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Bablis P, Day RR, Pollard H. Treatment of type 2 diabetes and stress using neuro-emotional technique: case report. Front Endocrinol (Lausanne) 2024; 15:1382757. [PMID: 39050563 PMCID: PMC11266090 DOI: 10.3389/fendo.2024.1382757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
This case report presents a novel, non-pharmacological treatment of Type 2 Diabetes in a 46-year-old male, demonstrating improvements in blood chemistry and psychometric markers after 8 treatments using a Mind-Body Intervention (MBI) called Neuro-Emotional Technique (NET). The patient presented with a diagnosis of Type 2 Diabetes (T2D), pain, psychosocial indicators of stress and anxiety, and a score of 4 on the ACE-Q (Adverse Childhood Experiences Questionnaire) that is consistent with a predisposition to chronic disease and autoimmune disorders. Glucose levels for this patient were above normal levels (typically between 10-15mmol/L where optimal range is between 4-10mmol/L) for at least two months prior to the 4-week NET intervention period, despite the standard use of conventional antidiabetic medications (insulin injections). The patient exhibited numerous indictors of chronic stress that were hypothesised to be underlying his medical diagnosis and a series of 8 NET treatments over a period of 4 weeks was recommended. Psychometric tests and glucose measurements were recorded at baseline (prior to treatment), 4 weeks (at the conclusion of treatment) and at 8 weeks (4 weeks following the conclusion of treatment). Results show that glucose levels were reduced, and self-reported measures of depression, anxiety, stress, distress and pain all decreased from high and extreme levels to within normal ranges after 4 weeks, with ongoing improvement at 8 weeks. McEwen described the concept of allostatic load and the disruptive effects that cumulative stress can have on both mental and physical health. It is hypothesized that NET reduces allostatic load thereby fortifying homeostasis and the salutogenic stress response mechanisms involved in recovery from chronic illness, possibly via the Psycho-Immune-Neuroendocrine (PINE) network. Further studies with larger sample sizes are required to establish whether these results could be extrapolated to a wider population, however the results of this case suggest that it may be beneficial to consider co-management of T2D with an MBI such as NET.
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Affiliation(s)
- Peter Bablis
- Department of Maternal and Child Health and Precision Medicine, University Research Institute, Athens, Greece
- Department of Integrative and Complementary Medicine, Universal Health, Sydney, NSW, Australia
| | - Ryan R. Day
- Department of Integrative and Complementary Medicine, Universal Health, Sydney, NSW, Australia
| | - Henry Pollard
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
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2
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Awang Jihadi MH, Yuda A, Sukorini AI, Hermansyah A, Shafqat N, Tan CS, Ming LC. Drug-related problems in hospitalized patients with type 2 diabetes mellitus: A systematic review. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100348. [PMID: 37885436 PMCID: PMC10598051 DOI: 10.1016/j.rcsop.2023.100348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction Type 2 diabetes mellitus (T2DM) is one of the non-communicable diseases which continues to rise in prevalence and mortality rate throughout the years. Drug-related problems (DRPs) are more prevalent among T2DM patients especially those with co-morbidities. Objective The objective of this study was to review and assess the prevalence and characteristics of DRPs among hospitalized type 2 diabetes mellitus patients. Methods The systematic review of the literature was carried out using five online databases: PubMed, Scopus, Google Scholar, Web of Science, and Cochrane Library from the inception of the database until June 2022. Studies included in the review were published in English or Malay language. The data were extracted and assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Results A total of 939 studies were identified with 20 studies that met inclusion criteria and were included in this systematic review. The overall prevalence of DRPs in all 20 studies ranged from 7% to 94%. The most common DRPs included drug-drug interaction (DDI), adverse drug reaction (ADR), therapeutic effectiveness problems, and inappropriate medication use. Conclusion The most common drug classes involved were antidiabetics (metformin), antihypertensives, antiplatelets and antibiotics. The risk factors contributing to DRPs included the presence of comorbidities, the number of medications, and polypharmacy. To conclude, the rate of DRPs incidence in hospitalized T2DM patients was observed to be high. Further future studies with appropriate study designs and methods of detecting DRPs will be necessary to reduce and prevent DRPs occurrences.
