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Peng P, Shen Y, Xiong H. Wearable monitoring device based on an internet management platform improves metabolic parameters in type 2 diabetes patients: a prospective pilot study. Postgrad Med 2024; 136:523-532. [PMID: 38870076 DOI: 10.1080/00325481.2024.2366156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES This pilot study aimed to prospectively investigate the effects of a wearable monitoring device, based on an Internet management platform, on the comprehensive management of type 2 diabetes mellitus (T2DM) patients. METHODS A total of 120 hospitalized patients with T2DM were enrolled and randomly divided into the control group and the intervention group. Patients in the control group only received conventional diabetes treatments, while patients in the intervention group were provided with a wearable monitoring device in addition to conventional diabetes treatments. Moreover, the wearable device could connect to an Internet platform for diabetes management and upload self-monitoring data. All patients were followed for 3 months. The changes in parameters representing glucose metabolism, blood lipids, renal function, and patient satisfaction were compared between the two groups. All results were analyzed on an intention-to-treat basis. RESULTS One hundred twenty subjects met all criteria and agreed to participate in this study. During the follow-up period, 5 and 4 subjects were lost to follow-up in the intervention and control groups, respectively. Compared with the control group, the blood glucose of the intervention group decreased significantly after 3 months (p < 0.05). Subgroup analysis found that females, those younger than 60 years, with baseline glycated hemoglobin A1c (HbA1c) levels of 8% or greater, and patients with good adherence showed significant improvements in HbA1c (p < 0.05). However, there was no significant difference in blood lipid and renal function. The intervention group showed a better adherence rate to blood glucose, comprehensive adherence rate, and diabetes treatment satisfaction (p < 0.05). One subject in the intervention group and two subjects in the control group reported mild hypoglycemia. No other adverse events such as infections and skin allergies occurred in the two groups. CONCLUSION The intervention of a wearable monitoring device based on an Internet management platform significantly improved blood glucose control in T2DM patients, as well as the overall adherence rate and patient satisfaction with treatment. CLINICAL TRIAL REGISTRATION NCT04973644.
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Affiliation(s)
- Ping Peng
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Endocrinology and Metabolism, The Wanjiang Hospital, Dongguan, China
| | - Yunfeng Shen
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Endocrinology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Haixia Xiong
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Chen M, Liu M, Pu Y, Wu J, Zhang M, Tang H, Kong L, Guo M, Zhu K, Xie Y, Li Z, Deng B, Xiong Z. The effect of health quotient and time management skills on self-management behavior and glycemic control among individuals with type 2 diabetes mellitus. Front Public Health 2024; 12:1295531. [PMID: 38633228 PMCID: PMC11021650 DOI: 10.3389/fpubh.2024.1295531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 03/21/2024] [Indexed: 04/19/2024] Open
Abstract
Objective The aim of this study was to evaluate the present status of self-management behavior and glycemic control in individuals diagnosed with Type 2 Diabetes Mellitus (T2D), as well as to examine the impact of health quotient (HQ) and time management skills on both self-management behavior and glycemic control. Methods Between October 2022 and March 2023, a purposive sampling method had been utilized to select 215 participants with type T2D. The survey concluded a general information questionnaire, an HQ scale, a diabetes time management questionnaire and a self-management behavior questionnaire. The health quotient(HQ)encompasses the individuals' knowledge, attitude toward health, and the ability to maintain their own well-being. The diabetes time management questionnaire was reverse-scored, with higher scores indicating an enhanced competence in time management. The path among variables was analyzed using structural equation modeling(SEM). Results SEM showed that the direct effect of HQ on time management was -0.566 (p < 0.05), the direct effect of time management on the effect of self-management was -0.617 (p < 0.05), the direct effect of HQ on self-management was 0.156, and the indirect effect was 0.349 (p < 0.05); the relationship between health quotient and self-management was partially mediated by time management, with a mediating effect size of 68.8%. In addition, self-management had a direct effect on HbAlc, with a size of -0.394 (p < 0.05); The impacts of both HQ and time management on HbAlc were found to be mediated by self-management, with HQ demonstrating an indirect effect of -0.199 (p < 0.05) and time management showing an indirect effect of 0.244 (p < 0.05). Conclusion Health quotient and time management in patients with T2D serve as catalysts for self-management behavior. They affect HbAlc level indirectly through self-management practices. The suggestion is to prioritize the cultivation of rational time organization and management skills in T2D patients, as well as enhance their health quotient level. This can facilitate a more effective improvement in patients' self-management behaviors, ultimately achieving the objective of maintaining optimal glycemic control.
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Affiliation(s)
- Mengjie Chen
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Man Liu
- The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, Sichuan, China
| | - Ying Pu
- The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Juan Wu
- The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Mingjiao Zhang
- West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hongxia Tang
- The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Laixi Kong
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Maoting Guo
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Kexue Zhu
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Yuxiu Xie
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Zhe Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, Sichuan, China
| | - Bei Deng
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Zhenzhen Xiong
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
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Adu FA, Poku CA, Adu AP, Owusu LB. The role of social support and self-management on glycemic control of type 2 diabetes mellitus with complications in Ghana: A cross-sectional study. Health Sci Rep 2024; 7:e2054. [PMID: 38650722 PMCID: PMC11033339 DOI: 10.1002/hsr2.2054] [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: 05/05/2023] [Revised: 02/08/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aims Diabetes mellitus (DM) can result in detrimental complications which are connected with long-term impairments and disabilities. Chronic complications are well-known consequences of type 2 diabetes mellitus (T2DM) progression, which reduce patient quality of life, place a burden on the healthcare system, and increase mortality. Measures to promote health outcomes for people with DM are scanty; the study therefore aimed at determining the effects of self-management and social support on glycemic control of T2DM with complications in Ghana. Methods A cross-sectional design using convenience sampling was conducted on 400 T2DM patients using Hensarling's Diabetes Family Support Scale and Summary of Diabetes Self‑Care Activities scale. Data analysis was conducted using descriptive, Pearson Moment Product Correlation and Binary Logistic Regression on self-management, social support, and glycemic control in T2DM patients. Results Social support among participants was high and there was a positive correlation or relationship between social support and T2DM self-management. There was a correlation between social support and self-management (r = 0.149, p < 0.05) and diet control (r = 0.221, p < 0.05). The results also showed a significant correlation between medication adherence and glycemic management (r = 0.116, p < 0.05) while female T2DM participants, individuals with at least primary education were less likely to have low self-management relative to T2DM. Conclusion Though the level of T2DM self-management was high it does not translate to good glycemic control. Focused health education programs should be incorporated into patients' care plans which will be particularly relevant for patients with T2DM and will contribute to positive physiological and psychological outcomes. Furthermore, a more robust monitoring and follow-up scheme should be scaled up or instituted for patients with T2DM.
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Affiliation(s)
- Frank Amankwah Adu
- Medical Technology in the Xiangya School of NursingCentral South UniversityChangshaChina
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Collins Atta Poku
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Amanda Parko Adu
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Lydia Boampong Owusu
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
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Liang W, Lo SHS, Chow KM, Zhong J, Ni X. Perception of self-management and glycaemic control in people with type 2 diabetes receiving insulin injection therapy: A qualitative study. Prim Care Diabetes 2023; 17:587-594. [PMID: 37658019 DOI: 10.1016/j.pcd.2023.08.006] [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: 11/09/2022] [Revised: 04/16/2023] [Accepted: 08/28/2023] [Indexed: 09/03/2023]
Abstract
AIM The aim of this study was to explore the experience of self-management and glycaemic control in Chinese people with type 2 diabetes receiving insulin injection therapy. METHODS A qualitative descriptive design was adopted with individual, semi-structured interviews. Participants were selected by purposive sampling. All face-to-face interviews were conducted between December 2020 and January 2021. The interviews were audio recorded and transcribed verbatim. Content analysis was used to analyse the interview data. RESULTS A total of 27 participants were recruited and individually interviewed. Three themes were generated: integrating insulin injection therapy into daily self-management; experiencing uncertainty when coping with suboptimal glycaemic control; and self-management programmes for optimal diabetes control. CONCLUSION All of our findings increase the understanding of self-management and glycaemic control in people with T2D receiving insulin injection therapy. Healthcare professionals should recognise the unmet needs of this cohort to promote their diabetes management. Appropriate and effective self-management programmes should be developed and implemented to alleviate the negative impacts of insulin injection therapy on diabetes management with consideration of cultural and personal context.
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Affiliation(s)
- Wei Liang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Suzanne Hoi Shan Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Ka Ming Chow
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Jie Zhong
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Xiaoying Ni
- Xidu Street Community Health Service Centre, Fengxian District, Shanghai, China
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Liu X, Yang W, Liu J, Huang X, Fang Y, Ming J, Lai J, Fu J, Ji Q, Wang L. The efficacy and safety of beinaglutide alone or in combination with insulin glargine in Chinese patients with type 2 diabetes mellitus who are inadequately controlled with oral antihyperglycemic therapy: A multicenter, open-label, randomized trial. J Diabetes 2023; 16:e13483. [PMID: 37864379 PMCID: PMC10850920 DOI: 10.1111/1753-0407.13483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/03/2023] [Accepted: 09/24/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND To compare glycemic control in Chinese patients with type 2 diabetes mellitus (T2DM) whose blood glucose levels were inadequately controlled with oral antidiabetic drugs after beinaglutide alone or combined with insulin glargine (IGlar). METHODS In this 16-week multicenter, randomized clinical trial, 68 participants randomly received beinaglutide or IGlar for 8 weeks, then the two drugs in combination for 8 weeks. The primary outcomes were the proportion of individuals achieving their glycemic target and the change in glucose variability as measured with a continuous glucose monitoring system from baseline to 8 and 16 weeks. RESULTS Both the beinaglutide and IGlar groups showed increased proportions achieving their glycemic target at 8 weeks, and the combination augmented the proportion reaching the glycated hemoglobin target from 25.42% at 8 weeks to 40.68% at 16 weeks. The beinaglutide group showed a significant reduction in body weight, body mass index, waist circumference, and systolic blood pressure. Beinaglutide elevated high-density lipoprotein cholesterol by 0.08 mmol/L (95% confidence interval [CI], 0.00-0.16), and diminished low-density lipoprotein cholesterol by 0.21 mmol/L (95% CI, 0.05-0.48), whereas IGlar showed no effect. Though IGlar was more efficient in lowering fasting plasma glucose than beinaglutide at comparable efficacies (to -1.57 mmol/L [95% CI, -2.60 to -0.54]), this difference was abolished in patients whose fasting C-peptide was ≥0.9 ng/mL. CONCLUSION Beinaglutide exhibited a favorable hypoglycemic effect on patients with T2DM, and in combination with IGlar, glucose level was further decreased. Low fasting C-peptide in patients may reduce the glycemic response to beinaglutide therapy. We recommend that C-peptide levels be evaluated when using or switching to the novel glucagon-like peptide-1 receptor agonists beinaglutide. TRIAL REGISTRATION ClinicalTrials.gov: NCT03829891.
