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Bage IJ, Kamalanathan S, Selvarajan S, Sahoo J, Jayanthi M, Naik D. The Association of Dyslipidemia and Atherogenic Indices With Glycemic Control in Diabetic Dyslipidemia Patients: A Real-World Landscape. Cureus 2023; 15:e45985. [PMID: 37900537 PMCID: PMC10601505 DOI: 10.7759/cureus.45985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Dyslipidemia is an important comorbid factor of type 2 diabetes mellitus (T2DM) that increases the risk of cardiovascular diseases. This study aimed to assess the pattern of dyslipidemia and atherogenic indices and determine its relation with glycemic control. METHODS A cross-sectional study enrolled 382 patients with diabetic dyslipidemia. The socio-demographics data, clinical features, and laboratory parameters were collected. The baseline lipid parameters such as total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glycated hemoglobin (HbA1C) were measured. Atherogenic indices such as TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio, non-HDL-C/HDL-C and atherogenic index of plasma (AIP) [log10 (TG/HDL-C)] were calculated. T2DM patients were classified into three groups based on the degree of glycemic control: Good glycemic control (HbA1C<7%), fair control (HbA1C 7-8%), and poor control (HbA1C>8%). RESULTS The population's mean age was 48.60±6.15 years, with 145 (38%) males. We found mixed dyslipidemia as the most prevalent (36.1%) form of dyslipidemia in our patients. The most common pattern in atherogenic indices was AIP (94.2%). HbA1c was positively correlated with duration of diabetes (r=0.253, p<0.001). In multivariate logistic regression analysis, duration of diabetes (>10 years) was significantly associated with poor glycemic control with an odds ratio (OR) of 2.31(95% CI; 1.25-4.24, p=0.007). CONCLUSION The present study indicated that neither the pattern of dyslipidemia nor the atherogenic indices were markers of poor glycemic control among South Indian patients attending our tertiary care institute. However, duration of diabetes was significantly associated with poor glycemic control.
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Affiliation(s)
- Isaac J Bage
- Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Sadishkumar Kamalanathan
- Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Sandhiya Selvarajan
- Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Jayaprakash Sahoo
- Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Mathaiyan Jayanthi
- Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Dukhabandhu Naik
- Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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Bakhach M, Reid MW, Pyatak EA, Berget C, Cain C, Thomas JF, Klingensmith GJ, Raymond JK. Home Telemedicine (CoYoT1 Clinic): A Novel Approach to Improve Psychosocial Outcomes in Young Adults With Diabetes. DIABETES EDUCATOR 2019; 45:420-430. [PMID: 31244396 DOI: 10.1177/0145721719858080] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the impact of a home telemedicine clinic model (CoYoT1 Clinic) on psychosocial and behavioral outcomes designed for young adults (YAs) with type 1 diabetes (T1D). METHODS YAs self-selected to participate in the CoYoT1 Clinic or serve as a usual care control. CoYoT1 Clinic visits consisted of an individual appointment with a provider and a group appointment with other YAs with T1D using home telemedicine. Psychosocial and behavioral functioning was assessed by 4 measures: Diabetes Distress Scale, Self-Efficacy for Diabetes Scale, Self-Management of Type 1 Diabetes in Adolescence Scale, and Center for Epidemiologic Studies Depression Scale. RESULTS Forty-two patients participated in the CoYoT1 Clinic and 39 patients served as controls. CoYoT1 participants reported lower levels of distress (P = .03), increased diabetes self-efficacy (P = .01), and improved ability to communicate with others about diabetes (P = .04) over the study period compared to controls. YA males in the control group reported increases in depressive symptoms (P = .03) during the study period, but CoYoT1 participants showed no changes. CONCLUSION Group home telemedicine for YAs with T1D positively affects diabetes distress, self-efficacy, and diabetes-specific communication. These positive findings have the potential to also affect the YAs' long-term diabetes outcomes. Further investigation of the model is needed.