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Affiliation(s)
- Mohammad Hisyamuddin Awang Jihadi
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Ana Yuda
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Anila Impian Sukorini
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Andi Hermansyah
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Naeem Shafqat
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Ching Siang Tan
- School of Pharmacy, KPJ Healthcare University, Nilai, Malaysia
| | - Long Chiau Ming
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
- School of Medical and Life Sciences, Sunway University, Sunway City, Malaysia
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Iheanacho CO, Akhumi TF, Eze UIH, Ojieabu WA. Prevalence and predictors of type 2 diabetes complications: a single centre observation. Afr Health Sci 2023; 23:308-317. [PMID: 38357114 PMCID: PMC10862620 DOI: 10.4314/ahs.v23i3.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Background Diabetes complications are a major burden on persons living with diabetes and the health care systems. Objectives The study assessed the glycemic control, prevalence and predictors of type 2 diabetes complications among patients in a healthcare centre. Methods Two hundred adults who had type 2 diabetes in a general hospital were recruited for the study. Cross-sectional and retrospective surveys were used to determine prevalence, number and types of complications in the patients. SPSS version 21 was used for descriptive analysis and Chi-square (p<0.05). Results A total of 200 (100%) respondents participated in the study and 97 (48.5%) had poor glycemic control. Mean number of complications per patient was 2.48 ± 1.22. Number of complications per person and type of complications were significantly associated with Age (p = 0.000 and p = 0.000, respectively), Gender (p = 0.008 and p = 0.031, respectively) and Occupation (p=0.000 and p=0.006, respectively). Marital status (p = 0.032) and years of diagnosis (p=0.021) were also associated with type of complications. The majority of patients 64 (32.0%) were admitted in the previous year for diabetes-related complications. Majority 159 (79.5%) had ≥ 2 number of complications from the observed 497 complications. Conclusions Poor glycemic control and high prevalence of complications were observed. Also, socio-demographic characteristics were likely predictors of number and type of complications. These findings are essential for improved planning and prioritizing of diabetes care.
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Affiliation(s)
- Chinonyerem O Iheanacho
- Department of Clinical Pharmacy and Public Health, Faculty of Pharmacy, University of Calabar, Calabar, Nigeria
| | - Tolulope Folashade Akhumi
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Nigeria
| | - Uchenna I H Eze
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Nigeria
| | - Winifred A Ojieabu
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Nigeria
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Ağralı H, Akyar İ. The effect of health literacy-based, health belief-constructed education on glycated hemoglobin (HbA1c) in people with type 2 diabetes: A randomized controlled study. Prim Care Diabetes 2022; 16:173-178. [PMID: 34980562 DOI: 10.1016/j.pcd.2021.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/05/2021] [Accepted: 12/14/2021] [Indexed: 11/20/2022]
Abstract
AIMS Adopting effective self-care behaviors is essential in maintaining optimal glycated hemoglobin (HbA1c) levels. The study aimed to evaluate the effect of health literacy-based, health belief-constructed education and counseling on glycated hemoglobin (HbA1c) in people with type 2 diabetes. METHODS The parallel-group, randomized controlled study was conducted between June 2019 and March 2020. One hundred and twenty patients were randomized to receive either 12-week health literacy-based group education and phone counseling (intervention, 60 patients) or routine diabetic care (control, 60 patients). The study was completed with 107 patients (54 intervention, 53 control). HbA1c (primary outcome), self-efficacy, perceived susceptibility, severity, barriers, and benefits (secondary outcomes) were evaluated at baseline and six months. RESULTS Both groups had decreases in HbA1c. There was no significant decrease in HbA1c between the intervention and control groups. However, there was a significant improvement in self-efficacy, change in perceived susceptibility, perceived barriers, and perceived benefits in the intervention group. This effect was the same for all patients in the high and low health literacy intervention groups. CONCLUSIONS Education and counseling based on health literacy levels and framed with health belief constructs change health beliefs, predicting higher engagement and efficacy in disease management activities. CLINICAL TRIAL NUMBER NCT04677127.
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Affiliation(s)
- Hatice Ağralı
- Faculty of Health Sciences, Department of Nursing, Süleyman Demirel University, Isparta, Turkey.
| | - İmatullah Akyar
- Associate Professor, Faculty of Nursing, Department of Internal Medicine Nursing, Hacettepe University, Ankara, Turkey.
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Ashor AW, Al-Rammahi TMM, Abdulrazzaq VM, Siervo M. Adherence to a healthy dietary pattern is associated with greater anti-oxidant capacity and improved glycemic control in Iraqi patients with Type 2 Diabetes. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-210016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Healthy dietary patterns are typically associated with improved metabolic and cardiovascular health in population-based cohorts. This study aims to investigate whether a healthy dietary score, derived from UK Diabetes and Diet Questionnaire (UKDDQ), is significantly associated with measures of metabolic health and nutritional status in patients with T2DM. METHODS: This cross-sectional study included 85 patients with T2DM (age: 51.7±9.4, BMI: 30.6±5.3) and 20 healthy volunteers (age: 48.4±8.6, BMI: 29.5±5) recruited from the Al-Hassan Diabetes and Endocrinology Specialized Center, Karbala, Iraq. Body weight, height and body mass index (BMI) and resting clinic blood pressure were measured. All participants completed the UKDDQ to assess the quality of the diet. Metabolic and nutritional biomarkers were measured in fasting blood samples. A composite nutritional heathy index score (CNHI-score) based on the sum of z-scores for plasma vitamin A, C and E concentrations was derived. RESULTS: In patients with T2DM the UKDDQ score was associated with lower fasting blood glucose (FBG) (r = –0.33; P < 0.01), hemoglobin A1C (r = –0.49; P < 0.001), total cholesterol (TC) (r = –0.26; P = 0.02) concentrations. In patients with T2DM, the CNHI-score significantly associated with UKDDQ (r = 0.43; P < 0.001). In addition, a higher CNHI-score was associated with FBG (r = –0.61; P < 0.001), HbA1C (r = –0.83; P < 0.001), TC (r = –0.30; P < 0.01) and triglyceride (r = –0.30; P < 0.01) concentrations. CONCLUSIONS: A healthy diet is associated with a higher concentration of anti-oxidant vitamins and better glycemic and lipid profile in healthy subjects and in patients with T2DM.
