1
|
Li XN, Kan YS, Liu HY, Pang J, He YY, Liu L, Zou Y, Zhang N, Zhang Y. Prevalence and contributing factors of impaired awareness of hypoglycemia in patients with type 2 diabetes: a meta-analysis. Acta Diabetol 2023; 60:1155-1169. [PMID: 37199797 DOI: 10.1007/s00592-023-02102-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/18/2023] [Indexed: 05/19/2023]
Abstract
AIMS To conduct a systematic review to summarize the definition, measurement tools, prevalence, and contributing factors of impaired awareness of hypoglycemia (IAH) in type 2 diabetes mellitus (T2DM). METHODS A reproducible search strategy was used to identify factors affecting IAH in T2DM in PubMed, MEDLINE, EMBASE, Cochrane, PsycINFO, and CINAHL from inception until 2022. Literature screening, quality evaluation, and information extraction were performed independently by 2 investigators. A meta-analysis of prevalence was performed using Stata 17.0. RESULTS The pooled prevalence of IAH in patients with T2DM was 22% (95%CI:14-29%). Measurement tools included the Gold score, Clarke's questionnaire, and the Pedersen-Bjergaard scale. IAH in T2DM was associated with sociodemographic factors (age, BMI, ethnicity, marital status, education level, and type of pharmacy patients visited), clinical disease factors (disease duration, HbAlc, complications, insulin therapy regimen, sulfonylureas use, and the frequency and severity of hypoglycemia), and behavior and lifestyle (smoking and medication adherence). CONCLUSION The study found a high prevalence of IAH in T2DM, with an increased risk of severe hypoglycemia, suggesting that medical workers should take targeted measures to address sociodemographic factors, clinical disease, and behavior and lifestyle to reduce IAH in T2DM and thus reduce hypoglycemia in patients.
Collapse
Affiliation(s)
- Xiang-Ning Li
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Yin-Shi Kan
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Hong-Yuan Liu
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou, China
| | - Juan Pang
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Yu-Ying He
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Lin Liu
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Yan Zou
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Ning Zhang
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Yu Zhang
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China.
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou, China.
| |
Collapse
|
2
|
Recent advances in microneedle designs and their applications in drug and cosmeceutical delivery. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
3
|
Hu X, Gong H, Hou A, Wu X, Shi P, Zhang Y. Effects of continuous subcutaneous insulin infusion on the microstructures, mechanical properties and bone mineral compositions of lumbar spines in type 2 diabetic rats. BMC Musculoskelet Disord 2022; 23:511. [PMID: 35637472 PMCID: PMC9150354 DOI: 10.1186/s12891-022-05452-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Continuous subcutaneous insulin infusion (CSII) for the treatment of type 2 diabetes (T2D) can improve the structure and strength of femur of rats, but the effect of CSII treatment on the lumbar spine of T2D rats is unknown. The purpose of this study is to investigate the effects of CSII on the microstructure, multi-scale mechanical properties and bone mineral composition of the lumbar spine in T2D rats. Methods Seventy 6-week-old male Sprague–Dawley (SD) rats were divided into two batches, each including Control, T2D, CSII and Placebo groups, and the duration of insulin treatment was 4-week and 8-week, respectively. At the end of the experiment, the rats were sacrificed to take their lumbar spine. Microstructure, bone mineral composition and nanoscopic-mesoscopic-apparentand-macroscopic mechanical properties were evaluated through micro-computed tomography (micro-CT), Raman spectroscopy, nanoindentation test, nonlinear finite element analysis and compression test. Results It was found that 4 weeks later, T2D significantly decreased trabecular thickness (Tb.Th), nanoscopic-apparent and partial mesoscopic mechanical parameters of lumbar spine (P < 0.05), and significantly increased bone mineral composition parameters of cortical bone (P < 0.05). It was shown that CSII significantly improved nanoscopic-apparent mechanical parameters (P < 0.05). In addition, 8 weeks later, T2D significantly decreased bone mineral density (BMD), bone volume fraction (BV/TV) and macroscopic mechanical parameters (P < 0.05), and significantly increased bone mineral composition parameters of cancellous bone (P < 0.05). CSII treatment significantly improved partial mesoscopic-macroscopic mechanical parameters and some cortical bone mineral composition parameters (P < 0.05). Conclusions CSII treatment can significantly improve the nanoscopic-mesoscopic-apparent-macroscopic mechanical properties of the lumbar spine in T2D rats, as well as the bone structure and bone mineral composition of the lumbar vertebrae, but it will take longer treatment time to restore the normal level. In addition, T2D and CSII treatment affected bone mineral composition of cortical bone earlier than cancellous bone of lumbar spine in rat. Our study can provide evidence for clinical prevention and treatment of T2D-related bone diseases.
