1
|
Hu X, Fang X, Wu M. Prevalence, awareness, treatment and control of type 2 diabetes in southeast China: A population-based study. J Diabetes Investig 2024; 15:1034-1041. [PMID: 38741389 PMCID: PMC11292384 DOI: 10.1111/jdi.14213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/15/2024] [Accepted: 03/25/2024] [Indexed: 05/16/2024] Open
Abstract
AIMS/INTRODUCTION To estimate the prevalence, awareness, treatment, control rate, and influence factors of type 2 diabetes in Fujian province and provide the scientific basic for prevention. MATERIALS AND METHODS A population-based study with the analysis of binary logistic regression was carried out to estimate the odds ratios of the influencing factor on type 2 diabetes. Data of the Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) in southeast China were used. The study sample originated from 12 counties in Fujian province and included 135,352 permanent residents aged 35-75 years in 2021. RESULTS The prevalence of type 2 diabetes was 18.32% (24,801/135,352). Among them, 13,921 (56.13%) were aware of their condition, 11,894 (47.96%) were receiving treatment, and 4,537 (18.29%) had achieved control of blood glucose. Multivariate logistic regression analysis showed that older age, men, low-family income, low-education level, urban locality, no medical insurance, and histories of myocardial infarction, stroke, dyslipidemia, hypertension, alcohol consumption, and obesity were associated with a higher prevalence of type 2 diabetes. CONCLUSIONS The prevalence of type 2 diabetes among residents aged 35-75 years in southeast China is high, whereas the status of its low awareness, treatment and control is severe, warranting a broad-based global strategy, including greater efforts in earlier screening, and more effective and affordable treatment is essential.
Collapse
Affiliation(s)
- Xiangju Hu
- School of Public HealthFujian Medical UniversityFuzhouChina
- Department for Chronic and Noncommunicable Disease Control and PreventionFujian Provincial Center for Disease Control and PreventionFuzhouChina
| | - Xin Fang
- Department for Chronic and Noncommunicable Disease Control and PreventionFujian Provincial Center for Disease Control and PreventionFuzhouChina
| | - Minxia Wu
- Public Technology Service CenterFujian Medical UniversityFuzhouChina
| |
Collapse
|
2
|
Ameneh PD, Mohtasham G, Sakineh R, Yadollah M, Ali R. School-based peer-led diabetes intervention among female adolescents: a cluster randomized trial. BMC Public Health 2023; 23:1170. [PMID: 37330461 PMCID: PMC10276363 DOI: 10.1186/s12889-023-15430-3] [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: 09/02/2022] [Accepted: 03/13/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes is increasing among adolescents and clear strategies are needed to prevent it. The aim of this study was to determine the effect of peer education on knowledge, health beliefs and preventive behaviors of type 2 diabetes in female adolescents. METHODS In this cluster randomized trial study, 168 students (84 people in each group) were enrolled. The data collection instrument was a questionnaire of knowledge (30 questions), health beliefs (16 questions) and behavior (20 questions) whose validity and reliability were confirmed. Then eight capable students were chosen as peer educators after being trained. The intervention group received 8 sessions of 90-min education through training, lectures, question and answer, and group discussion and with teaching aids such as pamphlets, educational clips and text messages. The post-test was administered two months after the treatment. Data collected using software SPSS16 and Chi-Square and ANCOVA test were used. RESULTS The result showed that the mean and standard deviation of general knowledge, disease symptoms, behavioral risk factors, mid-term outcomes and long-term outcomes, perceived self-efficacy, behavioral beliefs, perceived susceptibility, perceived severity, prevention of stress, healthy food/healthy diet, unhealthy food/unhealthy diet, high-risk behavior, and self-care in the intervention group has increased significantly 2 months after intervention compared of control group (P < 0.001). CONCLUSIONS Peer education increased knowledge and improved adolescents' health beliefs and behaviors. Therefore, training in adolescence in order to prevention of diabetes can be considered as an effective step, and the use of peer-led education in this field is recommended. TRIAL REGISTRATION Trial registration number IRCT20200811048361N1 from School of Public Health & Neuroscience Research Center-Shahid Beheshti University of Medical Sciences. Date applied: 30/12/2020. Date assigned: 01/12/2020.