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Affiliation(s)
- Ammar Waham Ashor
- Department of Internal Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
- Natioanl Diabetes Center, Mustansiriyah University, Baghdad, Iraq
| | | | | | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen’s Medical Centre, Nottingham, NG7 2UH, UK
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Akhoon N. Precision Medicine: A New Paradigm in Therapeutics. Int J Prev Med 2021; 12:12. [PMID: 34084309 PMCID: PMC8106271 DOI: 10.4103/ijpvm.ijpvm_375_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 02/04/2020] [Indexed: 11/26/2022] Open
Abstract
A key goal of clinical care is to treat patients as individuals and to approach therapeutics in such a way that it has optimal efficacy and minimal toxicity. With swift technological advances, such as genomic sequencing and molecular targeted drug exploitation, the concept of precision medicine has been robustly promoted in recent years. Precision medicine endeavors to demarcate diseases using multiple data sources from genomics to digital health metrics in order to facilitate an individualized yet "evidence-based" decision regarding diagnostic and therapeutic approaches. In this way, therapeutics can be centered toward patients based on their molecular presentation rather than grouping them into broad categories with a "one size fits all" approach. This review article is aimed to provide a broad overview of the advent and emergence of precision medicine in view of its current implications.
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Affiliation(s)
- Neha Akhoon
- Department of Pharmacology, Armed Forces Medical College, Pune, Maharashtra, India
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Yang X, Zhang P, Zhang F, Ke Z, Chen Q, Liu C. Protective effect of hypoglycemic granule against diabetes‐induced liver injury by alleviating glycolipid metabolic disorder and oxidative stress. J Cell Biochem 2020; 121:3221-3234. [DOI: 10.1002/jcb.29588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/09/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Xiaosong Yang
- Hubei Key Laboratory of Diabetes and AngiopathyHubei University of Science and TechnologyXianning China
| | - Pengjie Zhang
- Hubei Key Laboratory of Diabetes and AngiopathyHubei University of Science and TechnologyXianning China
| | - Feixue Zhang
- Hubei Key Laboratory of Diabetes and AngiopathyHubei University of Science and TechnologyXianning China
| | - Zhiqiang Ke
- Hubei Key Laboratory of Diabetes and AngiopathyHubei University of Science and TechnologyXianning China
| | - Qingjie Chen
- Hubei Key Laboratory of Diabetes and AngiopathyHubei University of Science and TechnologyXianning China
| | - Chao Liu
- Hubei Key Laboratory of Diabetes and AngiopathyHubei University of Science and TechnologyXianning China
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Arumugam G, Nagarathna R, Majumdar V, Singh M, Srinivasalu R, Sanjival R, Ram VS, Nagendra HR. Yoga-based lifestyle treatment and composite treatment goals in Type 2 Diabetes in a rural South Indian setup- a retrospective study. Sci Rep 2020; 10:6402. [PMID: 32286379 PMCID: PMC7156497 DOI: 10.1038/s41598-020-63133-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 03/20/2020] [Indexed: 11/14/2022] Open
Abstract
This multicentre retrospective study examined the effects of adjunct yoga-treatment in achieving composite cardiovascular goals for type 2 diabetes (T2D), set forth by the American Diabetes Association (ADA) in rural Indian settings. Records were extracted for 146 T2D patients, aged ≥20–70 years, and treated under the “Apollo Total Health Programme” for rural diabetes management, for the period April 2016 to November 2016. The study cohort comprised of two treatment groups (n = 73 each); non-yoga group (standard of care) and yoga group (adjunct yoga-treatment). Propensity score matching was applied between the study groups to define the cohort. Composite cardiovascular scores were based on the combination of individual ADA goals; A1c < 7%, blood pressure (BP) < 140/90 mmHg, stringent BP (<130/80 mmHg) and lipid, LDL-C < 100 mg/dl [risk factor for atherosclerotic cardiovascular disease]. Logistic regression was used to compare between the two treatment groups. Compared to standard of care, adjunct yoga-treatment was found to significantly facilitate the attainment of ADA composite score by 8-fold; A1c, ~2-fold; LDL-C, ~2-fold; BP < 140/90 mmHg and <130/80 mmHg by ~8-and ~6-fold respectively. This study provides the first evidence for significant efficacy of adjunct yoga-treatment for the attainment of favourable treatment goals for T2D in rural Indian settings. Clinical Trial Registration Number: CTRI/2020/02/0232790
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Affiliation(s)
- Geetharani Arumugam
- Division of Life sciences, Swami Vivekananda Yoga Anusandhana Samsathana, Bengaluru, 560106, Karnataka, India
| | - Raghuram Nagarathna
- Division of Life sciences, Swami Vivekananda Yoga Anusandhana Samsathana, Bengaluru, 560106, Karnataka, India
| | - Vijaya Majumdar
- Division of Life sciences, Swami Vivekananda Yoga Anusandhana Samsathana, Bengaluru, 560106, Karnataka, India.
