1
|
Blanchard J, Ahmed S, Clark B, Sanchez Cotto L, Rangasamy S, Thompson B. Design and Testing of a Smartphone Application for Real-Time Tracking of CSII and CGM Site Rotation Compliance in Patients With Type 1 Diabetes. J Diabetes Sci Technol 2024; 18:937-945. [PMID: 36539997 DOI: 10.1177/19322968221145178] [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] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Glycemic control in patients with type 1 diabetes can be difficult to achieve. One critical aspect of insulin delivery is site rotation, which is necessary to reduce dermatologic complications of repeated insulin infusion. No current application is designed to help patients track sites and instruct on overused sites. OBJECTIVE The objectives of this study were to (1) design a smartphone app, Insulin Site Guide, to gather real-time information on continuous subcutaneous insulin infusion (CSII) and continuous glucose monitor (CGM) site location and rotation compliance and instruct subjects on the use of an overused site; (2) conduct a usability study to measure site rotation compliance; and (3) report subject satisfaction with the app. DESIGN The app is installed on the subject's smartphone. Subjects use the app to record CSII and CGM placement in real-time. Data are sent to the study team at the end of the study. Subjects complete a questionnaire concerning the app. RESULTS We report site rotation compliance data for eight subjects and survey responses for 10 subjects. Initial data from eight subjects indicate a high site rotation compliance of 84% for insulin pumps. In general, the majority of users indicate high satisfaction with the app. CONCLUSIONS Insulin Site Guide is a mobile app that uses a novel algorithm to better guide site rotation. Use of the app has the potential to improve site rotation and decrease dermatologic complications of diabetes with long-term use.
Collapse
Affiliation(s)
- John Blanchard
- Translational Genomics Research Institute, Phoenix, AZ, USA
| | | | | | | | | | | |
Collapse
|
2
|
Zhou B, Guo Z, Zhao P, Wang H, Dong S, Cheng B, Yang J, Li B, Wang X. Fabrication and characterization of coated microneedle patches based on PEGDA for transdermal administration of metformin. Drug Deliv Transl Res 2024; 14:131-142. [PMID: 37450235 DOI: 10.1007/s13346-023-01387-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
Type 2 diabetes is one of the major challenges that the world is facing today. However, metformin (MET) as most type 2 diabetics' first-line oral hypoglycemic drug may cause serious side effects such as gastrointestinal irritation and nausea which reduce the patients' medication compliance. Therefore, the aim of the study was to design a safe and effective self-treatment device for the delivery of MET. Here, a kind of coated microneedle (MN) patches based on poly(ethylene glycol)diacrylate (PEGDA) were prepared by a two-step casting method and photopolymerization process for transdermal administration of MET. The needles wrapped with drug-loaded hyaluronic acid (HA) coating showed promising mechanical properties and drug delivery ability that allowed them to penetrate the skin barrier for rapid drug delivery, and they had no skin irritancy. The in vivo experiment of type 2 diabetic rats showed a satisfying hypoglycemic effect of the coated MN patches. The study shows that the prepared MN patches will be a potential method for the treatment of type 2 diabetes in the future.
Collapse
Affiliation(s)
- Bo Zhou
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan, 430070, People's Republic of China
- Hainan Institute, Wuhan University of Technology, Sanya, 572000, People's Republic of China
- Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, People's Republic of China
| | - Zhendong Guo
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan, 430070, People's Republic of China
- Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, People's Republic of China
| | - Peiwen Zhao
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan, 430070, People's Republic of China
- Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, People's Republic of China
| | - Hao Wang
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan, 430070, People's Republic of China
- Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, People's Republic of China
| | - Siyan Dong
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan, 430070, People's Republic of China
- School of Biosciences, University of Birmingham, Edgbaston, B15 2TT, UK
| | - Bo Cheng
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, 430060, People's Republic of China
| | - Jing Yang
- School of Foreign Languages, Wuhan University of Technology, Wuhan, 430070, People's Republic of China
| | - Binbin Li
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan, 430070, People's Republic of China.