Collapse
Affiliation(s)
- Pooresmaeil Dorosteh Ameneh
- Ph. D Student of Health Education & Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghaffari Mohtasham
- Professor of Health Education & Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rakhshanderou Sakineh
- Assistant Professor of Health Education & Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tabnak Ave., Daneshjou Blvd., P.O, Velenjak, Tehran Iran
| | - Mehrabi Yadollah
- Professor of Biostatistics, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ramezankhani Ali
- Professor of Health Education & Health Promotion School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
Dietary Management Tools Improve the Dietary Skills of Patients with T2DM in Communities. Nutrients 2022; 14:nu14214453. [PMID: 36364716 PMCID: PMC9654010 DOI: 10.3390/nu14214453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Dietary management is of paramount importance in the prevention and control of type 2 diabetes mellitus (T2DM). This one-year cluster-randomized controlled trial aims to evaluate the effect of dietary management tools on the dietary skills of patients with T2DM. Twenty-two communities were randomly assigned to an intervention group and a control group, and participants in the intervention group received a food guiding booklet (G) and a dinner set (D). The frequency of dietary management tools usage was collected at baseline and every three months, and different use patterns were identified by a group-based trajectory model. A self-compiled diabetic dietary skills scale and blood glucose were collected at baseline, 3, and 12 months, and a using generalized linear mixed model (GLMM) to explore the influence factors of dietary skills and blood glucose. The finding revealed four dietary tool-usage patterns among the participants: Insist using G/D, Give up gradually G/D, Give up after use G, and Never use G/D. GLMM indicated that dietary skills were higher over time (p < 0.05), and in participants using the guiding booklet (p < 0.001) or dinner set (p < 0.001), or with higher education (p < 0.001). Additionally, blood glucose were lower among participants with higher dietary skills (p = 0.003), higher educational level (p = 0.046), and a 3000−5000 monthly income (p = 0.026). These findings support using food management tools like the guiding booklet and dinner set as a useful strategy in primary health care centers for individuals with T2DM to increase their dietary skills and blood glucose control.
Collapse
|
4
|
Bossen D, Bak M, Braam K, Wentink M, Holla J, Visser B, Dallinga J. Online and Offline Behavior Change Techniques to Promote a Healthy Lifestyle: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010521. [PMID: 35010781 PMCID: PMC8744993 DOI: 10.3390/ijerph19010521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/17/2021] [Accepted: 12/27/2021] [Indexed: 02/04/2023]
Abstract
Combined lifestyle interventions (CLI) are focused on guiding clients with weight-related health risks into a healthy lifestyle. CLIs are most often delivered through face-to-face sessions with limited use of eHealth technologies. To integrate eHealth into existing CLIs, it is important to identify how behavior change techniques are being used by health professionals in the online and offline treatment of overweight clients. Therefore, we conducted online semi-structured interviews with providers of online and offline lifestyle interventions. Data were analyzed using an inductive thematic approach. Thirty-eight professionals with (n = 23) and without (n = 15) eHealth experience were interviewed. Professionals indicate that goal setting and action planning, providing feedback and monitoring, facilitating social support, and shaping knowledge are of high value to improve physical activity and eating behaviors. These findings suggest that it may be beneficial to use monitoring devices combined with video consultations to provide just-in-time feedback based on the client's actual performance. In addition, it can be useful to incorporate specific social support functions allowing CLI clients to interact with each other. Lastly, our results indicate that online modules can be used to enhance knowledge about health consequences of unhealthy behavior in clients with weight-related health risks.
Collapse
Affiliation(s)
- Daniël Bossen
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands; (M.B.); (K.B.); (M.W.); (B.V.); (J.D.)
- Correspondence:
| | - Monique Bak
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands; (M.B.); (K.B.); (M.W.); (B.V.); (J.D.)
| | - Katja Braam
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands; (M.B.); (K.B.); (M.W.); (B.V.); (J.D.)
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 2015 CE Haarlem, The Netherlands;
| | - Manon Wentink
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands; (M.B.); (K.B.); (M.W.); (B.V.); (J.D.)
| | - Jasmijn Holla
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 2015 CE Haarlem, The Netherlands;
- Amsterdam Rehabilitation Research Center, Reade, 1054 HW Amsterdam, The Netherlands
| | - Bart Visser
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands; (M.B.); (K.B.); (M.W.); (B.V.); (J.D.)
| | - Joan Dallinga
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands; (M.B.); (K.B.); (M.W.); (B.V.); (J.D.)
