies were included. Our results demonstrated that lifestyle interventions significantly lowered glycosylated haemoglobin (HbA1c) levels compared to the usual care for patients with type 2 diabetes mellitus, overall weighted mean difference, WMD = - 0.51 (- 0.67, - 0.35). Strategies combining individualized and group-based activities were the most effective, WMD = - 0.95 (- 1.24, - 0.66). Most of stratified analyses did not totally resolve heterogeneity, but improvement in HbA1c levels has been consistently observed. CONCLUSIONS The available evidence from RCTs shows that lifestyle intervention is more effective than the standard care regarding the glycaemic control of type 2 diabetic patients, particularly when there is a weight loss. It is time to translate this evidence to the primary health care practice. The protocol of the present systematic review was registered in PROSPERO, registration number CRD42018090469.
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Affiliation(s)
- Laura García-Molina
- Department of Preventive Medicine and Public Health, University of Granada, Avenida de la Investigación, 11, 18016, Granada, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5, 28029, Madrid, Spain.
| | - Anne-Mary Lewis-Mikhael
- Department of Obstetrics and Gynecology, McMaster University, 1280 Main Street West, Hamilton, ON, Canada
- High Institute of Pubic Health, Alexandria University, 165 El-Horreya Avenue - El-Ibrahimia, Alexandria, Egypt
| | - Blanca Riquelme-Gallego
- Department of Preventive Medicine and Public Health, University of Granada, Avenida de la Investigación, 11, 18016, Granada, Spain
- Fundación para la Investigación Biosanitaria de Andalucía Oriental (FIBAO), Avenida de Madrid, 15, 18018, Granada, Spain
| | - Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, Avenida de la Investigación, 11, 18016, Granada, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - María-Jesús Oliveras-López
- Department of Molecular Biology and Biochemical Engineering, University Pablo de Olavide, Carretera de Utrera, Km 1, 41013, Seville, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Avenida de la Investigación, 11, 18016, Granada, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5, 28029, Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Servicio Andaluz de Salud/Universidad de Granada, Avenida de Madrid, 15, 18018, Granada, Spain
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Kim H, Son H. Fatigue-Related Factors for Community-Dwelling Older Adults with Diabetes: A Theory-Guided Multi-Dimensional Approach Using the Dynamic Biopsychosocial Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4502. [PMID: 31731588 PMCID: PMC6887975 DOI: 10.3390/ijerph16224502] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/11/2019] [Accepted: 11/13/2019] [Indexed: 01/10/2023]
Abstract
Older adults with diabetes appear more susceptible to fatigue compared to younger adults with diabetes or healthy older adults, since aging and diabetes independently and synergistically influence fatigue. Few studies have investigated fatigue in older adults with diabetes using a multidimensional approach. This study explored the influences of physical, psychological, interpersonal, and contextual factors on diabetes fatigue using a dynamic biopsychosocial model. Face-to-face surveys were administered to community-dwelling older adults with diabetes and included variables across four domains (i.e., physical, psychological, interpersonal, and contextual factors). Univariate analyses and multiple linear regression were used. The mean fatigue score was 3.94 (standard deviation (SD) = 1.81) out of 7, and the prevalence of fatigue was 48.8%. Significant differences in fatigue severity by psychological, interpersonal, and contextual factors were found. Comorbidity and psychological factors were significant predictors of fatigue in the model, explaining 31.9% of the variance. As nearly half the sample experienced moderate or severe fatigue, which was significantly influenced by both comorbidity and psychological factors, including depression, sleep quality, and diet-related psychological characteristics, assessing patients' psychological status may be important. Awareness of fatigue could be incorporated into dietary interventions for older adults with diabetes.