- Hainan Institute, Wuhan University of Technology, Sanya, 572000, People's Republic of China.
- Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, People's Republic of China.
| | - Xinyu Wang
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, Wuhan, 430070, People's Republic of China.
- Foshan Xianhu Laboratory of the Advanced Energy Science and Technology Guangdong Laboratory, Xianhu Hydrogen Valley, Foshan, 528200, People's Republic of China.
- Hainan Institute, Wuhan University of Technology, Sanya, 572000, People's Republic of China.
- Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, People's Republic of China.
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.
| |
Collapse
|
3
|
Soewondo P, Suastika K, Kshanti IA, Mardianto M, Mudjanarko SW, Pramono RB, Mustikawati DE. Expert Opinion on Addressing the Gap in Injection Technique and Needle Reuse for People with Diabetes in Indonesia. Diabetes Metab Syndr Obes 2023; 16:4101-4107. [PMID: 38111730 PMCID: PMC10725793 DOI: 10.2147/dmso.s433254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/26/2023] [Indexed: 12/20/2023] Open
Abstract
The use of insulin for patients with diabetes mellitus in Indonesia appears to be under expectation; moreover, there are gaps in knowledge regarding the proper injection technique and pen needle reuse by both healthcare professionals (HCPs) and patients. To address these issues, a scientific expert meeting was held with the participation of endocrinologists and public health specialist from many different organizations in Indonesia to identify the challenges and problem related to injection technique, high pen needle reuse rate, and the need of all stakeholders. The experts agreed that it is necessary to ensure physicians to start the initiation phase as early as indicated, continue optimizing its dosage to reach targeted blood sugar based on guideline, and involve all relevant stakeholders to improve insulin distribution and patient access in every primary care facility in order to optimize the use of insulin or other injectable diabetes medications in Indonesia. Additionally, the experts believed that education on proper injection technique and improved reuse rate of pen needle is necessary. To date, Indonesian Diabetes Educators Association (IDEA/PEDI) has established guideline on injection technique. There are also recommendations on injection technique and needle reuse from Indonesian Society of Endocrinology (PERKENI) and Forum for Injection Technique & Therapy: Expert Recommendations (FITTER); however, this guideline/recommendation should be disseminated more widely among HCPs. In addition, cost-effectiveness studies based on local data are needed to propose and convince the Payors and other stakeholders. This article can be used as a guidance for HCPs and policymakers to improve current practice on injection technique, pen needle reuse, needle prescription and reimbursement policy in Indonesia and elsewhere.
Collapse
Affiliation(s)
- Pradana Soewondo
- Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Ketut Suastika
- Department of Internal Medicine, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G Ngoerah General Hospital Denpasar, Bali, Indonesia
| | - Ida Ayu Kshanti
- Department of Internal Medicine, Fatmawati General Hospital, Jakarta, Indonesia
| | - Mardianto Mardianto
- Faculty of Medicine, University of Sumatra Utara/Adam Malik Central Hospital, Internal Medicine, Medan, Indonesia
| | - Sony Wibisono Mudjanarko
- Department of Internal Medicine, Faculty of Medicine Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - R Bowo Pramono
- Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | | |
Collapse
|
4
|
