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Shannag S, Al-Jabari S, Sbitan L, Alsheyyab J, Zeitoon S, Hanandeh S, Alsous M, Gammoh O. Prevalence and correlates of insomnia and fatigue in patients with type 2 diabetes in Jordan. Int J Psychiatry Med 2024:912174241269543. [PMID: 39058894 DOI: 10.1177/00912174241269543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Objective: The present study examined the prevalence and correlates of insomnia and fatigue in patients with type-2 diabetes in Jordan.Methods: This was a cross-sectional online study involving a convenience sample of 390 patients with type-2 diabetes. Insomnia was assessed by the Insomnia-Severity Index (ISI-A) and fatigue by the Brief Fatigue Inventory (BFI-A).Results: Severe insomnia was present in 132 patients (33.8%), and was correlated with length of diabetes (diagnosis >5 years) (OR = 2.13, 95% CI = 1.19-3.81, P = 0.01), presence of uncontrolled diabetes (OR = 1.97, 95% CI = 1.45-2.69, P < 0.001), taking gabapentin (OR = 2.07, 95% CI = 1.07-4.01, P = 0.003), and age (<40 years) (OR = 0.30, 95% CI = 0.13-0.69, P = 0.005). Significant fatigue was also prevalent and correlated with gender (female) (B = 9.25, t = 4.48, P < 0.001), age (<40 years) (B = 7.56, t = 2.56, P = 0.01), a diagnosis of hypertension (B = 4.74, t = 2.03, P = 0.04), uncontrolled diabetes (B = 7.21, t = 4.82, P < 0.001), and taking a sulfonylurea (B = 8.03, t = 3.37, P < 0.001), carbamazepine (B = 10.93, t = 2.65, P = 0.008), or gabapentin (B = 12.60, t = 3.83, P < 0.001).Conclusion: Given the high prevalence of insomnia and fatigue in this population, increased attention by primary healthcare providers to these symptoms in diabetic patients is required, particularly in developing countries such as Jordan.
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Affiliation(s)
- Salam Shannag
- Department of Clinical Pharmacy and Pharmacy Practice, Yarmouk University, Irbid, Jordan
| | | | | | | | | | - Suzan Hanandeh
- Prince Hamzeh Hospital, Jordan Ministry of Health, Amman, Jordan
| | - Mervat Alsous
- Department of Clinical Pharmacy and Pharmacy Practice, Yarmouk University, Irbid, Jordan
| | - Omar Gammoh
- Department of Clinical Pharmacy and Pharmacy Practice, Yarmouk University, Irbid, Jordan
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Gray L, Sindall P, Pearson SJ. Does resistance training ameliorate cancer-related fatigue in cancer survivors? A systematic review with meta-analysis. Disabil Rehabil 2024; 46:2213-2222. [PMID: 37345506 DOI: 10.1080/09638288.2023.2226408] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) is unrelenting. As neither rest nor sleep ameliorates cognitive, emotional, and physical symptoms, quality of life is diminished. This study examines resistance training (RT) effectiveness on CRF in cancer survivors. The secondary aims were to identify the dose-response relationship of RT frequency, intensity, and volume on CRF in different cancer survivor populations. MATERIALS AND METHODS Systematic searches via numerous databases for RCTs were performed in June 2022. Patient-reported outcome measures (PROM), were analysed, pre-to-post intervention, using a random-effects model. The Physiotherapy Evidence Database (PEDro) scale informed methodological quality assessment. RESULTS Eight studies were included (cancer survivors: breast (BCS) = 5; endometrial (ECS) = 1; prostate (PCS) = 2). Overall, RT interventions ≥ 6 weeks elicited large significant reductions in CRF for FACIT-F (SMD = 0.932, p = <0.001) and moderate significant reductions in CRF for PFS-R (SMD = -0.622, p = 0.004). CONCLUSION Main findings indicate that RT ameliorates CRF, especially in BCS; however, individualised approaches should be advocated. Supervised training elicited the greatest positive outcomes, thus should be a pivotal part of the cancer rehabilitation pathway. Future studies should be adequately powered, undertake discrete analyses of different cancer types, and investigate chronic RT effects.
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Affiliation(s)
- Luke Gray
- Department of Health and Social Care, University of Salford, Salford, UK
| | - Paul Sindall
- Department of Health and Social Care, University of Salford, Salford, UK
| | - Stephen J Pearson
- Department of Health and Social Care, University of Salford, Salford, UK
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Lin C, Yeh FC, Glynn NW, Gmelin T, Wei YC, Chen YL, Huang CM, Shyu YC, Chen CK. Associations of depression and perceived physical fatigability with white matter integrity in older adults. Psychiatry Res Neuroimaging 2024; 340:111793. [PMID: 38373367 DOI: 10.1016/j.pscychresns.2024.111793] [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: 10/18/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUNDS Fatigability is prevalent in older adults. However, it is often associated with depressed mood. We aim to investigate these two psychobehavioral constructs by examining their underpinning of white matter structures in the brain and their associations with different medical conditions. METHODS Twenty-seven older adults with late-life depression (LLD) and 34 cognitively normal controls (CN) underwent multi-shell diffusion MRI. Fatigability was measured with the Pittsburgh Fatigability Scale. We examined white matter integrity by measuring the quantitative anisotropy (QA), a fiber tracking parameter with better accuracy than the traditional imaging technique. RESULTS We found those with LLD had lower QA in the 2nd branch of the left superior longitudinal fasciculus (SLF-II), and those with more physical fatigability had lower QA in more widespread brain regions. In tracts associated with more physical fatigability, the lower QA in left acoustic radiation and left superior thalamic radiation correlated with higher blood glucose (r = - 0.46 and - 0.49). In tracts associated with depression, lower QA in left SLF-II correlated with higher bilirubin level (r = - 0.58). DISCUSSION Depression and fatigability were associated with various white matter integrity changes, which correlated with biochemistry biomarkers all related to inflammation.
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Affiliation(s)
- Chemin Lin
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan; College of Medicine, Chang Gung University, Taoyuan County, Taiwan; Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Keelung, Taiwan
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nancy W Glynn
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Theresa Gmelin
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yi-Chia Wei
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan; Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Keelung, Taiwan; Department of Neurology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Yao-Liang Chen
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yu-Chiau Shyu
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Keelung, Taiwan
| | - Chih-Ken Chen
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan; College of Medicine, Chang Gung University, Taoyuan County, Taiwan; Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Keelung, Taiwan.
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Fekih N, Zghal F, Machfer A, Ben Hadj Hassen H, Zarizissi S, Bouzid MA. Peripheral fatigue regulation during knee extensor exercise in type 1 diabetes and consequences on the force-duration relationship. Eur J Appl Physiol 2024; 124:897-908. [PMID: 37733138 DOI: 10.1007/s00421-023-05318-w] [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: 04/26/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE This study aimed to examine if peripheral fatigue is adjusted during knee extensor (KE) exercise in order not to surpass a critical threshold patient with type 1 diabetes (T1D) and the consequences of this mechanism on the force-duration relationship. METHODS Eleven T1D individuals randomly performed two different sessions in which they performed 60 maximum voluntary contractions (MVC; 3 s contraction, 2 s relaxation). One trial was performed in the non-fatigued state (CTRL) and another after fatiguing neuromuscular stimulation of the KE (FNMES). Peripheral and central fatigue were quantified by the difference between pre and post exercise in quadriceps voluntary activation (ΔVA) and potentiated twitch (ΔPtw). Critical torque (CT) was determined as the average force of the last 12 contractions, whereas W' was calculated as the area above the CT. RESULTS Although FNMES led to a significant decrease in potentiated twitch (Ptw) before performing the 60-MVCs protocol (p < 0.05), ΔVA (∼ -7.5%), ΔPtw (∼ -39%), and CT (∼816 N) post-MVCs were similar between the two conditions. The difference in W' between CTRL and FNMES was correlated with the level of pre-fatigue induced in FNMES (r2 = 0.60). In addition, W' was correlated with ΔPtw (r2 = 0.62) in the CTRL session. CONCLUSION Correlative results in the present study indicate that regulating peripheral fatigue mechanisms at a critical threshold limit W'. Additionally, peripheral fatigue during KE exercise is limited to an individual threshold in T1D patients.
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Affiliation(s)
- Nadia Fekih
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education, University of Sfax, Road of the Aerodrome, Km 3.5, BP 1068, 3000, Sfax, Tunisia
| | - Firas Zghal
- Faculté des Sciences du Sport, LAMHESS, Université Côte d'Azur, Nice, France
| | - Amal Machfer
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education, University of Sfax, Road of the Aerodrome, Km 3.5, BP 1068, 3000, Sfax, Tunisia
| | - Hayfa Ben Hadj Hassen
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education, University of Sfax, Road of the Aerodrome, Km 3.5, BP 1068, 3000, Sfax, Tunisia
| | - Slim Zarizissi
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education, University of Sfax, Road of the Aerodrome, Km 3.5, BP 1068, 3000, Sfax, Tunisia
| | - Mohamed Amine Bouzid
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education, University of Sfax, Road of the Aerodrome, Km 3.5, BP 1068, 3000, Sfax, Tunisia.
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McGuire B, Dadah H, Oliver D. The effects of acute hyperglycaemia on sports and exercise performance in type 1 diabetes: A systematic review and meta-analysis. J Sci Med Sport 2024; 27:78-85. [PMID: 38030440 DOI: 10.1016/j.jsams.2023.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/29/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES People with type 1 diabetes (T1D) are advised by health care professionals to target mild hyperglycaemia before and during exercise, to reduce the risk of hypoglycaemia. This review aimed to summarise the available evidence on the effects of acute hyperglycaemia on sports and exercise performance in T1D. DESIGN Systematic review and meta-analysis. METHODS Medline, EMBASE, CENTRAL, and Web of Science were searched until 29th May 2023 for studies investigating the effects of acute hyperglycaemia on any sports or exercise performance outcome in T1D. Random-effects meta-analysis was performed using standardised mean differences (SMD) when more than one study reported data for similar outcomes. Certainty of evidence for each outcome was assessed using GRADE. RESULTS Seven studies were included in the review, comprising data from 119 people with T1D. Meta-analysis provided moderate-certainty evidence that acute hyperglycaemia does not significantly affect aerobic exercise performance (SMD -0.17; 95 % CI -0.59, 0.26; p = 0.44). There is low- or very-low certainty evidence that acute hyperglycaemia has no effect on anaerobic (two outcomes), neuromuscular (seven outcomes) or neurocognitive performance (three outcomes), except impaired isometric knee extension strength. One study provided low-certainty evidence that the performance effects of hyperglycaemia may depend on circulating insulin levels. CONCLUSIONS Acute hyperglycaemia before or during exercise appears unlikely to affect aerobic performance to an extent that is relevant to most people with T1D, based on limited evidence. Future research in this field should focus on anaerobic, neuromuscular and neurocognitive performance, and examine the relevance of circulating insulin levels.
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Affiliation(s)
| | - Hashim Dadah
- St George's University Hospitals NHS Foundation Trust, UK
| | - Dominic Oliver
- Department of Psychiatry, University of Oxford, UK; NIHR Oxford Health Biomedical Research Centre, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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Nguyen C, Parson HK, Pettaway J, Ingram A, Sears T, Bard JT, Forte S, Wintringham JA, Vinik E, Siraj ES, Casellini CM. Utilizing a quality of life tool to examine the presence of fatigue in subjects with diabetes mellitus. J Clin Transl Endocrinol 2023; 34:100328. [PMID: 38034042 PMCID: PMC10682818 DOI: 10.1016/j.jcte.2023.100328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/12/2023] [Accepted: 10/20/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction The prevalence of fatigue in patients with diabetes mellitus (DM) can be as high as 50 %. Physical, mental, and psychosocial components of fatigue negatively impact quality of life (QOL), morbidity and mortality. Several tools have been developed to address fatigue, but none specifically for measuring fatigue in DM. The aim of this study was to assess the impact of diabetes and neuropathy on fatigue using the Norfolk QOL-Fatigue (QOL-F) survey. Methods 605 adult participants from [Anonymous] were recruited (400 subjects with type 1 or type 2 DM and 205 subjects without diabetes (controls)). All subjects completed the Norfolk QOL-F. Demographics, weight, BMI, and duration of diabetes were obtained. The Norfolk QOL-F, a 35-item validated questionnaire, assesses five domains: subjective fatigue, physical and cognitive fatigue, reduced activities, impaired activities of daily living, and depression. Results Subjects with DM reported significantly higher fatigue total scores (52.63vs33.89, p < 0.0001) and in all five domains when compared to controls. Patients with DM with neuropathy were significantly more fatigued than those without (59.72vs27.83, p < 0.0001). Fatigue scores in patients with DM without neuropathy were similar to controls (27.83vs33.89, p = NS). In multivariate analysis, age, gender, and presence of neuropathy significantly impacted fatigue scores. Conclusions The Norfolk QOL-F questionnaire can potentially identify the impact of chronic diseases such as diabetes on fatigue. Assessing the different components of fatigue is important for clinicians in improving disease management and outcomes. Further investigations are needed to confirm these observations in specific cohorts with other comorbidities.