| | - Mandeep Singh
- Health Programme-Apollo Hospitals Ardhagiri road, Aragonda village, Tavanampalle mandal, Chittoor district, 517129, Andhrapradesh, India
| | - Rambabu Srinivasalu
- Health Programme-Apollo Hospitals Ardhagiri road, Aragonda village, Tavanampalle mandal, Chittoor district, 517129, Andhrapradesh, India
| | - Rajagopal Sanjival
- Health Programme-Apollo Hospitals Ardhagiri road, Aragonda village, Tavanampalle mandal, Chittoor district, 517129, Andhrapradesh, India
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Jung CH. Comprehensive Efforts Are Needed to Improve the Quality of Primary Diabetes Care in Korea. Endocrinol Metab (Seoul) 2019; 34:265-267. [PMID: 31565878 PMCID: PMC6769346 DOI: 10.3803/enm.2019.34.3.265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 11/22/2022] Open
Affiliation(s)
- Chan Hee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
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Wankeu-Nya M, Watcho P, Deeh Defo PB, Ngadjui E, Nguelefack TB, Kamtchouing P, Kamanyi A. Aqueous and ethanol extracts of Dracaena arborea (Wild) Link (Dracaenaceae) alleviate reproductive complications of diabetes mellitus in rats. Andrologia 2019; 51:e13381. [PMID: 31373720 DOI: 10.1111/and.13381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 05/13/2019] [Accepted: 07/04/2019] [Indexed: 12/20/2022] Open
Abstract
Reproductive dysfunction is one of the most prevalent diabetes complications. Draceana arborea is known to enhance sexual function in diabetic rats, but the underlying mechanisms have not been thoroughly elucidated. This study examined the effects of D. arborea on some reproductive complications of diabetes in rats. Aqueous and ethanol (500 and 100 mg/kg respectively) extracts of D. arborea, Sildenafil citrate (1.44 mg/kg), trimethylamine-N-oxide (TMAO, 20 mg/kg) and distilled water (10 ml/kg) were orally administered for 28 days to streptozotocin-induced diabetic rats. Glycaemia, body and reproductive organ masses, fertility parameters, total proteins, antioxidant enzymes activities, serum and testicular testosterone and the histology of the testes and epididymis were determined. Results revealed significant decreases in body and absolute and relative masses of testes, epididymis, seminal vesicles, prostate and vas deferens, fertility parameters, epididymal and testicular total proteins, serum and testicular testosterone levels as well as antioxidant enzymes activities. Interestingly, while having minor anti-hyperglycaemic effects, these abnormalities associated with testicular and epididymal alterations were alleviated by D. arborea especially the aqueous extract (500 mg/kg). These outcomes provided evidence of the androgenic properties of D. arborea in diabetic rats, which could be useful for a better management of sexual dysfunctions in diabetic patients.