Guo L, Zhang Q, Xue Y, Ran X, Chen L, Jiang S, Liu D, Ji Q, Liu J. A Nationwide Cross-sectional Survey of Knowledge and Practices of Diabetes Drug Injection Techniques of Patients, Nurses, and Physicians: The China IT Improve Study. Mayo Clin Proc 2023; 98:1482-1500. [PMID: 37656085 DOI: 10.1016/j.mayocp.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE To investigate the knowledge and practices of diabetes drug injection techniques of diabetes patients, nurses, and physicians to support formulating national guidelines for standardized diabetes drug injection techniques. PATIENTS AND METHODS In this nationwide multicenter cross-sectional survey conducted between November and December 2020, patients, nurses, and physicians were randomly chosen from 250 primary, 150 secondary, and 100 tertiary care hospitals using the stratified cluster sampling method. Their knowledge and/or practices of diabetes drug injection techniques were surveyed using the Diabetes Drug Injection Knowledge and Practice Questionnaire for Physicians, Nurses, and Patients. RESULTS In total, 10,694, 2643, and 2816 eligible questionnaires were collected from patients, physicians, and nurses, respectively. Overall, 78.2% (7588/9709) type 2 diabetes patients failed to attain the target hemoglobin A1c. Hypoglycemic episodes and lipohypertrophy occurred in 19.8% and 34.7% of the patients, respectively. Needle reuse (odds ratio, 1.19; 95% CI, 1.07 to 1.33) and incorrect injection site rotation (odds ratio, 1.32; 95% CI, 1.16 to 1.51) were associated with failure to attain the target hemoglobin A1c. Overall, 48.9% physicians and 20.4% nurses had a poor knowledge domain score. Care setting and training, diabetes care experience, and regions were significant determinants of diabetes drug injection knowledge domain scores in both physicians and nurses. CONCLUSION Poor glycemic control, occurrences of injection-associated complications in diabetes patients, and poor knowledge domain scores of a subset of physicians and nurses highlight the importance of regular assessment and education regarding diabetes drug injection techniques for physicians and nurses and development of national guidelines for diabetes drug injection. TRIAL REGISTRATION Chictr.org.cn (ChiCTR2100045302).
Collapse
Affiliation(s)
- Lixin Guo
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
| | - Qiu Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yaoming Xue
- Department of Endocrinology, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Xingwu Ran
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Liming Chen
- Department of Endocrinology, Tianjin Medical University Chu Hsien-I Memorial Hospital, Tianjin, China
| | - Sheng Jiang
- Department of Endocrinology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Dongfang Liu
- Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiuhe Ji
- Department of Endocrinology, Xijing Hospital of Air Force Military Medical University, Xian, China
| | - Jing Liu
- Department of Endocrinology, Clinical Research Center for Metabolic Disease, Gansu Province Hospital, Lanzhou, China
| |
Collapse
|
5
|
Liao Y, Liu X, Huang J, Chen Q, Li N, Zhou P. Insulin injection knowledge, attitude and behaviour of nurses: A cross-sectional study in Guangdong Province. Nurs Open 2023; 10:3754-3765. [PMID: 36808890 PMCID: PMC10170902 DOI: 10.1002/nop2.1633] [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: 05/12/2022] [Revised: 12/07/2022] [Accepted: 01/13/2023] [Indexed: 02/20/2023] Open
Abstract
AIM To understand the insulin injection knowledge, attitude and behaviour of nurses and their influencing factors in Guangdong Province. DESIGN Cross-sectional study. METHODS A total of 19,853 nurses from 82 hospitals in 15 cities in Guangdong, China, participated in this study. The scores of the nurses' insulin injection knowledge, attitude and behaviour were determined through a questionnaire, and multivariate regression analysis was used to evaluate the influencing factors of insulin injection in different dimensions. STROBE. RESULTS Among all nurses involved in this study, 22.3% of nurses had good knowledge, 75.9% of nurses had good attitude and 92.7% of nurses had good behaviour. Pearson's correlation analysis showed that knowledge, attitude scores and behaviour scores were significantly correlated. The influencing factors of knowledge, attitude and behaviour included gender, age, education, nurse level, work experience, type of ward, diabetes nursing certification, position held and most recent insulin administration.