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Affiliation(s)
- Catherine Nguyen
- School of Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA
| | - Henri K. Parson
- Strelitz Diabetes Center, EVMS Endocrine & Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA 23510, USA
| | - Jordan Pettaway
- Strelitz Diabetes Center, EVMS Endocrine & Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA 23510, USA
| | - Amber Ingram
- Strelitz Diabetes Center, EVMS Endocrine & Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA 23510, USA
| | - Taneisha Sears
- Strelitz Diabetes Center, EVMS Endocrine & Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA 23510, USA
| | - Jason T. Bard
- School of Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA
| | - Steven Forte
- School of Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA
| | | | - Etta Vinik
- Strelitz Diabetes Center, EVMS Endocrine & Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA 23510, USA
| | - Elias S. Siraj
- Strelitz Diabetes Center, EVMS Endocrine & Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA 23510, USA
| | - Carolina M. Casellini
- Strelitz Diabetes Center, EVMS Endocrine & Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA 23510, USA
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Kuo HJ, García AA, Huang YC, Zuñiga JA, Benner AD, Cuevas H, Fan KC, Hsu CY. Impact of Fatigue and Its Influencing Factors on Diabetes Self-Management in Adults With Type 2 Diabetes: A Structural Equation Modeling Analysis. Sci Diabetes Self Manag Care 2023; 49:438-448. [PMID: 37873569 DOI: 10.1177/26350106231205029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
PURPOSE The purposes of this study were to (1) examine the relationships between fatigue, its influencing factors, and diabetes self-management and (2) test the mediation effects of fatigue on the link between the influencing factors and diabetes self-management in adults with type 2 diabetes. METHODS This cross-sectional, correlational study was guided by the theory of unpleasant symptoms. Data were collected using structured questionnaires. Fatigue was measured by the Fatigue Symptom Inventory and the Multidimensional Fatigue Inventory. Diabetes self-management was measured by the Summary of Diabetes Self-Care Activities. From March to July 2021, a convenience sample of 150 participants was recruited from 2 diabetes outpatient clinics of a regional hospital in Taiwan. Data were analyzed using structural equation modeling. RESULTS A more recent diagnosis of diabetes, more depressive symptoms, and lower sleep quality were related to higher fatigue. Higher fatigue correlated with less performance in diabetes self-management. Fatigue mediated the relationship between depressive symptoms, sleep quality, and diabetes self-management. CONCLUSIONS Fatigue had a mediating effect on the link between psychological influencing factors and diabetes self-management. Future development of fatigue interventions integrating depressive symptoms and sleep management will likely increase the performance of diabetes self-management and improve the health outcomes in adults with type 2 diabetes. The study tested the theory of unpleasant symptoms using empirical data and will assist in building theory-guided fatigue interventions to improve diabetes self-management in people with type 2 diabetes.
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Affiliation(s)
- Hsuan-Ju Kuo
- School of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | | | - Ya-Ching Huang
- School of Nursing, Texas A&M University, College Station, Texas
| | - Julie A Zuñiga
- School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Aprile D Benner
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas
| | - Heather Cuevas
- School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Kang-Chih Fan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu City, Taiwan
| | - Chih-Yao Hsu
- Taipei City Hospital Renai Branch, Taipei City, Taiwan
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Rosenberg AGW, Dingemans VDA, Bos-Roubos AG, Luijks S, Dessens AB, Dykgraaf R, Roos-Hesselink JW, Van Rossum EFC, Van Der Lely AJ, De Graaff LCG. Associations Between Fatigue and Endocrine and Non-endocrine Health Problems in Turner Syndrome: Cohort Study and Review. J Clin Endocrinol Metab 2023; 108:e1649-e1659. [PMID: 37296515 PMCID: PMC10655540 DOI: 10.1210/clinem/dgad337] [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: 01/13/2023] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
CONTEXT Turner syndrome (TS) is a rare chromosomal disorder characterized by gonadal dysfunction, short stature, and heart defects, among other features. Women with TS often suffer from severe fatigue, for which they are typically referred to endocrinologists. The diagnostic work-up is generally time-consuming and invasive, and it rarely solves the problem. To prevent the personal and financial burden of unnecessary diagnostic procedures, it is crucial to understand fatigue in TS. OBJECTIVE To explore the association between fatigue and endocrine and non-endocrine comorbidities in a-for rare disorders-large group of women with TS. METHODS 170 genetically confirmed women with TS who attended the TS Reference Center underwent a systematic health screening, including a structured interview, complete physical examination, biochemical measurements, perceived stress and fatigue questionnaires, and additional tests when indicated. RESULTS Median (interquartile range) age was 32.6 (23.9-41.4) years. Severe fatigue was experienced by 1 in 3 women with TS. Liver enzyme disturbances and body mass index were significantly associated with higher fatigue scores. Perceived stress was highly correlated with fatigue. CONCLUSION There was no association between fatigue and most endocrine and non-endocrine disorders, which implies that fatigue is only partly explained by somatic disorders. The high correlation between perceived stress and fatigue suggests that TS-related neuropsychological processes may play an important role in the etiology of fatigue in women with TS. We provide a practical algorithm for the endocrine, non-endocrine, and psychological approach to fatigue in women with TS.
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Affiliation(s)
- Anna G W Rosenberg
- Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Veerle D A Dingemans
- Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Anja G Bos-Roubos
- Center of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, 5803 AC Venray, The Netherlands
| | - Sanne Luijks
- Obstetrics and Gynecology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- Turner Syndrome Reference Center, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Arianne B Dessens
- Turner Syndrome Reference Center, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, University Medical Center, Sophia Children's Hospital, 3015 GD Rotterdam, The Netherlands
- ENDO-ERN, European Reference Network on Rare Endocrine Conditions
| | - Ramon Dykgraaf
- Obstetrics and Gynecology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- Turner Syndrome Reference Center, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Jolien W Roos-Hesselink
- Turner Syndrome Reference Center, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Cardiology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Elisabeth F C Van Rossum
- Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- Turner Syndrome Reference Center, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- ENDO-ERN, European Reference Network on Rare Endocrine Conditions
- Obesity Center Centrum Gezond Gewicht, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Aart J Van Der Lely
- Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- ENDO-ERN, European Reference Network on Rare Endocrine Conditions
| | - Laura C G De Graaff
- Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- Turner Syndrome Reference Center, Erasmus MC, University Medical Center, 3015 GD Rotterdam, The Netherlands
- ENDO-ERN, European Reference Network on Rare Endocrine Conditions
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McCready RG, Gilley KR, Kusumo LE, Hall GM, Vichaya EG. Chronic Stress Exacerbates Hyperglycemia-Induced Affective Symptoms in Male Mice. Neuroimmunomodulation 2023; 30:302-314. [PMID: 37852199 PMCID: PMC10641805 DOI: 10.1159/000534669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/16/2023] [Indexed: 10/20/2023] Open
Abstract
INTRODUCTION Among chronically ill populations, affective disorders remain underdiagnosed and undertreated. A high degree of comorbidity exists between diabetes and affective disorders, particularly depression and anxiety. The mechanisms underlying stress-induced affective dysregulation are likely distinct from those induced by diabetes. A direct comparison between stress- and hyperglycemia-induced affective dysregulation could provide insight into distinct mechanistic targets for depression/anxiety associated with these different conditions. METHODS To this end, the present study used male C57BL/6J mice to compare the independent and combined behavioral and neuroinflammatory effects of two models: (1) unpredictable chronic mild stress and (2) pharmacologically induced hyperglycemia. RESULTS Streptozotocin-induced hyperglycemia was associated with a set of behavioral changes reflective of the neurovegetative symptoms of depression (i.e., reduced open field activity, reduced grooming, increased immobility in the forced swim task, and decreased marble burying), increased hippocampal Bdnf and Tnf expression, and elevations in frontal cortex Il1b expression. Our chronic stress protocol produced alterations in anxiety-like behavior and decreased frontal cortex Il1b expression. DISCUSSION While the combination of chronic stress and hyperglycemia produced limited additive effects, their combination exacerbated total symptom burden. Overall, the data indicate that stress and hyperglycemia induce different symptom profiles via distinct mechanisms.
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Affiliation(s)
- Riley G McCready
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Kayla R Gilley
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Laura E Kusumo
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Grace M Hall
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
| | - Elisabeth G Vichaya
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA
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Barakou I, Sakalidis KE, Abonie US, Finch T, Hackett KL, Hettinga FJ. Effectiveness of physical activity interventions on reducing perceived fatigue among adults with chronic conditions: a systematic review and meta-analysis of randomised controlled trials. Sci Rep 2023; 13:14582. [PMID: 37666869 PMCID: PMC10477297 DOI: 10.1038/s41598-023-41075-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023] Open
Abstract
Fatigue is barrier of physical activity participation in adults with chronic conditions. However, physical activity alleviates fatigue symptoms. This systematic review and meta-analysis aimed to (1) synthesise evidence from randomised controlled trials (RCTs) exploring the effects of physical activity interventions on fatigue reduction and (2) evaluate their effectiveness. Medline/CINAHL/EMBASE/Web of Science and Scopus were searched up to June 24th, 2023. Two reviewers independently conducted study screening and selection (RCTs), extracted data and assessed risk of bias (RoB2). Outcome was the standardised mean difference (SMD) with 95% confidence intervals in fatigue between experimental and control groups. 38 articles met the inclusion criteria. Overall, physical activity interventions moderately reduced fatigue (SMD = 0.54, p < 0.0001). Interventions lasting 2-6 weeks demonstrated a larger effect on fatigue reduction (SMD = 0.86, p < 0.00001). Interventions with 18-24 sessions showed a large effect on fatigue reduction (SMD = 0.97, p < 0.00001). Aerobic cycling and combination training interventions had a large to moderate effect (SMD = 0.66, p = 0.0005; SMD = 0.60, p = 0.0010, respectively). No long-term effects were found during follow-up. Physical activity interventions moderately reduced fatigue among adults with chronic conditions. Duration, total sessions, and mode of physical activity were identified as key factors in intervention effectiveness. Further research is needed to explore the impact of physical activity interventions on fatigue.
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Affiliation(s)
- Ioulia Barakou
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, NE7 7XA, UK
| | - Kandianos Emmanouil Sakalidis
- Department of Sport Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumberland Building, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Ulric Sena Abonie
- Department of Sport Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumberland Building, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Tracy Finch
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, NE7 7XA, UK
| | - Katie L Hackett
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
- CRESTA Fatigue Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Florentina Johanna Hettinga
- Department of Sport Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumberland Building, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK.
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Zhu X, Lee ES, Lim PX, Chen YC, Chan FHF, Griva K. Exploring barriers and enablers of self-management behaviours in patients with diabetic foot ulcers: A qualitative study from the perceptions of patients, caregivers, and healthcare professionals in primary care. Int Wound J 2023; 20:2764-2779. [PMID: 36970982 PMCID: PMC10410341 DOI: 10.1111/iwj.14153] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 08/10/2023] Open
Affiliation(s)
- Xiaoli Zhu
- Nursing ServicesNational Healthcare Group PolyclinicsSingaporeSingapore
- Population/Global Health, Lee Kong Chian School of Medicine, NanyangTechnological UniversitySingaporeSingapore
| | - Eng Sing Lee
- Clinical Research UnitNational Healthcare Group PolyclinicsSingaporeSingapore
- Lee Kong Chian School of MedicineNanyang Technological UniversitySingaporeSingapore
| | - Phoebe X.H. Lim
- Population/Global Health, Lee Kong Chian School of Medicine, NanyangTechnological UniversitySingaporeSingapore
| | - Yee Chui Chen
- Nursing ServicesNational Healthcare Group PolyclinicsSingaporeSingapore
| | - Frederick H. F. Chan
- Population/Global Health, Lee Kong Chian School of Medicine, NanyangTechnological UniversitySingaporeSingapore
| | - Konstadina Griva
- Population/Global Health, Lee Kong Chian School of Medicine, NanyangTechnological UniversitySingaporeSingapore
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12
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Refisch A, Sen ZD, Klassert TE, Busch A, Besteher B, Danyeli LV, Helbing D, Schulze-Späte U, Stallmach A, Bauer M, Panagiotou G, Jacobsen ID, Slevogt H, Opel N, Walter M. Microbiome and immuno-metabolic dysregulation in patients with major depressive disorder with atypical clinical presentation. Neuropharmacology 2023; 235:109568. [PMID: 37182790 DOI: 10.1016/j.neuropharm.2023.109568] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/24/2023] [Accepted: 04/30/2023] [Indexed: 05/16/2023]
Abstract
Depression is highly prevalent (6% 1-year prevalence) and is the second leading cause of disability worldwide. Available treatment options for depression are far from optimal, with response rates only around 50%. This is most likely related to a heterogeneous clinical presentation of major depression disorder (MDD), suggesting different manifestations of underlying pathophysiological mechanisms. Poorer treatment outcomes to first-line antidepressants were reported in MDD patients endorsing an "atypical" symptom profile that is characterized by preserved reactivity in mood, increased appetite, hypersomnia, a heavy sensation in the limbs, and interpersonal rejection sensitivity. In recent years, evidence has emerged that immunometabolic biological dysregulation is an important underlying pathophysiological mechanism in depression, which maps more consistently to atypical features. In the last few years human microbial residents have emerged as a key influencing variable associated with immunometabolic dysregulations in depression. The microbiome plays a critical role in the training and development of key components of the host's innate and adaptive immune systems, while the immune system orchestrates the maintenance of key features of the host-microbe symbiosis. Moreover, by being a metabolically active ecosystem commensal microbes may have a huge impact on signaling pathways, involved in underlying mechanisms leading to atypical depressive symptoms. In this review, we discuss the interplay between the microbiome and immunometabolic imbalance in the context of atypical depressive symptoms. Although research in this field is in its infancy, targeting biological determinants in more homogeneous clinical presentations of MDD may offer new avenues for the development of novel therapeutic strategies for treatment-resistant depression.