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Affiliation(s)
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea;
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137
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Abu-Saad K, Murad H, Barid R, Olmer L, Ziv A, Younis-Zeidan N, Kaufman-Shriqui V, Gillon-Keren M, Rigler S, Berchenko Y, Kalter-Leibovici O. Development and Efficacy of an Electronic, Culturally Adapted Lifestyle Counseling Tool for Improving Diabetes-Related Dietary Knowledge: Randomized Controlled Trial Among Ethnic Minority Adults With Type 2 Diabetes Mellitus. J Med Internet Res 2019; 21:e13674. [PMID: 31621640 PMCID: PMC6913526 DOI: 10.2196/13674] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/10/2019] [Accepted: 08/19/2019] [Indexed: 12/25/2022] Open
Abstract
Background Ethnic minority populations exhibit disproportionately high rates of type 2 diabetes mellitus (T2DM). Electronic health tools have the potential to facilitate the cultural adaptation and tailoring of T2DM education to improve the knowledge and management of diabetes mellitus (DM). Objective This study aimed (1) to develop an adaptable Interactive Lifestyle Assessment, Counseling, and Education (I-ACE) software to support dietitian-delivered lifestyle counseling among low-socioeconomic status (SES) ethnic minority patients with T2DM and (2) to evaluate its effect on DM-related dietary knowledge and management compared with standard lifestyle advice (SLA) in a randomized controlled trial (RCT). Methods The I-ACE software, developed in consultation with clinical dieticians, incorporates evidence-based dietary and physical activity (PA) recommendations and educational materials. The features and behavioral change techniques include quantitative lifestyle (dietary intake and PA) assessment and simulation, individually tailored education and recommendations, motivational interviewing, and goal setting. For the unblinded pilot RCT, 50 overweight or obese Arab adults (aged 40-62 years) with poorly controlled T2DM were recruited from primary care clinics and randomly assigned to receive 4 in-person, dietician-delivered counseling sessions over 6 months using either (1) the I-ACE tool (experimental arm) or (2) the SLA methods (comparison arm). All outcome assessments were face-to-face. DM-related dietary knowledge (primary outcome) was measured at baseline, 3, 6, and 12 months. Lifestyle and other parameters were measured before, during, and after the intervention. Multiple linear regression and repeated measures linear mixed models were used to compare the changes in study outcomes and explore time trends in between-group and within-group changes. Results A total of 25 participants were enrolled in each arm, of whom 24 and 21 completed the final assessment of the primary outcome in the I-ACE and SLA arms, respectively. DM-related lifestyle knowledge increased more rapidly in the I-ACE arm than in the SLA arm (P value for study arm×time interaction=.02). Within the I-ACE arm, the mean (SE) differences in added sugar and dietary fiber intakes from baseline to 12 months were −2.6% (SE 1.0%) of total energy (P=.03) and 2.7 (SE 0.0) g/1000 kcal (P=.003), respectively. The odds of engaging in any leisure PA at 12 months tended to be higher in the I-ACE arm versus SLA arm, but did not reach statistical significance (odds ratio 2.8; 95% CI 0.7-11.6; P=.16). Both arms exhibited significant reductions in HbA1c (P value for change over time <.001). Conclusions The use of the I-ACE software in a 6-month, 4-session dietician-delivered lifestyle counseling intervention improved the efficiency of lifestyle education, compared with SLA, among low-SES, ethnic minority patients with T2DM. This pilot trial provides justification for conducting a large-scale trial to evaluate its effectiveness and applicability in routine clinical care among ethnically diverse populations. Trial Registration ClinicalTrials.gov NCT01858506; https://clinicaltrials.gov/ct2/show/NCT01858506.