Collapse
Affiliation(s)
- Xiaorong Hu
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China
| | - He Gong
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China.
| | - Aiqi Hou
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China
| | - Xiaodan Wu
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China
| | - Peipei Shi
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China
| | - Yingying Zhang
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical Aids, Beijing, 100176, China.
| |
Collapse
|
4
|
Shen Z, Xu J, Yin W, Liu Q, Fan M, Luo C. Common Sense Model program on illness perceptions in patients with impaired awareness of hypoglycemia. Contemp Nurse 2022; 58:171-191. [PMID: 35477371 DOI: 10.1080/10376178.2022.2071311] [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: 11/03/2022]
Abstract
BACKGROUND Illness perceptions are important for patients with insulin-treated type 2 diabetes mellitus (T2DM) and impaired awareness of hypoglycemia (IAH), as they determine health-related behaviors and motivations. Patients with IAH in many countries have poor illness perception, and there is a paucity of research exploring the effectiveness of Common Sense Model (CSM)-based interventions in this population. OBJECTIVE To investigate the effects of a CSM-based intervention program on perceptions of illness in patients with insulin-treated T2DM and IAH. DESIGN Quasi-randomized controlled trialMethods: 78 patients with IAH receiving routine care were included. The intervention group (n = 39) participated in a CSM-based program, whereas the control group (n = 39) did not. Illness perceptions, coping styles, hypoglycemia fear, and awareness of hypoglycemia at baseline, 1 month, and 3 months were analyzed and compared between the two groups. RESULTS The intervention group exhibited significant improvements in consequences (β = -1.615, P = 0.032); personal control (β = -1.897, P = 0.006); treatment control (β = -1.274, P = 0.046); and positive coping style (β = 4.872, P = 0.002) at the 3-month follow-up, and timeline (β = 2.769, P = 0.004) at the 1-month follow-up. Hypoglycemia fear and awareness were not significantly improved in the intervention group compared with the control group. No intervention-related adverse events were observed. CONCLUSIONS A CSM-based intervention program can modify illness perceptions to an extent and improve the positive coping style in patients with IAH.Impact statement: Nurses should conduct a CSM-based intervention program to help patients with IAH improve illness perceptions.
Collapse
Affiliation(s)
- Zhijia Shen
- Nursing Department, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, SuZhou, China
| | - Jianou Xu
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Wei Yin
- Affiliated hospital of Jiangsu University, Jiangsu, China
| | - Qiaoyan Liu
- Affiliated hospital of Jiangsu University, Jiangsu, China
| | - Minyu Fan
- Oncology department, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, SuZhou, China
| | - Caifeng Luo
- School of Medicine, Jiangsu University, Jiangsu, People's Republic of China
| |
Collapse
|
5
|
Wan Y, Xu X, Gilbert RG, Sullivan MA. A Review on the Structure and Anti-Diabetic (Type 2) Functions of β-Glucans. Foods 2021; 11:57. [PMID: 35010185 PMCID: PMC8750484 DOI: 10.3390/foods11010057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/19/2021] [Accepted: 12/24/2021] [Indexed: 12/14/2022] Open
Abstract
Type 2 diabetes, a long-term chronic metabolic disease, causes severe and increasing economic and health problems globally. There is growing evidence that β-glucans can function as bioactive macromolecules that help control type 2 diabetes with minimal side effects. However, conflicting conclusions about the antidiabetic activities of β-glucans have been published, potentially resulting from incomplete understanding of their precise structural characteristics. This review aims to increase clarity on the structure-function relationships of β-glucans in treating type 2 diabetes by examining detailed structural and conformational features of naturally derived β-glucans, as well as both chemical and instrumental methods used in their characterization, and their underlying anti-diabetic mechanisms. This may help to uncover additional structure and function relationships and to expand applications of β-glucans.