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Affiliation(s)
- Alexander Refisch
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany.
| | - Zümrüt Duygu Sen
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Tilman E Klassert
- Host Septomics Group, Centre for Innovation Competence (ZIK) Septomics, University Hospital Jena, 07745, Jena, Germany; Respiratory Infection Dynamics, Helmholtz Centre for Infection Research (HZI), Inhoffenstr, Braunschweig, Germany
| | - Anne Busch
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany; Center for Sepsis Control and Care, Jena, Germany
| | - Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Lena Vera Danyeli
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany
| | - Dario Helbing
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany; Leibniz Institute on Aging-Fritz Lipmann Institute, 07745, Jena, Germany; Institute of Molecular Cell Biology, Jena University Hospital, Friedrich Schiller University Jena, 07745, Jena, Germany
| | - Ulrike Schulze-Späte
- Section of Geriodontics, Department of Conservative Dentistry and Periodontology, Jena University Hospital, Jena, Germany
| | - Andreas Stallmach
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Germany
| | - Michael Bauer
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany; Center for Sepsis Control and Care, Jena, Germany; Theoretical Microbial Ecology, Friedrich Schiller University Jena, Jena, Germany
| | - Gianni Panagiotou
- Department of Microbiome Dynamics, Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll-Institute, Jena, Germany
| | - Ilse D Jacobsen
- Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany, and Institute of Microbiology, Friedrich Schiller University Jena, Jena, Germany
| | - Hortense Slevogt
- Host Septomics Group, Centre for Innovation Competence (ZIK) Septomics, University Hospital Jena, 07745, Jena, Germany; Respiratory Infection Dynamics, Helmholtz Centre for Infection Research (HZI), Inhoffenstr, Braunschweig, Germany; Department of Pulmonary Medicine, Hannover Medical School, 30625, Hannover, Germany
| | - Nils Opel
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany; German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany; German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Germany; Center for Behavioral Brain Sciences, Magdeburg, Germany
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13
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Muijsenberg AJL, Houben-Wilke S, Zeng Y, Spruit MA, Janssen DJA. Methods to assess adults' learning styles and factors affecting learning in health education: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 107:107588. [PMID: 36502561 DOI: 10.1016/j.pec.2022.107588] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/10/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To develop learner-centered education, knowledge about learning styles and factors that affect the ability to learn in patients and their significant others are essential. The present scoping review aims to identify current evidence on 1) how learning styles are assessed within health education, for adult patients as well as their significant others and 2) factors affecting learning in adult patients and their significant others who receive health education. METHODS Systematic literature searches were performed in ERIC, PubMed, Web of Science and PsycINFO. INCLUSION CRITERIA 1) participants ≥ 18 years; 2) participants were patients or significant others; 3) assessment of learning style and/or factors affecting learning; and 4) health education as context. RESULTS 45 articles were included. Learning style within health education can be assessed with multiple choice questions, qualitative methods and a validated questionnaire. Health literacy was the most reported factor affecting learning, followed by anxiety and illness condition. CONCLUSIONS Prior to the development of learner-centered education for patients and significant others, learning styles as well as factors affecting learning should be assessed in both patients and significant others. PRACTICE IMPLICATIONS The process of learning is complex, and it is a shared responsibility of both the learner and the educator.
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Affiliation(s)
| | | | - Yuqin Zeng
- Department of Research and Development, Ciro, Horn, the Netherlands
| | - Martijn A Spruit
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Daisy J A Janssen
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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14
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Pate R, Caswell N, Gardner KJ, Holyoak L. A structural equation model in adults with type 1 and 2 diabetes: exploring the interplay of psychological states and diabetes outcomes, and the mediating effect of resilience. Acta Diabetol 2022; 59:1575-1587. [PMID: 36038781 PMCID: PMC9581857 DOI: 10.1007/s00592-022-01955-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/04/2022] [Indexed: 11/01/2022]
Abstract
AIMS Type 1 and 2 diabetes mellitus (T1DM and T2DM) can lead to emotional distress and cognitive impairments, often caused by psychological factors such as low mood or anxiety; yet, few studies have explored the theoretical mechanisms underlying these relationships and within one study. This study explored the relationships between psychological states (anxiety/worry, fatigue) and diabetes outcomes (diabetes distress, cognitive dysfunction), and whether resilience mediated the association between these in T1DM and T2DM. METHODS A sample of 307 UK adults with a clinical diagnosis of diabetes (T1DM = 129; T2DM = 178) completed a cross-sectional online survey, composed of six questionnaires. Associations between variables were investigated using Pearson's correlations and Structural Equation Modelling (SEM). RESULTS Psychological states were significantly correlated with diabetes outcomes, and resilience was significantly related to both psychological states and diabetes outcomes. The SEM model achieved an acceptable model fit with a significant mediating effect of resilience between psychological states (anxiety/worry, fatigue) and diabetes outcomes (diabetes distress, cognitive dysfunction), with no significant differences between diabetes type. CONCLUSIONS We propose a new theoretical model of T1DM and T2DM that could be used to provide guidance for those designing interventions. These findings help to understand the complex nature of diabetes management, suggesting resilience could be a key factor in managing psychological states and diabetes outcomes.
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Affiliation(s)
- Rosalind Pate
- School of Psychology, University of Central Lancashire, Preston, UK
| | - Noreen Caswell
- School of Psychology, University of Central Lancashire, Preston, UK
| | | | - Lynda Holyoak
- School of Psychology, University of Central Lancashire, Preston, UK
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15
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Romadlon DS, Huang HC, Chen YC, Hu SH, Hasan F, Chiang Morales MD, Dwi Marta OF, Al Baqi S, Chiu HY. Fatigue following type 2 diabetes: Psychometric testing of the Indonesian version of the multidimensional fatigue Inventory-20 and unmet fatigue-related needs. PLoS One 2022; 17:e0278165. [PMID: 36441696 PMCID: PMC9704682 DOI: 10.1371/journal.pone.0278165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
Patients with type 2 diabetes mellitus (T2DM) often experience fatigue. The Multidimensional Fatigue Inventory (MFI-20) is a valid tool for evaluating fatigue; however, its psychometric properties have not been examined in Indonesian-speaking patients with T2DM. This study assessed the psychometric properties of the Indonesian version of the Multidimensional Fatigue Inventory-20 (IMFI-20) in patients with T2DM and investigated fatigue in a health-care setting. A cross-sectional design was adopted. Two hundred patients with T2DM were interviewed in clinics. Five self-structured measures were used to assess the frequency and duration of fatigue and the health-care utilization of patients with fatigue. Cronbach's alpha and intraclass correlation (ICC) were used to evaluate the internal consistency and test-retest reliability of the Indonesian version of the MFI-20 (IMFI-20). The criterion, convergent, and known-group validity of the IMFI-20 were also examined, and its underlying structure was determined using explanatory factor analysis. The STROBE checklist was used. The results revealed that approximately half of the patients experienced fatigue. Among those with fatigue, 62% reported that their fatigue was rarely or never treated by their physicians. The IMFI-20 exhibited satisfactory model fit, excellent internal consistency (Cronbach's alpha of 0.92), and test-retest ICC of 0.93. The IMFI-20 was significantly associated with the Functional Assessment of Chronic Illness Therapy-Fatigue, Beck Depression Inventory-Second Edition, and Pittsburgh Sleep Quality Index (r = 0.705, 0.670, and 0.581, respectively). The IMFI-20 exhibited known-group validity for unfavorable sleep quality and HbA1C ≥ 6.5%. Our findings suggest that patients with T2DM who experience fatigue are often overlooked by health-care providers, and that the IMFI-20, which exhibits excellent psychometric properties, can be adopted by studies that use fatigue as an endpoint in Indonesian-speaking populations.
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Affiliation(s)
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Sophia H. Hu
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Faizul Hasan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Milton D. Chiang Morales
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ollyvia Freeska Dwi Marta
- Department of Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, Indonesia
| | | | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
- * E-mail:
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16
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Kusnanto K, Arifin H, Pradipta RO, Gusmaniarti G, Kuswanto H, Setiawan A, Lee BO. Resilience-based Islamic program as a promising intervention on diabetes fatigue and health-related quality of life. PLoS One 2022; 17:e0273675. [PMID: 36048792 PMCID: PMC9436096 DOI: 10.1371/journal.pone.0273675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/11/2022] [Indexed: 12/08/2022] Open
Abstract
Psychological problems commonly experienced by patients with type 2 diabetes mellitus (T2DM) cause diabetes fatigue conditions that can further worsen the treatment prognosis. We conducted this investigation to determine the effectiveness of a resilience-based Islamic program on diabetes fatigue and health-related quality of life (HRQoL) by measuring the biochemical indicators of T2DM. This was a quasi-experimental study performed from May to August 2021, in which 80 respondents aged 18–64 years diagnosed with T2DM were included through purposive sampling at a male:female sex ratio of 1:1 in the control group and 17:23 in the treatment group. A resilience-based Islamic program (a combination of stress management, mindfulness, prayer, and dhikr (the ritual formula of Sufi brotherhood recited devotionally in praise of Allah and as a means of attaining ecstatic experience)) was implemented in the treatment group for six sessions by blended online and offline interventions. Multidimensional Fatigue Inventory-20 and World Health Organization Quality of Life, Brief Form were used to evaluate diabetes fatigue and HRQoL. Blood tests were performed to measure HbA1c, total antioxidant serum, insulin, cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) levels from baseline to 3 months. Statistical analyses were conducted using paired t test, Wilcoxon signed-rank test, independent t test, and Mann–Whitney U test. The resilience-based Islamic program had a beneficial impact on the levels of HbA1c (p < 0.001), lipid profile (triglyceride) (p = 0.011), HDL-c (p = 0.01), LDL-c (p < 0.001), total antioxidant serum (p = 0.001), insulin (p < 0.001), diabetes fatigue (p < 0.05), and HRQoL (p < 0.05) in patients of the treatment group. The results of biochemical tests related to T2DM also indicated a reduction in diabetes fatigue and an increase in HRQoL due to the resilience-based Islamic program. Considering that a patient’s resilience to diabetes is an important factor in the management of diabetes fatigue, the resilience-based Islamic program can be applied at public health centers and community levels to increase T2DM resilience.
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Affiliation(s)
- Kusnanto Kusnanto
- Department of Fundamental Nursing Care, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Hidayat Arifin
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
- Doctoral Program in School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Rifky Octavia Pradipta
- Department of Fundamental Nursing Care, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- * E-mail:
| | - Gusmaniarti Gusmaniarti
- Early Childhood Teacher Education Study Program, Faculty of Teacher Training and Education, Universitas Muhammadiyah Surabaya, Surabaya, Indonesia
| | - Heri Kuswanto
- Department of Statistics, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia
| | - Agus Setiawan
- Department of Community Health Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
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Świątczak M, Młodziński K, Sikorska K, Raczak A, Lipiński P, Daniłowicz-Szymanowicz L. Chronic Fatigue Syndrome in Patients with Deteriorated Iron Metabolism. Diagnostics (Basel) 2022; 12:diagnostics12092057. [PMID: 36140459 PMCID: PMC9498000 DOI: 10.3390/diagnostics12092057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/11/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Fatigue is a common, non-specific symptom that often impairs patients’ quality of life. Even though fatigue may be the first symptom of many serious diseases, it is often underestimated due to its non-specific nature. Iron metabolism disorders are a prominent example of conditions where fatigue is a leading symptom. Whether it is an iron deficiency or overload, tiredness is one of the most common features. Despite significant progress in diagnosing and treating iron pathologies, the approach to chronic fatigue syndrome in such patients is not precisely determined. Our study aims to present the current state of knowledge on fatigue in patients with deteriorated iron metabolism.