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Affiliation(s)
- Kathleen Abu-Saad
- Cardiovascular Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
| | - Havi Murad
- Biostatistics and Biomathematics Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
| | - Rivka Barid
- Biostatistics and Biomathematics Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel.,Israel Central Bureau of Statistics, Jerusalem, Israel
| | - Liraz Olmer
- Biostatistics and Biomathematics Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
| | - Arnona Ziv
- Information and Computerization Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
| | - Nuha Younis-Zeidan
- Diet and Nutrition Service Unit for the Arab population in Sharon-Shomron District, Clalit Health Services, Arara, Israel
| | | | - Michal Gillon-Keren
- Institute of Endocrinology and Diabetes, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Shmuel Rigler
- Sharon-Shomron District, Clalit Health Services, Hadera, Israel
| | - Yakir Berchenko
- Biostatistics and Biomathematics Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel.,Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ofra Kalter-Leibovici
- Cardiovascular Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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138
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Position of the Academy of Nutrition and Dietetics: The Role of Medical Nutrition Therapy and Registered Dietitian Nutritionists in the Prevention and Treatment of Prediabetes and Type 2 Diabetes. J Acad Nutr Diet 2019; 118:343-353. [PMID: 29389511 DOI: 10.1016/j.jand.2017.11.021] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Indexed: 01/03/2023]
Abstract
It is the position of the Academy of Nutrition and Dietetics that for adults with prediabetes or type 2 diabetes, medical nutrition therapy (MNT) provided by registered dietitian nutritionists (RDNs) is effective in improving medical outcomes and quality of life, and is cost-effective. MNT provided by RDNs is also successful and essential to preventing progression of prediabetes and obesity to type 2 diabetes. It is essential that MNT provided by RDNs be integrated into health care systems and public health programs and be adequately reimbursed. The Academy's evidence-based nutrition practice guidelines for the prevention of diabetes and the management of diabetes document strong evidence supporting the clinical effectiveness of MNT provided by RDNs. Cost-effectiveness has also been documented. The nutrition practice guidelines recommend that as part of evidence-based health care, providers caring for individuals with prediabetes or type 2 diabetes should be referred to an RDN for individualized MNT upon diagnosis and at regular intervals throughout the lifespan as part of their treatment regimen. Standards of care for three levels of diabetes practice have been published by the Diabetes Care and Education Practice Group. RDNs are also qualified to provide additional services beyond MNT in diabetes care and management. Unfortunately, barriers to accessing RDN services exist. Reimbursement for services is essential. Major medical and health organizations have provided support for the essential role of MNT and RDNs for the prevention and treatment of type 2 diabetes.
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139
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Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Diabetes Care. J Acad Nutr Diet 2019; 118:932-946.e48. [PMID: 29703344 DOI: 10.1016/j.jand.2018.03.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 03/06/2018] [Indexed: 01/10/2023]
Abstract
There are 30.3 million people with diabetes and 86 million with prediabetes in the United States, underscoring the growing need for comprehensive diabetes care and nutrition for the management of diabetes and diabetes-related conditions. Management of diabetes is also critical for the prevention of diabetes-related complications such as cardiovascular and renal disease. The Diabetes Care and Education Dietetic Practice Group along with the Academy of Nutrition and Dietetics Quality Management Committee have updated the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitian Nutritionists (RDNs) in Diabetes Care. The SOP and SOPP for RDNs in Diabetes Care provide indicators that describe three levels of practice: competent, proficient, and expert. The SOP utilizes the Nutrition Care Process and clinical workflow elements for care and management of those with diabetes and prediabetes. The SOPP describes six domains that focus on professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Specific indicators outlined in the SOP and SOPP depict how these standards apply to practice. The SOP and SOPP are complementary resources for RDNs caring for individuals with diabetes or specializing in diabetes care or practicing in other diabetes-related areas, including research. The SOP and SOPP are intended to be used for RDN self-evaluation for ensuring competent practice and for determining potential education and training needs for advancement to a higher practice level in a variety of settings.
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140
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Wang Q, Duan Y, Liang J, Chen Z, Chen J, Zheng Y, Chen Y, Tang C. Reporting quality of 2014-2018 clinical practice guidelines on diabetes according to the RIGHT checklist. Endocrine 2019; 65:531-541. [PMID: 31313224 DOI: 10.1007/s12020-019-02005-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Reporting Items for Clinical Practice Guidelines (CPGs) in HealThcare (RIGHT) checklist was used as a tool to assess the reporting quality of 2014-2018 CPGs on diabetes treatment, aiming to promote the application of RIGHT and improve the reporting quality of future guidelines. METHODS We searched Chinese Biomedical Literature Service System (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP database, Medline, Embase, Allied, and Complementary MEdicine Database (AMED), and Medlive and Google Scholar (Google academics), and collected published CPGs on diabetes with published date during 1st January, 2014 and 7th November, 2018. CPGs on diabetes issued since 2014 were included and filtered by two reviewers independently. Then the basic information extraction and RIGHT evaluation of the included CPG are carried out. RESULTS A total of 34 guidelines were included, out of which 7 are for Chinese and 27 for other countries. Overall, basic information (domain 1) got the highest (64.66%) reporting rate, while financing and conflict-of-interest statements and management (domain 6) got the lowest (8.1%). For all guidelines, classification of guidelines (item 1c) was sufficiently reported, and description of the specific sources of funding for all stages of guideline development (item 18a) was not reported. For Chinese CPGs, financing and conflict-of-interest statements and management (domain 6) was most insufficiently reported, and only identification of guideline in the title (item 1a), corresponding information of the developer or author (item 4), description of basic epidemiology (item 5), and subgroup description (item 7b) out of 22 items were better reported than foreign guidelines. CONCLUSIONS Overall, the CPGs on diabetes during 2014-2018 adhered to ~41% RIGHT checklist, of which Chinese CPGs adhered less than that of foreign guidelines. It is suggested that the RIGHT reporting checklist should be endorsed and used by CPG developers to ensure higher quality and adequate use of guidelines.