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 2015 CE Haarlem, The Netherlands;
| |
Collapse
|
5
|
Elfaki I, Mir R, Duhier FMA, Alotaibi MA, Alalawy AI, Barnawi J, Babakr AT, Mir MM, Altayeb F, Mirghani H, Frah EAM. Clinical Implications of MiR128, Angiotensin I Converting Enzyme and Vascular Endothelial Growth Factor Gene Abnormalities and Their Association with T2D. Curr Issues Mol Biol 2021; 43:1859-1875. [PMID: 34889890 PMCID: PMC8928978 DOI: 10.3390/cimb43030130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 02/07/2023] Open
Abstract
Type 2 DM (T2D) results from the interaction of the genetic and environmental risk factors. Vascular endothelial growth factor (VEGF), angiotensin I-converting enzyme (ACE), and MicroRNAs (MiRNAs) are involved in important physiological processes. Gene variations in VEGF, ACE and MiRNA genes are associated with diseases. In this study we investigated the associations of the VEGF-2578 C/A (rs699947), VEGF-2549 insertion/deletion (I/D), and ACE I/D rs4646994 and Mir128a (rs11888095) gene variations with T2D using the amplification refractory mutation system PCR (ARMS-PCR) and mutation specific PCR (MSP). We screened 122 T2D cases and 126 healthy controls (HCs) for the rs699947, and 133 T2D cases and 133 HCs for the VEGF I/D polymorphism. For the ACE I/D we screened 152 cases and 150 HCs, and we screened 129 cases and 112 HCs for the Mir128a (rs11888095). The results showed that the CA genotype of the VEGF rs699947 and D allele of the VEGF I/D polymorphisms were associated with T2D with OR =2.01, p-value = 0.011, and OR = 2.42, p-value = 0.010, respectively. The result indicated the D allele of the ACE ID was protective against T2D with OR = 0.10, p-value = 0.0001, whereas the TC genotype and the T allele of the Mir128a (rs11888095) were associated with increased risk to T2D with OR = 3.16, p-value = 0.0001, and OR = 1.68, p-value = 0.01, respectively. We conclude that the VEGF (rs699947), VEGF I/D and Mir128a (rs11888095) are potential risk loci for T2D, and that the D allele of the ACE ID polymorphism may be protective against T2D. These results help in identification and stratification for the individuals that at risk for T2D. However, future well-designed studies in different populations and with larger sample sizes are required. Moreover, studies to examine the effects of these polymorphisms on VEGF and ACE proteins are recommended.
Collapse
Affiliation(s)
- Imadeldin Elfaki
- Department of Biochemistry, Faculty of Science, University of Tabuk, Tabuk 71491, Saudi Arabia;
| | - Rashid Mir
- Prince and Fahd Bin Sultan Research Chair, Department of Medical Lab Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia; (R.M.); (F.M.A.D.); (J.B.); (F.A.)
| | - Faisel M. Abu Duhier
- Prince and Fahd Bin Sultan Research Chair, Department of Medical Lab Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia; (R.M.); (F.M.A.D.); (J.B.); (F.A.)
| | - Maeidh A. Alotaibi
- King Faisal Medical Complex Laboratory, Ministry of Health, Taif 26521, Saudi Arabia;
| | - Adel Ibrahim Alalawy
- Department of Biochemistry, Faculty of Science, University of Tabuk, Tabuk 71491, Saudi Arabia;
| | - Jameel Barnawi
- Prince and Fahd Bin Sultan Research Chair, Department of Medical Lab Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia; (R.M.); (F.M.A.D.); (J.B.); (F.A.)
| | - Abdullatif Taha Babakr
- Department of Medical Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah 57039, Saudi Arabia;
| | - Mohammad Muzaffar Mir
- Department of Basic Medical Sciences, College of Medicine, University of Bisha, Bisha 61992, Saudi Arabia;
| | - Faris Altayeb
- Prince and Fahd Bin Sultan Research Chair, Department of Medical Lab Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia; (R.M.); (F.M.A.D.); (J.B.); (F.A.)