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Affiliation(s)
- Michał Świątczak
- II Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland
| | - Krzysztof Młodziński
- II Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland
| | - Katarzyna Sikorska
- Department of Tropical Medicine and Epidemiology, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland
| | - Alicja Raczak
- Clinical Psychology Department, Faculty of Health Sciences, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Paweł Lipiński
- Department of Molecular Biology, Institute of Genetics and Animal Breeding, Polish Academy of Sciences, Wólka Kosowska, 05-552 Jastrzębiec, Poland
| | - Ludmiła Daniłowicz-Szymanowicz
- II Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland
- Correspondence:
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18
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Khashayar P, Shirzad N, Zarbini A, Esteghamati A, Hemmatabadi M, Sharafi E. Diabetes-related distress and its association with the complications of diabetes in Iran. J Diabetes Metab Disord 2022; 21:1569-1575. [PMID: 35915591 PMCID: PMC9328774 DOI: 10.1007/s40200-022-01103-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022]
Abstract
Purpose Diabetes-related distress (DRD) has negative emotional effects on the patients’ quality of life. This is while the condition often goes undiagnosed despite it being common among diabetic patients. This study investigated the prevalence of DRD and its association with diabetes complications among a group of Iranian type 2 diabetic patients (T2DM). Methods This descriptive-analytical cross-sectional study was conducted on 186 T2DM patients referred to a diabetes clinic in a teaching hospital from the beginning of May 2019 to the end of April 2020. Two questionnaires on disease-related information and diabetes distress screening scale (DDS) were filled out for each patient. The latter was divided into four domains, emotional burden (EB), diabetes-related interpersonal distress (ID), physician-related distress (PD), and regimen-related distress (RD). In addition to the frequency of DRD and its association with age, sex, body mass index (BMI), hypertension, hemoglobin A1C, duration of disease, and type of medication regimen (oral, insulin, or mix) along with the history of cardiovascular disease (CVDs), retinopathy, nephropathy, and diabetic foot were assessed. Results DRD was reported in 47% of the patients. Being female, old age, hypertension, high hemoglobin A1C levels, nephropathy, and retinopathy were significantly associated with DRD (P-value = < 0.001, 0.013, 0.014, 0.007, 0.001, and 0.004, respectively). The history of the diabetic foot had a significant relationship with PD and ID (P-value = 0.007 and < 0.001, respectively). Multivariate regression showed gender and the existence of complications to have a direct effect on the development of DRD. Conclusion DRD prevalence is relatively high and requires screening to identify and treat high-risk patients. Further studies are needed to study diabetes, its complications and their relation with DRD to help reduce such conditions and improve the patient’s quality of life.
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Affiliation(s)
- Pouria Khashayar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Nooshin Shirzad
- Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, P. O. Box, Tehran, 13145-784 Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Aghil Zarbini
- Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, P. O. Box, Tehran, 13145-784 Iran
| | - Mahboobeh Hemmatabadi
- Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, P. O. Box, Tehran, 13145-784 Iran
| | - Elham Sharafi
- Department of Psychiatry, Psychosomatic Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Hersche R, Roser K, Weise A, Michel G, Barbero M. Fatigue self-management education in persons with disease-related fatigue: A comprehensive review of the effectiveness on fatigue and quality of life. PATIENT EDUCATION AND COUNSELING 2022; 105:1362-1378. [PMID: 34561143 DOI: 10.1016/j.pec.2021.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/09/2021] [Accepted: 09/09/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To systematically synthesize the effectiveness of fatigue self-management education (SME) on fatigue and quality of life (QoL) in persons with disease-related fatigue, and to describe the intervention characteristics. METHODS We systematically reviewed the literature on SMEs in people with disease-related fatigue. We included randomized controlled trials (RCT), which aimed to improve self-management skills for fatigue in daily life. We synthesized the effectiveness and mapped the intervention characteristics. RESULTS We included 26 RCTs studying samples from eight disease groups. At follow-up, 46% studies reported statistically significant improvements on fatigue and 46% on QoL. For persons with cancer 6/8 and multiple sclerosis 8/10 RCTs showed positive evidence in favor of SME. The range of effect sizes was wide (d: 0.0 ->0.8). Delivery modalities (inpatient, outpatient, home), interactions (individual, group, remote), and duration [range (h): 1-17.5] varied. CONCLUSIONS The overall evidence on the effectiveness of SMEs on fatigue and QoL is limited and inconsistent. For persons with cancer and multiple sclerosis, the evidence provides a positive effect. The RCTs with medium to large effect on QoL indicate the potential benefit of SMEs. PRACTICAL IMPLICATION Duration and peer interaction should be considered when tailoring SMEs to populations and contexts.
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Affiliation(s)
- Ruth Hersche
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Landquart, Switzerland.
| | - Katharina Roser
- Department of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland
| | - Andrea Weise
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Landquart, Switzerland
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland
| | - Marco Barbero
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Landquart, Switzerland
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20
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Romano TM, Linhares MM, Posegger KR, Rangel ÉB, Gonzalez AM, Salzedas-Netto AA, Mucci S, Silva-Junior HT, Lopes Filho GDJ, Medina-Pestana JO. Evaluation of psychological symptoms in patients before and after simultaneous pancreas-kidney transplantation: a single-center cross-sectional study. Acta Cir Bras 2022; 37:e370202. [PMID: 35475809 PMCID: PMC9020788 DOI: 10.1590/acb370202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/09/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose: Simultaneous pancreas-kidney transplantation (SPKT) brings several benefits for insulin-dependent type-1 diabetic patients associated with end-stage renal disease (ESRD). However, data on psychological outcomes for the waiting list and the transplanted patients are still lacking. Methods: Using the psychological Beck inventories of anxiety (BAI) and depression (BDI), 39 patients on the waiting list were compared to 88 post-transplanted patients who had undergone SPKT. Results: Significant differences were found regarding depression (p = 0.003) but not anxiety (p = 0.161), being the pretransplant patients more vulnerable to psychological disorders. Remarkable differences were observed relative to the feeling of punishment (p < 0.001) and suicidal thoughts (p = 0.008) between the groups. It was observed that patients who waited a longer period for the transplant showed more post-transplant anxiety symptoms due to the long treatment burden (p = 0.002). Conclusions: These results demonstrated the positive impact of SPKT on psychological aspects related to depression when comparing the groups. The high number of stressors in the pretransplant stage impacts more severely the psychosocial condition of the patient.
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21
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Su Y, Cochrane BB, Reding K, Herting JR, Tinker LF, Zaslavsky O. Mediterranean Diet and Fatigue among Community-Dwelling Postmenopausal Women. J Nutr Gerontol Geriatr 2022; 41:22-45. [PMID: 35038968 PMCID: PMC9835016 DOI: 10.1080/21551197.2022.2025972] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We investigated cross-sectional relationships between the Mediterranean diet and overall fatigue, energy, and weariness scores among 4,563 women aged 65+ from the Women's Health Initiative study. We also used the Isocaloric Substitution approach to explore whether the substitution of fish for red and processed meat, whole for non-whole grains, and whole fruit for fruit juice relate to RAND-36 measured overall fatigue and its subdomains. The alternate Mediterranean Diet (aMED) Index quintiles (Q1-Q5) and selected Mediterranean foods available on a Food Frequency Questionnaire were exposure measures. Results showed aMED Q5 was associated with 2.99 (95% CI: 0.88, 5.11), 4.01 (95% CI: 1.51, 6.53), and 2.47 (95% CI: 0.24, 4.70) point improvements in fatigue, energy, and weariness scores, respectively, compared with aMED Q1. Substituting fish for red and processed meat and whole for non-whole grains was associated with more favorable fatigue scores, whereas substituting whole fruit for juice was not.
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Affiliation(s)
- Yan Su
- School of Nursing, University of Washington, Seattle, WA
| | - Barbara B. Cochrane
- School of Nursing, University of Washington, Seattle, WA
- Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, WA
| | - Kerryn Reding
- School of Nursing, University of Washington, Seattle, WA
| | | | - Lesley F. Tinker
- Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, WA
| | - Oleg Zaslavsky
- School of Nursing, University of Washington, Seattle, WA
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22
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Romadlon DS, Hasan F, Wiratama BS, Chiu HY. Prevalence and risk factors of fatigue in type 1 and type 2 diabetes: A systematic review and meta-analysis. J Nurs Scholarsh 2021; 54:546-553. [PMID: 34958178 DOI: 10.1111/jnu.12763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/12/2021] [Accepted: 12/15/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This meta-analysis was conducted to determine the prevalence and risk factors of fatigue in type 1 and type 2 diabetes mellitus (DM). METHODS Observational studies reporting the prevalence and risk factors of fatigue in type 1 or 2 DM were systematically searched for in PubMed, Embase, CINAHL Plus, Cochrane Trial, and ProQuest Dissertation and Theses databases. Data were extracted by two independent reviewers. A random-effect model was used for data analysis. FINDINGS We included 19 studies involving 7131 patients with type 1 DM and 32 studies involving 34,994 patients with type 2 DM in the study. The pooled prevalence of fatigue in type 1 and type 2 DM was 44% and 50%, respectively. The Asia-Pacific region (e.g., Japan and Australia), South America, and Africa lacked reports regarding fatigue prevalence in type 1 DM, and North Asia and Southeast Asia lacked reports of fatigue prevalence in type 2 DM. Depression and physical activity were the only two variables significantly correlated with fatigue in both type 1 and type 2 DM (all p < 0.05). CONCLUSIONS Approximately half of the patients with type 1 or type 2 DM experienced fatigue, with the prevalence of 44% and 50%, respectively. Our findings regarding its risk factors can provide an evidence-based approach for managing fatigue in DM patients. CLINICAL RELEVANCE This meta-analysis emphasizes the importance of fatigue management in patients with type 1 and type 2 DM. Most significantly, our results on risk factors related to fatigue in diabetes can contribute to the development of evidence-based strategies for managing fatigue in individuals with DM.
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Affiliation(s)
| | - Faizul Hasan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Bayu Satria Wiratama
- Graduate Institute of Injury and Prevention, School of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Epidemiology, Biostatistics and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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23
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Cook AS, Zill A. Working With Type 1 Diabetes: Investigating the Associations Between Diabetes-Related Distress, Burnout, and Job Satisfaction. Front Psychol 2021; 12:697833. [PMID: 34803795 PMCID: PMC8599573 DOI: 10.3389/fpsyg.2021.697833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022] Open
Abstract
The present study investigates the association between diabetes-related distress (DD) and work outcomes (burnout and job satisfaction) among employed people with type 1 diabetes. Employed adults with type 1 diabetes (N = 297) completed an online survey. Measures assessed emotional, social, food- and treatment-related DD, burnout, and job satisfaction, as well as the type of insulin treatment. We conducted multiple regression analyses to test our hypotheses. Emotional DD was significantly and positively associated with burnout. Social DD was significantly and negatively associated with job satisfaction. The type of treatment (insulin pen versus insulin pump) had no significant effect on the outcomes. This study sets the stage for research on the interactions between working conditions, work outcomes and illness symptoms, and problems of people with type 1 diabetes, and, generally, employees with chronic illnesses. The findings have implications for individual health and illness management, burnout prevention, and occupational health measures.
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Affiliation(s)
- Alexandra Sasha Cook
- Psychology Research Institute, University of Amsterdam, Amsterdam, Netherlands.,Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Alexander Zill
- Department of Psychology, Technische Universität Chemnitz, Chemnitz, Germany
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24
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Kuo HJ, Huang YC, García AA. An integrative review of fatigue in adults with type 2 diabetes mellitus: Implications for self-management and quality of life. J Clin Nurs 2021; 31:1409-1427. [PMID: 34585452 DOI: 10.1111/jocn.16058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/15/2021] [Accepted: 09/12/2021] [Indexed: 01/19/2023]
Abstract
AIMS AND OBJECTIVES To synthesise empirical studies on factors related to fatigue and its impact on diabetes self-management (DSM) and quality of life (QOL) in adults with type 2 diabetes mellitus (T2DM). BACKGROUND Fatigue is commonly reported in people with T2DM, a chronic condition that is highly prevalent worldwide. However, a holistic understanding of the consequences and factors related to fatigue in adults with T2DM is not well synthesised. DESIGN This integrative review used Whittemore and Knafl's methodology and was reported according to the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. METHODS The theory of unpleasant symptoms (TOUS) was used as a conceptual model to guide the review. The PubMed, PsychINFO and CINAHL databases were searched to identify studies that recruited adults with T2DM, were peer-reviewed, written in English and investigated fatigue as a primary or secondary outcome. Two investigators independently appraised the quality of the studies and extracted the data. RESULTS Twenty-nine articles met the inclusion criteria: 23 observational studies, two randomised controlled trials, one quasi-experimental study and three qualitative studies. All articles were of high quality. Physiological (e.g. T2DM duration, complications and inflammatory biomarkers), psychological (e.g. diabetes distress, depression and sleep quality) and situational factors (e.g. race/ethnicity, education and social support) were related to fatigue. Studies reported fatigue as a barrier to physical activity, healthy eating behaviours and the physical aspect of QOL. CONCLUSIONS Multiple factors are related to fatigue in adults with T2DM. Gaps in the literature include the multiple dimensions of fatigue, the effectiveness of interventions to alleviate fatigue and fatigue experiences in under-represented populations. RELEVANCE TO CLINICAL PRACTICE This integrative review supports the complex origin of fatigue and its impact on adults with T2DM. Nurses should evaluate modifiable factors related to fatigue and provide support to help improve DSM and QOL in this population.
