1
|
Luo W, Zhang J, Luo Y, Wu Q, Chen L, Liu C, Lin M. Factors associated with glycemic control in patients with T2DM: evidence from a cross-sectional study in China. BMC Endocr Disord 2024; 24:77. [PMID: 38831300 PMCID: PMC11149194 DOI: 10.1186/s12902-024-01605-5] [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: 01/31/2024] [Accepted: 05/19/2024] [Indexed: 06/05/2024] Open
Abstract
OBJECTIVE This study aimed to analyze the factors influencing glycemic control in patients with type 2 diabetes mellitus (T2DM). METHODS Baseline data, encompassing basic information, lifestyle habits, and treatment of 305 T2DM patients from March 2021 to January 2023, were collected and analyzed using SPSS 26.0 software. RESULTS Univariate and multivariate logistic regression analyses identified insulin therapy (OR = 2.233; 95%Cl = 1.013-4.520; P = 0.026) and regular clinic visits (OR = 0.567; 95%Cl = 0.330-0.973; P = 0.040) as independent factors influencing glycemic control. No observed interactions between the two variables were noted. CONCLUSION History of insulin therapy and regular clinic visits were significantly and independently associated with glycated hemoglobin control in T2DM patients. Tailored interventions based on individual circumstances are recommended to optimize glycemic control.
Collapse
Affiliation(s)
- Wenting Luo
- Department of Scientific Research, School of Medicine, the First Affiliated Hospital of Xiamen University, Xiamen University, No.24, Bailu Road, Siming District, Xiamen, 361003, Fujian, China
| | - Jiayu Zhang
- Department of Intensive Care Medicine, School of Medicine, the First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, 361003, China
| | - Yanxing Luo
- School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Qiuwan Wu
- Department of Scientific Research, School of Medicine, the First Affiliated Hospital of Xiamen University, Xiamen University, No.24, Bailu Road, Siming District, Xiamen, 361003, Fujian, China
| | - Longfei Chen
- Department of Scientific Research, School of Medicine, the First Affiliated Hospital of Xiamen University, Xiamen University, No.24, Bailu Road, Siming District, Xiamen, 361003, Fujian, China
| | - Changqin Liu
- Department of Endocrinology and Diabetes, School of Medicine, the First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, 361003, China
| | - Minqiang Lin
- Department of Scientific Research, School of Medicine, the First Affiliated Hospital of Xiamen University, Xiamen University, No.24, Bailu Road, Siming District, Xiamen, 361003, Fujian, China.
- Institute of Clinical Medical Research, School of Medicine, the First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, 361003, China.
| |
Collapse
|
2
|
Nduka SO, Emeneka OC, Nduka IJ, Onunkwo JC. Cardiovascular risk screening: a 10-year prediction cross-sectional study in a Nigerian agrarian community. Pan Afr Med J 2024; 47:59. [PMID: 38646134 PMCID: PMC11032074 DOI: 10.11604/pamj.2024.47.59.38486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 12/12/2023] [Indexed: 04/23/2024] Open
Abstract
Introduction cardiovascular disease (CVD) is a major public health issue with a high global death rate and a significant death contribution from low-and middle-income countries. Modifiable and non-modifiable risk factors assessment and screening are important in their effective prevention and control. This study was designed to screen and assess cardiovascular risk factors in an agrarian community in Nigeria and to predict their 10-year CVD risk. Methods this was a cross-sectional study carried out in the Umueri community in Anambra State, Nigeria. Each participant responded to an epidemiologic survey using the World Health Organization (WHO) cardiovascular risk factors assessment tool with point-of-care screening procedures. The risk assessment for 10-year CV risk was conducted using region-specific WHO/ISH charts. Patients´ characteristics were analyzed and presented in frequencies and percentages. Results the mean age, systolic blood pressure, fasting plasma glucose, and total cholesterol of the study population were 54 years ± 1.27, 132 mmHg ± 2.088, 130 mg/dl ± 4.608, and 215 mg/dl ± 10.355 respectively. However, 98 (48.8%) have never had their blood pressure checked. About a quarter of the population had a high predicted risk of developing CVD within 10 years. Conclusion most of the assessed cardiovascular risk factors in the community are on average above the normal ranges and their probability risk of developing CVD within the next 10 years is high.