Collapse
Affiliation(s)
- Yangyang Liao
- School of Nursing, Jinan University, Guangzhou, China
| | - Xueyan Liu
- Department of Endocrine Metabolism, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiewei Huang
- School of Nursing, Jinan University, Guangzhou, China.,Nursing Department, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Qingling Chen
- Department of Endocrine Metabolism, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ningning Li
- School of Nursing, Jinan University, Guangzhou, China
| | - Peiru Zhou
- School of Nursing, Jinan University, Guangzhou, China.,Department of Health Management, The Fifth Affiliated Hospital of Jinan University, Heyuan, China
| |
Collapse
|
6
|
Wu X, Zhao F, Zhang M, Yuan L, Zheng Y, Huang J, Li Y, Li C. Insulin Injection Knowledge, Attitudes, and Practices of Nurses in China: A Cross-Sectional Nationwide Study. Diabetes Ther 2021; 12:2451-2469. [PMID: 34350563 PMCID: PMC8384991 DOI: 10.1007/s13300-021-01122-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/16/2021] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION To evaluate insulin injection knowledge, attitudes, and practices of nurses across China in order to provide reference for the formulation of a national unified standard of insulin injection practice and the targeted implementation of standardized training on insulin injection for nurses. METHODS We enrolled nurses who worked and injected insulin at grassroot hospitals including community health service centers and township clinics, secondary and tertiary care hospitals across China between July 28, 2019 and August 30, 2019. A nurse insulin injection knowledge, attitude, and practice questionnaire was used to evaluate the knowledge, attitude, and practice level of nurses. RESULTS A total of 223,368 nurses were included in the study. The mean knowledge score was 13.70 ± 3.30 and 35.19% had a poor knowledge score. The mean attitude score was 17.18 ± 2.69 for the study nurses; merely 3.15% had a poor attitude score. The mean practice score of the study population was 83.03 ± 8.16 and only 0.88% had a poor practice score. Pearson correlation analysis showed significant correlation between the knowledge score and the attitude score (r = 0.29; P < 0.001), the knowledge score and the practice score (r = 0.27; P < 0.001), and between the attitude score and the practice score (r = 0.56; P < 0.001). A multivariate analysis revealed that nurses with higher knowledge scores were also more likely to have higher attitude scores and practice scores, and nurses with higher attitude scores were also more likely to have higher practice scores. CONCLUSION Chinese nurses have a good attitude and behavior towards insulin injection, while their knowledge of insulin injection is insufficient. It is also revealed that knowledge of insulin injection can directly or indirectly affect insulin injection behavior through attitude, indicating that hospitals should formulate unified insulin injection norms and regularly organize relevant training and assessment so as to improve nurses' knowledge, attitude, and behavior of insulin injection.
Collapse
Affiliation(s)
- Xinjuan Wu
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
| | - Fang Zhao
- Department of Nursing, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Mingxia Zhang
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, China
| | - Li Yuan
- Department of Endocrinology and Metabolism, West China School of Nursing, West China Hospital of Sichuan University, Sichuan University, Chengdu, 610041, China
| | - Yining Zheng
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Jin Huang
- Clinical Nursing Teaching and Research Section/Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Yangxi Li
- Respiratory Center, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Caihong Li
- Department of Endocrinology, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, 102218, China
| |
Collapse
|
7
|
Wang W, Huang R, Chen Y, Tu M. Values of ultrasound for diagnosis and management of insulin-induced lipohypertrophy: A prospective cohort study in China. Medicine (Baltimore) 2021; 100:e26743. [PMID: 34398053 PMCID: PMC8294902 DOI: 10.1097/md.0000000000026743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/28/2021] [Indexed: 01/04/2023] Open
Abstract
The aim of this study was to explore the values of ultrasound for diagnosis and management of insulin-induced lipohypertrophy and further analyzing the impact of body mass index and subcutaneous fat thickness on ultrasound manifestations of lipohypertrophy.In this 3-month, prospective cohort study, a total of 162 patients with diabetes who used insulin therapy more than 1 year with unknown lipohypertrophy status were enrolled into this study. Demographic information, assessment of glycemic control and insulin injection technique were evaluated. Physical and ultrasound examination were separately performed to detect lipohypertrophy by a team of diabetes educator nurses or ultrasonographer in a blinded fashion. Patients with lipohypertrophy received insulin injection technique education based on ultrasound examination and Chinese guideline.Ultrasound examination detected 41.1% more patients (74.1% vs 52.5%; P < .001) with lipohypertrophy and 61.2% more lesions (216 vs 134; P < .001) than physical examination. Glycosylated hemoglobin A1c and fasting blood glucose were significantly decreased in patients with lipohypertrophy or subclinical lipohypertrophy (lipohypertrophy without visual and palpation changes) after receiving insulin injection technique education based on ultrasound examination and Chinese guideline than baseline at 3 months (P < .001). The proportion of lesions with ultrasound manifestation 2 (distortion of surrounding connective tissue) in obese and STF (>15 mm) groups were no more than 50% and showed a decreased trend with increased subcutaneous fat thickness and body mass index (P < .001).Lipohypertrophy has characteristic ultrasound manifestations which can detect more accurate results than palpation alone and provide detailed information to promote effective education on lipohypertrophy management, thereby improving glycemic control.