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Affiliation(s)
- Hsuan-Ju Kuo
- The University of Texas at Austin School of Nursing, Austin, Texas, USA
| | - Ya-Ching Huang
- Texas State University St. David's School of Nursing, Round Rock, Texas, USA
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25
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Park SY, Park CH. Diagnosis of Muscle Fatigue Using Surface Electromyography and Analysis of Associated Factors in Type 2 Diabetic Patients with Neuropathy: A Preliminary Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9635. [PMID: 34574559 PMCID: PMC8469078 DOI: 10.3390/ijerph18189635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022]
Abstract
Diabetic neuropathy (DN) is a major complication associated with diabetes mellitus (DM) and results in fatigue. We investigated whether type 2 diabetic patients with or without neuropathy experienced muscle fatigue and determined the most influencing factor on muscle fatigue. Overall, 15 out of 25 patients with type 2 DM were diagnosed with DN using a nerve conduction study in the upper and lower extremities, and the composite score (CS) was calculated. We obtained the duration of DM and body mass index (BMI) from subjects, and they underwent a series of laboratory tests including HbA1c, fasting plasma glucose, triglycerides, and high- and low-density lipoprotein. To qualify muscle fatigue, this study used surface electromyography (sEMG). Anode and cathode electrodes were attached to the medial gastrocnemius. After 100% isometric maximal voluntary contracture of plantarflexion, the root mean square, median frequency (MDF), and mean power frequency (MNF) were obtained. We showed a correlation among laboratory results, duration of DM, BMI, CS, and parameters of muscle fatigue. The duration of DM was related to fatigue of the muscle and CS (p < 0.05). However, CS was not related to fatigue. The MDF and MNF of muscle parameters were positively correlated with HbA1c and fasting plasma glucose (p < 0.05). In conclusion, we suggest that the duration of DM and glycemic control play important roles in muscle fatigue in patients with DN. Additionally, sEMG is useful for diagnosing muscle fatigue in patients with DN.
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Affiliation(s)
- So Young Park
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital, Seoul 02447, Korea;
| | - Chan Hyuk Park
- Department of Physical & Rehabilitation Medicine, Inha University Hospital, Incheon 22332, Korea
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26
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Takada Y, Hanaoka T, Imagita H, Yasui T, Takeshita D, Abe M, Kawata S, Yamakami T, Okada K, Washio H, Okuda S, Minematsu A, Nakamura T, Terada S, Yamada T, Nakatani A, Sakata S. Long-term wheel-running prevents reduction of grip strength in type 2 diabetic rats. Physiol Rep 2021; 9:e15046. [PMID: 34558206 PMCID: PMC8461031 DOI: 10.14814/phy2.15046] [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] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/29/2022] Open
Abstract
Diabetic skeletal muscles show reduced contractile force and increased fatigability. Hands are a target for several diabetes-induced complications. Therefore, reduced handgrip strength often occurs as a consequence of diabetes. The aim of this study was to examine whether long-term exercise can prevent reduction of grip strength in type 2 diabetes mellitus (T2DM) model OLETF rats, and to explore the mechanisms underlying diabetes-induced grip strength reduction. Ten 5-week-old OLETF rats were used as experimental animals, and five non-diabetic LETO rats as controls of OLETF rats. Half OLETF rats performed daily voluntary wheel-running for 17 months (OLETF + EXE), and the rest of OLETF and LETO rats were sedentary. Grip strength was higher in OLETF + EXE and LETO groups than in OLETF group. OLETF group with hyperglycemia showed an increase in HbA1c, serum TNF-α, and muscle SERCA activity, but a decrease in circulating insulin. Each fiber area, total fiber area, and % total fiber area in type IIb fibers of extensor digitorum longus muscles were larger in OLETF + EXE and LETO groups than in OLETF group. There was a positive correlation between grip strength and the above three parameters concerning type IIb fiber area. Therefore, type IIb fiber atrophy may be the major direct cause of grip strength reduction in OLETF group, although there seems multiple etiological mechanisms. Long-term wheel-running may have blocked the diabetes-induced reduction of grip strength by preventing type IIb fiber atrophy. Regular exercise may be a potent modality for preventing not only the progression of diabetes but muscle dysfunction in T2DM patients.
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Affiliation(s)
- Yoshihiro Takada
- Division of Health ScienceGraduate School of Health ScienceKio UniversityNaraJapan
- Department of Human DevelopmentGraduate School of Human Development and EnvironmentKobe UniversityKobeJapan
| | - Tomoko Hanaoka
- Division of Health ScienceGraduate School of Health ScienceKio UniversityNaraJapan
| | - Hidetaka Imagita
- Division of Health ScienceGraduate School of Health ScienceKio UniversityNaraJapan
| | - Toshihide Yasui
- Division of Health ScienceGraduate School of Health ScienceKio UniversityNaraJapan
- Department of Health and SportsMukogawa Women's UniversityNishinomiyaJapan
| | - Daisuke Takeshita
- Division of Health ScienceGraduate School of Health ScienceKio UniversityNaraJapan
| | - Masami Abe
- Graduate School of Health SciencesSapporo Medical UniversitySapporoJapan
| | - Shinnosuke Kawata
- Division of Health ScienceGraduate School of Health ScienceKio UniversityNaraJapan
| | - Taku Yamakami
- Division of Health ScienceGraduate School of Health ScienceKio UniversityNaraJapan
| | - Keisuke Okada
- Division of Health ScienceGraduate School of Health ScienceKio UniversityNaraJapan
| | - Hiroe Washio
- Department of NursingSchool of Health SciencesKansai University of International StudiesMikiJapan
| | - Syunji Okuda
- Division of Health ScienceGraduate School of Health ScienceKio UniversityNaraJapan
| | - Akira Minematsu
- Division of Health ScienceGraduate School of Health ScienceKio UniversityNaraJapan
| | - Tomohiro Nakamura
- Division of Human SciencesFaculty of EngineeringOsaka Institute of TechnologyOsakaJapan
| | - Shin Terada
- Department of Life SciencesGraduate School of Arts and SciencesUniversity of TokyoTokyoJapan
| | - Takashi Yamada
- Graduate School of Health SciencesSapporo Medical UniversitySapporoJapan
| | - Akira Nakatani
- Laboratory of Exercise PhysiologyDepartment of Health and Sports Science EducationNara University of EducationNaraJapan
| | - Susumu Sakata
- Department of Physiology 1Nara Medical University School of MedicineKashiharaJapan
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27
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Bi Y, Zhang L, Li X, Kan Y, Li S, Zou Y, Liu L, Yuan Y, Gong W, Zhang Y. Contributing factors of fatigue in patients with type 2 diabetes: A systematic review. Psychoneuroendocrinology 2021; 130:105280. [PMID: 34049018 DOI: 10.1016/j.psyneuen.2021.105280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 11/29/2022]
Abstract
Remarkable evidence supports the link between type 2 diabetes (T2DM) and fatigue. However, a unifying recommendation to identify and prevent fatigue or to prevent its clinical consequences in T2DM is not available at present. Therefore, this study aimed to conduct a systematic review to summarize the definition, measurement tools, and contributing factors of fatigue in T2DM. Nine articles were included for analysis, and results showed that T2DM fatigue was associated with five major factors, including sociodemographic factors, clinical disease factors, inflammatory factors, psychological factors, and behavior and lifestyle. The contributing factors of T2DM fatigue are reviewed, and clinical benefits provide a theoretical basis for further clinical intervention to prevent the occurrence of fatigue and improve the patient's treatment compliance and self-management ability and may be beneficial to their quality of life.
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Affiliation(s)
- Yaxin Bi
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Lu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Xiangning Li
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yinshi Kan
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Shuang Li
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yan Zou
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Lin Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yuan Yuan
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Weijuan Gong
- School of Nursing, Yangzhou University, Yangzhou, China; Department of Immunology, School of Medicine, Yangzhou University, Yangzhou, China
| | - Yu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Jiangsu Key Laboratory of Zoonosis, Yangzhou University, China.
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28
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Kuo HJ, Chang NT, Tien YW, Chou YJ, Shun SC. Determinants of Quality of Life in Individuals With a Dual Diagnosis of Resectable Pancreatic Cancer and Diabetes Mellitus. Oncol Nurs Forum 2021; 48:390-402. [PMID: 34142999 DOI: 10.1188/21.onf.390-402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To explore the associations among clinical characteristics, fatigue, diabetes mellitus (DM) self-care activities, and quality of life (QOL) in individuals with resectable pancreatic cancer and DM. SAMPLE & SETTING 57 individuals with resectable pancreatic cancer and DM from an outpatient pancreatic surgical department in Taiwan were included in the final analysis. METHODS & VARIABLES A cross-sectional, correlational design was used. QOL, fatigue, and DM self-care were measured by the European Organisation for Research and Treatment of Cancer QOL Questionnaire-Core 30, the Fatigue Symptom Inventory, and the Summary of Diabetes Self-Care Activities. RESULTS Participants who had a shorter duration of DM and higher levels of fatigue (including intensity, duration, and interference) reported lower QOL scores. Participants who performed more DM self-care activities and physical activity per week had higher QOL scores. Fatigue, DM self-care activities, and DM duration were significant factors related to QOL. IMPLICATIONS FOR NURSING Shorter DM duration, increased fatigue, and fewer DM self-care activities were determinants of worse QOL in individuals with resectable pancreatic cancer and DM.
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29
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Poppe L, De Paepe AL, Van Ryckeghem DML, Van Dyck D, Maes I, Crombez G. The impact of mental and somatic stressors on physical activity and sedentary behaviour in adults with type 2 diabetes mellitus: a diary study. PeerJ 2021; 9:e11579. [PMID: 34178463 PMCID: PMC8216170 DOI: 10.7717/peerj.11579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/19/2021] [Indexed: 11/20/2022] Open
Abstract
Background Adopting an active lifestyle is key in the management of type 2 diabetes mellitus (T2DM). Nevertheless, the majority of individuals with T2DM fails to do so. Additionally, individuals with T2DM are likely to experience mental (e.g., stress) and somatic (e.g., pain) stressors. Research investigating the link between these stressors and activity levels within this group is largely lacking. Therefore, current research aimed to investigate how daily fluctuations in mental and somatic stressors predict daily levels of physical activity (PA) and sedentary behaviour among adults with T2DM. Methods Individuals with T2DM (N = 54) were instructed to complete a morning diary assessing mental and somatic stressors and to wear an accelerometer for 10 consecutive days. The associations between the mental and somatic stressors and participants’ levels of PA and sedentary behaviour were examined using (generalized) linear mixed effect models. Results Valid data were provided by 38 participants. We found no evidence that intra-individual increases in mental and somatic stressors detrimentally affected participants’ activity levels. Similarly, levels of sedentary behaviour nor levels of PA were predicted by inter-individual differences in the mental and somatic stressors.
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Affiliation(s)
- Louise Poppe
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Annick L De Paepe
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Dimitri M L Van Ryckeghem
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Section Experimental Health Psychology, Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.,Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Iris Maes
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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30
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Fatigue among diabetic patients: A descriptive study. ENFERMERIA CLINICA 2021. [PMID: 33357794 DOI: 10.1016/j.enfcli.2020.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fatigue among patients with diabetes mellitus (DM) should be taken seriously because it requires complex and sustained management. Despite commonly experienced by DM patients, healthcare providers often overlook fatigue and its underlying factors. What should be noted is that poorly treated fatigue will negatively impact daily activities, lower the ability to concentrate and may even cause mood swings. All these may deteriorate health, increase the risk of complications and reduce life quality in general. This study aims to describe fatigue among DM patients in Denpasar Community Health Centre. The research design is cross-sectional in nature. The participants were 50 DM patients treated at Denpasar Community Health Centre, selected by using a purposive sampling technique with inclusion and exclusion criteria. The results show that 74 per cent of the patients experienced moderate, 18 per cent mild and 8 per cent severe fatigue. The practical implication is nurses are expected to be able to identify risk factors for fatigue among DM patients so that they can provide appropriate treatment and minimise further complications.