| | - Hyder Mirghani
- Internal Medicine and Endocrine, Medical Department, Faculty of Medicine, University of Tabuk, Tabuk 71491, Saudi Arabia;
| | - Ehab A. M. Frah
- Department of Statistics, Faculty of Science, University of Tabuk, Tabuk 71491, Saudi Arabia;
| |
Collapse
|
6
|
de Hoogh IM, Winters BL, Nieman KM, Bijlsma S, Krone T, van den Broek TJ, Anderson BD, Caspers MPM, Anthony JC, Wopereis S. A Novel Personalized Systems Nutrition Program Improves Dietary Patterns, Lifestyle Behaviors and Health-Related Outcomes: Results from the Habit Study. Nutrients 2021; 13:1763. [PMID: 34067248 PMCID: PMC8224682 DOI: 10.3390/nu13061763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/21/2022] Open
Abstract
Personalized nutrition may be more effective in changing lifestyle behaviors compared to population-based guidelines. This single-arm exploratory study evaluated the impact of a 10-week personalized systems nutrition (PSN) program on lifestyle behavior and health outcomes. Healthy men and women (n = 82) completed the trial. Individuals were grouped into seven diet types, for which phenotypic, genotypic and behavioral data were used to generate personalized recommendations. Behavior change guidance was also provided. The intervention reduced the intake of calories (-256.2 kcal; p < 0.0001), carbohydrates (-22.1 g; p < 0.0039), sugar (-13.0 g; p < 0.0001), total fat (-17.3 g; p < 0.0001), saturated fat (-5.9 g; p = 0.0003) and PUFA (-2.5 g; p = 0.0065). Additionally, BMI (-0.6 kg/m2; p < 0.0001), body fat (-1.2%; p = 0.0192) and hip circumference (-5.8 cm; p < 0.0001) were decreased after the intervention. In the subgroup with the lowest phenotypic flexibility, a measure of the body's ability to adapt to environmental stressors, LDL (-0.44 mmol/L; p = 0.002) and total cholesterol (-0.49 mmol/L; p < 0.0001) were reduced after the intervention. This study shows that a PSN program in a workforce improves lifestyle habits and reduces body weight, BMI and other health-related outcomes. Health improvement was most pronounced in the compromised phenotypic flexibility subgroup, which indicates that a PSN program may be effective in targeting behavior change in health-compromised target groups.
Collapse
Affiliation(s)
- Iris M. de Hoogh
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| | | | | | - Sabina Bijlsma
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| | - Tanja Krone
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| | - Tim J. van den Broek
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| | | | - Martien P. M. Caspers
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| | - Joshua C. Anthony
- Habit, Oakland, CA 94607, USA;
- Campbell Soup Company, Camden, NJ 08103, USA
| | - Suzan Wopereis
- TNO, Netherlands Organization for Applied Scientific Research, 3704 HE Zeist, The Netherlands; (I.M.d.H.); (S.B.); (T.K.); (T.J.v.d.B.); (M.P.M.C.)
| |
Collapse
|
7
|
Kang E, Kim KH, Cho YM, Park SM, Kim YJ, Lee HY, Rhee YE, Kim S, Yun YH. Effect of Changes in Patient's Self-management Strategies on Clinical Outcomes: Evidence from a Cohort Study of Patients with Diabetes, Hypertension, and Hyperlipidemia. Int J Behav Med 2020; 28:479-487. [PMID: 33170470 DOI: 10.1007/s12529-020-09937-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Self-management has become the dominant care model for chronic disease management. This study aimed to investigate the effect of changes in self-management strategies on the clinical outcomes of chronic diseases. METHODS Two hundred ninety-seven patients with one or more chronic disease (diabetes, dyslipidemia, or hypertension) were registered and followed in this prospective cohort study. We compared differences in the changes in clinical outcomes from baseline to 6 months according to the improvement of self-management strategies by analysis of covariance. RESULTS Diabetic patients with improved self-management strategies showed a significantly greater change in HbA1c levels compared to patients without improvement of self-management strategies (group difference in HbA1c = 0.51%). In hypertensive patients, systolic and diastolic blood pressure (BP) showed a significant decline in the patients with improved self-management strategies (group difference in systolic BP = 6.2 mmHg and in diastolic BP = 5.5 mmHg). Clinical outcomes improved significantly when self-management strategies improved in people with a poor self-management strategy at baseline. CONCLUSIONS This study suggests that improvements in self-management strategies are associated with an improvement in clinical outcomes among patients with chronic diseases, especially for those with an initially poor self-management strategy.
Collapse
Affiliation(s)
- EunKyo Kang
- Public Healthcare Center, Seoul National University Hospital, Seoul, Korea.,Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 103 Daehak-ro Jongno-gu, Seoul, 03080, Korea
| | - Kyae Hyung Kim
- Public Healthcare Center, Seoul National University Hospital, Seoul, Korea.,Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 103 Daehak-ro Jongno-gu, Seoul, 03080, Korea
| | - Young Min Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 103 Daehak-ro Jongno-gu, Seoul, 03080, Korea
| | - Yong-Jin Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ye Eun Rhee
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea
| | - Soojeong Kim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea
| | - Young Ho Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 103 Daehak-ro Jongno-gu, Seoul, 03080, Korea. .,Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea.