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Affiliation(s)
- Qianmei Wang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, No. 232 Waihuan Dong Road, 510000, Guangzhou, China
| | - Yuting Duan
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, No. 232 Waihuan Dong Road, 510000, Guangzhou, China
- Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, 3/F, Jockey Club School of Chinese Medicine Building, 7 Baptist University Road, Kowloon Tong, Hong Kong SAR, China
| | - Jielin Liang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, No. 232 Waihuan Dong Road, 510000, Guangzhou, China
| | - Ze Chen
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, No. 232 Waihuan Dong Road, 510000, Guangzhou, China
| | - Juexuan Chen
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, No. 232 Waihuan Dong Road, 510000, Guangzhou, China
| | - Yan Zheng
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, No. 232 Waihuan Dong Road, 510000, Guangzhou, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
- Chinese GRADE Center, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, 199 Donggang West Road, Chengguan District, 730000, Lanzhou, China
| | - Chunzhi Tang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, No. 232 Waihuan Dong Road, 510000, Guangzhou, China.
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Zhang H, Goldberg SI, Hosomura N, Shubina M, Simonson DC, Testa MA, Turchin A. Lifestyle Counseling and Long-term Clinical Outcomes in Patients With Diabetes. Diabetes Care 2019; 42:1833-1836. [PMID: 31371430 DOI: 10.2337/dc19-0629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/28/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the relationship between lifestyle counseling in primary care settings and clinical outcomes in patients with diabetes. RESEARCH DESIGN AND METHODS We retrospectively studied hyperglycemic adults with diabetes treated at primary care practices between 2000 and 2014. We analyzed the relationship between frequency of lifestyle counseling (identified using natural language processing of electronic notes) and a composite outcome of death and cardiovascular events during subsequent follow-up. RESULTS Among patients with monthly counseling or more, 10-year cumulative incidence of the primary outcome was 33.0% compared with 38.1% for less than monthly counseling (P = 0.0005). In multivariable analysis, higher frequency of lifestyle counseling was associated with lower incidence of the primary outcome (hazard ratio 0.88 [95% CI 0.82-0.94]; P < 0.001). CONCLUSIONS More frequent lifestyle counseling was associated with a lower incidence of cardiovascular events and death among patients with diabetes.