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31
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Gupta J, Kapoor D, Sood V. Quality of Life and its Determinants in Patients with Diabetes Mellitus from Two Health Institutions of Sub-himalayan Region of India. Indian J Endocrinol Metab 2021; 25:211-219. [PMID: 34760676 PMCID: PMC8547395 DOI: 10.4103/ijem.ijem_246_21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/15/2021] [Accepted: 08/06/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) causes serious deterioration in general quality of life (QoL) mainly affecting the health-related quality of life (HRQOL). Routine assessment of QoL improves communication with the patient, helps to predict treatment response, and supports clinical decision-making. QoL can predict an individual's capacity to manage the disease and maintain long-term health and wellbeing. AIMS To find out the QoL and its socio-demographic, anthropometric, and clinical determinants among DM patients attending health institutions from sub-Himalayan region, catering rural population. SETTINGS AND DESIGN This cross-sectional study was conducted in two hospitals mostly catering rural population from 2014 to 2018. Purposive sampling technique was used. MATERIALS AND METHODS Socio-demographic, anthropometric, and clinical data of DM patients (N = 300) were collected. They were administeredHindi translation of QoL Instrument for Indian Diabetes Patients (QOLID) and Patient Health Questionnaire-9 (PHQ-9). All statistical analyses were carried out using Statistical Package for Social Sciences (SSPS) (Version 17.0, USA). RESULTS About 10% had very poor, 13% poor, 11% average, 16% good, and 50% very good QoL on QOLID. General health (GH) and treatment satisfaction (TS) were the most affected domains. Fatigue was the most common symptom (79%) reported in QOLID. Age more than 55 years, rural background, and PHQ-9 score of more than 7 were predictors of poorer QoL. CONCLUSION There is a need for a holistic and collaborative care of DM patients, to maintain a good HRQoL. Screening of depression, fatigue, and regular assessment of QoL should be emphasized.
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Affiliation(s)
- Jyoti Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India
| | - Dheeraj Kapoor
- Department of Medicine, Dr. Rajendra Prasad Government Medical College, Himachal Pradesh, India
| | - Vivek Sood
- Department of Medicine, Dr. Rajendra Prasad Government Medical College, Himachal Pradesh, India
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32
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Fritz J, Phillips AJK, Hunt LC, Imam A, Reid KJ, Perreira KM, Mossavar-Rahmani Y, Daviglus ML, Sotres-Alvarez D, Zee PC, Patel SR, Vetter C. Cross-sectional and prospective associations between sleep regularity and metabolic health in the Hispanic Community Health Study/Study of Latinos. Sleep 2021; 44:5937003. [PMID: 33095850 DOI: 10.1093/sleep/zsaa218] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/19/2020] [Indexed: 12/23/2022] Open
Abstract
STUDY OBJECTIVES Sleep is an emergent, multi-dimensional risk factor for diabetes. Sleep duration, timing, quality, and insomnia have been associated with diabetes risk and glycemic biomarkers, but the role of sleep regularity in the development of metabolic disorders is less clear. METHODS We analyzed data from 2107 adults, aged 19-64 years, from the Sueño ancillary study of the Hispanic Community Health Study/Study of Latinos, followed over a mean of 5.7 years. Multivariable-adjusted complex survey regression methods were used to model cross-sectional and prospective associations between the sleep regularity index (SRI) in quartiles (Q1-least regular, Q4-most regular) and diabetes (either laboratory-confirmed or self-reported antidiabetic medication use), baseline levels of insulin resistance (HOMA-IR), beta-cell function (HOMA-β), hemoglobin A1c (HbA1c), and their changes over time. RESULTS Cross-sectionally, lower SRI was associated with higher odds of diabetes (odds ratio [OR]Q1 vs. Q4 = 1.64, 95% CI: 0.98-2.74, ORQ2 vs. Q4 = 1.12, 95% CI: 0.70-1.81, ORQ3 vs. Q4 = 1.00, 95% CI: 0.62-1.62, ptrend = 0.023). The SRI effect was more pronounced in older (aged ≥ 45 years) adults (ORQ1 vs. Q4 = 1.88, 95% CI: 1.14-3.12, pinteraction = 0.060) compared to younger ones. No statistically significant associations were found between SRI and diabetes incidence, as well as baseline HOMA-IR, HOMA-β, and HbA1c values, or their changes over time among adults not taking antidiabetic medication. CONCLUSIONS Our results suggest that sleep regularity represents another sleep dimension relevant for diabetes risk. Further research is needed to elucidate the relative contribution of sleep regularity to metabolic dysregulation and pathophysiology.
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Affiliation(s)
- Josef Fritz
- Circadian and Sleep Epidemiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Andrew J K Phillips
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Larissa C Hunt
- Circadian and Sleep Epidemiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Akram Imam
- Circadian and Sleep Epidemiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Kathryn J Reid
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Chicago, IL
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Martha L Daviglus
- College of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Phyllis C Zee
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Chicago, IL
| | - Sanjay R Patel
- Center for Sleep and Cardiovascular Outcomes Research, University of Pittsburgh, Pittsburgh, PA
| | - Céline Vetter
- Circadian and Sleep Epidemiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
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Bhati P, Singla D, Masood S, Hussain ME. Type 2 Diabetes Mellitus Patients Manifest Greater Muscle Fatigability Than Healthy Individuals During Dynamic Fatigue Protocol. J Manipulative Physiol Ther 2021; 44:205-220. [PMID: 33902943 DOI: 10.1016/j.jmpt.2019.10.015] [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: 05/07/2019] [Revised: 10/11/2019] [Accepted: 10/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The present study aimed to investigate the electromyographic (EMG) indices of muscle fatigue along with biochemical marker of fatigue-that is, blood lactate-during a dynamic fatigue protocol in individuals with type 2 diabetes mellitus (T2DM) vs a healthy control group. Secondarily, it aimed to examine the association between EMG indices of muscle fatigue and blood lactate in these patients. METHODS Thirty-four participants took part in the study: 19 individuals with T2DM (age, 53.5 ± 6.85 years) and 15 age-matched healthy controls (age, 50.2 ± 3.55 years). Participants performed a dynamic fatigue protocol consisting of 5 sets of 10 repetitions each at an intensity of the 10-repetition maximum. Surface EMG of the vastus medialis and vastus lateralis muscles was recorded during the dynamic fatigue protocol, and EMG indices such as median frequency (MF), slope of MF (MFslope), Dimitrov muscle fatigue spectral index, and root-mean-square were evaluated for each contraction across all the 5 sets. Blood lactate concentrations were also assessed 3 times during the fatigue protocol. RESULTS Findings revealed that EMG muscle fatigue indices such as MF, MFslope, and Dimitrov muscle fatigue spectral index were significantly altered in individuals with T2DM vs healthy individuals across the sets and repetitions for both the vastus medialis (P < .001) and vastus lateralis muscles (P < .001). There was a significantly greater rise in blood lactate in individuals with T2DM than in healthy individuals (P < .001), which was not found to be associated with changes in EMG indices of muscle fatigue. CONCLUSION Findings suggest the existence of significantly greater fatigue in the knee extensor muscles of individuals with T2DM than healthy individuals.
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Affiliation(s)
- Pooja Bhati
- Assistant Professor, Faculty of Physiotherapy, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana-122505, India
| | - Deepika Singla
- Assistant Professor, Faculty of Physiotherapy, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana-122505, India
| | - Sarfaraz Masood
- Professor and Dean, Faculty of Physiotherapy & Allied Health Sciences, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana-122505, India
| | - M Ejaz Hussain
- Assistant Professor, Faculty of Physiotherapy, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana-122505, India.
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YERLİKAYA T, BAŞAKCI ÇALIK B, CAVLAK U, SİRKECİ Ö. Upper Extremity Functioning in Individuals with Type 2 Diabetes Mellitus: A Comparative Study. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.723847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Rahmanian F, Dehghani M, Karimaghaee P, Mohammadi M, Abolpour R. Hardware-in-the-loop control of glucose in diabetic patients based on nonlinear time-varying blood glucose model. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nassif N, Noueiri B. Dental Treatment Effect on Blood Glucose Level Fluctuation in Type 1 Balanced Diabetic Children. Int J Clin Pediatr Dent 2021; 14:212-216. [PMID: 34413594 PMCID: PMC8343672 DOI: 10.5005/jp-journals-10005-1907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Pediatric dentists, while treating diabetic patients, have a major concern about the occurrence of hypo- or hyperglycemia complications. So far, no dental care protocol is elaborated to help practitioners in creating a safe environment for their patients. This study aims to evaluate the blood glucose level (BGL) fluctuation in type 1 diabetic children according to the type of the delivered treatment and its duration, to outline guidance for predicting the occurrence of a hypo- or hyperglycemia complication. MATERIALS AND METHODS A cross-sectional approach was conducted on 70 balanced diabetic children aged between 7 years and 12 years old (32 females and 38 males) in the Department of Pediatric Dentistry at the Lebanese University in Beirut. Only the patients having a BGL between 70 mg/dL and 300 mg/dL could undergo dental treatment. The gender, the duration of the dental session (≤30 or >30 minutes), the BGLs at the baseline and the end of the session were noted. The types of the performed dental treatment were classified as simple, and unpleasant acts. RESULTS For the female group, only eight sessions lasted ≤30 minutes. The results of simple and unpleasant interventions >30 minutes showed that BGLs before and after treatment were almost identical (p > 0.05). In the male group, for the simple acts >30 minutes, the BGL showed a significant fluctuation (p = 0.02). CONCLUSION Dentists must be aware of signs of discomfort in balanced type 1 diabetic children to avoid severe complications. This study highlights a new range of BGLs (70-300 mg/dL) that allows safe dental treatment. HOW TO CITE THIS ARTICLE Nassif N, Noueiri B. Dental Treatment Effect on Blood Glucose Level Fluctuation in Type 1 Balanced Diabetic Children. Int J Clin Pediatr Dent 2021;14(2):212-216.
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Affiliation(s)
- Nahla Nassif
- Department of Pediatric Dentistry, School of Dentistry, Lebanese University, Beirut, Lebanon
| | - Balsam Noueiri
- Department of Pediatric Dentistry, School of Dentistry, Lebanese University, Beirut, Lebanon
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Abstract
BACKGROUND People with Type 2 diabetes frequently report increased fatigue and sleep disturbance. These symptoms might put them at a higher risk for unhealthy eating behavior-detrimental to diabetes control. OBJECTIVES The aim of the study was to examine the effect of fatigue and sleep on eating behavior in people with Type 2 diabetes by using a daily diary approach. METHODS Data from 56 patients were collected during a baseline interview and an 8-day ambulatory assessment period in the free-living setting. Each day, participants completed one diary upon awakening to assess their sleep duration and sleep quality during the previous night and morning fatigue. They also completed one diary before going to bed to assess their eating behavior during the day (e.g., uncontrolled eating, cognitive restraint, emotional eating, and snacking). Data from 7 days were analyzed using generalized estimating equations. RESULTS During the 7 days, controlling for age, gender, and body mass index, between-person fatigue was a significant predictor of uncontrolled eating, emotional eating, and snacking. Similarly, controlling for the covariates, between-person sleep quality was a significant predictor of uncontrolled eating and emotional eating. No associations were found between sleep duration and eating behavior. DISCUSSIONS At the between-person level, reporting higher fatigue or poorer sleep quality was associated with higher levels of unhealthy eating behavior. Patients with Type 2 diabetes with high fatigue or poor sleep quality may require additional attention to support their healthy eating.
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Çilliler AE, Güven B. Inter-ictal fatigue and antiepileptic drugs in patients with epilepsy. Acta Neurol Belg 2021; 121:107-111. [PMID: 32043217 DOI: 10.1007/s13760-020-01292-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 01/30/2020] [Indexed: 11/26/2022]
Abstract
Fatigue is a frequently reported symptom in patients with epilepsy (PWE) while the pathophysiology, causes and effects on the disease are not yet fully understood. Fatigue may occur as a side effect of antiepileptic drugs (AEDs); however, it varies greatly depending on both the characteristics of the patients and the AEDs used. The aim of this study was to investigate the relation between fatigue, clinical features and AEDs and doses used in monotherapy in PWE. Ninety consecutive patients with the diagnosis of epilepsy, treated as monotherapy were included in the study. Demographic data, seizure type and frequency, AEDs and their doses were recorded. Fatigue severity scale (FSS) was used in the evaluation of fatigue. Cases of fatigue were defined by a FSS score ≥ 4. The mean age of the patients (57 females, 33 males) was 33 ± 12.7 years and the mean disease duration was 11.7 ± 9.1 years. Used as monotherapy, AEDs included carbamazepine (n = 29, 32.2%), valproic acid (n = 28, 31.1%), levetiracetam (n = 23, 25.6%) and lamotrigine (n = 10, 11.1%). Fatigue was reported by 52.2% of patients (FSS score ≥ 4). It was found that patients with fatigue had more seizures in the last year than those without (p = 0.031). There was no relation between fatigue and AEDs. The doses of carbamazepine and levetiracetam were significantly correlated with the scores of FSS (p = 0.042 and p = 0.023, respectively), and there was no correlation between the doses of valproic acid and lamotrigine and the scores of FSS. The results of our study showed that; approximately half of the patients with epilepsy had fatigue. Although the relation between AEDs and fatigue was not detected, it was pointed out that AED doses may play a role in the development of fatigue.