| |
Collapse
|
8
|
Silva-Tinoco R, Cuatecontzi-Xochitiotzi T, De la Torre-Saldaña V, León-García E, Serna-Alvarado J, Orea-Tejeda A, Castillo-Martínez L, Gay JG, Cantú-de-León D, Prada D. Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: an analysis from real-world evidence. BMC Endocr Disord 2020; 20:130. [PMID: 32843004 PMCID: PMC7449009 DOI: 10.1186/s12902-020-00604-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 07/30/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although important achievements have been done in type 2 diabetes mellitus (T2D) treatment and glycemic control, new strategies may take advantage of non-pharmacological approaches and of other potential determinants of health (e.g., socioeconomic status, education, diabetes knowledge, physical activity, and self-care behavior). However, the relationships between these factors are not totally clear and have not been studied in the context of large urban settings. This study aimed to explore the relationship between these determinants of glycemic control (GC) in a low-income urban population from Mexico City, focused in exploring potential the mediation of self-care behaviors in the association between diabetes knowledge and GC. METHODS A multicenter cross-sectional study was conducted in patients with type 2 diabetes (T2D) from 28 primary care outpatient centers located in Mexico City. Using multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and GC. The mediation analyses to determine the pathways on glycemic control were done using linear regression models, where the significance of indirect effects was calculated with bootstrapping. RESULTS The population (N = 513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Both socioeconomic status and level of education were directly associated with diabetes knowledge. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with GC (β: -0.102, 95% Confidence Interval [95% CI] -0.189, - 0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with GC (for physical activity: β: -0.112, 95% CI -0.194, - 0.029). The association between diabetes knowledge and GC was not observed after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p-value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on GC was 17% independently mediated by physical activity (p-value: 0.049). CONCLUSIONS Socioeconomic and educational gradients influence diabetes knowledge among primary care patients with type 2 diabetes. Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on GC. Our results indicate that diabetes knowledge should be reinforced in low-income T2D patients, with an emphasis on the benefits physical activity has on improving GC.
Collapse
Affiliation(s)
- Rubén Silva-Tinoco
- Clínica Especializada en el Manejo de la Diabetes en la Ciudad de México, Servicios de Salud Pública de la Ciudad de México, Alfonso Toro s/n, Col. Escuadrón 201, Iztapalapa, 09060, Mexico City, Mexico.
| | - Teresa Cuatecontzi-Xochitiotzi
- Clínica Especializada en el Manejo de la Diabetes en la Ciudad de México, Servicios de Salud Pública de la Ciudad de México, Alfonso Toro s/n, Col. Escuadrón 201, Iztapalapa, 09060, Mexico City, Mexico
| | - Viridiana De la Torre-Saldaña
- Clínica Especializada en el Manejo de la Diabetes en la Ciudad de México, Servicios de Salud Pública de la Ciudad de México, Alfonso Toro s/n, Col. Escuadrón 201, Iztapalapa, 09060, Mexico City, Mexico
| | - Enrique León-García
- Servicios de Salud Pública del Gobierno de la Ciudad de México, Mexico City, Mexico
| | | | - Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic at Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Lilia Castillo-Martínez
- Departamento de Nutriología Clínica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Juan G Gay
- Tecnología e Información para la Salud, TIS, Mexico City, Mexico
| | - David Cantú-de-León
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología - Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Diddier Prada
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología - Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Support and Research Promotion Program (AFINES), Faculty of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Department of Biomedical Informatics, Faculty of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University, New York City, USA
| |
Collapse
|
9
|
Liu D, Wen Q, Liu M, Gao Y, Luo L, Zhang Z, Chen Q. Dietary supplements for prediabetes: A protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20347. [PMID: 32443387 PMCID: PMC7253655 DOI: 10.1097/md.0000000000020347] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The number of prediabetic individuals is at a high level worldwide and they have an increased risk of developing diabetes, causing severe physical impairment and heavy financial burden. Recently, using various dietary supplements is increasingly common, and relevant trials of different diseases are increasing correspondingly. The effects of dietary supplements have been confirmed in some studies among prediabetic individuals. However, there remains no comprehensive systematic review to assess the efficacy and safety of dietary supplements intake in prediabetic individuals. METHODS We plan to search and retrieve applicable randomized controlled trials of dietary supplements for prediabetic individuals in the following databases before June 2020: PubMed, Web of Science, EMBASE, the Cochrane Library, the Cochrane Central Register of Controlled Trials(CENTRAL), Allied and Complementary Medicine Database(AMED), Chinese Biomedical Literature database, Wan Fang database, Chinese Scientific Journal database (VIP), Chinese National Knowledge Infrastructure database(CNKI), and the ClinicalTrials.gov website. Two reviewers will separately perform study selection, data extraction, methodological quality assessment and quality of evidence assessment. Data analysis and publication bias will be conducted by Review Manager 5.3. RESULTS AND CONCLUSIONS This evidence-based medicine systematic review will prove the efficacy and safety of multifarious dietary supplements for prediabetes. ETHICS AND DISSEMINATION As this systematic review is based merely on already published literature, no approval of the ethics committee is required. We will disseminate this systematic review to a peer-reviewed journal. PROTOCOL REGISTRATION NUMBER INPLASY202040057.