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Affiliation(s)
- Xiangyang Liu
- Department of Endocrinology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Wenjuan Yang
- Department of EndocrinologyShaanxi Aerospace HospitalXi'anChina
| | - Jianrong Liu
- Department of EndocrinologyXi'an Chang An HospitalXi'anChina
| | - Xinxi Huang
- Department of Endocrinology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Yujie Fang
- Department of Endocrinology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Jie Ming
- Department of Endocrinology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Jingbo Lai
- Department of Endocrinology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Jianfang Fu
- Department of Endocrinology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Qiuhe Ji
- Department of Endocrinology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Li Wang
- Department of Endocrinology, Xijing HospitalAir Force Medical UniversityXi'anChina
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Lin M, Chen T, Fan G. Current status and influential factors associated with adherence to self-monitoring of blood glucose with type 2 diabetes mellitus patients in grassroots communities: a cross-sectional survey based on information-motivation-behavior skills model in China. Front Endocrinol (Lausanne) 2023; 14:1111565. [PMID: 37441499 PMCID: PMC10335788 DOI: 10.3389/fendo.2023.1111565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/16/2023] [Indexed: 07/15/2023] Open
Abstract
Objective Self-monitoring of blood glucose (SMBG) plays a vital role in the maintenance of blood glucose with type 2 diabetes mellitus(T2DM) and pre-diabetes patients. The study was intended to describe the current status of SMBG with T2DM and pre-diabetes patients in grassroots communities, explore the relationship between SMBG frequency and blood glucose level and apply information-motivation-behavior(IMB) model to analyze the potential influencing factors of SMBG compliance based on electronic questionnaires. Methods A cross-sectional study was conducted with 1388 T2DM and pre-diabetes patients who completed electronic questionnaires composed of demographics and IMB model content. Chi-square test, Mann-Whitney U test and multivariable logistic regression model analysis were utilized to explore deeply causes of SMBG compliance. Results The results of this study showed that among 1388 T2DM patients, only 26.2% (363/1388) patients reached SMBG standard, indicating low compliance with SMBG. Given that SMBG is one of the individual predictors of type 2 risk in prediabetes patients, this result suggests that the SMBG compliance rate needs to be improved. Patients with fixed occupation (OR=1.989, P=0.035), BMI in normal range (OR=1.336, P=0.049), smoking habit(OR=1.492, P=0.019), understanding SMBG frequency (OR=1.825, P<0.001), understanding control goal of blood glucose (OR=1.414, P<0.001), knowing all the functions of the blood glucose meter (OR=1.923, P<0.001), buying a blood glucose meter/test paper conveniently(OR=2.329, P=0.047), taking supplementary measurement when forgetting blood glucose test(OR=2.044, P=0.005), rotating all the fingers when measuring blood glucose (OR=1.616, P<0.001) and less pain at the needling site(OR=2.114, P<0.001)were independently promoting factors of adherence to SMBG. However, the lack of accessibility and convenience of blood glucose meter or heavy financial burden were blocking factors of adherence to SMBG. Moreover, there were still bottlenecks such as lack of health care knowledge and needle pricking pain. Conclusion This study verified the practicability of applying IMB model to SMBG with T2DM and pre-diabetes patients. Adherence to SMBG still remained to improved, and putting more emphasis in improvement of individual information, motivation and behavioral skills with patients might be beneficial to maintain better adherence to SMBG in long-term routine of diabetes self-management.
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Affiliation(s)
- Manxin Lin
- School of Public Health, Shantou University, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Tingting Chen
- School of Public Health, Shantou University, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Guanhua Fan
- Shantou University Medical College, Shantou, China
- Health Management Center of Outpatient Department, Cancer hospital of Shantou University Medical College, Shantou, China
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Sendekie AK, Dagnew EM, Tefera BB, Belachew EA. Health-related quality of life and its determinants among patients with diabetes mellitus: a multicentre cross-sectional study in Northwest Ethiopia. BMJ Open 2023; 13:e068518. [PMID: 36697040 PMCID: PMC9884918 DOI: 10.1136/bmjopen-2022-068518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This study assessed the health-related quality of life (HRQoL) and its determinants in patients with diabetes. DESIGN AND SETTING An institutional-based multicentre prospective cross-sectional study design was conducted in diabetes follow-up clinics of selected hospitals in Northwest Ethiopia from April to July 2022. PARTICIPANTS All eligible adult patients with diabetes at the selected facilities. MAIN OUTCOME MEASURES HRQoL was measured using EuroQol 5-dimensions 5-levels (EQ-5D-5L) and the EuroQol-Visual Analogue Scales (EQ-VAS) instruments. A lower EQ-5D-5L utility mean score for each dimension and/or an overall lower utility score of EQ-5D-5L and EQ-VAS scores are intended to show poor HRQoL. Linear regression analysis was used to identify the association of HRQoL and other variables. RESULTS Out of the 422 samples approached, 402 (95.3%) participated in the study. Most of the participants (>85%) reported having moderate-to-severe problems in all five EQ dimensions. The overall EQ-5D-5L utility and EQ-VAS scores were 0.56 (±0.11) and 56.7 (±10.1), respectively. A higher body mass index (BMI) (p < 0.001), a higher number of medications (p = 0.037), a high level of blood glucose (p < 0.001), the presence of comorbidities and/or complications (p = 0.031), hypoglycaemia (p = 0.043) and taking insulin (p < 0.001) were associated with worsened HRQoL, whereas practicing self-monitoring of blood glucose (p = 0.002) and taking aspirin (p = 0.008) had a significant association with increased HRQoL. CONCLUSION This study concluded that the HRQoL of patients was compromised in all five measuring dimensions. The EQ-5D-5L utility and EQ-VAS scores were far lower than other findings. Clinical and medication-related variables, such as a higher BMI, a higher number of medications, the presence of comorbidities and/or complications, hypoglycaemia and insulin use were associated with poor HRQoL in patients with diabetes. As a result, interventions should be individualised and focused on determinant factors.
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Affiliation(s)
- Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ephrem Mebratu Dagnew
- Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Bereket Bahiru Tefera
- Department of Pharmacy, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Hu L, Jin X, Li Y, Yang D, Zhang Z, He X, Chen W, Gong N. A Mixed Methods Assessment of Self- Management Needs and Preferences of People with Type 2 Diabetes Mellitus in China. Patient Prefer Adherence 2023; 17:653-666. [PMID: 36935941 PMCID: PMC10022447 DOI: 10.2147/ppa.s394003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/25/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Consistent and effective self-management is a major challenge for people with diabetes and long-term effects can be difficult to sustain despite the many interventions. Interventions often fail to take patients' perceptions of self-management into account from their perspective. Exploring the needs preferences and the influencing factors of self-management in patients can improve the effectiveness of self-management. METHODS This study used a mixed research approach, exploring patient needs and preferences through web crawl methods and using qualitative interviews to explore the logic of preferences. 1605 data were obtained from 4 online health communities through web crawlers. Data were coded using grounded theory to analyze self-management needs. The codes were also coded for frequency statistics and ranked to explain the self-management preferences. The second phase explained the logic of the ranked distribution of preferences through one-on-one interviews with 22 patients. RESULTS This study summarized six self-management needs of people with diabetes through web crawler data, among which medication management and conflict between disease and daily life were the most important concerns of patients. The reasons why patients are particularly concerned about these two needs were explored through qualitative interviews, and it was found that patients' concerns about medication were mainly due to the following three aspects: the effect of drugs is direct and obvious, medication use makes life less complicated, and progressive side effects. The patients' concerns about the conflict between disease and daily life are often caused by the following three aspects: diabetes impacts social roles, disease complicates life, and reducing the impact of the disease on life. CONCLUSION The self-management needs of Chinese diabetics have six themes. Medication management, conflict between disease and daily life, diet, diabetes knowledge, blood glucose monitoring and exerciseIn order of frequency of mention and possible preference: medication management, conflict between disease and daily life were the most frequent needs, while diet, knowledge about diabetes, blood glucose monitoring and exercise were their least frequent needs.Understanding the individual's perception and understanding of diabetes self-management and the expression of the patient's daily life situations can guide the medical team to optimize collaboration on personalized care plans.