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Affiliation(s)
- Aslı Ece Çilliler
- Neurology Department, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
| | - Bülent Güven
- Neurology Department, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Cheval B, Maltagliati S, Sieber S, Beran D, Chalabaev A, Sander D, Cullati S, Boisgontier MP. Why Are Individuals With Diabetes Less Active? The Mediating Role of Physical, Emotional, and Cognitive Factors. Ann Behav Med 2021; 55:904-917. [PMID: 33491067 DOI: 10.1093/abm/kaaa120] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite the key role of physical activity in the management of diabetes, many individuals with diabetes do not engage in the recommended levels of physical activity. However, our knowledge of the mechanisms underlying the relationship between diabetes and physical inactivity is limited. PURPOSE To investigate the associations between diabetes and the levels and evolution of physical activity across aging, and to determine whether physical, emotional, and cognitive factors mediate these associations. METHODS Data from 105,622 adults aged 50-96 years from the Survey of Health, Ageing and Retirement in Europe (SHARE) were used in adjusted linear mixed models to examine whether diabetes was associated with physical activity levels and variations across aging. The potential mediators were subjective energy, muscle strength, physical and cognitive disability, sleep problems, depressive symptoms, and cognitive functions. The variables were measured up to seven times over a 13-year period. RESULTS Individuals with diabetes demonstrated a lower level and a steeper decrease in physical activity across aging than individual without diabetes. Mediators explained ~53% and 94% of the association of diabetes with the level of physical activity and with the linear evolution of physical activity across aging, respectively. All mediators were significantly associated with physical activity. Physical and cognitive disability as well as depressive symptoms were the strongest mediators, while sleep was the lowest one. CONCLUSIONS These findings suggest that the etiology of physical inactivity in individuals with diabetes can result from several physical, emotional, and cognitive changes associated with the emergence of this disease.
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Affiliation(s)
- Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Switzerland.,Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | | | - Stefan Sieber
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Switzerland
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Switzerland
| | | | - David Sander
- Swiss Center for Affective Sciences, University of Geneva, Switzerland.,Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory, University of Fribourg, Switzerland.,Department of Readaptation and Geriatrics, University of Geneva, Switzerland
| | - Matthieu P Boisgontier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
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Mostafavi F, Alavijeh FZ, Salahshouri A, Mahaki B. The psychosocial barriers to medication adherence of patients with type 2 diabetes: a qualitative study. Biopsychosoc Med 2021; 15:1. [PMID: 33461565 PMCID: PMC7812642 DOI: 10.1186/s13030-020-00202-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/11/2020] [Indexed: 11/25/2022] Open
Abstract
Background The adherence of diabetic patients to their medication regimen is associated with many psychosocial factors that are still unknown. Therefore, the present study aims to identify the psychosocial barriers to medication adherence of patients with type2 diabetes (T2D). Methodology This descriptive qualitative study was done in Isfahan, Iran by conducting in-depth unstructured interviews with 23 purposively selected patients with T2D and 10 healthcare providers (HCPs). The participants were interviewed face-to-face between November 2017 and June 2018 at the patient’s home, a Health Care Center, or at the diabetes clinic. Data analysis was performed using MAXQDA-10 software and the conventional content analysis. Results The analysis of the data led to six categories of perceived psychosocial barriers: 1) fear, concern and distress, 2) exhaustion and burnout, 3) the children’s issues being the priority, 4) poor financial support, 5) communication challenges, and 6) poor work conditions. Conclusions This study identified some of the psychosocial barriers to medication adherence of patients with T2D, which will be of great help to researchers and HCPs in designing and implementing effective interventions to overcome these barriers and change patient self-care behaviors and increase their medication adherence.
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Affiliation(s)
- Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereshteh Zamani Alavijeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Salahshouri
- Department of Health Education and Promotion, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357 - 15751, Iran.
| | - Behzad Mahaki
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Senefeld JW, Harmer AR, Hunter SK. Greater Lower Limb Fatigability in People with Prediabetes than Controls. Med Sci Sports Exerc 2020; 52:1176-1186. [PMID: 31815831 DOI: 10.1249/mss.0000000000002238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The study purpose was to compare perceived fatigability and performance fatigability after high-velocity contractions with knee extensor muscles between people with prediabetes, people with type 2 diabetes (T2D), and controls without diabetes matched for age, body mass index, and physical activity. METHODS Twenty people with prediabetes (11 men, 9 women: 63.1 ± 6.0 yr, 26.9 ± 4.2 kg·m, 8030 ± 3110 steps per day), 39 with T2D (23 men, 16 women: 61.2 ± 8.5 yr, 29.4 ± 6.4 kg·m, 8440 ± 4220 steps per day), and 27 controls (13 men, 14 women: 58.1 ± 9.4 yr, 27.3 ± 4.3 kg·m, 8400 ± 3000 steps per day) completed the Fatigue Impact Scale as a measure of perceived fatigability and a fatigue protocol including 120 maximal-effort, high-velocity concentric contractions (MVCC; 1 contraction/3 s) with the knee extensors using a submaximal load (30% maximum) to quantify performance fatigability. Electrical stimulation was used to assess voluntary activation and contractile function of the knee extensor muscles before and after the fatigue protocol. RESULTS Fatigue Impact Scale scores were not different between people with prediabetes, people with T2D, and controls (12.5 ± 15.1, 18.3 ± 22.7, and 12.6 ± 18.6, respectively; P = 0.517). However, people with prediabetes had greater reductions in MVCC power during the fatigue protocol than did controls (31.8% ± 22.6% vs 22.1% ± 21.1%, P < 0.001), and both groups had lesser reductions than the T2D group (44.8% ± 21.9%, P < 0.001). Similarly, the prediabetes group had larger reductions in electrically evoked twitch amplitude than the control group (32.5% ± 24.9% vs 21.3% ± 33.0%, P < 0.001), but lesser reductions than those with T2D (44.0% ± 23.4%, P < 0.001). For all three groups, a greater decline in MVCC power was associated with larger reductions of twitch amplitude (r = 0.350, P < 0.001). CONCLUSION People with prediabetes have greater performance fatigability of the knee extensors due to contractile mechanisms compared with controls, although less performance fatigability than that of people with T2D.
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Affiliation(s)
- Jonathon W Senefeld
- Clinical and Translational Rehabilitation Health Sciences Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Alison R Harmer
- Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, AUSTRALIA
| | - Sandra K Hunter
- Clinical and Translational Rehabilitation Health Sciences Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
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Aljihmani L, Kerdjidj O, Zhu Y, Mehta RK, Erraguntla M, Sasangohar F, Qaraqe K. Classification of Fatigue Phases in Healthy and Diabetic Adults Using Wearable Sensor. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6897. [PMID: 33287112 PMCID: PMC7729463 DOI: 10.3390/s20236897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 11/16/2022]
Abstract
Fatigue is defined as "a loss of force-generating capacity" in a muscle that can intensify tremor. Tremor quantification can facilitate early detection of fatigue onset so that preventative or corrective controls can be taken to minimize work-related injuries and improve the performance of tasks that require high-levels of accuracy. We focused on developing a system that recognizes and classifies voluntary effort and detects phases of fatigue. The experiment was designed to extract and evaluate hand-tremor data during the performance of both rest and effort tasks. The data were collected from the wrist and finger of the participant's dominant hand. To investigate tremor, time, frequency domain features were extracted from the accelerometer signal for segments of 45 and 90 samples/window. Analysis using advanced signal processing and machine-learning techniques such as decision tree, k-nearest neighbor, support vector machine, and ensemble classifiers were applied to discover models to classify rest and effort tasks and the phases of fatigue. Evaluation of the classifier's performance was assessed based on various metrics using 5-fold cross-validation. The recognition of rest and effort tasks using an ensemble classifier based on the random subspace and window length of 45 samples was deemed to be the most accurate (96.1%). The highest accuracy (~98%) that distinguished between early and late fatigue phases was achieved using the same classifier and window length.
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Affiliation(s)
- Lilia Aljihmani
- Department of Electrical & Computer Engineering, Texas A & M University at Qatar, Doha 23874, Qatar; (O.K.); (K.Q.)
| | - Oussama Kerdjidj
- Department of Electrical & Computer Engineering, Texas A & M University at Qatar, Doha 23874, Qatar; (O.K.); (K.Q.)
| | - Yibo Zhu
- Department of Industrial & Systems Engineering, Texas A & M University, College Station, TX 77843, USA; (Y.Z.); (R.K.M.); (M.E.); (F.S.)
| | - Ranjana K. Mehta
- Department of Industrial & Systems Engineering, Texas A & M University, College Station, TX 77843, USA; (Y.Z.); (R.K.M.); (M.E.); (F.S.)
| | - Madhav Erraguntla
- Department of Industrial & Systems Engineering, Texas A & M University, College Station, TX 77843, USA; (Y.Z.); (R.K.M.); (M.E.); (F.S.)
| | - Farzan Sasangohar
- Department of Industrial & Systems Engineering, Texas A & M University, College Station, TX 77843, USA; (Y.Z.); (R.K.M.); (M.E.); (F.S.)
| | - Khalid Qaraqe
- Department of Electrical & Computer Engineering, Texas A & M University at Qatar, Doha 23874, Qatar; (O.K.); (K.Q.)
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Kim H, Son H. A Moderated-Mediation Model of the Relationship between Dietary Satisfaction and Fatigue in Older Adults with Diabetes: The Role of Meal Planning and Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8823. [PMID: 33261015 PMCID: PMC7729502 DOI: 10.3390/ijerph17238823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 01/12/2023]
Abstract
Little research has examined the pathways between psychological factors and fatigue in older adults with diabetes. This study explored the pathways between diet-related quality of life and depressive symptoms in predicting fatigue using a moderated-mediation model. A convenience sample of adults ≥65 years (n = 127) with diabetes completed a cross-sectional survey including measures of fatigue severity, diet-related quality of life, and depressive symptoms, and a moderated-mediation analysis assessed the relationships between them. Diet satisfaction was negatively related to fatigue, which was mediated by depressive symptoms. In the moderated-mediation model, diet satisfaction had a conditional effect on fatigue through the mediating effect of depressive symptoms, moderated by meal planning difficulty. At higher levels of perceived meal planning difficulty, lower diet satisfaction was indirectly associated with higher fatigue through depressive symptoms, but this pathway was non-significant at lower levels. Findings suggest that supportive care for diet therapy might improve psychological outcomes in older adults with diabetes, especially for those having difficulties with daily dietary practice. Meal planning difficulties in the dietary management of diabetes accompanied by low diet satisfaction may lead to negative psychological outcomes. Monitoring satisfaction and burdens associated with dietary practices could improve fatigue in this population.
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Affiliation(s)
- Hyerang Kim
- Department of Nursing Science, Howon University, 64 Howondae 3gil, Impi, Gunsan 54058, Jeollabuk-do, Korea;
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
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Tyagi O, Zhu Y, Johnson C, Mehta RK, Sasangohar F, Erraguntla M, Qaraqe K. Neural Signatures of Handgrip Fatigue in Type 1 Diabetic Men and Women. Front Hum Neurosci 2020; 14:564969. [PMID: 33240061 PMCID: PMC7680760 DOI: 10.3389/fnhum.2020.564969] [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] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 10/14/2020] [Indexed: 01/22/2023] Open
Abstract
Type 1 diabetes (T1D) is associated with reduced muscular strength and greater muscle fatigability. Along with changes in muscular mechanisms, T1D is also linked to structural changes in the brain. How the neurophysiological mechanisms underlying muscle fatigue is altered with T1D and sex related differences of these mechanisms are still not well investigated. The aim of this study was to determine the impact of T1D on the neural correlates of handgrip fatigue and examine sex and T1D related differences in neuromuscular performance parameters, neural activation and functional connectivity patterns between the motor regions of the brain. Forty-two adults, balanced by condition (healthy vs T1D) and sex (male vs female), and performed submaximal isometric handgrip contractions until voluntary exhaustion. Initial strength, endurance time, strength loss, force variability, and complexity measures were collected. Additionally, hemodynamic responses from motor-function related cortical regions, using functional near-infrared spectroscopy (fNIRS), were obtained. Overall, females exhibited lower initial strength (p < 0.0001), and greater strength loss (p = 0.023) than males. While initial strength was significantly lower in the T1D group (p = 0.012) compared to the healthy group, endurance times and strength loss were comparable between the two groups. Force complexity, measured as approximate entropy, was found to be lower throughout the experiment for the T1D group (p = 0.0378), indicating lower online motor adaptability. Although, T1D and healthy groups fatigued similarly, only the T1D group exhibited increased neural activation in the left (p = 0.095) and right (p = 0.072) supplementary motor areas (SMA) over time. A sex × condition × fatigue interaction effect (p = 0.044) showed that while increased activation was observed in both T1D females and healthy males from the Early to Middle phase, this was not observed in healthy females or T1D males. These findings demonstrate that T1D adults had lower adaptability to fatigue which they compensated for by increasing neural effort. This study highlights the importance of examining both neural and motor performance signatures when investigating the impact of chronic conditions on neuromuscular fatigue. Additionally, the findings have implications for developing intervention strategies for training, rehabilitation, and ergonomics considerations for individuals with chronic conditions.