Collapse
|
10
|
Azzi JL, Azzi S, Lavigne-Robichaud M, Vermeer A, Barresi T, Blaine S, Giroux I. Participant Evaluation of a Prediabetes Intervention Program Designed for Rural Adults. CAN J DIET PRACT RES 2019; 81:80-85. [PMID: 31736334 DOI: 10.3148/cjdpr-2019-033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The type 2 diabetes epidemic is a global crisis threatening the health and economies of many nations. This study aimed to evaluate a prediabetes intervention program designed for rural adults in southwestern Ontario based on the feedback of participants. Rural adults with prediabetes were referred by physicians to an intervention program developed to assist with unique barriers rural adults face related to the built environment and socioeconomic status when adopting a healthy lifestyle. After 6 monthly education sessions offered by a dietitian and a nurse, participants completed a questionnaire to share their program experience. In addition, 6 focus groups consisting of 5-9 participants were conducted to assess program acceptability, feasibility, and practicality. Of 49 enrolled, 35 participants aged 60.8 ± 7.1 (mean ± SD) evaluated the program. Participants reported finding the program to be acceptable, feasible, and practical due to the interactive nature of the sessions, the group setting and the availability of health professionals. This prediabetes lifestyle intervention program was perceived as successfully addressing rural adults' needs in terms of adopting a healthy lifestyle. Feedback received through program evaluation, which included a participant experience survey and focus groups has helped improve this program and may benefit other prediabetes education intervention programs.
Collapse
Affiliation(s)
- Jayson L Azzi
- Faculty of Medicine, University of Ottawa, Ottawa, ON
| | - Sarita Azzi
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON
| | | | | | | | | | - Isabelle Giroux
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON
| |
Collapse
|
11
|
Correlates, Facilitators and Barriers of Healthy Eating Among Primary Care Patients with Prediabetes in Singapore-A Mixed Methods Approach. Nutrients 2019; 11:nu11051014. [PMID: 31064063 PMCID: PMC6566398 DOI: 10.3390/nu11051014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/22/2019] [Accepted: 04/25/2019] [Indexed: 01/05/2023] Open
Abstract
Healthy diet remains the primary means to prevent chronic diseases among those with prediabetes. We conducted a mixed methods study, consisting of a cross-sectional survey and in-depth interviews to assess factors associated with fulfilling the healthy plate recommendation, and to explore reasons for the behaviour among primary care patients with prediabetes in Singapore. The prevalence of meeting the recommendation was 57.3%. This was positively associated with being married and negatively associated with being Malay, frequency of eating out weekly and frequency of deep-fried food consumption weekly. The recurrent themes for not meeting the recommendation included family influence, perception of healthy food being not tasty, lack of skills to prepare or choose healthy food, difficulty in finding healthier options when eating out, and healthy food being costly. The recurrent themes for meeting the recommendation included family influence, self-discipline, fear of disease complications, education by healthcare professionals, mass media influence and health promotion campaigns. Much more remains to be done to promote healthy eating among these patients. There were different levels of facilitators and barriers to healthy eating. Apart from the individual and interpersonal levels, practitioners and policy makers need to work together to address the organisational, community and policy barriers to healthy eating.