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Affiliation(s)
- Lei Hu
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Xiaoyuan Jin
- Department of Social Medicine of School of Public Health, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yundong Li
- School of Ethnology and Sociology, Yunnan University, Kunming, Yunnan, People’s Republic of China
| | - Dan Yang
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Ziqing Zhang
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Xiaoyu He
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Weiju Chen
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
| | - Ni Gong
- School of Nursing, Jinan University, Guangzhou, Guangdong, People’s Republic of China
- Correspondence: Ni Gong; Weiju Chen, School of Nursing, Jinan University, No. 601 West Huangpu Avenue, Tianhe District, Guangzhou, Guangdong, People’s Republic of China, Tel +86 15013217344;+86 18688898425, Email ;
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Sendekie AK, Belachew EA, Dagnew EM, Netere AK. Rate of glycaemic control and associated factors in patients with type 2 diabetes mellitus treated with insulin-based therapy at selected hospitals in Northwest Ethiopia: a multicentre cross-sectional study. BMJ Open 2022; 12:e065250. [PMID: 36691186 PMCID: PMC9454077 DOI: 10.1136/bmjopen-2022-065250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/16/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This study was aimed to determine the level of glycaemic control and associated factors in patients with type 2 diabetes mellitus (T2DM) treated with insulin-based therapy. DESIGNS Institutional-based multicentre cross-sectional study design was employed to conduct this study. SETTINGS The diabetes follow-up clinics of selected hospitals in Northwest Ethiopia. PARTICIPANTS Adult patients with T2DM treated with insulin-based therapy at the selected hospitals who met the eligibility criteria were the study participants. MAIN OUTCOME MEASURES Good glycaemic control; when fasting blood glucose (FBG) level ranged from 70 to 130 mg/dL, and FBG <70 and >130 mg/dL was considered poor glycaemic control. A logistic regression model was used to identify determinants of poor glycaemic control. A p<0.05 at 95% CI was statistically significant. RESULTS Of 403 study participants, 54.8% were males with a mean age of 55.03±10.8 years. Though patients with T2DM were treated with insulin-based therapy, most of the participants (72.5%) could not achieve the target FBG. The overall mean FBG was 177.1±54.3, and far from the target glucose level. Patients who could not practise self-monitoring of blood glucose were found more likely to have poor glycaemic control compared with those who practised self-monitoring (p<0.001). Whereas patients who had a normal body mass index (p=0.011) and who were treated with premixed insulin-based therapy (p=0.04) were found less likely to have poor glycaemic control compared with patients with obesity and who received NPH insulin based-regimens, respectively. CONCLUSION This study demonstrated that a significant proportion of the study samples could not achieve glycaemic targets and the average blood glucose was far higher than the recommended glycaemic target level. Insulin initiation and titration, considering the determinants of glycaemic control, could be recommended to achieve target glycaemic levels.
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Affiliation(s)
- Ashenafi Kibret Sendekie
- Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Eyayaw Ashete Belachew
- Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Ephrem Mebratu Dagnew
- Clinical Pharmacy, Debre Markos University College of Health Science, Debre Markos, Amhara, Ethiopia
| | - Adeladlew Kassie Netere
- Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Ye J, Deng J, Liang W, Luo H, Wen M, Liu L, Wang M, Shu Y. Time in Range Assessed by Capillary Blood Glucose in Relation to Insulin Sensitivity and β-Cell Function in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in China. J Diabetes Investig 2022; 13:1825-1833. [PMID: 35739637 DOI: 10.1111/jdi.13876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022] Open
Abstract
AIMS This study investigated the association of capillary blood glucose (CBG)-assessed time in range (TIR) (3.9-10.0 mmol/L) with insulin sensitivity and islet β-cell function (BCF). MATERIALS AND METHODS We recruited 455 patients with type 2 diabetes mellitus. Seven-point glucose-profile data (pre- and 120-min post-main meals, bedtime) were collected over three consecutive days. Plasma glucose and serum insulin concentrations were measured at 0, 60, and 120 min after a 100-g standard steamed bread meal test. The homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda index were computed to evaluate insulin resistance (IR). HOMA of β-cell function (HOMA-β) and the area under the curve between insulin and blood glucose (IAUC0-120 /GAUC0-120 ) were used to estimate BCF. RESULTS TIR was positively correlated with 60- and 120-min insulin values, IAUC0-120 , the Matsuda index, HOMA-β, and IAUC0-120 /GAUC0-120 (rs : 0.154, 0.129, 0.137, 0.194, 0.341, and 0.334, respectively; P <0.05) but inversely correlated with HOMA-IR (rs : -0.239, P <0.001). After adjusting for confounders, multinomial multiple logistic regression analysis revealed that the odds ratios (ORs) of achieving the target TIR (>70%) increased by 12% (95% confidence interval [CI]: 3-21%), 7% (95% CI: 1-14%), 10% (95% CI: 5-16%), and 45% (95% CI: 25-68%) for each 10-mIU/L increase in 60- and 120-min insulin value, 10-unit increase in HOMA-β, and unit increase in IAUC0-120 /GAUC0-120 , respectively (P <0.05). Nevertheless, the OR decreased by 10% (95% CI: 1-18%) for each unit increase in HOMA-IR (P <0.05). CONCLUSIONS IR and BCF are related to CBG-assessed TIR.
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Affiliation(s)
- Jingwen Ye
- Department of Endocrinology,the Sixth Affiliated Hospital, South China University of Technology, Guidan Road 120, Foshan, 528200, Guangdong Province, China
| | - Jiajin Deng
- Department of Ophthalmology,the Sixth Affiliated Hospital, South China University of Technology, Guidan Road 120, Foshan, 528200, Guangdong Province, China
| | - Weiqiang Liang
- Department of Endocrinology,the Sixth Affiliated Hospital, South China University of Technology, Guidan Road 120, Foshan, 528200, Guangdong Province, China
| | - Haizhao Luo
- Department of Endocrinology,the Sixth Affiliated Hospital, South China University of Technology, Guidan Road 120, Foshan, 528200, Guangdong Province, China
| | - Mei Wen
- Department of Endocrinology,the Sixth Affiliated Hospital, South China University of Technology, Guidan Road 120, Foshan, 528200, Guangdong Province, China
| | - Lei Liu
- Department of Endocrinology,the Sixth Affiliated Hospital, South China University of Technology, Guidan Road 120, Foshan, 528200, Guangdong Province, China
| | - Mingzhu Wang
- Department of Endocrinology,the Sixth Affiliated Hospital, South China University of Technology, Guidan Road 120, Foshan, 528200, Guangdong Province, China
| | - Yi Shu
- Department of Endocrinology,the Sixth Affiliated Hospital, South China University of Technology, Guidan Road 120, Foshan, 528200, Guangdong Province, China
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11
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Pleus S, Freckmann G, Schauer S, Heinemann L, Ziegler R, Ji L, Mohan V, Calliari LE, Hinzmann R. Self-Monitoring of Blood Glucose as an Integral Part in the Management of People with Type 2 Diabetes Mellitus. Diabetes Ther 2022; 13:829-846. [PMID: 35416589 PMCID: PMC9076772 DOI: 10.1007/s13300-022-01254-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022] Open
Abstract
For decades, self-monitoring of blood glucose (SMBG) has been considered a cornerstone of adequate diabetes management. Structured SMBG can follow different monitoring patterns, and it results in improved glycemic control, reduced hypoglycemia, and a better quality of life of people with diabetes. The technology, usability, and accuracy of SMBG systems have advanced markedly since their introduction a few decades ago. Current SMBG systems are small and easy to use, require small (capillary) blood sample volumes, and provide measurement results within seconds. In addition, devices are increasingly equipped with features such as connectivity to other devices and/or digital diaries and diabetes management tools. Although measurement quality can come close to or equal that of the glucose monitoring systems used by healthcare professionals, several available SMBG systems still do not meet internationally accepted accuracy standards, such as the International Organization for Standardization 15197 standard. Reports from China, India, and Brazil based on local experience suggest that in addition of the accuracy issues of SMBG systems, other obstacles also need to be overcome to optimize SMBG usage. Nonetheless, adequate usage of SMBG data is of high relevance for the management of people with type 2 diabetes mellitus.
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Affiliation(s)
- Stefan Pleus
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Guido Freckmann
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Sebastian Schauer
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | | | - Ralph Ziegler
- Diabetes Clinic for Children and Adolescents, Muenster, Germany
| | - Linong Ji
- Peking University People's Hospital, Peking, China
| | - Viswanathan Mohan
- Dr. Mohan's Diabetes Specialities Centre, Chennai, India
- Madras Diabetes Research Foundation, Chennai, India
| | - Luis Eduardo Calliari
- Pediatric Endocrine Unit, Pediatric Department, Santa Casa School of Medical Department, Santa Casa School of Medical Sciences, Sao Paulo, Brazil
| | - Rolf Hinzmann
- Roche Diabetes Care GmbH, Sandhofer Straße 116, 68305, Mannheim, Germany.
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12
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Tang J, Wu T, Hu X, Gao L. Self-care activities among patients with type 2 diabetes mellitus: A cross-sectional study. Int J Nurs Pract 2021; 27:e12987. [PMID: 34101931 DOI: 10.1111/ijn.12987] [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: 11/03/2019] [Revised: 05/19/2021] [Accepted: 05/29/2021] [Indexed: 11/30/2022]
Abstract
AIMS This study investigated self-care activities and identified their related factors in Chinese patients with type 2 diabetes mellitus. METHODS A cross-sectional study was conducted in Guangzhou, China, between September 2016 and February 2017, involving 202 Chinese patients with type 2 diabetes mellitus. Measures included the Summary of Diabetes Self-Care Activities Questionnaire and Revised Illness Perception Questionnaire. RESULTS Self-care activities in Chinese patients with type 2 diabetes mellitus were suboptimal overall. Foot care and blood sugar testing were the self-care activities that were performed the least. One fifth of patients smoked. Some subscales of illness perceptions, receiving health education on diabetes, employment status, education level, body mass index, age and time since type 2 diabetes mellitus diagnosis, were related to self-care activities in patients with type 2 diabetes mellitus. CONCLUSION Health-care providers and nurses should encourage greater engagement in self-care activities in patients with type 2 diabetes mellitus, especially foot care and blood sugar testing. Illness perceptions may be used as a framework to guide interventions.