Collapse
Affiliation(s)
- Sunday Odunke Nduka
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Obinna Chris Emeneka
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Ifeoma Jovita Nduka
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Jude Chinedu Onunkwo
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| |
Collapse
|
3
|
Deru LS, Gipson EZ, Hales KE, Bikman BT, Davidson LE, Horne BD, LeCheminant JD, Tucker LA, Bailey BW. The Effects of a High-Carbohydrate versus a High-Fat Shake on Biomarkers of Metabolism and Glycemic Control When Used to Interrupt a 38-h Fast: A Randomized Crossover Study. Nutrients 2024; 16:164. [PMID: 38201992 PMCID: PMC10780935 DOI: 10.3390/nu16010164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
This study aimed to determine the impact of various fast-interrupting shakes on markers of glycemic control including glucose, β-hydroxybutyrate (BHB), insulin, glucagon, GLP-1, and GIP. Twenty-seven sedentary adults (twelve female, fifteen male) with overweight or obesity completed this study. One condition consisted of a 38-h water-only fast, and the other two conditions repeated this, but the fasts were interrupted at 24 h by either a high carbohydrate/low fat (HC/LF) shake or an isovolumetric and isocaloric low carbohydrate/high fat (LC/HF) shake. The water-only fast resulted in 135.3% more BHB compared to the HC/LF condition (p < 0.01) and 69.6% more compared to the LC/HF condition (p < 0.01). The LC/HF condition exhibited a 38.8% higher BHB level than the HC/LF condition (p < 0.01). The area under the curve for glucose was 14.2% higher in the HC/LF condition than in the water condition (p < 0.01) and 6.9% higher compared to the LC/HF condition (p < 0.01), with the LC/HF condition yielding 7.8% more glucose than the water condition (p < 0.01). At the 25-h mark, insulin and glucose-dependent insulinotropic polypeptide (GIP) were significantly elevated in the HC/LF condition compared to the LC/HF condition (p < 0.01 and p = 0.02, respectively) and compared to the water condition (p < 0.01). Furthermore, insulin, GLP-1, and GIP were increased in the LC/HF condition compared to the water condition at 25 h (p < 0.01, p = 0.015, and p < 0.01, respectively). By the 38-h time point, no differences were observed among the conditions for any of the analyzed hormones. While a LC/HF shake does not mimic a fast completely, it does preserve some of the metabolic changes including elevated BHB and glucagon, and decreased glucose and insulin compared to a HC/LF shake, implying a potential for improved metabolic health.
Collapse
Affiliation(s)
- Landon S. Deru
- Department of Exercise Science, Brigham Young University, Provo, UT 84602, USA
- Division of Physical Activity and Weight Management, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Elizabeth Z. Gipson
- Department of Exercise Science, Brigham Young University, Provo, UT 84602, USA
| | - Katelynn E. Hales
- Department of Exercise Science, Brigham Young University, Provo, UT 84602, USA
| | - Benjamin T. Bikman
- Department of Cellular Biology and Physiology, Brigham Young University, Provo, UT 84602, USA
| | - Lance E. Davidson
- Department of Exercise Science, Brigham Young University, Provo, UT 84602, USA
| | - Benjamin D. Horne
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT 84107, USA;
| | - James D. LeCheminant
- Department of Nutrition, Dietetics and Food Science, Brigham Young University, Provo, UT 84602, USA;
| | - Larry A. Tucker
- Department of Exercise Science, Brigham Young University, Provo, UT 84602, USA
| | - Bruce W. Bailey
- Department of Exercise Science, Brigham Young University, Provo, UT 84602, USA
| |
Collapse
|
4
|
Adhikari P, Sriyuktasuth A, Phligbua W. Social determinants of health and glycemic control in persons with type 2 diabetes mellitus attending a tertiary hospital in Nepal: A cross-sectional study. BELITUNG NURSING JOURNAL 2023; 9:489-497. [PMID: 37901380 PMCID: PMC10600700 DOI: 10.33546/bnj.2753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/03/2023] [Accepted: 09/05/2023] [Indexed: 10/31/2023] Open
Abstract
Background Diabetes mellitus (DM) is an emerging global public health challenge worldwide, including Nepal. Social determinants of health (SDOH) play a major role in glycemic control among persons with type 2 DM (T2DM). However, little is known about the association between SDOH and glycemic control among individuals with T2DM in Nepal. Objective This study aimed to identify the level of glycemic control and SDOH associated with glycemic control among Nepalese with T2DM. Methods This cross-sectional study was conducted at a tertiary hospital in Kathmandu, Nepal, among 135 Nepalese diagnosed with T2DM who attended follow-up appointments. Convenience sampling and inclusion criteria were utilized for participant selection. Data were collected from April to June 2021 using validated scales. Descriptive statistics, Chi-square test, and binary logistic regression were employed to analyze the data. Results The mean age of the participants in this study was 53.84 (SD = 11.78) years, and the average monthly household income was 567.64 (SD = 362.30) USD. The majority of the participants (77.8%) were literate and had no health insurance coverage (73.3%). Approximately 64.4% of the participants showed suboptimal glycemic control indicated by glycated hemoglobin (HbA1c) ≥7%. The significant determinants of good glycemic control included monthly household income of >850 USD (odds ratio [OR] = 12.20, 95% confident interval [CI] = 1.76-84.61, p = 0.011) and 341-600 USD (OR = 7.64, 95% CI 1.35-42.98, p = 0.021), being literate (OR = 6.37, 95% CI = 1.65-24.49, p = 0.007), having health insurance (OR = 5.82, 95% CI = 1.49-22.65, p = 0.011), sufficient health literacy (OR = 3.46, 95% CI = 1.10-10.83, p = 0.03), and high (OR = 16.17, 95% CI = 2.36-110.67, p = 0.005) and moderate (OR = 7.02, 95% CI = 1.26-39.07, p = 0.026) food availability, respectively. Conclusion The study revealed suboptimal glycemic control in Nepalese with T2DM. This study presents essential social determinants of glycemic control in this population. Therefore, healthcare providers, particularly nurses, should pay more attention to assessing social determinants and provide targeted interventions to patients with T2DM who have low income, are illiterate, have no health insurance coverage, have insufficient health literacy, and have low resources for food availability.