Collapse
|
12
|
Luo J, Chen J, Sun Y, Zhou H, Xu K, Huang F, Huang P. Quantitative contrast-enhanced ultrasound of renal perfusion: a technology for the assessment of early diabetic nephropathy in cynomolgus macaques with type 2 diabetes mellitus. Abdom Radiol (NY) 2019; 44:1850-1857. [PMID: 30694370 DOI: 10.1007/s00261-019-01908-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE The aim of this study was to investigate the effectiveness of contrast-enhanced ultrasound (CEUS) in predicting early nephropathy in cynomolgus macaques with spontaneous type 2 diabetes mellitus (T2DM). METHODS Six cynomolgus macaques with spontaneous T2DM and six normal cynomolgus macaques (Group 1) were included in this study. The time-intensity curve was used to obtain parameters such as peak values, red blood volume (RBV), red blood flow (RBF), time to peak (TTP), and mean transit time (MTT). Biopsy renal tissue samples were assessed histopathologically. Six cynomolgus macaques with spontaneous T2DM were subgrouped into T2DM without nephropathy group (Group 2) and T2DM with nephropathy group (Group 3) based on histopathological findings. RESULTS Peak value had the largest area under the curve comparing with RBF, RBV, TTP, MTT. The sensitivity and specificity of peak value with cut-off value of 38.65 dB for the diagnosis of DN were 98.3% and 83%, respectively. Peak value, RBV, and RBF in Group 3 was significantly decreased compared with Group 1 and Group 2 (P = 0.000, x2 = 23.99; P = 0.003, x2 = 9.14; P = 0.02, x2 = 5.14). CONCLUSIONS The perfusion parameter of peak value in CEUS might be useful in predicting early diabetic nephropathy in spontaneous T2DM cynomolgus macaques.
Collapse
|
13
|
Sandercock V, Andrade J. Evaluation of Worksite Wellness Nutrition and Physical Activity Programs and Their Subsequent Impact on Participants' Body Composition. J Obes 2018; 2018:1035871. [PMID: 30631593 PMCID: PMC6304910 DOI: 10.1155/2018/1035871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/17/2018] [Accepted: 11/05/2018] [Indexed: 12/14/2022] Open
Abstract
Background Adult obesity is globally recognized as a public health concern. As adults spend most of their weekdays at work, worksite wellness programs may include topics of nutrition education and physical activity to improve an employee's body composition. However, results are inconsistent with the impact they have on employees' body composition. Objective The purpose of this systematic review was to evaluate worksite wellness nutrition and physical activity programs and their subsequent impact on participants' body composition. Methods Extraction of articles was completed through 4 databases: PubMed, CINAHL, SCOPUS, and PsycINFO using keywords such as "nutrition and physical activity interventions/programs" and "weight." A 9-point inclusion criterion was established. Evaluation of the articles was assessed using the Academy of Nutrition and Dietetics Evidence-Based Manual. Results A total of 962 articles were identified. Twenty-three met the inclusion criterion. Seventeen studies resulted in a change in body composition (e.g., decreased BMI (kg/m2), waist circumference, and body fat percentage), and six studies did not show any changes. Programs that had professionals frequently interact with participants, regardless if the interactions were done daily, weekly, or monthly, led to a change in body composition. Additionally, programs that incorporated a motivation theory and provided content relevant to participants' needs resulted in a change in body composition. Conclusion Evidence supports that future worksite wellness programs that are designed using a motivational theory and content that is created relevant to participants' needs and that has frequent interactions with participants may result in a change in body composition.
Collapse
Affiliation(s)
- Victoria Sandercock
- School of Family and Consumer Sciences, Eastern Illinois University, Charleston 61920, USA
| | - Jeanette Andrade
- Food Science and Human Nutrition, University of Florida, Gainesville, FL 32611, USA
| |
Collapse
|
14
|
Kempf K, Röhling M, Niedermeier K, Gärtner B, Martin S. Individualized Meal Replacement Therapy Improves Clinically Relevant Long-Term Glycemic Control in Poorly Controlled Type 2 Diabetes Patients. Nutrients 2018; 10:E1022. [PMID: 30081574 PMCID: PMC6115894 DOI: 10.3390/nu10081022] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/28/2018] [Accepted: 08/01/2018] [Indexed: 12/24/2022] Open
Abstract
Background Formula diets can improve glycemic control or can even induce remission in type 2 diabetes. We hypothesized that especially an individualized intense meal replacement by a low-carbohydrate formula diet with accompanied self-monitoring of blood glucose (SMBG) contributes to long-term improvements in HbA1c, weight, and cardiometabolic risk factors in poorly controlled type 2 diabetes. Methods Type 2 diabetes patients were randomized into either a moderate group (M-group) with two meal replacements/day (n = 160) or a stringent group (S-group) with three meal replacements/day (n = 149) during the first week of intervention (1300⁻1500 kcal/day). Subsequently, both groups reintroduced a low-carbohydrate lunch based on individual adaption due to SMBG in weeks 2⁻4. After week 4, breakfast was reintroduced until week 12. During the follow-up period, all of the participants were asked to continue replacing one meal per day until the 52-weeks follow-up. Additionally, an observational control group (n = 100) remained in routine care. Parameters were compared at baseline, after 12 and 52 weeks within and between all of the groups. Results 321 participants (83%) completed the acute meal replacement phase after 12 weeks and 279 participants (72%) the whole intervention after 52 weeks. Both intervention groups achieved improvements in HbA1c, fasting blood glucose, blood pressure, and weight (all p < 0.001) within 12 weeks. However, these results were not significantly different between both of the intervention groups. The estimated treatment difference in HbA1c reduction was (mean (95% confidence interval [CI]) -0.10% with 95% CI [-0.40; 0.21] also (p > 0.05) (S-group vs. M-group) not statistically different after 12 weeks. However, only the S-group showed a clinically relevant improvement in HbA1c of -0.81% [-1.06; -0.55] (p < 0.001) after 52 weeks of follow-up, whereas HbA1c was not statistically different between the M- and control group. Conclusion Individualized meal replacement with SMBG demonstrated beneficial effects on HbA1c and cardiometabolic parameters in type 2 diabetes. Furthermore, the initiation of a weight loss program with one week of full meal replacement (three meals per day) resulted in a clinically relevant long-term HbA1c reduction, as compared to an observational control group that had standard care.