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Affiliation(s)
- Jiao Tang
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Tingting Wu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiling Hu
- the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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13
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Chin YF, Huang TT, Yu HY, Yang HM, Hsu BRS. Factors related to hospital-to-home transitional self-monitoring blood glucose behaviour among patients with diabetes-related foot ulcer. Int J Nurs Pract 2021; 27:e12950. [PMID: 33915598 DOI: 10.1111/ijn.12950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 02/09/2021] [Accepted: 04/06/2021] [Indexed: 12/15/2022]
Abstract
AIMS To explore the factors related to hospital-to-home transitional self-monitoring blood glucose behaviour among patients with diabetes-related foot ulcer. BACKGROUND The 30-day readmission rate of patients with diabetes-related foot ulcer can be reduced when good glycaemic control is achieved. The practice of self-monitoring blood glucose promotes optimal glycaemic control. DESIGN A comparative descriptive study. METHODS In this study, 200 participants, who had been hospitalized due to diabetes-related foot ulcer, were recruited from August 2017 to July 2018. Before participants were discharged from the hospital, psychosocial factors (family support, threat belief, self-efficacy and knowledge) and pre-hospitalization self-monitoring blood glucose behaviour were collected using a structured questionnaire. Then, after discharge, self-monitoring blood glucose behaviour delivery was collected again. RESULTS Five variables explained 47% of the variance in the delivery of self-monitoring of blood glucose at home. The delivery of hospital-to-home transitional self-monitoring blood glucose behaviour was more likely for individuals with higher pre-discharge self-efficacy, higher post-discharge self-efficacy, more attention to pre-hospitalization glycaemic status and post-discharge insulin usage and those without an insensitive foot. CONCLUSION Self-monitoring blood-glucose behaviour should be promoted among post-discharge patients with diabetes-related foot ulcer. The modifiable factors identified in this study can be integrated into the discharge plan.
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Affiliation(s)
- Yen-Fan Chin
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Endocrinology and Metabolism, Linkou Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tzu-Ting Huang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsing-Yi Yu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Child Ophthalmology, Department of Ophthalmology, Linkou Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hui-Mei Yang
- Department of Endocrinology and Metabolism, Linkou Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Brend Ray-Sea Hsu
- Department of Endocrinology and Metabolism, Linkou Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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14
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Lu R, Li Y, Zheng Z, Yan Z. Exploring Factors Associated with Self-Management Compliance among Rural Elders with Diabetes. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211012491. [PMID: 33899547 PMCID: PMC8082998 DOI: 10.1177/00469580211012491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of the study was to examine the social-ecological factors associated with diabetic self-management compliance among elders with diabetes in China. A total of 2,586 rural elderly residents who were 60-years-old or above participated in the survey. Socio-demographic factors, social support, healthcare accessibility and health risk factors were measured, along with self-reported medication and blood glucose monitoring data. Among the 117 individuals with diabetes, the medication compliance rate was 79.49%. The elderly who had high economic status were more likely to meet medication treatment compliance. Only 58.97% of study participants monitored blood glucose once a month. Younger age (<70-year-old), higher economic status, more social support and better healthcare accessibility were associated with higher blood glucose monitoring compliance odds. Diabetic medication and blood glucose testing tools should be more comprehensively covered by the national insurance program. Healthcare accessibility should be increased through transportation support, building more local facilities, such as mobile labs, and promoting affordable home-visit care. Self-management education programs about diabetes for rural elders should be promoted.
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Affiliation(s)
- Ruoyan Lu
- Public Health School of Fujian Medical University, Fuzhou, China
| | - Yueping Li
- Public Health School of Fujian Medical University, Fuzhou, China
| | - Zhenquan Zheng
- Public Health School of Fujian Medical University, Fuzhou, China
| | - Zi Yan
- School of Health Sciences, Merrimack College, North Andover, MA, USA
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15
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Masyuko S, Ngongo CJ, Smith C, Nugent R. Patient-reported outcomes for diabetes and hypertension care in low- and middle-income countries: A scoping review. PLoS One 2021; 16:e0245269. [PMID: 33449968 PMCID: PMC7810280 DOI: 10.1371/journal.pone.0245269] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/26/2020] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Patient-reported outcome measures (PROMs) assess patients' perspectives on their health status, providing opportunities to improve the quality of care. While PROMs are increasingly used in high-income settings, limited data are available on PROMs use for diabetes and hypertension in low-and middle-income countries (LMICs). This scoping review aimed to determine how PROMs are employed for diabetes and hypertension care in LMICs. METHODS We searched PubMed, EMBASE, and ClinicalTrials.gov for English-language studies published between August 2009 and August 2019 that measured at least one PROM related to diabetes or hypertension in LMICs. Full texts of included studies were examined to assess study characteristics, target population, outcome focus, PROMs used, and methods for data collection and reporting. RESULTS Sixty-eight studies met the inclusion criteria and reported on PROMs for people diagnosed with hypertension and/or diabetes and receiving care in health facilities. Thirty-nine (57%) reported on upper-middle-income countries, 19 (28%) reported on lower-middle-income countries, 4 (6%) reported on low-income countries, and 6 (9%) were multi-country. Most focused on diabetes (60/68, 88%), while 4 studies focused on hypertension and 4 focused on diabetes/hypertension comorbidity. Outcomes of interest varied; most common were glycemic or blood pressure control (38), health literacy and treatment adherence (27), and acute complications (22). Collectively the studies deployed 55 unique tools to measure patient outcomes. Most common were the Morisky Medication Adherence Scale (7) and EuroQoL-5D-3L (7). CONCLUSION PROMs are deployed in LMICs around the world, with greatest reported use in LMICs with an upper-middle-income classification. Diabetes PROMs were more widely deployed in LMICs than hypertension PROMs, suggesting an opportunity to adapt PROMs for hypertension. Future research focusing on standardization and simplification could improve future comparability and adaptability across LMIC contexts. Incorporation into national health information systems would best establish PROMs as a means to reveal the effectiveness of person-centered diabetes and hypertension care.
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Affiliation(s)
- Sarah Masyuko
- RTI International, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Ministry of Health, Nairobi, Kenya
| | - Carrie J. Ngongo
- RTI International, Seattle, Washington, United States of America
- * E-mail:
| | - Carole Smith
- RTI International, Seattle, Washington, United States of America
- Department of Neurology, University of Washington, Seattle, Washington, United States of America
| | - Rachel Nugent
- RTI International, Seattle, Washington, United States of America
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16
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Wu W, He S, Shen Y, Zhang J, Wan Y, Tang X, Liu S, Yao X. Natural Product Luteolin Rescues THAP-Induced Pancreatic β-Cell Dysfunction through HNF4α Pathway. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2020; 48:1435-1454. [PMID: 32907363 DOI: 10.1142/s0192415x20500706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Endoplasmic reticulum stress (ER stress) plays a main role in pancreatic [Formula: see text]-cell dysfunction and death because of intracellular Ca[Formula: see text] turbulence and inflammation activation. Although several drugs are targeting pancreatic [Formula: see text]-cell to improve [Formula: see text]-cell function, there still lacks agents to alleviate [Formula: see text]-cell ER stress conditions. Therefore we used thapsigargin (THAP) or high glucose (HG) to induce ER stress in [Formula: see text]-cell and aimed to screen natural molecules against ER stress-induced [Formula: see text]-cell dysfunction. Through screening the Traditional Chinese drug library ([Formula: see text] molecules), luteolin was finally discovered to improve [Formula: see text]-cell function. Cellular viability results indicated luteolin reduced the THAP or HG-induced [Formula: see text]-cell death and apoptosis through MTT and flow cytometry assay. Moreover, luteolin improved [Formula: see text]-cell insulin secretion ability under ER stress conditions. Also ER stress-induced intracellular Ca[Formula: see text] turbulence and inflammation activation were inhibited by luteolin treatment. Mechanically, luteolin inhibited HNF4[Formula: see text] signaling, which was induced by ER stress. Moreover, luteolin reduced the transcriptional level of HNF4[Formula: see text] downstream gene, such as Asnk4b and HNF1[Formula: see text]. Conversely HNF4[Formula: see text] knockdown abolished the effect of luteolin on [Formula: see text]-cell using siRNA. These results suggested the protective effect of luteolin on [Formula: see text]-cell was through HNF4[Formula: see text]/Asnk4b pathway. In conclusion, our study discovered that luteolin improved [Formula: see text]-cell function and disclosed the underlying mechanism of luteolin on [Formula: see text]-cell, suggesting luteolin is a promising agent against pancreatic dysfunction.
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Affiliation(s)
- Wenyu Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, P. R. China
| | - Shijun He
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern, Medical University, Guangzhou 510515, P. R. China
| | - Yuli Shen
- Nephrology Department, Longgang District People's Hospital of Shenzhen, Shenzhen 518172, P. R. China
| | - Jiawen Zhang
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern, Medical University, Guangzhou 510515, P. R. China
| | - Yihong Wan
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern, Medical University, Guangzhou 510515, P. R. China
| | - Xiaodong Tang
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern, Medical University, Guangzhou 510515, P. R. China
| | - Shuwen Liu
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern, Medical University, Guangzhou 510515, P. R. China.,Center of Pharmacy, Nanhai Hospital, Southern Medical University, Foshan 510080, P. R. China
| | - Xingang Yao
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of New Drug Screening, Guangzhou Key Laboratory of Drug Research for Emerging Virus Prevention and Treatment, School of Pharmaceutical Sciences, Southern, Medical University, Guangzhou 510515, P. R. China.,Center of Clinical Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou 510515, P. R. China
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17
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Gao L, Zhang P, Weng J, Lu J, Guo X, Jia W, Yang W, Zou D, Zhou Z, Pan C, Gao Y, Li X, Zhu D, Wu Y, Garg SK, Ji L. Patient characteristics and 6-month dose of basal insulin associated with HbA1c achievement <7.0% in Chinese people with type 2 diabetes: results from the Observational Registry of Basal Insulin Treatment (ORBIT). J Diabetes 2020; 12:668-676. [PMID: 32329194 DOI: 10.1111/1753-0407.13046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 04/16/2020] [Accepted: 04/19/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The efficacy of basal insulin (BI) for adequate glycemic control in patients with type 2 diabetes mellitus (T2DM) has been well documented by randomized clinical trials. This post hoc analysis of the Observational Registry of Basal Insulin Treatment (ORBIT) study was performed to explore the 6-month dose of BI used in insulin-naïve T2DM patients achieving HbA1c target (<7%) and determine the patient characteristics that affect the 6-month dose of BI in the setting of real-world clinics in China. METHODS This multicenter observational registry screened 19 894 adult T2DM patients with inadequately controlled hyperglycemia and treated with oral antidiabetic drugs (OADs) in China. Of these patients, 5191 who continued to receive BI after 6 months and achieved HbA1c target were analyzed. Patient characteristics including age, body weight, fasting plasma glucose (FPG), use of OADs, insulin (type and dose), and glycemic control were recorded at baseline and 6-month follow-ups. RESULTS The 6-month dose of BI needed for effective glycemic control was 0.20 ± 0.08 U/kg/day. High body mass index, high FPG, young age, longer duration of diabetes or OAD treatment, a greater number of OADs at baseline, and allocation to detemir and glargine were significant independent predictors for high dose of BI at 6 months. CONCLUSIONS This post hoc analysis of the ORBIT registry provides key information on the 6-month dose of BI needed for effective glycemic control in Chinese T2DM patients. Furthermore, it identified crucial patient characteristics that are significant determinants of the dose of BI in a real-world setting.