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Affiliation(s)
- Modeste Wankeu-Nya
- Animal Organisms Biology and Physiology Laboratory, University of Douala, Douala, Cameroon.,Animal Physiology and Phytopharmacology Laboratory, University of Dschang, Dschang, Cameroon
| | - Pierre Watcho
- Animal Physiology and Phytopharmacology Laboratory, University of Dschang, Dschang, Cameroon
| | - Patrick B Deeh Defo
- Animal Physiology and Phytopharmacology Laboratory, University of Dschang, Dschang, Cameroon
| | - Esther Ngadjui
- Animal Physiology and Phytopharmacology Laboratory, University of Dschang, Dschang, Cameroon
| | - Telesphore B Nguelefack
- Animal Physiology and Phytopharmacology Laboratory, University of Dschang, Dschang, Cameroon
| | - Pierre Kamtchouing
- Department of Animal Biology and Physiology, University of Yaoundé I, Yaounde, Cameroon
| | - Albert Kamanyi
- Animal Physiology and Phytopharmacology Laboratory, University of Dschang, Dschang, Cameroon
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Whyte MB, Munro N. Changing the care pathway for Type 2 diabetes at the time of diagnosis: the role of the multidisciplinary team. Diabet Med 2019; 36:653-654. [PMID: 30378713 PMCID: PMC6594028 DOI: 10.1111/dme.13852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M B Whyte
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - N Munro
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
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Tachkov K, Mitov K, Mitkova Z, Kamusheva M, Dimitrova M, Petkova V, Savova A, Doneva M, Tcarukciev D, Valov V, Angelova G, Manova M, Petrova G. Improved quality of diabetes control reduces complication costs in Bulgaria. BIOTECHNOL BIOTEC EQ 2019. [DOI: 10.1080/13102818.2019.1604160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Konstantin Tachkov
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Konstantin Mitov
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Zornitsa Mitkova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Kamusheva
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Dimitrova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Valentina Petkova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Alexandra Savova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Miglena Doneva
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Dimitar Tcarukciev
- University Endocrinology Hospital “Ivan Penchev”, Medical University of Sofia, Sofia, Bulgaria
| | | | - Galia Angelova
- Linguistic Modelling and Knowledge Processing Department, Institute of Information and Communication Technologies, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Manoela Manova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Guenka Petrova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
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Affiliation(s)
- Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Fereidoun Azizi, Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: + 98-2122409309, E-mail:
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Casanova LM, Espíndola-Netto JM, Tinoco LW, Sola-Penna M, Costa SS. The Use of NMR Metabolite Profiling andin vivoHypoglycemic Assay for Comparison of Unfractionated Aqueous Leaf Extracts of TwoOcimumSpecies. Chem Biodivers 2016; 13:686-94. [DOI: 10.1002/cbdv.201500180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 01/05/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Livia Marques Casanova
- Laboratório de Química de Produtos Naturais Bioativos - LPN-Bio; Instituto de Pesquisas de Produtos Naturais; Universidade Federal do Rio de Janeiro; Rio de Janeiro 21941-902 RJ Brazil
| | - Jair Machado Espíndola-Netto
- Laboratório de Enzimologia e Controle do Metabolismo - LabECoM; Faculdade de Farmácia; Universidade Federal do Rio de Janeiro; Rio de Janeiro 21941-902 RJ Brazil
| | - Luzineide Wanderley Tinoco
- Laboratório Multiusuário de Análises por RMN - LAMAR; Instituto de Pesquisas de Produtos Naturais; Universidade Federal do Rio de Janeiro; Rio de Janeiro 21941-902 RJ Brazil
| | - Mauro Sola-Penna
- Laboratório de Enzimologia e Controle do Metabolismo - LabECoM; Faculdade de Farmácia; Universidade Federal do Rio de Janeiro; Rio de Janeiro 21941-902 RJ Brazil
| | - Sônia Soares Costa
- Laboratório de Química de Produtos Naturais Bioativos - LPN-Bio; Instituto de Pesquisas de Produtos Naturais; Universidade Federal do Rio de Janeiro; Rio de Janeiro 21941-902 RJ Brazil
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Ahima RS. Editorial: Rethinking the definition of diabetes for precision medicine. Mol Endocrinol 2016; 29:335-7. [PMID: 25723483 DOI: 10.1210/me.2015-1037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Rexford S Ahima
- Division of Endocrinology, Diabetes, and Metabolism, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104
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Hu Y, Zhou X, Liu P, Wang B, Duan DM, Guo DH. A comparison study of metformin only therapy and metformin combined with Chinese medicine jianyutangkang therapy in patients with type 2 diabetes: A randomized placebo-controlled double-blind study. Complement Ther Med 2016; 24:13-8. [DOI: 10.1016/j.ctim.2015.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 09/07/2015] [Accepted: 11/27/2015] [Indexed: 02/01/2023] Open
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Smulyan H, Lieber A, Safar ME. Hypertension, Diabetes Type II, and Their Association: Role of Arterial Stiffness. Am J Hypertens 2016; 29:5-13. [PMID: 26156872 DOI: 10.1093/ajh/hpv107] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 06/16/2015] [Indexed: 12/14/2022] Open
Abstract
In patients with both hypertension and type II diabetes, the systolic blood pressure (SBP) increases linearly with age, while that of diastolic blood pressure (DBP) declines curvilinearly as early as age 45, all suggesting the development of increased arterial stiffness. Increased stiffness is an important, independent, and significant risk predictor in subjects with hypertension and diabetes. In patients with both diseases, stiffness assessed at the same mean arterial pressure (MAP) was significantly higher in diabetic patients. Arterial stiffness is related to age, heart rate (HR), and MAP, but in diabetic patients, it also related to diabetes duration and insulin treatment (IT). In the metabolic syndrome (MetSyn), diabetes also acts on the small arteries through capillary rarefaction to reduce the effective length of the arterial tree, increases the reflected pulse wave and thus the pulse pressure (PP). These studies indicate that diabetes and hypertension additively contribute to increased pulsatility and suggest that any means to reduce stiffness would be beneficial in these conditions.