Collapse
Affiliation(s)
- Prava Adhikari
- Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | | | | |
Collapse
|
5
|
Adam CA, Marcu DTM, Mitu O, Roca M, Aursulesei Onofrei V, Zabara ML, Tribuș LC, Cumpăt C, Crișan Dabija R, Mitu F. Old and Novel Predictors for Cardiovascular Risk in Diabetic Foot Syndrome—A Narrative Review. APPLIED SCIENCES 2023; 13:5990. [DOI: 10.3390/app13105990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Diabetic foot syndrome (DFS) is a complication associated with diabetes that has a strong negative impact, both medically and socio-economically. Recent epidemiological data show that one in six patients with diabetes will develop an ulcer in their lifetime. Vascular complications associated with diabetic foot have multiple prognostic implications in addition to limiting functional status and leading to decreased quality of life for these patients. We searched the electronic databases of PubMed, MEDLINE and EMBASE for studies that evaluated the role of DFS as a cardiovascular risk factor through the pathophysiological mechanisms involved, in particular the inflammatory ones and the associated metabolic changes. In the era of evidence-based medicine, the management of these cases in multidisciplinary teams of “cardio-diabetologists” prevents the occurrence of long-term disabling complications and has prognostic value for cardiovascular morbidity and mortality among diabetic patients. Identifying artificial-intelligence-based cardiovascular risk prediction models or conducting extensive clinical trials on gene therapy or potential therapeutic targets promoted by in vitro studies represent future research directions with a modulating role on the risk of morbidity and mortality in patients with DFS.
Collapse
Affiliation(s)
- Cristina Andreea Adam
- Department of Medical Specialties I and III and Department of Surgical Specialties, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, 700661 Iasi, Romania
| | - Dragos Traian Marius Marcu
- Department of Medical Specialties I and III and Department of Surgical Specialties, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Clinical Hospital of Pneumophthisiology Iași, 700115 Iasi, Romania
| | - Ovidiu Mitu
- Department of Medical Specialties I and III and Department of Surgical Specialties, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- “St. Spiridon” Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Mihai Roca
- Department of Medical Specialties I and III and Department of Surgical Specialties, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, 700661 Iasi, Romania
| | - Viviana Aursulesei Onofrei
- Department of Medical Specialties I and III and Department of Surgical Specialties, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- “St. Spiridon” Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Mihai Lucian Zabara
- Department of Medical Specialties I and III and Department of Surgical Specialties, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Laura Carina Tribuș
- Department of Internal Medicine, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Internal Medicine, Ilfov County Emergency Hospital, 022104 Bucharest, Romania
| | - Carmen Cumpăt
- Department of Medical Specialties I and III and Department of Surgical Specialties, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Management, “Alexandru Ioan Cuza” University, 700506 Iasi, Romania
| | - Radu Crișan Dabija
- Department of Medical Specialties I and III and Department of Surgical Specialties, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Clinical Hospital of Pneumophthisiology Iași, 700115 Iasi, Romania
| | - Florin Mitu
- Department of Medical Specialties I and III and Department of Surgical Specialties, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Clinical Hospital of Pneumophthisiology Iași, 700115 Iasi, Romania
- Academy of Medical Sciences, 030167 Bucharest, Romania
- Academy of Romanian Scientists, 700050 Iasi, Romania
| |
Collapse
|
6
|
Khanal MK, Bhandari P, Dhungana RR, Gurung Y, Rawal LB, Pandey G, Bhandari M, Bhuiyan R, Devkota S, de Courten M, de Courten B. Electrocardiogram abnormalities and renal impairment in patients with type 2 diabetes mellitus: A healthcare facilities-based cross-sectional study in Dang district of Nepal. J Diabetes Investig 2023; 14:602-613. [PMID: 36747483 PMCID: PMC10034961 DOI: 10.1111/jdi.13985] [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: 11/23/2022] [Revised: 12/28/2022] [Accepted: 01/17/2023] [Indexed: 02/08/2023] Open
Abstract