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Affiliation(s)
- Leili Gao
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Puhong Zhang
- Diabetes Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital, Division of life sciences and medicine, University of Science and Technology of China, Hefei, China
| | - Juming Lu
- Department of Endocrinology, The General Hospital of the People's Liberation Army, Beijing, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wenying Yang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Dajin Zou
- Department of Endocrinology, The Second Military Medical University, Shanghai, China
| | - Zhiguang Zhou
- Department of Endocrinology, Xiangya Second Hospital, Changsha, China
| | - Changyu Pan
- Department of Endocrinology, The General Hospital of the People's Liberation Army, Beijing, China
| | - Yan Gao
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Xian Li
- Diabetes Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Dongshan Zhu
- Diabetes Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Yangfeng Wu
- Diabetes Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Satish K Garg
- Barbara Davis Center for Diabetes, University of Colorado Denver, Colorado, Aurora, USA
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
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18
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Zhang Y, Dai J, Han X, Zhao Y, Zhang H, Liu X, Li W, Ling H, Zhou X, Ying C. Glycemic variability indices determined by self-monitoring of blood glucose are associated with β-cell function in Chinese patients with type 2 diabetes. Diabetes Res Clin Pract 2020; 164:108152. [PMID: 32360707 DOI: 10.1016/j.diabres.2020.108152] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 04/05/2020] [Accepted: 04/14/2020] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Glycemic control plays an important role in diabetes management, and self-monitoring of blood glucose (SMBG) is critical to achieving good glycemic control. However, there are few studies about the relationship between SMBG-estimated glycemic indices and β-cell function. Here we investigated the association between glucose variation indices estimated by SMBG and β-cell function among Chinese patients with type 2 diabetes mellitus (T2DM). METHODS In this cross‑sectional study, 397 patients with T2DM were recruited from February 2015 to October 2016. β-cell function was monitored using the Homeostasis Model Assessment 2 (HOMA2)-%β index. The parameters evaluated by SMBG were the mean blood glucose (MBG), standard deviation of MBG (SDBG), largest amplitude of glycemic excursions (LAGE), and postprandial glucose excursion (PPGE). RESULTS HOMA2-%β was negatively correlated with SDBG, LAGE, PPGE, and MBG (r = -0.350, -0.346, -0.178, and -0.631, respectively; all p < 0.01). After adjusting for confounding characteristics (diabetic duration, triglyceride, total cholesterol, fasting C-peptide, HOMA2-insulin resistance index, hypoglycemia, and diabetic treatments) and glycated hemoglobin A1c on a continuous scale, odds ratios of SDBG, LAGE, PPGE, and MBG between the patients in the lowest and highest HOMA2-%β quartiles were 2.02 (1.14-3.57), 1.24 (1.04-1.49), 1.13 (0.86-1.51), and 2.26 (1.70-3.00). HOMA2-%β was independently associated with SDBG, LAGE, and MBG. CONCLUSIONS Increased SDBG and LAGE assessed by SMBG are associated with β-cell dysfunction in Chinese patients with T2DM.
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Affiliation(s)
- Yusheng Zhang
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu 221002, PR China
| | - Jiao Dai
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu 221002, PR China
| | - Xiao Han
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu 221002, PR China
| | - Yue Zhao
- The Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu 221002, PR China
| | - Hui Zhang
- Department of Endocrinology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, PR China
| | - Xuan Liu
- Department of Endocrinology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, PR China
| | - Wei Li
- Department of Endocrinology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, PR China
| | - Hongwei Ling
- Department of Endocrinology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, PR China
| | - Xiaoyan Zhou
- Laboratory of Morphology, Xuzhou Medical University, Xuzhou, Jiangsu 221004, PR China
| | - Changjiang Ying
- Department of Endocrinology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, PR China.
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Ji L, Gao L, Chen L, Wang Y, Ma Z, Ran X, Sun Z, Xu X, Wang G, Guo L, Shan Z. Insulin delivery with a needle-free insulin injector versus a conventional insulin pen in Chinese patients with type 2 diabetes mellitus: A 16-week, multicenter, randomized clinical trial (the FREE study). EClinicalMedicine 2020; 23:100368. [PMID: 32529176 PMCID: PMC7283138 DOI: 10.1016/j.eclinm.2020.100368] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Insulin therapy is poorly accepted by patients with type 2 diabetes mellitus (T2DM). A needle-free insulin injector has been developed for patients who fear injections or are reluctant to initiate insulin therapy when it is clearly indicated. The objective of this trial was to evaluate the glucose-lowering effect, tolerability, patient satisfaction and compliance with insulin treatment via a needle-free insulin injector (NFII) compared with insulin treatment via a conventional insulin pen (CIP) in patients with T2DM. METHODS A total of 427 patients with T2DM were enrolled in a prospective, multicenter, randomized, open-label study, and were randomly assigned 1:1 to receive 16 weeks' treatment with basal insulin or premixed insulin administered either by a NFII or CIP. TRIAL REGISTRATION ClinicalTrials.gov (NCT03243903). FINDINGS In the 412 patients who completed the study, the adjusted mean reduction of HbA1c from baseline at week 16 in the NFII group was 0.55% (95% CI -0.71, -0.39), which was non-inferior and statistically superior to the HbA1c reduction in the CIP group (0.26%, 95% CI -0.42, -0.11). Patients in the NFII group showed significantly higher treatment satisfaction scores than those in the CIP group (mean scores, 8.17 ± 1.78 vs. 7.21 ± 2.22, respectively; p<0.0001). The occurrence of hypoglycemia was similar in the two groups, and the NFII group showed reduced incidences of skin scratches, indurations and lower VAS pain scores. INTERPRETATION Insulin therapy through needle-free injector showed a non-inferior glycemic-lowering effect and a significantly enhanced level of patient satisfaction with insulin treatment compared with conventional insulin therapy through needle injections. In addition, the needle-free injector also had a better safety profile. FUNDING This study were funded by Beijing QS Medical Technology Co., Ltd, as well as The Major Chronic Non-communicable Disease Prevention and Control Research.
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Affiliation(s)
- Linong Ji
- Department of Endocrinology and Metabolism, Peking University Peoples Hospital, Beijing, China
- Corresponding author.
| | - Leili Gao
- Department of Endocrinology and Metabolism, Peking University Peoples Hospital, Beijing, China
| | - Liming Chen
- Metabolic Disease Hospital, Tianjin Medical University, Heping District, Tianjin, China
| | - Yangang Wang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhongshu Ma
- Department of Endocrinology and Metabolism, General Hospital of Tianjin Medical University, Tianjin, China
| | - Xingwu Ran
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Xiangjin Xu
- Department of Endocrinology, Fuzhou General Hospital of Nanjing Command, Fujian Province, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Zhongyan Shan
- Department of Endocrinology, the First Affiliated Hospital of China Medical University, Shenyang, China
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Addai-Mensah O, Annani-Akollor ME, Nsafoah FO, Fondjo LA, Owiredu EW, Danquah KO, Duneeh RV, Amponsah FA. Effect of poor glycaemic control on plasma levels and activity of protein C, protein S, and antithrombin III in type 2 diabetes mellitus. PLoS One 2019; 14:e0223171. [PMID: 31560710 PMCID: PMC6764655 DOI: 10.1371/journal.pone.0223171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 08/23/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) patients are predisposed to several diabetes-related complications. Dysregulation of the haemostatic mechanisms have been implicated. There are however no current studies assessing the levels and activity of protein C (PC), protein S (PS), and antithrombin III (AT III), which are essential in haemostatic regulation, in a single cohort of T2DM patients. This study evaluated the effect of poorly-managed T2DM on the levels and activity of PC, PS, and AT III. METHODS This cross-sectional study was conducted at the Diabetes Clinic, Cocoa Clinic in Kumasi, Ghana. A total of 242 T2DM patients, comprising 152 patients with poorly-managed diabetes and 90 well-managed diabetes patients, were recruited for the study. Fasting blood glucose, liver function tests and lipid profile were performed for each respondent. Glycated haemoglobin (HbA1c) was estimated by turbidimetric inhibition immunoassay. The levels and activity of PC, PS and AT III were measured by solid phase sandwich ELISA method. RESULTS There was a negative correlation between HbA1c and the levels and activity of PC, PS and AT III. The levels and activity of PC [(5.78 vs 4.64 μg/ml, p<0.0001) and (42.22 vs 36.21 U/ml, p = 0.01) respectively], PS [(22.55 vs 20.29 μg/ml, p = 0.010) and (235.94 vs 211.67 U/ml, p<0.0001) respectively] and AT III [(16.28 vs 14.41μg/ml, p<0.0001) and (176.01 vs 160.09 U/ml, p = 0.03) respectively] were significantly increased in patients with well-managed T2DM compared to the poorly-managed diabetes patients. Likewise, the levels and activity of PC, PS, and AT III was higher among T2DM patients using statins than patients who were statin-naïve. Among patients with well-managed T2DM, those who were on statins had significantly higher levels and activities of PC, PS, and AT III compared to well-managed T2DM patients not on statins. However, there no statistically significant differences between the level and activity of PC, PS, and AT III among poorly-managed T2DM patients with respect to statin status. CONCLUSION Poorly-managed type 2 diabetes mellitus is associated with reduced levels and activity of PC, PS and AT III compared to well-managed T2DM. Though use of statins may improve the levels and activity of the PC, PS and AT III in T2DM, their effect is limited in the presence of poorly-controlled T2DM. Proper management of diabetes is essential to reduce the likelihood of thrombotic events among T2DM patients.