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Affiliation(s)
- Oshin Tyagi
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Yibo Zhu
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Connor Johnson
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Ranjana K. Mehta
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Farzan Sasangohar
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Madhav Erraguntla
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Khalid Qaraqe
- Department of Electrical and Computer Engineering, Texas A&M University at Qatar, Doha, Qatar
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Polonsky WH, Layne JE, Parkin CG, Kusiak CM, Barleen NA, Miller DP, Zisser H, Dixon RF. Impact of Participation in a Virtual Diabetes Clinic on Diabetes-Related Distress in Individuals With Type 2 Diabetes. Clin Diabetes 2020; 38:357-362. [PMID: 33132505 PMCID: PMC7566922 DOI: 10.2337/cd19-0105] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The Onduo Virtual Diabetes Clinic is a telehealth program for people with type 2 diabetes that combines mobile app technology, remote personalized lifestyle coaching, connected blood glucose meters, real-time continuous glucose monitoring (rtCGM) devices, and clinical support from board-certified endocrinologists. This analysis evaluated change in diabetes distress among 228 program participants who reported moderate distress (score 2.0-2.9) or high distress (score ≥3.0) on the 17-item Diabetes Distress Scale (DDS17) at enrollment. Participants reported significant reductions in overall distress from 3.0 ± 0.8 at baseline to 2.5 ± 0.9 (P <0.001) at an average of 6 months of follow-up. Significant reductions in all DDS17 subscale scores were observed; most notable were reductions in the regimen-related and emotional distress subscales (-0.9 and -0.4, respectively; both P <0.001). Significantly greater reductions in overall distress (P = 0.012) and regimen-related distress (P <0.001) were reported by participants who were prescribed and used intermittent rtCGM (n = 77) versus nonusers (n = 151). Although the generalizability of these findings may be limited by the study's small sample size and potential for self-selection bias, these results do suggest that telemedicine programs such as the Onduo VDC could be a valuable tool for addressing the problem of diabetes-related distress.
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Affiliation(s)
- William H. Polonsky
- Behavioral Diabetes Institute, San Diego, CA
- University of California, San Diego, San Diego, CA
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Assessment of the efficacy of a fatigue management therapy in schizophrenia: study protocol for a randomized, controlled multi-centered study (ENERGY). Trials 2020; 21:797. [PMID: 32943079 PMCID: PMC7500003 DOI: 10.1186/s13063-020-04606-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/12/2020] [Indexed: 11/17/2022] Open
Abstract
Background Fatigue is a well-known common clinical feature of numerous chronic diseases including various forms of cancer, neurological disorders such as multiple sclerosis, and psychiatric disorders. A significant proportion of people with schizophrenia (30–60%) reportedly experience fatigue, which impacts negatively on participation in various activities, including work, study, leisure, and social pursuits. Causes of fatigue in schizophrenia are poorly understood and there are no established treatments. Several evidence-based interventions for fatigue syndrome including psychoeducation, cognitive behavioral therapy, and graded exercise therapy have been shown to be effective in other medical conditions and could be adapted to address fatigue in schizophrenia patients. As there are no psychosocial or pharmacological interventions with proved efficacy for fatigue in schizophrenia, there is an urgent need for the development of strategies to improve fatigue management in schizophrenia. The aim of this project is to evaluate in a single blind randomized clinical trial the efficacy of a cognitive-behavioral therapy (CBT) intervention compared to treatment as usual (TAU) on fatigue as the main outcome in schizophrenia patients. Clinical symptoms, physical functioning, major cognitive functions, quality of life and functioning, treatment dosage, daily motor activity, biological markers with inflammatory markers are also considered as secondary outcomes. Methods/design Two hundred patients meeting the inclusion criteria will be randomized to either of the study arms (intervention or TAU). The ENERGY intervention will be delivered according to a standardized treatment manual comprising six modules addressing fatigue and sleep over 14 individual therapy sessions. The treatment encompasses core CBT principles of psycho-education, behavioral activation, behavioral experiments, cognitive restructuring, problem-solving, and relapse prevention. Sessions will follow the traditional CBT structure of agenda setting, review of homework tasks, and introduction of a new concept/technique with collaborative discussions on how to implement such strategies in the participant’s day-to-day environment. Our primary endpoint will be the severity of fatigue assessed at baseline and at the 9-month follow-up using the “Multidimensional Fatigue Inventory” (MFI). Discussion The trial will provide the first test of CBT intervention for fatigue for patients with schizophrenia. This study will also test to what extent the treatment can be implemented in everyday practice. Trial registration ClinicalTrials.govNCT04332601. Registered on 10 April 2020.
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Milaneschi Y, Lamers F, Berk M, Penninx BWJH. Depression Heterogeneity and Its Biological Underpinnings: Toward Immunometabolic Depression. Biol Psychiatry 2020; 88:369-380. [PMID: 32247527 DOI: 10.1016/j.biopsych.2020.01.014] [Citation(s) in RCA: 186] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 12/03/2019] [Accepted: 01/18/2020] [Indexed: 12/14/2022]
Abstract
Epidemiological evidence indicates the presence of dysregulated homeostatic biological pathways in depressed patients, such as increased inflammation and disrupted energy-regulating neuroendocrine signaling (e.g., leptin, insulin). Alterations in these biological pathways may explain the considerable comorbidity between depression and cardiometabolic conditions (e.g., obesity, metabolic syndrome, diabetes) and represent a promising target for intervention. This review describes how immunometabolic dysregulations vary as a function of depression heterogeneity by illustrating that such biological dysregulations map more consistently to atypical behavioral symptoms reflecting altered energy intake/expenditure balance (hyperphagia, weight gain, hypersomnia, fatigue, and leaden paralysis) and may moderate the antidepressant effects of standard or novel (e.g., anti-inflammatory) therapeutic approaches. These lines of evidence are integrated in a conceptual model of immunometabolic depression emerging from the clustering of immunometabolic biological dysregulations and specific behavioral symptoms. The review finally elicits questions to be answered by future research and describes how the immunometabolic depression dimension could be used to dissect the heterogeneity of depression and potentially to match subgroups of patients to specific treatments with higher likelihood of clinical success.
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Affiliation(s)
- Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam University Medical Center/Vrije Universiteit & GGZinGeest, Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam University Medical Center/Vrije Universiteit & GGZinGeest, Amsterdam, The Netherlands
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Treatment, School of Medicine, Deakin University and Barwon Health, Geelong, Victoria, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam University Medical Center/Vrije Universiteit & GGZinGeest, Amsterdam, The Netherlands
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Christensen SF, Scherber RM, Brochmann N, Goros M, Gelfond J, Andersen CL, Flachs EM, Mesa R. Body Mass Index and Total Symptom Burden in Myeloproliferative Neoplasms Discovery of a U-shaped Association. Cancers (Basel) 2020; 12:E2202. [PMID: 32781663 PMCID: PMC7465643 DOI: 10.3390/cancers12082202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/30/2020] [Accepted: 08/02/2020] [Indexed: 12/18/2022] Open
Abstract
Elevated body mass index (BMI) is a global health problem, leading to enhanced mortality and the increased risk of several cancers including essential thrombocythemia (ET), a subtype of the Philadelphia-chromosome negative myeloproliferative neoplasms (MPN). Furthermore, evidence states that BMI is associated with the severity of symptom burden among cancer patients. MPN patients often suffer from severe symptom burden. The purpose of this study was to examine whether deviations from a normal BMI in an MPN population are associated with higher symptom burden and reduced quality of life (QoL). A combined analysis of two large cross-sectional surveys, the Danish Population-based Study, MPNhealthSurvey (n = 2044), and the international Fatigue Study (n = 1070), was performed. Symptoms and QoL were assessed using the validated Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF). Analysis of covariance was used to estimate the effects of different BMI categories on symptom scores while adjusting for age, sex, and MPN subtype. A U-shaped association between BMI and Total Symptom Burden was observed in both datasets with significantly higher mean scores for underweight and obese patients relative to normal weight (mean difference: underweight 5.51 (25.8%), p = 0.006; obese 5.70 (26.6%) p < 0.001). This is an important finding, as BMI is a potentially modifiable factor in the care of MPN patients.
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Affiliation(s)
| | - Robyn Marie Scherber
- Department of Hematology/Oncology, UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX 78229, USA;
- Hematologic Malignancies, Incyte Corporation, Wilmington, DE 19803, USA
| | - Nana Brochmann
- Department of Hematology, Zealand University Hospital, 4000 Roskilde, Denmark;
| | - Martin Goros
- Department of Population Health Sciences, UT Health San Antonio, San Antonio, TX 78229, USA; (M.G.); (J.G.)
| | - Jonathan Gelfond
- Department of Population Health Sciences, UT Health San Antonio, San Antonio, TX 78229, USA; (M.G.); (J.G.)
| | | | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400 Copenhagen, Denmark;
| | - Ruben Mesa
- Department of Hematology/Oncology, UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX 78229, USA;
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Abdelbasset WK, Abdelhalim NM. Assessing the effects of 6 weeks of intermittent aerobic exercise on aerobic capacity, muscle fatigability, and quality of life in diabetic burned patients: Randomized control study. Burns 2020; 46:1193-1200. [DOI: 10.1016/j.burns.2019.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/27/2019] [Accepted: 12/22/2019] [Indexed: 12/30/2022]
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Izgu N, Gok Metin Z, Karadas C, Ozdemir L, Metinarikan N, Corapcıoglu D. Progressive Muscle Relaxation and Mindfulness Meditation on Neuropathic Pain, Fatigue, and Quality of Life in Patients With Type 2 Diabetes: A Randomized Clinical Trial. J Nurs Scholarsh 2020; 52:476-487. [PMID: 32536026 DOI: 10.1111/jnu.12580] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE To examine the effects of progressive muscle relaxation and mindfulness meditation on the severity of diabetic peripheral neuropathic pain (DPNP), fatigue, and quality of life in patients with type 2 diabetes. DESIGN An assessor-blinded prospective randomized controlled trial. METHODS Participants were randomly assigned to the relaxation group (RG; n = 28), meditation group (MG; n = 25), or control group (CG; n = 24). The mean age of participants was 64.2 ± 8.1 years in the RG, 61.6 ± 8.0 years in the MG, and 64.1± 6.6 years in the CG. Patients in the intervention groups performed progressive muscle relaxation or mindfulness meditation at their home for 12 weeks, 20 min daily. The CG received only an attention-matched controlled education on pancreas anatomy and diabetes. Data collection was performed at baseline and at weeks 12 and 14 using the VAS, FACIT Fatigue Scale (FACIT-F), and Neuropathic Pain Impact on Quality of Life Questionnaire (NePIQoL). FINDINGS VAS scores were significantly lower in the RG and MG at week 12 (p < .05) and were statistically significant in the RG at week 14. Additionally, fatigue severity decreased significantly in the RG at weeks 12 and 14, compared to that in the CG (p < .05). While no significant difference was found in the quality of life scores between the study groups at weeks 12 and 14 (p > .05), a significant improvement in quality of life scores in the RG were provided at week 12 compared to those at baseline and week 14 (p < .05). CONCLUSIONS Both progressive muscle relaxation and mindfulness meditation had a positive impact on providing pain relief in patients with DPNP. Moreover, progressive muscle relaxation also appeared to have a beneficial effect on fatigue. CLINICAL RELEVANCE Based on the results, progressive muscle relaxation and mindfulness meditation can be recommended as supportive therapies for the management of DPNP.
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Affiliation(s)
- Nur Izgu
- Assistant Professor, Hacettepe University Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey
| | - Zehra Gok Metin
- Associate Professor, Hacettepe University Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey
| | - Canan Karadas
- Research Assistant, Hacettepe University Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey
| | - Leyla Ozdemir
- Professor, Hacettepe University Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey
| | - Nuran Metinarikan
- Ankara University School of Medicine Ibni Sina Hospital, Endocrinolocy and Metabolic Diseases Outpatient Unit, Ankara, Turkey
| | - Demet Corapcıoglu
- Professor, Ankara University School of Medicine Ibni Sina Hospital, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey
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