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Affiliation(s)
- Huabing Zhang
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.,Brigham and Women's Hospital, Boston, MA
| | | | - Naoshi Hosomura
- Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | | | - Donald C Simonson
- Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | | | - Alexander Turchin
- Brigham and Women's Hospital, Boston, MA .,Harvard Medical School, Boston, MA.,Baim Institute for Clinical Research, Boston, MA
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142
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Nkomani S, Ruskaniko S, Blaauw R. The impact of existing diabetes self-management education interventions on knowledge, attitudes and practices in public health care institutions in Harare, Zimbabwe. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2019. [DOI: 10.1080/16070658.2019.1641272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Sanele Nkomani
- Division of Human Nutrition, Stellenbosch University, Cape Town, South Africa
| | | | - Renée Blaauw
- Division of Human Nutrition, Stellenbosch University, Cape Town, South Africa
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Koot D, Goh PSC, Lim RSM, Tian Y, Yau TY, Tan NC, Finkelstein EA. A Mobile Lifestyle Management Program (GlycoLeap) for People With Type 2 Diabetes: Single-Arm Feasibility Study. JMIR Mhealth Uhealth 2019; 7:e12965. [PMID: 31127720 PMCID: PMC6555118 DOI: 10.2196/12965] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/14/2019] [Accepted: 03/30/2019] [Indexed: 01/22/2023] Open
Abstract
Background Singapore’s current prevalence of diabetes exceeds 13.6%. Although lifestyle modification can be effective for reducing the risks for complications of type 2 diabetes mellitus (T2DM), traditional lifestyle interventions are often difficult to administer in the primary care setting due to limited resources. Mobile health apps can address these limitations by offering low-cost, adaptable, and accessible platforms for disseminating lifestyle management interventions. Objective Using the RE-AIM evaluation framework, this study assessed the potential effectiveness and feasibility of GlycoLeap, a mobile lifestyle management program for people with T2DM, as an add-on to standard care. Methods This single-arm feasibility study recruited 100 patients with T2DM and glycated hemoglobin (HbA1c) levels of ≥7.5% from a single community health care facility in Singapore. All participants were given access to a 6-month mobile lifestyle management program, GlycoLeap, comprising online lessons and the Glyco mobile phone app with a health coaching feature. The GlycoLeap program was evaluated using 4 relevant dimensions of the RE-AIM framework: (1) reach (percentage who consented to participate out of all patients approached), (2) effectiveness (percentage point change in HbA1c [primary outcome] and weight loss [secondary outcome]), (3) implementation (program engagement as assessed by various participatory metrics), and (4) maintenance (postintervention user satisfaction surveys to predict the sustainability of GlycoLeap). Participants were assessed at baseline and at follow-up (≥12 weeks after starting the intervention). Results A total of 785 patients were approached of whom 104 consented to participate, placing the reach at 13.2%. Four were excluded after eligibility screening, and 100 patients were recruited. Program engagement (implementation) started out high but decreased with time for all evaluated components. Self-reported survey data suggest that participants monitored their blood glucose on more days in the past week at follow-up compared to baseline (P<.001) and reported positive changes to their diet due to app engagement (P<.001) (implementation). Primary outcome data were available for 83 participants. Statistically significant improvements were observed for HbA1c (–1.3 percentage points, P<.001) with greater improvements for those who logged their weight more often (P=.007) (effectiveness). Participants also had a 2.3% reduction in baseline weight (P<.001) (effectiveness). User satisfaction was high with 74% (59/80) and 79% (63/80) of participants rating the app good or very good and claiming that they would probably or definitely recommend the app to others, respectively (maintenance). Conclusions Although measures of program engagement decreased with time, clinically significant improvements in HbA1c were achieved with the potential for broader implementation. However, we cannot rule out that these improvements were due to factors unrelated to GlycoLeap. Therefore, we would recommend evaluating the effectiveness and cost effectiveness of GlycoLeap using a randomized controlled trial of at least 12 months. Trial Registration ClinicalTrials.gov NCT03091517; https://clinicaltrials.gov/ct2/show/NCT03091517 (Archived by WebCite at http://www.webcitation.org/77rNqhwRn)
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Affiliation(s)
- David Koot
- SingHealth Polyclinics, Singapore, Singapore
| | | | - Robyn Su May Lim
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Yubing Tian
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
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144
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Evert AB, Dennison M, Gardner CD, Garvey WT, Lau KHK, MacLeod J, Mitri J, Pereira RF, Rawlings K, Robinson S, Saslow L, Uelmen S, Urbanski PB, Yancy WS. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care 2019; 42:731-754. [PMID: 31000505 PMCID: PMC7011201 DOI: 10.2337/dci19-0014] [Citation(s) in RCA: 595] [Impact Index Per Article: 119.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Alison B Evert