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Affiliation(s)
- Harold Smulyan
- State University of New York Upstate Medical University, Syracuse, New York, USA;
| | - Ari Lieber
- Centre de Diagnostic et de Therapeutique, Hotel Dieu, Paris, France
| | - Michel E Safar
- Centre de Diagnostic et de Therapeutique, Hotel Dieu, Paris, France
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Da Silva D, Casanova LM, Marcondes MC, Espindola-Netto JM, Paixão LP, De Melo GO, Zancan P, Sola-Penna M, Costa SS. Antidiabetic activity ofSedum dendroideum: Metabolic enzymes as putative targets for the bioactive flavonoid kaempferitrin. IUBMB Life 2014; 66:361-70. [DOI: 10.1002/iub.1270] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 04/23/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Daniel Da Silva
- Laboratório de Enzimologia e Controle do Metabolismo (LabECoM), BioTecFar, Faculdade de Farmácia; Universidade Federal do Rio de Janeiro; Rio de Janeiro Brazil
| | - Livia Marques Casanova
- Laboratório de Química de Produtos Naturais Bioativos (LPN-Bio), Núcleo de Pesquisa de Produtos Naturais; Universidade Federal do Rio de Janeiro; Rio de Janeiro Brazil
| | - Mariah Celestino Marcondes
- Laboratório de Oncobiologia Molecular (LabOMol), BioTecFar, Faculdade de Farmácia; Universidade Federal do Rio de Janeiro; Rio de Janeiro Brazil
| | - Jair Machado Espindola-Netto
- Laboratório de Enzimologia e Controle do Metabolismo (LabECoM), BioTecFar, Faculdade de Farmácia; Universidade Federal do Rio de Janeiro; Rio de Janeiro Brazil
| | - Larissa Pereira Paixão
- Laboratório de Oncobiologia Molecular (LabOMol), BioTecFar, Faculdade de Farmácia; Universidade Federal do Rio de Janeiro; Rio de Janeiro Brazil
| | - Giany Oliveira De Melo
- Laboratório de Química de Produtos Naturais Bioativos (LPN-Bio), Núcleo de Pesquisa de Produtos Naturais; Universidade Federal do Rio de Janeiro; Rio de Janeiro Brazil
| | - Patricia Zancan
- Laboratório de Oncobiologia Molecular (LabOMol), BioTecFar, Faculdade de Farmácia; Universidade Federal do Rio de Janeiro; Rio de Janeiro Brazil
| | - Mauro Sola-Penna
- Laboratório de Enzimologia e Controle do Metabolismo (LabECoM), BioTecFar, Faculdade de Farmácia; Universidade Federal do Rio de Janeiro; Rio de Janeiro Brazil
| | - Sônia Soares Costa
- Laboratório de Química de Produtos Naturais Bioativos (LPN-Bio), Núcleo de Pesquisa de Produtos Naturais; Universidade Federal do Rio de Janeiro; Rio de Janeiro Brazil
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Bron M, Ayyagari R, Sharma H, Chen K, Bozas A, Wu E. Management of Patients Using Combination Therapy With Pioglitazone and a Dipeptidyl Peptidase-4 Inhibitor: An Analysis of Initial Versus Sequential Combination Therapy. Postgrad Med 2014; 126:47-55. [DOI: 10.3810/pgm.2014.05.2755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Pilleron S, Pasquier E, Boyoze-Nolasco I, Villafuerte JJ, Olchini D, Fontbonne A. Participative decentralization of diabetes care in Davao City (Philippines) according to the Chronic Care Model: a program evaluation. Diabetes Res Clin Pract 2014; 104:189-95. [PMID: 24560175 DOI: 10.1016/j.diabres.2014.01.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 09/16/2013] [Accepted: 01/17/2014] [Indexed: 11/29/2022]
Abstract
AIM To assess the effectiveness of the Diabetes Project in Davao City, Philippines, regarding diabetes care access, diabetes management and cardiovascular risk factors. The project was developed in accordance with the Chronic Care Model (CCM) framework. METHODS A non-randomized cross-sectional survey was conducted in nine intervention and five control Barangays (villages). People with diabetes aged ≥20 years were interviewed using a structured questionnaire; height, weight, waist circumference, and blood pressure were measured; HbA1c was tested with a NSGP-certified point-of-care device. Logistic regression models were used to compare the two groups. RESULTS The intervention group (n=503) scored better than the controls (n=136) on the following (OR, 95% CI): percentage of patients taking metformin (1.5, 1.0-2.2); and in the last 12 months: laboratory test for fasting blood sugar (1.6, 1.1-2.3), HbA1c (6.0, 2.4-15.1), lipid profile (1.7, 1.1-2.5), nutritionist visit (1.6, 1.0-2.5) and therapeutic education session (2.7, 1.8-4.0). Glycemic control (HbA1c<7%) was also better in the intervention Barangays (1.6, 1.0-2.4). There were no statistical differences between the two groups for number of visits, and levels of other cardiovascular risk factors. CONCLUSIONS Our findings support the effectiveness of implementing the CCM framework in a low-to-middle income country on glycemic control and diabetes management.