Collapse
Affiliation(s)
- Yujun Wan
- Centre for Nutrition and Food Sciences, Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Xiaojuan Xu
- College of Chemistry and Molecular Sciences, Wuhan University, Wuhan 430072, China;
| | - Robert G. Gilbert
- Centre for Nutrition and Food Sciences, Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, QLD 4072, Australia;
- Joint International Research Laboratory of Agriculture and Agri-Product Safety, College of Agriculture, Yangzhou University, Yangzhou 225009, China
| | - Mitchell A. Sullivan
- Glycation and Diabetes Group, Mater Research Institute, The University of Queensland, Translational Research Institute, Brisbane, QLD 4072, Australia
| |
Collapse
|
6
|
Zhang XP, Wang BB, Hu LF, Fei WM, Cui Y, Guo XD. Safety evaluation of 3-month effects of microneedle patches prepared from hyaluronic acid in mice. Biochem Eng J 2021. [DOI: 10.1016/j.bej.2021.108157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
7
|
Gomez-Peralta F, Fornos Pérez JA, Molinero A, Sánchez Barrancos IM, Arranz Martínez E, Martínez-Pérez P, Mera Gallego I, Andrés-Rodríguez NF. Adherence to antidiabetic treatment and impaired hypoglycemia awareness in type 2 diabetes mellitus assessed in Spanish community pharmacies: the ADHIFAC study. BMJ Open Diabetes Res Care 2021; 9:9/2/e002148. [PMID: 34845061 PMCID: PMC8633992 DOI: 10.1136/bmjdrc-2021-002148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/19/2021] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Adherence to treatment and hypoglycemia awareness are strongly linked to glycemic control and hypoglycemia risk in people with type 2 diabetes mellitus (T2DM). Community pharmacies are suitable facilities to detect these conditions, and should be involved in the strategies to minimize the associated risks and burden. RESEARCH DESIGN AND METHODS This cross-sectional study conducted at community pharmacies across Spain assessed the prevalence of low adherence to antidiabetic treatments, the frequency of impaired hypoglycemia awareness, and their predictive factors. Adherence was measured with the 8-item Morisky Medication Adherence Scale (MMAS-8) and electronic records of dispensed treatments. The Clarke questionnaire was used to assess impaired hypoglycemia awareness. Healthcare counseling provided in the pharmacy was collected. RESULTS Seventy-nine pharmacists and 618 subjects with T2DM participated in the study. Mean age in the overall T2DM population was 67 years, being the majority (69%) pensioners. Adherence was high in 41% of participants, medium in 35%, and low in 24% according to the MMAS-8. Impaired hypoglycemia awareness was observed in 25% of participants. Main determinants of low adherence were the level of education, the number of treatments per patient, hypoglycemia awareness, and the type of pharmacy. Predictive factors of impaired hypoglycemia awareness were the level of education, information on diabetes-related complications, adherence levels, and the type of pharmacy. The proportion of participants who had healthcare counseling was 71% in the overall population and 100% in subjects with impaired hypoglycemia awareness and low adherence. Healthcare counseling comprised diabetes education (69%), pharmacotherapeutic assessment (20%), and physician referrals (11%). CONCLUSION Lack of adherence to antidiabetic treatments and impaired hypoglycemia awareness are frequent and correlate in T2DM. Community pharmacies can detect these conditions and should have an active role in the design of strategies to minimize them.
Collapse
Affiliation(s)
- Fernando Gomez-Peralta
- Endocrinology and Nutrition Unit, Segovia Hospital Complex, Segovia, Castilla y León, Spain
| | - José A Fornos Pérez
- Community Pharmacy Cangas de Morrazo, Pontevedra, Spain
- Diabetes Group of the Spanish Society of Clinical, Family and Community Pharmacy (SEFAC), Barcelona, Spain
| | - Ana Molinero
- Diabetes Group of the Spanish Society of Clinical, Family and Community Pharmacy (SEFAC), Barcelona, Spain
- Community Pharmacy Fuenlabrada, Madrid, Spain
| | | | | | - Pablo Martínez-Pérez
- Department of Clinical Medicine, Miguel Hernandez University of Elche - Campus of San Juan de Alicante, San Juan, Spain
| | - Inés Mera Gallego
- Diabetes Group of the Spanish Society of Clinical, Family and Community Pharmacy (SEFAC), Barcelona, Spain
- Community Pharmacy Maella, Zaragoza, Spain
| | - N Floro Andrés-Rodríguez
- Diabetes Group of the Spanish Society of Clinical, Family and Community Pharmacy (SEFAC), Barcelona, Spain
- Community Pharmacy Vigo, Vigo, Spain
| |
Collapse
|