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Affiliation(s)
- Marwan Bakhach
- Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, California
| | - Mark W Reid
- Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, California
| | - Elizabeth A Pyatak
- Chan Division of Occupational Science and Occupational Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, California
| | - Cari Berget
- Barbara Davis Center for Diabetes, University of Colorado, Department of Pediatrics, Anschutz Medical Campus, Aurora, Colorado
| | - Cindy Cain
- Barbara Davis Center for Diabetes, University of Colorado, Department of Pediatrics, Anschutz Medical Campus, Aurora, Colorado
| | - John Fred Thomas
- Department of Telehealth, School of Medicine, University of Colorado, Aurora, Colorado.,Department of Psychiatry, School of Medicine, University of Colorado, Aurora, Colorado.,Department of Epidemiology, School of Public Health, University of Colorado, Aurora, Colorado
| | - Georgeanna J Klingensmith
- Barbara Davis Center for Diabetes, University of Colorado, Department of Pediatrics, Anschutz Medical Campus, Aurora, Colorado
| | - Jennifer K Raymond
- Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, California
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Reid MW, Krishnan S, Berget C, Cain C, Thomas JF, Klingensmith GJ, Raymond JK. CoYoT1 Clinic: Home Telemedicine Increases Young Adult Engagement in Diabetes Care. Diabetes Technol Ther 2018; 20:370-379. [PMID: 29672162 DOI: 10.1089/dia.2017.0450] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Young adults with type 1 diabetes (T1D) experience poor glycemic control, disengagement in care, and are often lost to the medical system well into their adult years. Diabetes providers need a new approach to working with the population. The goal of this study was to determine whether an innovative shared telemedicine appointment care model (CoYoT1 Clinic [pronounced as "coyote"; Colorado Young Adults with T1D]) for young adults with T1D improves care engagement, satisfaction, and adherence to American Diabetes Association (ADA) guidelines regarding appointment frequency. SUBJECTS AND METHODS CoYoT1 Clinic was designed to meet the diabetes care needs of young adults (18-25 years of age) with T1D through home telemedicine. Visits occurred every 3 months over the 1-year study (three times by home telemedicine and one time in-person). Outcomes were compared to patients receiving treatment as usual (control). RESULTS Compared with controls, CoYoT1 patients attended significantly more clinic visits (P < 0.0001) and increased their number of clinic visits from the year before the intervention. Seventy-four percent of CoYoT1 patients were seen four times over the 12-month study period, meeting ADA guidelines, but none in the control group met the ADA recommendation. CoYoT1 patients used diabetes technologies more frequently and reported greater satisfaction with care compared with controls. CONCLUSIONS Delivering diabetes care by home telemedicine increases young adults' adherence to ADA guidelines and usage of diabetes technologies, and improves retention in care when compared to controls. Home telemedicine may keep young adults engaged in their diabetes care during this challenging transition period.
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Affiliation(s)
- Mark W Reid
- 1 Department of Surgery, Division of Ophthalmology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California , Los Angeles, California
| | - Subramanian Krishnan
- 1 Department of Surgery, Division of Ophthalmology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California , Los Angeles, California
| | - Cari Berget
- 2 Department of Pediatrics, Barbara Davis Center for Diabetes, University of Colorado , Aurora, Colorado
| | - Cindy Cain
- 2 Department of Pediatrics, Barbara Davis Center for Diabetes, University of Colorado , Aurora, Colorado
| | - John Fred Thomas
- 3 Department of Telehealth, School of Medicine, University of Colorado , Aurora, Colorado
- 4 Department of Psychiatry, School of Medicine, University of Colorado , Aurora, Colorado
- 5 Department of Epidemiology, School of Public Health, University of Colorado , Aurora, Colorado
| | - Georgeanna J Klingensmith