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Affiliation(s)
- Sophie Pilleron
- Prevention and Health Unit, Handicap International Federation, Lyon, France; INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France; Univ Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France.
| | - Estelle Pasquier
- Prevention and Health Unit, Handicap International Federation, Lyon, France
| | | | | | - Davide Olchini
- Prevention and Health Unit, Handicap International Federation, Lyon, France
| | - Annick Fontbonne
- INSERM-IRD, UMR 204 Nutripass, IRD/UM1/UM2/SupAgro, Montpellier, France
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Janero DR. Synthetic agents in the context of metabolic/bariatric surgery: expanding the scope and impact of diabetes drug discovery. Expert Opin Drug Discov 2014; 9:221-8. [DOI: 10.1517/17460441.2014.876988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- David R Janero
- Northeastern University, Bouvé College of Health Sciences, Center for Drug Discovery, Department of Pharmaceutical Sciences, and Health Sciences Entrepreneurs, 360 Huntington Avenue, 116 Mugar Life Sciences Hall, Boston, MA 02115-5000, USA ;
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Ferrannini E, Berk A, Hantel S, Pinnetti S, Hach T, Woerle HJ, Broedl UC. Long-term safety and efficacy of empagliflozin, sitagliptin, and metformin: an active-controlled, parallel-group, randomized, 78-week open-label extension study in patients with type 2 diabetes. Diabetes Care 2013; 36:4015-21. [PMID: 24186878 PMCID: PMC3836134 DOI: 10.2337/dc13-0663] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the long-term safety and efficacy of empagliflozin, a sodium glucose cotransporter 2 inhibitor; sitagliptin; and metformin in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS In this randomized, open-label, 78-week extension study of two 12-week, blinded, dose-finding studies of empagliflozin (monotherapy and add-on to metformin) with open-label comparators, 272 patients received 10 mg empagliflozin (166 as add-on to metformin), 275 received 25 mg empagliflozin (166 as add-on to metformin), 56 patients received metformin, and 56 patients received sitagliptin as add-on to metformin. RESULTS Changes from baseline in HbA1c at week 90 were -0.34 to -0.63% (-3.7 to -6.9 mmol/mol) with empagliflozin, -0.56% (-6.1 mmol/mol) with metformin, and -0.40% (-4.4 mmol/mol) with sitagliptin. Changes from baseline in weight at week 90 were -2.2 to -4.0 kg with empagliflozin, -1.3 kg with metformin, and -0.4 kg with sitagliptin. Adverse events (AEs) were reported in 63.2-74.1% of patients on empagliflozin and 69.6% on metformin or sitagliptin; most AEs were mild or moderate in intensity. Hypoglycemic events were rare in all treatment groups, and none required assistance. AEs consistent with genital infections were reported in 3.0-5.5% of patients on empagliflozin, 1.8% on metformin, and none on sitagliptin. AEs consistent with urinary tract infections were reported in 3.8-12.7% of patients on empagliflozin, 3.6% on metformin, and 12.5% on sitagliptin. CONCLUSIONS Long-term empagliflozin treatment provided sustained glycemic and weight control and was well tolerated with a low risk of hypoglycemia in patients with type 2 diabetes.