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Affiliation(s)
- Otchere Addai-Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- * E-mail: ,
| | - Max Efui Annani-Akollor
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Frederick Obeng Nsafoah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Ahenkorah Fondjo
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwabena Owusu Danquah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Pedersen‐Bjergaard U, Alsifri S, Aronson R, Berković MC, Galstyan G, Gydesen H, Lekdorf JB, Ludvik B, Moberg E, Ramachandran A, Khunti K. Comparison of the HAT study, the largest global hypoglycaemia study to date, with similar large real-world studies. Diabetes Obes Metab 2019; 21:844-853. [PMID: 30456887 PMCID: PMC6590793 DOI: 10.1111/dom.13588] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 11/30/2022]
Abstract
AIMS Optimal diabetes care requires clear understanding of the incidence of hypoglycaemia in real-world clinical practice. Current data on hypoglycaemia are generally limited to those reported from randomised controlled clinical trials. The Hypoglycaemia Assessment Tool (HAT) study, a non-interventional real-world study of hypoglycaemia, assessed hypoglycaemia in 27 585 individuals across 24 countries. The present study compared the incidence of hypoglycaemia from the HAT study with other similarly designed, large, real-world studies. MATERIALS AND METHODS A literature search of PubMed (1995-2017) for population-based studies of insulin-treated patients with type 1 or type 2 diabetes (T1D, T2D), excluding clinical trials and reviews, identified comparable population-based studies reporting the incidence of hypoglycaemia. RESULTS The 24 comparative studies, including more than 24 000 participants with T1D and more than 160 000 participants with T2D, varied in design, size, inclusion criteria, definitions of hypoglycaemia and method of recording hypoglycaemia. Reported rates (events per patient-year [PPY]) of hypoglycaemia were higher in patients with T1D than in those with T2D (overall T1D, 21.8-73.3 and T2D, 1.3-37.7; mild/non-severe T1D, 29.0-126.7 and T2D, 1.3-41.5; severe T1D, 0.7-5.8 and T2D, 0.0-2.5; nocturnal T1D, 2.6-11.3 and T2D, 0.38-9.7) and were similar to the ranges found in the HAT study. CONCLUSIONS The HAT data on hypoglycaemia incidence were comparable with those from other real-world studies and indicate a high incidence of hypoglycaemia among insulin-treated patients. Differences in rates among studies are mostly explained by differences in patient populations and study methodology. The goal of reducing hypoglycaemia should be a target for continued educational and evidence-based pharmacological interventions.
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Affiliation(s)
| | | | - Ronnie Aronson
- Endocrinology and MetabolismLMC Diabetes and EndocrinologyTorontoOntarioCanada
| | | | | | | | | | - Bernhard Ludvik
- Division of Endocrinology and MetabolismRudolfstiftung Hospital and Karl‐Landsteiner InstituteViennaAustria
| | | | | | - Kamlesh Khunti
- Diabetes Research CentreUniversity of LeicesterLeicesterUK
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Wang X, Luo JF, Qi L, Long Q, Guo J, Wang HH. Adherence to self-monitoring of blood glucose in Chinese patients with type 2 diabetes: current status and influential factors based on electronic questionnaires. Patient Prefer Adherence 2019; 13:1269-1282. [PMID: 31413552 PMCID: PMC6662864 DOI: 10.2147/ppa.s211668] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/30/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND PURPOSE Self-monitoring of blood glucose (SMBG) is important to the management of diabetes mellitus, yet most patients with type 2 diabetes mellitus (T2DM) do not perform SMBG as recommended. The current status and influential factors of SMBG in China have not been well investigated. This study aimed to describe the present status of SMBG adherence in China and investigate the influential factors based on electronic questionnaires. PATIENTS AND METHODS A cross-sectional study was conducted from June to July of 2017 at hospitals in Changsha, China. Seven hundred and twenty-one patients with T2DM completed the information‑motivation‑behavioral (IMB) skills questionnaire and other electronic questionnaires composed of demographic and clinical characteristics as well as diabetes-related and psychological scales. Univariate comparisons and multivariate logistic regression were used to explore the relationships among SMBG adherence and related factors. RESULTS Seven hundred and twenty-one patients with valid questionnaires were included. Only 27.5% (198/721) of the patients with T2DM were SMBG adherent based on the guideline of the Chinese Diabetes Society (CDS) in 2017. Among all groups of treatment regimens, the rate of SMBG adherence was highest at 36.6% (82/224) in patients on oral hypoglycaemic drugs (OHAs). In multivariable analysis, the treatment of OHAs (OR =3.731, CI 2.162-6.437) and diet/exercise (OR =3.534, CI 1.841-6.783), the patient having their own blood glucose meter (OR =6.916, CI 4.054-11.800) and a higher education level (OR =3.780, CI 1.688-8.466) were significantly associated with SMBG adherence. CONCLUSION Most Chinese patients with T2DM did not perform SMBG as recommended. The treatment of OHAs and diet/exercise, the patient having their own blood glucose meter, a higher education level and other factors were correlates of SMBG adherence. There is clearly a need for prospective, multicenter, large-scale studies to explore the reasons for patients' failure to practice SMBG adherence.
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Affiliation(s)
- Xin Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
| | - Jun-Fei Luo
- The College of Literature and Journalism, Central South University, Changsha, Hunan, People’s Republic of China
| | - Lin Qi
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, the Second Xiangya Hospital, Changsha, Hunan, People’s Republic of China
| | - Qing Long
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
| | - Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
- Correspondence: Jia GuoXiangya School of Nursing, Central South University, No. 172 Tongzipo Road, Changsha410013, Hunan, People’s Republic of ChinaTel +86 1 387 594 7418Email
| | - Hong-Hong Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
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Shen Y, Zhu W, Lu L, Lu F, Kan K, Bao Y, Zhou J, Jia W. Contribution of structured self-monitoring of blood glucose to self-efficacy in poorly controlled diabetes patients in China. Diabetes Metab Res Rev 2019; 35:e3067. [PMID: 30144264 DOI: 10.1002/dmrr.3067] [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: 06/08/2018] [Revised: 08/13/2018] [Accepted: 08/18/2018] [Indexed: 11/10/2022]
Abstract
AIM To investigate the association between structured self-monitoring of blood glucose (SMBG) and diabetes self-efficacy in Chinese patients. METHODS This study was a single-centre, open-label, prospective, randomized controlled trial. A total of 250 type 1 and type 2 diabetes patients were recruited and randomly assigned to the structured SMBG group and the control group in a 1:1 ratio. The main outcome observed in this subgroup analysis was a change in the diabetes self-efficacy scale (DSES) scores. A multivariate generalized estimating equation was used to evaluate factors affecting the DSES scores. RESULTS We found that the DSES scores tended to decrease significantly with the follow-up time in the intervention group (Wald β = 7.882, P < .001; Wald β = 3.130, P = .003; Wald β = 7.879, P < .001). However, no significant differences in the DSES scores were detected in the control group. Glycaemic control improved in both the intervention and control groups at the third month (P < .05). In the intervention group, sustained improvement of the DSES scores maintained the improvement in glycaemic control through the sixth month. In the control group, glycaemic control tended to deteriorate in the sixth month without the support of an improved DSES scores (P = .056). CONCLUSION Structured SMBG could contribute to the effective and persistent improvement of diabetes self-efficacy. (ClinicalTrials.gov, NCT02225691).
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Affiliation(s)
- Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wei Zhu
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lihua Lu
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Fengdi Lu
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Kai Kan
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Olamoyegun MA, Akinlade AT, Ala OA. Audit of insulin prescription patterns and associated burden among diabetics in a tertiary health institution in Nigeria. Afr Health Sci 2018; 18:852-864. [PMID: 30766548 PMCID: PMC6354893 DOI: 10.4314/ahs.v18i4.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Insulin is one of the most important anti-diabetic agents in the management of diabetes even among type 2 diabetic. OBJECTIVE There was need to assess insulin adherence, mode of insulin delivery and burden of insulin usage among diabetics. METHODS A cross-sectional, prospective questionnaire, orally administered at a Diabetes Clinic of a University Teaching Hospital, SouthWest, Nigeria. Participants were consecutive patients with diabetes who were 18 years or older presently on insulin either alone or in combination with other anti-diabetic agents for at least 3 months. Baseline demographic and insulin treatment information were obtained. RESULTS Two hundred and thirteen (213) participants were studied. Of these, 21 (9.9%) had T1DM and 192 (90.1%) had T2DM, (means age, 58.6 ± 13.1 years, mean duration of diabetes, 7.0 ± 6.9 years). Insulin adherence was noted in 72.8% with better adherence among those who self-injected insulin compared to those who were injected by health care professionals (HCPs) or relations. Among the respondents, 80.8% were on human insulin and pre-mixed insulin was the most commonly used form of insulin (52.6%). Most participants (52.6%) were taking 10-20 units per day, only 22 (10.3%) were on >40units/day. Reuse of insulin needle was found in 74.6% of the participants. Major reasons for insulin omission were non-availability of insulin and patients being tired of insulin injection. CONCLUSION The insulin adherence among diabetics in this study was high. Non-availability of insulin, insulin injection pain and being tired of continual insulin usage were some of the reasons for non-adherent to insulin usage.