- 2 Department of Pediatrics, Barbara Davis Center for Diabetes, University of Colorado , Aurora, Colorado
| | - Jennifer K Raymond
- 6 Department of Pediatrics, Division of Endocrinology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California , Los Angeles, California
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Rtibi K, Selmi S, Grami D, Saidani K, Sebai H, Amri M, Eto B, Marzouki L. Ceratonia siliqua L. (immature carob bean) inhibits intestinal glucose absorption, improves glucose tolerance and protects against alloxan-induced diabetes in rat. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2017; 97:2664-2670. [PMID: 27739095 DOI: 10.1002/jsfa.8091] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/07/2016] [Accepted: 10/08/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND This study was designed to investigate the effects of immature carob pod aqueous extract (ICPAE) on intestinal glucose absorption in vitro and in vivo using an oral glucose tolerance test (OGTT) as well as the potential antidiabetic effect in alloxan-induced diabetic rats. OGTT was carried by administration of glucose (2 g kg-1 , p.o.) and after treatment with extract (50, 100 and 200 mg kg-1 body weight). Diabetes was induced by single intraperitoneal injection of alloxan (150 mg kg-1 ). However, the extracts at various doses or glibenclamide (GLB, 10 mg kg-1 body weight) were given by oral administration for 2 weeks. RESULTS ICPAE (50-2000 µg mL-1 ) exerted dose-dependent reduction of sodium-dependent glucose transport across isolated mice jejunum and the maximal inhibition exceeded 50%.The ICPAE treatment improved glucose tolerance. More importantly, ICPAE at various doses showed a significant reduction in blood glucose and biochemical profiles in diabetic rats. CONCLUSION Our findings confirm that the degree of maturity of carob characterized by a different phytochemical composition may be responsible for these actions. Therefore, these compounds may be used as a food supplement in hyperglycemia and diabetes treatments. © 2016 Society of Chemical Industry.
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Affiliation(s)
- Kaïs Rtibi
- Laboratoire de Neurophysiologie Fonctionnelle et Pathologies, Département des Sciences Biologiques, Faculté des Sciences de Tunis, 2092 Tunis, Tunisia
- Laboratoire de Nutrition et Physiologie Animale, Institut Supérieur de Biotechnologie de Béja, BP, 382-9000 Béja, Tunisia
| | - Slimen Selmi
- Laboratoire de Nutrition et Physiologie Animale, Institut Supérieur de Biotechnologie de Béja, BP, 382-9000 Béja, Tunisia
| | - Dhekra Grami
- Laboratoire de Nutrition et Physiologie Animale, Institut Supérieur de Biotechnologie de Béja, BP, 382-9000 Béja, Tunisia
| | - Khouloud Saidani
- Laboratoire de Nutrition et Physiologie Animale, Institut Supérieur de Biotechnologie de Béja, BP, 382-9000 Béja, Tunisia
| | - Hichem Sebai
- Laboratoire de Nutrition et Physiologie Animale, Institut Supérieur de Biotechnologie de Béja, BP, 382-9000 Béja, Tunisia
| | - Mohamed Amri
- Laboratoire de Neurophysiologie Fonctionnelle et Pathologies, Département des Sciences Biologiques, Faculté des Sciences de Tunis, 2092 Tunis, Tunisia
| | - Bruno Eto
- Laboratoires TransCell-Lab, Faculté de Médecine Xavier Bichât, 75018 Paris, France
| | - Lamjed Marzouki
- Laboratoire de Neurophysiologie Fonctionnelle et Pathologies, Département des Sciences Biologiques, Faculté des Sciences de Tunis, 2092 Tunis, Tunisia
- Laboratoire de Nutrition et Physiologie Animale, Institut Supérieur de Biotechnologie de Béja, BP, 382-9000 Béja, Tunisia
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Migdalis I, Leslie D, Mavrogiannaki A, Papanas N, Valensi P, Vlassara H. Diabetes Mellitus 2014. Int J Endocrinol 2015; 2015:845759. [PMID: 26101527 PMCID: PMC4458529 DOI: 10.1155/2015/845759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 03/16/2015] [Indexed: 12/02/2022] Open
Affiliation(s)
- Ilias Migdalis
- 2nd Medical Department and Diabetes Centre, NIMTS Hospital, 12 Monis Petraki, 11521 Athens, Greece
- *Ilias Migdalis:
| | - David Leslie
- Department of Diabetes, Saint Bartholomew's Hospital, University of London and Blizard Institute, London EC1A 7BE, UK
| | - Anastasia Mavrogiannaki
- 2nd Medical Department and Diabetes Centre, NIMTS Hospital, 12 Monis Petraki, 11521 Athens, Greece