Collapse
Affiliation(s)
- Kerstin Kempf
- West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany.
| | - Martin Röhling
- West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany.
| | - Katja Niedermeier
- West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany.
| | - Babette Gärtner
- West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany.
| | - Stephan Martin
- West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany.
- Faculty of Medicine, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany.
| |
Collapse
|
15
|
van Dongen EJI, Haveman-Nies A, Wezenbeek NLW, Dorhout BG, Doets EL, de Groot LCPGM. Effect, process, and economic evaluation of a combined resistance exercise and diet intervention (ProMuscle in Practice) for community-dwelling older adults: design and methods of a randomised controlled trial. BMC Public Health 2018; 18:877. [PMID: 30005654 PMCID: PMC6045872 DOI: 10.1186/s12889-018-5788-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 07/03/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Exercise and nutrition are important for older adults to maintain or to regain their muscle mass, function, strength, and ultimately quality of life. The effectiveness of combined resistance exercise and diet interventions is commonly evaluated in controlled clinical studies, but evidence from real-life settings is lacking. This article describes the effectiveness, process, and economic evaluation design of a combined nutrition and exercise intervention for community-dwelling older adults in a Dutch real-life setting. METHODS The ProMuscle in Practice study is a randomised controlled multicentre intervention study, conducted in five municipalities in the Netherlands. Two hundred community-dwelling older adults (≥65 years) who are frail or pre-frail based on Fried frailty criteria or who experience strength loss are randomised over an intervention and control group by municipality. In the first 12-week intensive support intervention, participants in the intervention group perform resistance exercise training guided by a physiotherapist twice a week and increase protein intake by consuming protein-rich products under the supervision of a dietitian. Afterwards, they continue with a 12-week moderate support intervention. The control group receives only regular care during the two 12-week periods. Effect outcomes are measured at all locations at baseline, 12 weeks, 24 weeks, 36 weeks and only at three locations at 52 weeks. The primary outcome is physical functioning (Short Physical Performance Battery). Secondary outcomes include leg muscle strength, lean body mass, activities of daily living, social participation, food intake, and quality of life. Qualitative and quantitative implementation process data are collected during the intervention. Healthcare use and intervention costs are registered for the economic evaluation. DISCUSSION Evaluating the effects, implementation, and costs of this combined intervention provides valuable insight into the feasibility of this intervention for community-dwelling older adults and into the intervention's ability to improve or to maintain physical functioning and quality of life. TRIAL REGISTRATION Netherlands Trial Register ( NTR6038 ) since 30 August 2016.
Collapse
Affiliation(s)
- Ellen J. I. van Dongen
- Food, Health & Consumer Research, Wageningen Food & Biobased Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Annemien Haveman-Nies
- Division of Strategic Communication, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
- Division of Human Nutrition, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
- GGD Noord-en Oost-Gelderland, Academic Collaborative Centre AGORA, P.O. Box 3, 7200 AA Zutphen, The Netherlands
| | - Nick L. W. Wezenbeek
- Division of Human Nutrition, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Berber G. Dorhout
- Division of Human Nutrition, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Esmée L. Doets
- Food, Health & Consumer Research, Wageningen Food & Biobased Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Lisette C. P. G. M. de Groot
- Division of Human Nutrition, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| |
Collapse
|