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Affiliation(s)
- Michael A Olamoyegun
- Department of Internal Medicine, Endocrinology, Diabetes & Metabolism Unit, Ladoke Akintola University of Technology, & LAUTECH Teaching Hospital, Ogbomoso, Oyo State, Nigeria
| | | | - Oluwabukola A Ala
- Department of Medicine, BOWEN University & BOWEN University Teaching Hospital, Ogbomoso
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Ji M, Ren D, Gary-Webb TL, Dunbar-Jacob J, Erlen JA. Characterizing a Sample of Chinese Patients With Type 2 Diabetes and Selected Health Outcomes. DIABETES EDUCATOR 2018; 45:105-115. [DOI: 10.1177/0145721718811561] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose The purpose of the study is to describe the characteristics and selected health outcomes of a sample of Chinese patients with type 2 diabetes (T2DM) and to examine gender differences based on social cognitive theory. There is limited study in theory-driven research conducted in China and a lack of evidence in collectively examining the associated factors among Chinese patients with T2DM based on a theory, especially among those living in a suburban area. Methods Following a cross-sectional design, data were collected from 207 patients (50.2% women; mean age, 56.1 years) with T2DM from an outpatient clinic in a suburban area of Beijing, China. Participants completed a survey, and clinical values were retrieved from the patients’ medical records. Results Of the participants, more than half had suboptimal glycemic control; only a small proportion had recommended levels in performing self-management behaviors. A large proportion had metabolic syndrome and were overweight or obese. Compared with men, women demonstrated poorer health literacy and problem solving, received less social support, and presented with more depressive symptoms. Conclusion Glycemic control and self-management were suboptimal in this sample, and a large proportion of the sample was at risk of developing cardiovascular disease. Gender differences exist regarding health literacy, depressive symptoms, problem solving, and social support. Social cognitive theory may provide a lens for addressing factors that are important in improving health outcomes among Chinese patients with T2DM. This evidence will help health care providers to identify pertinent factors through a multifactorial approach, therefore providing tailored care for Chinese patients with T2DM.
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Affiliation(s)
- Meihua Ji
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Dianxu Ren
- Center for Research and Evaluation and Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tiffany L. Gary-Webb
- Behavioral and Community Health Sciences and Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Judith A. Erlen
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
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Song YS, Koo BK, Kim SW, Yi KH, Shin K, Moon MK. Improvement of Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus under Insulin Treatment by Reimbursement for Self-Monitoring of Blood Glucose. Diabetes Metab J 2018; 42:28-42. [PMID: 29199404 PMCID: PMC5842298 DOI: 10.4093/dmj.2018.42.1.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 08/07/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND In Korea, the costs associated with self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes mellitus (T2DM) under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy. METHODS Among all adult T2DM patients with ≥3 months of reimbursement (n=854), subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c) was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up <7%. RESULTS HbA1c levels significantly decreased from 8.5%±1.3% to 8.2%±1.2% during the follow-up (P<0.001) in all the study subjects (n=409). Among them, 35.5% (n=145) showed a significant improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012). In the improvement group, the baseline HbA1c (P<0.001), fasting C-peptide (P=0.016), and daily dose of insulin/body weight (P=0.024) showed significant negative correlations with the degree of HbA1c change. Multivariate analysis showed that subjects in the Medical Aid system were about 2.5-fold more likely to improve in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022). CONCLUSION The reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system.
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Affiliation(s)
- Young Shin Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
- Center for Medical Informatics, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Sang Wan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Ka Hee Yi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Kichul Shin
- Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
- Center for Medical Informatics, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.
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Grady M, Katz LB, Anderson P, Levy BL. Health Care Professionals' Clinical Perspectives on Glycemic Control and Satisfaction With a New Blood Glucose Meter With a Color Range Indicator: Online Evaluation in India, Russia, China, and the United States. JMIR Diabetes 2018; 3:e1. [PMID: 30291071 PMCID: PMC6238869 DOI: 10.2196/diabetes.9143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/07/2017] [Accepted: 11/12/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND We previously demonstrated in patients with diabetes that displaying blood glucose results in association with color improved their ability to interpret glucose results. OBJECTIVE The objective of this study was to investigate the perceptions of health care professionals (HCPs) in specific countries about the value of color on a new glucose meter and to determine if HCP perspectives among countries differ on the value of this approach in clinical practice. METHODS A total of 180 HCPs, including 105 endocrinologists, 34 primary care physicians, 25 diabetes educators, and 16 pharmacists, were recruited from India (n=50), Russia (n=50), China (n=50), and the United States (n=30). These HCPs experienced the OneTouch Select Plus Simple glucose meter online from their own office computer using interactive demonstrations (webpages, meter simulator, and video clips). After providing demographic and current clinical practice insights, HCPs responded to questions about the utility of the color-enhanced glucose meter. RESULTS Mean age and years in their current professional role for the 180 HCPs was 41.3 (SD 8.1) and 13.3 (SD 6.8) years for endocrinologists, 41.3 (SD 8.3) and 14.1 (SD 6.8) years for primary care physicians, 37.5 (SD 8.7) and 12.7 (SD 6.8) years for diabetes educators, and 35.9 (SD 5.3) and 9.5 (SD 5.2) years for pharmacists. In all, 88% (44/50) of Russian and 83% (25/30) of American HCPs said their patients find it easy to recognize low, in-range, or high blood glucose results compared to 56% (28/50) of HCPs in China and 42% (21/50) in India. Regardless of country, HCPs had less confidence that their patients act on blood glucose results with 52% (26/50) in Russia, 63% (19/30) in the United States, 60% (30/50) in China, and 40% (20/50) in India responding positively. During the interactive online meter experience, HCPs from all countries responded positively to questions about a meter with color features. After reflecting on the value of this meter, most HCPs strongly agreed or agreed their patients would be more inclined to act on results using a meter with color features (Russia: 92%, 46/50; United States: 70%, 21/30; China: 98%, 49/50; India: 94%, 47/50). They also said that color was particularly useful for patients with lower numeracy or education who may struggle with interpreting results (Russia: 98%, 49/50; United States: 77%, 23/30; China: 100%, 50/50; India: 82%, 41/50). CONCLUSIONS This multicountry online study provides evidence that HCPs had high overall satisfaction with the OneTouch Select Plus glucose meter, which uses color-coded information to assist patients with interpreting blood glucose results. This may be especially helpful in patient populations with low numeracy or literacy and limited access to health care and direct interaction with HCPs.
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Affiliation(s)
- Mike Grady
- LifeScan Scotland Ltd, Inverness, United Kingdom
| | | | - Pamela Anderson
- Johnson & Johnson Health Care Systems Inc, Titusville, NJ, United States
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Luo Y, Bao Y, Zhang P, Zhu D, Li X, Ji J, Zhang H, Ji L, on behalf of the ORBIT Study Group. Self-Monitoring of Blood Glucose in Patients with Type 2 Diabetes Before and After Initiating Basal Insulin Treatment in China. Diabetes Technol Ther 2017. [DOI: 10.1089/dia.2017.0040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yingying Luo
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Yuqian Bao
- Department of Endocrinology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Puhong Zhang
- Diabetes Research Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Dongshan Zhu
- Diabetes Research Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Xian Li
- Biostatistics and Economic Evaluation Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Jiachao Ji
- Biostatistics and Economic Evaluation Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Heng Zhang
- Diabetes Research Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
- Diabetes Research Program, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
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Ji L, Su Q, Feng B, Shan Z, Hu R, Xing X, Xue Y, Yang T, Hua Y. Structured self-monitoring of blood glucose regimens improve glycemic control in poorly controlled Chinese patients on insulin therapy: Results from COMPASS. J Diabetes 2017; 9:495-501. [PMID: 27249791 DOI: 10.1111/1753-0407.12434] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 05/24/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The use of self-monitoring of blood glucose (SMBG) among patients with insulin-treated, type 2 diabetes (T2DM) in China is suboptimal. Herein we evaluated the effectiveness of structured SMBG for improving glycemic control and increasing the frequency of SMBG. METHODS Insulin-treated (>3 months) T2DM patients aged ≥18 years with HbA1c >8.0 % (64 mmol/mol) were recruited to the study. They received SMBG materials and were advised on a structured SMBG regimen for their insulin therapy. Patients were trained to self-adjust insulin dosage according to SMBG readings and were seen by physicians at Months 3 and 6. Endpoints included changes in HbA1c, SMBG frequency, and hypoglycemia frequency. RESULTS The study enrolled 820 patients, with mean (± SD) age 55.1 ± 9.8 years, body mass index 24.9 ± 3.6 kg/m2 , HbA1c 9.7 ± 1.6 % (83 mmol/mol), and diabetes duration 9.8 ± 7.1 years, with median insulin therapy of 30.3 (3.0-274.1) months, from 19 Chinese clinics. By Month 3, 99.9 % of patients performed daily SMBG. At Months 3 and 6, HbA1c had decreased from baseline (-1.81 % and -1.73 %, respective; P < 0.0001 for both), with reduced hypoglycemia. In addition, 36.2 % and 39.9 % of patients achieved HbA1c <7.0 % (53 mmol/mol) at Months 3 and 6, respectively. The largest HbA1c improvements were for patients with a shorter duration of diabetes and insulin therapy. CONCLUSIONS A structured SMBG regimen, with training on interpretation of and responses to SMBG readings, increased SMBG frequency and improved HbA1c and the management of insulin-treated T2DM.