| | - Nikolaos Papanas
- Outpatient Clinic of the Diabetic Foot, Second Department of Internal Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Paul Valensi
- Department of Endocrinology, Diabetology and Nutrition, Jean Verdier Hospital, AP-HP, Paris Nord University, CRNH-IdF, CINFO, 93140 Bondy, France
| | - Helen Vlassara
- Division of Experimental Diabetes and Aging, Mount Sinai School of Medicine, 1 Gustave L, Levy Place, P.O. Box 1460, New York City, NY 10029, USA
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Castaneda-Sceppa C, Castaneda F. Sodium-dependent glucose transporter protein as a potential therapeutic target for improving glycemic control in diabetes. Nutr Rev 2011; 69:720-9. [DOI: 10.1111/j.1753-4887.2011.00423.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Miranda-Massari JR, Gonzalez MJ, Jimenez FJ, Allende-Vigo MZ, Duconge J. Metabolic correction in the management of diabetic peripheral neuropathy: improving clinical results beyond symptom control. CURRENT CLINICAL PHARMACOLOGY 2011; 6:260-73. [PMID: 22082324 PMCID: PMC3682498 DOI: 10.2174/157488411798375967] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Revised: 06/07/2011] [Accepted: 09/23/2011] [Indexed: 12/28/2022]
Abstract
Current Clinical Management Guidelines of Diabetic Peripheral Neuropathy (DPN) are based on adequate glucose control and symptomatic pain relief. However, meticulous glycemic control could delay the onset or slow the progression of diabetic neuropathy in patients with DM type 2, but it does not completely prevent the progression of the disease. Complications of DPN as it continues its natural course, produce increasing pain and discomfort, loss of sensation, ulcers, infections, amputations and even death. In addition to the increased suffering, disability and loss of productivity, there is a very significant economic impact related to the treatment of DPN and its complications. In USA alone, it has been estimated that there are more than 5,000,000 patients suffering from DPN and the total annual cost of treating the disease and its complications is over $10,000 million dollars. In order to be able to reduce complications of DPN, it is crucial to improve or correct the metabolic conditions that lead to the pathology present in this condition. Pathophysiologic mechanisms implicated in diabetic neuropathy include: increased polyol pathway with accumulation of sorbitol and reduced Na+/K+-ATPase activity, microvascular damage and hypoxia due to nitric oxide deficit and increased oxygen free radical activity. Moreover, there is a decrease in glutathione and increase in homocysteine. Clinical trials in the last two decades have demonstrated that the use of specific nutrients can correct some of these metabolic derangements, improving symptom control and providing further benefits such as improved sensorium, blood flow and nerve regeneration. We will discuss the evidence on lipoic acid, acetyl-L-carnitine, benfotiamine and the combination of active B vitamins L-methylfolate, methylcobalamin and piridoxal-6-phosphate. In addition, we discuss the role of metformin, an important drug in the management of diabetes, and the presence of specific polymorphic genes, in the risk of developing DPN and how metabolic correction can reduce these risks.
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Affiliation(s)
- Jorge R. Miranda-Massari
- RECNAC 2 Project, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
- School of Pharmacy, Department of Pharmacy Practice, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Michael J. Gonzalez
- RECNAC 2 Project, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
- Graduate School of Public Health, Department of Human Development, Nutrition Program, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Francisco J. Jimenez
- School of Pharmacy, Department of Pharmacy Practice, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Myriam Z. Allende-Vigo
- School of Medicine, Department of Endocrinology, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Jorge Duconge
- RECNAC 2 Project, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
- Pharmaceutical Sciences, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
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