- UW Neighborhood Clinics, UW Medicine, University of Washington, Seattle, WA
| | | | - Christopher D Gardner
- Stanford Diabetes Research Center and Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA
| | - W Timothy Garvey
- Diabetes Research Center, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
- Birmingham Veterans Affairs Medical Center, Birmingham, AL
| | | | | | - Joanna Mitri
- Section on Clinical, Behavioral and Outcomes Research Lipid Clinic, Adult Diabetes Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | | | | | | | - Laura Saslow
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI
| | | | | | - William S Yancy
- Duke Diet and Fitness Center, Department of Medicine, Duke University Health System, Durham, NC
- Durham Veterans Affairs Medical Center, Durham, NC
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145
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Benson GA, Sidebottom A, Hayes J, Miedema MD, Boucher J, Vacquier M, Sillah A, Gamam S, VanWormer JJ. Impact of ENHANCED (diEtitiaNs Helping pAtieNts CarE for Diabetes) Telemedicine Randomized Controlled Trial on Diabetes Optimal Care Outcomes in Patients with Type 2 Diabetes. J Acad Nutr Diet 2019; 119:585-598. [DOI: 10.1016/j.jand.2018.11.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/07/2018] [Accepted: 11/13/2018] [Indexed: 10/27/2022]
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146
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Vetrani C, Bozzetto L, Giorgini M, Cavagnuolo L, Di Mattia E, Cipriano P, Mangione A, Todisco A, Inghilterra G, Giacco A, Annuzzi G, Rivellese AA. Fibre-enriched buckwheat pasta modifies blood glucose response compared to corn pasta in individuals with type 1 diabetes and celiac disease: Acute randomized controlled trial. Diabetes Res Clin Pract 2019; 149:156-162. [PMID: 30779970 DOI: 10.1016/j.diabres.2019.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/08/2019] [Accepted: 02/13/2019] [Indexed: 11/25/2022]
Abstract
AIM People with type 1 diabetes and celiac disease (T1D&CD) have high blood glucose variability. Processed gluten-free foods have shown to induce a worse metabolic profile whereas naturally gluten-free foods may represent healthier options. On the other hand, dietary fibre has shown to reduce postprandial glycemic excursions in individuals with diabetes. Thus, we evaluated the acute effect of fibre-enriched buckwheat (FBP) and corn pasta (CP) on postprandial blood glucose response (PP-BGR). METHODS Ten adult patients with T1D&CD consumed two meals with the same amount of carbohydrate while differing only for pasta type (FBP or CP) preceded by the same insulin bolus. Participants utilized continuous glucose monitoring (CGM) and data over 6 h after meal were analyzed. RESULTS PP-BGR differed between the two meals, being significantly lower in the first period (0-3 h) after the CP than the FBP meal (iAUC: -38 ± 158 vs. 305 ± 209 mmol/L · 180 min, p = 0.040), whereas significantly higher in the second period (3-6 h) after the CP than the FBP meal (iAUC: 432 ± 153 vs. 308 ± 252 mmol/L · 180 min, p = 0.030). Overall, a less variable postprandial profile was observed after FBP than CP consumption. CONCLUSIONS In individuals with T1D&CD, the acute consumption of FBP induces significant differences in PP-BGR compared with CP that may be clinically relevant.
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Affiliation(s)
- Claudia Vetrani
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Lutgarda Bozzetto
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marisa Giorgini
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Luisa Cavagnuolo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Elpidio Di Mattia
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Paola Cipriano
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Anna Mangione
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | | | - Angela Giacco
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giovanni Annuzzi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Angela A Rivellese
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
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147
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Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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148
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Sameer AS, Banday MZ, Nissar S, Saeed SA. A Comparison of Biomarkers in the Assessment of Glycemic Control in Diabetes: Reviewing the Evidence. Curr Diabetes Rev 2019; 15:471-479. [PMID: 30961503 DOI: 10.2174/1389557519666190408197922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/21/2019] [Accepted: 04/02/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes Mellitus (DM) is a chronic life-long progressive multisystem heterogeneous metabolic disorder with complex pathogenesis. INTRODUCTION Hyperglycemia is not only one of the classical signs of DM, but it also serves as the pivotal prerequisite for the diagnosis of the disease. However, with the advancement in the field of analytical biochemistry, a number of alternative and specific biomarkers have been discovered which can be used for better diagnosis of the DM. In this review, we have discussed various aspects of DM and different biomarkers used in assessing glycemia. METHODOLOGY A thorough literature survey was conducted to identify various studies that reported the use of conventional and non-conventional markers for the assessment of glycemia in DM patients. CONCLUSION The accurate detection and hence diagnosis of DM has become easy and more specific with the use of various biomarkers.