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Affiliation(s)
- Linong Ji
- Peking University People's Hospital, Beijing, China
| | - Qing Su
- Xinhua Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Bo Feng
- Tongji University Oriental Hospital, Shanghai, China
| | - Zhongyan Shan
- The First Hospital of China Medical University, Liaoning, China
| | - Renming Hu
- Huashan Hospital Affiliated to Fudan University, Shanghai, China
| | - Xiaoping Xing
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | - Tao Yang
- The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province People's Hospital), Jiangsu, China
| | - Yanyin Hua
- Zhejiang Province People's Hospital, Zhejiang, China
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Baruah MP, Kalra S, Bose S, Deka J. An Audit of Insulin Usage and Insulin Injection Practices in a Large Indian Cohort. Indian J Endocrinol Metab 2017; 21:443-452. [PMID: 28553603 PMCID: PMC5434731 DOI: 10.4103/ijem.ijem_548_16] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Insulin remains the cornerstone of therapy in a substantial number of patients with type 2 diabetes mellitus (T2DM). Inadequate knowledge regarding insulin usage is likely to influence its acceptance and adherence, and outcome of therapy, underscoring great need to investigate knowledge, attitude, and practice of insulin usage in patients with T2DM. METHODOLOGY A cross-sectional registry-based retrospective study analyzed data collected from 748 respondents (male: 466, female: 282), mostly from high or middle economic status, who were enrolled as outpatient in a referral clinic during last 10 years (2006-2016), to assess the general characteristics of patients with type 2 diabetes and their baseline knowledge, attitude, and practice of insulin usage and injection practices. RESULTS Mean ± standard deviation (SD) of duration of diabetes was 12.24 ± 7.60 years and mean ± SD duration of insulin therapy was 3.42 ± 4.18 years, which was initiated after a mean ± SD diabetes duration of 8.80 ± 6.42 years. Mean insulin dose per kilogram of body weight/day was 0.51 ± 0.27 units. Total daily dose of insulin was 33.36 ± 18.44 units and number of injections/day (mean ± SD) was 2.06 ± 0.73. Among the respondents, 58.96% were on human insulin and 35.70% were on analog insulin. Pen devices were used by 66.08% of the population whereas 31.76% used insulin syringes. The prevalence of lipohypertrophy (LH) was 12.57%, which was significantly (P < 0.001) associated with wrong technique with regard to injection angle (10.45% vs. 23.02%), site of injection (7.00% vs. 30.51%), rotation of site of injection (0.88% vs. 17.66%), and reuse of needle (5.77% vs. 15.19%). LH was also significantly (P < 0.05) associated with the use of human (14.74%) compared to analog insulin (8.24%). CONCLUSION The current study highlights the unique patterns of insulin usage and associated high prevalence of LH among insulin users in India.
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Affiliation(s)
- Manash P. Baruah
- Consultant Endocrinologist, Excel Care Hospital, Guwahati, Assam, India
| | - Sanjay Kalra
- Cosultant Endocrinologist, Bharti Hospital and BRIDE, Karnal, Haryana, India
| | - Saptarshi Bose
- Scientific Advisor, Biocon Limited, Bengaluru, Karnataka, India
| | - Jumi Deka
- Diabetic Counselor, Excel Care Hospital, Guwahati, Assam, India
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One-Year Results of a Synthetic Intervention Model for the Primary Prevention of T2D among Elderly Individuals with Prediabetes in Rural China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040417. [PMID: 28420105 PMCID: PMC5409618 DOI: 10.3390/ijerph14040417] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/31/2017] [Accepted: 04/10/2017] [Indexed: 12/26/2022]
Abstract
Objective: The objective of this study was to evaluate the effectiveness of a synthetic intervention model aimed at preventing type 2 diabetes and controlling plasma glucose, body weight and waist circumference in elderly individuals with prediabetes in rural China. Methods: We randomly assigned 434 (180 men and 254 women; mean age, 69 years; mean body mass index, 23.6 kg/m2) with prediabetes to either the intervention group or the control group. Each participant in the intervention group received synthetic intervention for 1 year. Results: The incidence of diabetes was 4.2% in the intervention group, versus 19.7% in the control group at the end of 1 year (p < 0.001). Compared with the control group, the intervention group experienced a great decrease in fasting glucose (−3.9 vs. 2.2 mg/dL, p < 0.001), body weight (−3.2 vs. 1.7 kg, p < 0.001), waist circumference (−2.4 vs. 1.0 cm, p < 0001), total cholesterol (−9.1 vs. −4.6 mg/dL. p = 0.014) and HbA1c (−1.0 vs. 0.1 mg %, p = 0.002) at the end of 1 year. Conclusions: The incidence of diabetes of the control group was higher than that of the intervention group. Besides, the synthetic intervention contributes to weight loss and glucose decrease, and may be effective in reducing the risk of diabetes among elderly individuals with prediabetes in rural China.
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Xiang Y, Luo P, Cai X, Tang Y, Wu Z. Results of a pilot study of patient-to-patient education strategy on self-management among glycemic uncontrolled patients with diabetes. Patient Prefer Adherence 2017; 11:787-793. [PMID: 28458523 PMCID: PMC5402899 DOI: 10.2147/ppa.s130060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The purpose of this study was to assess the efficacy and practicability of patient-to-patient (PTP) education strategy on glycemic control among patients with type 2 diabetes mellitus. METHODS Eligible subjects from outpatient clinic were recruited and randomized to either intervention group or control group. Inpatients with poor outcomes and complications acted as mentors to share their experience with the intervention group in three tailored classes. Besides, the intervention group received general advice from specialists. The control group received general advice only. The glucose metabolic status and behavior modification indicators were evaluated before and after intervention. In addition, both groups finished a questionnaire survey regarding awareness to diabetic complications after intervention. RESULTS Eighty-four subjects were recruited (42 subjects for each group), and 51 subjects finished the study. Both the intervention group (n=29) and the control group (n=22) showed a tendency toward a decrease in glycosylated hemoglobin level (A1c, -0.8% vs -0.4%, P<0.05) and improvement in behavior modification (+5.0 vs +2.8, P<0.05) after 6 months. The intervention group (13.8%) obtained a higher percentage than the control group (9.1%) whose A1c reached ≤7%. The body mass index did not change significantly in any group. The questionnaire score about complication awareness was higher in the intervention group than in the control group. CONCLUSION This preliminary evidence suggests that PTP education strategy is acceptable for facilitating the outcome of glycemic control. Patient sense of complications may work on A1c reduction.
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Affiliation(s)
- Yingying Xiang
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Pingyan Luo
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Xueqin Cai
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Yuqin Tang
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Zhongming Wu
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
- Correspondence: Zhongming Wu, Tianjin Medical University Metabolic Diseases Hospital, No 66 Tongan Road, Heping District, Tianjin, 300070, People’s Republic of China, Tel/fax +86 22 2334 3729, Email
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Matsuba I, Sawa T, Kawata T, Kanamori A, Jiang D, Machimura H, Takeda H, Han JH, Wang K, Tanaka K, Shen L, Ajima M, Kaneshiro M, Kim SW, Umezawa S, Asakura T, Suzuki S, Kim SC. Cross-National Variation in Glycemic Control and Diabetes-Related Distress Among East Asian Patients Using Insulin: Results from the MOSAIc Study. Diabetes Ther 2016; 7:349-60. [PMID: 27255328 PMCID: PMC4900985 DOI: 10.1007/s13300-016-0178-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Guidelines recommend insulin progression for patients with type 2 diabetes (T2D) with inadequate glycemic control. The Multinational Observational Study Assessing Insulin use (MOSAIc [ClinicalTrials.gov identifier, NCT01400971]) study is a 2-year observational study, investigating factors that influence insulin progression in T2D patients. In this first of two reports, we describe baseline clinical and psychosocial characteristics of Chinese, Japanese, and South Korean patients who participated in MOSAIc. Insulin treatment, factors affecting progression, and outcomes will be reported separately. METHODS Patients with T2D using insulin for ≥3 months were eligible. Baseline demographic, clinical, and psychosocial data were collected from patients. Quality of life instruments, including the Diabetes Distress Scale (DDS), were used to assess patient's concerns about disease management, support, and emotional burden. The association between the DDS and the selected covariates was also assessed. RESULTS A total of 373 patients in China, 157 in Japan, and 141 in South Korea were enrolled from July 2011 to July 2013. Mean ± standard deviation duration (years) of T2D differed across countries (China 11.4 ± 7.5; Japan 13.8 ± 8.7; South Korea 15.7 ± 8.8; P < 0.0001). Japanese patients used more noninsulin anti-hyperglycemic agents than did Chinese or South Korean patients (P < 0.0001). Exclusive use of basal insulin was most common in Japan and South Korea compared with China, whereas approximately 66.8% of Chinese patients used mixed insulin. Covariates associated with the DDS were younger age [P = 0.044 (Japan)], higher incidence of monthly hypoglycemia [P = 0.036 [China]; P = 0.021 (South Korea)], and male gender [P = 0.037 (South Korea)]. CONCLUSIONS There were significant differences amongst East Asian patients with T2D treated with insulin, including in quality of life scores. Results from the MOSAIc longitudinal analyses will further investigate trends of insulin intensification and barriers to insulin progression. FUNDING Eli Lilly and Company.
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Affiliation(s)
- Ikuro Matsuba
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, Kanagawa, Japan.
| | - Tasuku Sawa
- Department of Internal Medicine, Kawasaki Saiwai Hospital, Kanagawa, Japan
| | - Takehiro Kawata
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, Kanagawa, Japan
| | - Akira Kanamori
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, Kanagawa, Japan
| | | | - Hideo Machimura
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, Kanagawa, Japan
| | - Hiroshi Takeda
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, Kanagawa, Japan
| | | | - Ke Wang
- Eli Lilly Suzhou Pharmaceutical Company, Shanghai, China
| | - Keiji Tanaka
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, Kanagawa, Japan
| | - Li Shen
- Eli Lilly Suzhou Pharmaceutical Company, Shanghai, China
| | - Miho Ajima
- Department of Diabetology, Kawasaki Saiwai Clinic, Kanagawa, Japan
| | - Mizuki Kaneshiro
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, Kanagawa, Japan
| | - Sang-Wook Kim
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Shinichi Umezawa
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, Kanagawa, Japan
| | - Taro Asakura
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, Kanagawa, Japan
| | | | - Seoyoung C Kim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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