AIMS/INTRODUCTION The global burden of diabetes mellitus is rising substantially, with a further increase in cardiovascular and kidney disease burden. These public health problems are highly prevalent in low- and middle-income countries, including Nepal. However, there is limited evidence on cardiac and renal conditions among patients with type 2 diabetes mellitus. We determined the status of electrocardiogram (ECG) abnormalities and renal impairment among patients with type 2 diabetes mellitus in Nepal. METHODS We carried out a cross-sectional study in Tulsipur Sub-Metropolitan City of Nepal using a multistage stratified sampling technique to recruit patients with type 2 diabetes mellitus. We used World Health Organization stepwise approach to surveillance (WHO STEPS) questionnaires and carried out resting ECG to collect data of 345 patients with type 2 diabetes mellitus. Logistic regression analysis assessed the factors associated with ECG abnormalities and renal impairment. RESULTS The study showed that 6.1% of participants had major ECG abnormalities (95% confidence interval [CI] 3.8-8.6%), which were associated with hypertension (P = 0.01%) and low socioeconomic status (P = 0.01). The proportion of major and/or minor ECG abnormalities was 47.8% (95% CI 40.5-51%), and were significantly associated with age (odds ratio [OR] 1.04, 95% CI 1.01-1.07), higher education (OR 3.50, 95% CI 1.31-9.33), unemployment (OR 3.02, 95% CI 1.08-8.48), body mass index (OR 1.09, 95% CI 1.02-1.17) and duration of type 2 diabetes mellitus >5 years (OR 2.42, 95% CI 1.19-4.93). The proportion of renal impairment was 3.5% (95% CI 1.5-4.5%) which was associated with older age (OR 1.08, 95% CI 1.00-1.17) and hypertension (OR 12.12, 95% CI 1.07-138.22). CONCLUSION A significant proportion of patients with type 2 diabetes mellitus had ECG abnormalities and renal impairment, which were significantly associated with hypertension. Therefore, hypertension management and early screening are essential to prevent future cardiorenal complications among patients with type 2 diabetes mellitus.
Collapse
Affiliation(s)
| | | | - Raja Ram Dhungana
- Center for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Yadav Gurung
- Child and Youth Health Research Center, Auckland University of Technology, Auckland, New Zealand
| | - Lal B Rawal
- School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney, NSW, Australia
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Sydney, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, NSW, Australia
| | - Gyanendra Pandey
- Dirghayu Polyclinic and Research Center Pvt. Ltd, Tulsipur, Dang, Nepal
| | - Madan Bhandari
- Ministry of Health, Provincial Ayurveda Hospital, Dang, Nepal
| | - Rijwan Bhuiyan
- Department of Health Promotion and Health Education, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
| | - Surya Devkota
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Maximilian de Courten
- Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Vic., Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Vic., Australia
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, Vic., Australia
| |
Collapse
|
7
|
The Mechanisms of the Potential Probiotic Lactiplantibacillus plantarum against Cardiovascular Disease and the Recent Developments in its Fermented Foods. Foods 2022; 11:foods11172549. [PMID: 36076735 PMCID: PMC9455256 DOI: 10.3390/foods11172549] [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: 07/15/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Cardiovascular disease (CVD) has become the leading cause of death worldwide. Many recent studies have pointed out that Lactiplantibacillus plantarum (Lb. plantarum) has great potential in reducing the risk of CVD. Lb. plantarum is a kind of lactic acid bacteria (LAB) widely distributed in fermented food and the human intestinal tract, some strains of which have important effects on human health and the potential to be developed into probiotics. In this review, we summarize the mechanism of potential probiotic strains of Lb. plantarum against CVD. It could regulate the body’s metabolism at the molecular, cellular, and population levels, thereby lowering blood glucose and blood lipids, regulating blood pressure, and ultimately reducing the incidence of CVD. Furthermore, since Lb. plantarum is widely utilized in food industry, we highlight some of the most important new developments in fermented food for combating CVD; providing an insight into these fermented foods can assist scientists in improving the quality of these foods as well as alleviating patients’ CVD symptoms. We hope that in the future functional foods fermented by Lb. plantarum can be developed and incorporated into the daily diet to assist medication in alleviating CVD to some extent, and maintaining good health.
Collapse
|