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Affiliation(s)
- Aga S Sameer
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, National Guard Health Affairs, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mujeeb Z Banday
- Department of Biology, United Arab Emirates University (UAEU), Al Ain, Abu Dhabi, United Arab Emirates
| | - Saniya Nissar
- Department of Clinical Biochemistry, University of Kashmir, Hazratbal, Srinagar, Kashmir, India
| | - Sheikh A Saeed
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, National Guard Health Affairs, Jeddah, Saudi Arabia
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149
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Smart CE, Annan F, Higgins LA, Jelleryd E, Lopez M, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2018; 19 Suppl 27:136-154. [PMID: 30062718 DOI: 10.1111/pedi.12738] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 07/16/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Carmel E Smart
- Department of Paediatric Endocrinology, John Hunter Children's Hospital, Newcastle, NSW, Australia.,School of Health Sciences, University of Newcastle, Newcastle, NSW, Australia
| | | | | | | | | | - Carlo L Acerini
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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150
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Ibrahim M, Tuomilehto J, Aschner P, Beseler L, Cahn A, Eckel RH, Fischl AH, Guthrie G, Hill JO, Kumwenda M, Leslie RD, Olson DE, Pozzilli P, Weber SL, Umpierrez GE. Global status of diabetes prevention and prospects for action: A consensus statement. Diabetes Metab Res Rev 2018; 34:e3021. [PMID: 29757486 DOI: 10.1002/dmrr.3021] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 12/15/2022]
Abstract
Primary prevention of type 2 diabetes (T2D) should be achievable through the implementation of early and sustainable measures. Several randomized control studies that found success in preventing the progression to T2D in high-risk populations have identified early and intensive intervention based on an individualized prevention model as the key factor for participant benefit. The global prevalence of both overweight and obesity has now been widely recognized as the major epidemic of the 21st century. Obesity is a major risk factor for the progression from normal glucose tolerance to prediabetes and then to T2D. However, not all obese individuals will develop prediabetes or progress to diabetes. Intensive, multicomponent behavioural interventions for overweight and obese adults can lead to weight loss. Diabetes medications, including metformin, GLP-1 agonists, glitazones, and acarbose, can be considered for selected high-risk patients with prediabetes when lifestyle-based programmes are proven unsuccessful. Nutrition education is the cornerstone of a healthy lifestyle. Also, physical activity is an integral part of the prediabetes management plan and one of the main pillars in the prevention of diabetes. Mobile phones, used extensively worldwide, can facilitate communication between health professionals and the general population, and have been shown to be helpful in the prevention of T2D. Universal screening is needed. Noninvasive risk scores should be used in all countries, but they should be locally validated in all ethnic populations focusing on cultural differences around the world. Lifestyle interventions reduce the progression to prediabetes and diabetes. Nevertheless, many questions still need to be answered.
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Affiliation(s)
| | - Jaakko Tuomilehto
- Dasman Diabetes Institute, Kuwait, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland, and Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Pablo Aschner
- Javeriana University School of Medicine, San Ignacio University Hospital, Bogota, Colombia
| | - Lucille Beseler
- Family Nutrition Center of South Florida, Coconut Creek, FL, USA
| | - Avivit Cahn
- Hadassah Hebrew University Hospital, The Diabetes Unit & Endocrinology and Metabolism Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Robert H Eckel
- University of Colorado Denver Anschutz Medical Campus, University of Colorado Hospital, Denver, CO, USA
| | - Amy Hess Fischl
- University of Chicago Kovler Diabetes Center, Chicago, IL, USA
| | - George Guthrie
- Florida Hospital Graduate Medical Education, Orlando, FL, USA
| | - James O Hill
- Colorado Nutrition Obesity Research Center (NORC), University of Colorado School of Medicine, Aurora, CO, USA
| | | | - R David Leslie
- Blizard Institute, Queen Mary, University of London, London, UK
| | - Darin E Olson
- Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA, USA
| | - Paolo Pozzilli
- Unit of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy
- Centre of Immunobiology, Barts and the London School of Medicine, Queen Mary, University of London, London, UK
| | - Sandra L Weber
- Greenville Health System, University of South Carolina School of Medicine-Greenville, Greenville, SC, USA
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