Collapse
|
8
|
Wang W, Tong Y, Chen Y, Tu M, Chen H. Evaluation of ultrasound examination combined with intensive injection technique education on insulin-induced lipohypertrophy (LH) management: a prospective cohort study in China. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-00935-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
9
|
Hacene MNB, Saker M, Youcef A, Koudri S, Cheriet S, Merzouk H, Lounici A, Alkhatib N. Insulin injection technique in the western region of Algeria, Tlemcen. Pan Afr Med J 2020; 36:327. [PMID: 33193981 PMCID: PMC7603825 DOI: 10.11604/pamj.2020.36.327.21278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 07/13/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction Algeria has more than 1.7 million diabetic patients on to whom a descriptive assessment particularly on the insulin usage behaviors has not yet been initiated, although is needed. This study aims to provide a descriptive analysis of how Algerian diabetic patients perceive and apply insulin injection techniques. Methods using the “patient” questionnaire within the Injection Technique Questionnaire (ITQ) 2016 survey, this study assessed the insulin injection practices of 100 patients recruited over a seven-month period in western Algeria at the Tlemcen University Hospital Center. The results of this study are compared to those of the ITQ 2016 survey. Results pens are the instruments of injection for 98% of Algerians who continue to use mostly long needles of 6- and 8-mm, although 4mm needles are the recommended safer option. Insulin analogues (fast and basal) are plebiscite. Arms and thighs are the preferred injection sites; the abdomen (the preferred site elsewhere) is neglected for reasons to be investigated. The correct re-suspension technique for cloudy insulin is unknown. Extensive pen needle re-use (10+ times) for over half of the patients exposes them to both higher intramuscular (IM) injection risk and lipohypertrophy (LH). Injection training is performed in Algeria by the diabetologist. Conclusion this study describes for the first time Algerian patients´ insulin injection technique. It highlights their skills and identifies many deficiencies which patients and professionals must correct given the issues in this area.
Collapse
Affiliation(s)
- Mohammed Nassim Boukli Hacene
- Department of Pharmacy, Faculty of Medicine, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria.,Laboratory of Physiology, Pathophysiology and Biochemistry of Nutrition, Department of Biology, Faculty of Natural and Life Sciences, Earth and Universe, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Meriem Saker
- Laboratory of Physiology, Pathophysiology and Biochemistry of Nutrition, Department of Biology, Faculty of Natural and Life Sciences, Earth and Universe, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Amina Youcef
- Department of Pharmacy, Faculty of Medicine, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria.,Laboratory of Physiology, Pathophysiology and Biochemistry of Nutrition, Department of Biology, Faculty of Natural and Life Sciences, Earth and Universe, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Soumia Koudri
- Department of Pharmacy, Faculty of Medicine, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Souad Cheriet
- Department of Pharmacy, Faculty of Medicine, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Hafida Merzouk
- Laboratory of Physiology, Pathophysiology and Biochemistry of Nutrition, Department of Biology, Faculty of Natural and Life Sciences, Earth and Universe, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Ali Lounici
- Department of Internal Medicine, University Hospital Center Tidjani Damerdji Tlemcen 13000, Algeria.,Laboratory of Research on Diabetes, Faculty of Medicine, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Nimer Alkhatib
- Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, Arizona, USA.,MidCapital Health Care, Amman, Jordan
| |
Collapse
|