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Kones R. Molecular sources of residual cardiovascular risk, clinical signals, and innovative solutions: relationship with subclinical disease, undertreatment, and poor adherence: implications of new evidence upon optimizing cardiovascular patient outcomes. Vasc Health Risk Manag 2013; 9:617-70. [PMID: 24174878 PMCID: PMC3808150 DOI: 10.2147/vhrm.s37119] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Residual risk, the ongoing appreciable risk of major cardiovascular events (MCVE) in statin-treated patients who have achieved evidence-based lipid goals, remains a concern among cardiologists. Factors that contribute to this continuing risk are atherogenic non-low-density lipoprotein (LDL) particles and atherogenic processes unrelated to LDL cholesterol, including other risk factors, the inherent properties of statin drugs, and patient characteristics, ie, genetics and behaviors. In addition, providers, health care systems, the community, public policies, and the environment play a role. Major statin studies suggest an average 28% reduction in LDL cholesterol and a 31% reduction in relative risk, leaving a residual risk of about 69%. Incomplete reductions in risk, and failure to improve conditions that create risk, may result in ongoing progression of atherosclerosis, with new and recurring lesions in original and distant culprit sites, remodeling, arrhythmias, rehospitalizations, invasive procedures, and terminal disability. As a result, identification of additional agents to reduce residual risk, particularly administered together with statin drugs, has been an ongoing quest. The current model of atherosclerosis involves many steps during which disease may progress independently of guideline-defined elevations in LDL cholesterol. Differences in genetic responsiveness to statin therapy, differences in ability of the endothelium to regenerate and repair, and differences in susceptibility to nonlipid risk factors, such as tobacco smoking, hypertension, and molecular changes associated with obesity and diabetes, may all create residual risk. A large number of inflammatory and metabolic processes may also provide eventual therapeutic targets to lower residual risk. Classically, epidemiologic and other evidence suggested that raising high-density lipoprotein (HDL) cholesterol would be cardioprotective. When LDL cholesterol is aggressively lowered to targets, low HDL cholesterol levels are still inversely related to MCVE. The efflux capacity, or ability to relocate cholesterol out of macrophages, is believed to be a major antiatherogenic mechanism responsible for reduction in MCVE mediated in part by healthy HDL. HDL cholesterol is a complex molecule with antioxidative, anti-inflammatory, anti-thrombotic, antiplatelet, and vasodilatory properties, among which is protection of LDL from oxidation. HDL-associated paraoxonase-1 has a major effect on endothelial function. Further, HDL promotes endothelial repair and progenitor cell health, and supports production of nitric oxide. HDL from patients with cardiovascular disease, diabetes, and autoimmune disease may fail to protect or even become proinflammatory or pro-oxidant. Mendelian randomization and other clinical studies in which raising HDL cholesterol has not been beneficial suggest that high plasma levels do not necessarily reduce cardiovascular risk. These data, coupled with extensive preclinical information about the functional heterogeneity of HDL, challenge the "HDL hypothesis", ie, raising HDL cholesterol per se will reduce MCVE. After the equivocal AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes) study and withdrawal of two major cholesteryl ester transfer protein compounds, one for off-target adverse effects and the other for lack of efficacy, development continues for two other agents, ie, anacetrapib and evacetrapib, both of which lower LDL cholesterol substantially. The negative but controversial HPS2-THRIVE (the Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events) trial casts further doubt on the HDL cholesterol hypothesis. The growing impression that HDL functionality, rather than abundance, is clinically important is supported by experimental evidence highlighting the conditional pleiotropic actions of HDL. Non-HDL cholesterol reflects the cholesterol in all atherogenic particles containing apolipoprotein B, and has outperformed LDL cholesterol as a lipid marker of cardiovascular risk and future mortality. In addition to including a measure of residual risk, the advantages of using non-HDL cholesterol as a primary lipid target are now compelling. Reinterpretation of data from the Treating to New Targets study suggests that better control of smoking, body weight, hypertension, and diabetes will help lower residual risk. Although much improved, control of risk factors other than LDL cholesterol currently remains inadequate due to shortfalls in compliance with guidelines and poor patient adherence. More efficient and greater use of proven simple therapies, such as aspirin, beta-blockers, angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, combined with statin therapy, may be more fruitful in improving outcomes than using other complex therapies. Comprehensive, intensive, multimechanistic, global, and national programs using primordial, primary, and secondary prevention to lower the total level of cardiovascular risk are necessary.
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Affiliation(s)
- Richard Kones
- Cardiometabolic Research Institute, Houston, TX, USA
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Kianbakht S, Dabaghian FH. Improved glycemic control and lipid profile in hyperlipidemic type 2 diabetic patients consuming Salvia officinalis L. leaf extract: a randomized placebo. Controlled clinical trial. Complement Ther Med 2013; 21:441-6. [PMID: 24050577 DOI: 10.1016/j.ctim.2013.07.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/26/2013] [Accepted: 07/10/2013] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Evaluation of the efficacy and safety of Salvia officinalis L. (S. officinalis) leaf extract in the treatment of hyperlipidemic type 2 diabetic patients. DESIGN Randomized placebo-controlled parallel group study. SETTING Diabetes Clinic (Karaj City, Alborz Province of Iran). INTERVENTIONS The efficacy and safety of taking S. officinalis leaf extract (one 500 mg capsule t.i.d. for 3 months) in treatment of 40 hyperlipidemic (hypercholesterolemic and/or hypertriglyceridemic) type 2 diabetic patients were evaluated and compared with the placebo group (n=40). MAIN OUTCOME MEASURES Fasting blood levels of glucose, glycosylated hemoglobin (HbA1c), total cholesterol, triglyceride, LDL-C (low density lipoprotein cholesterol), HDL-C (high density lipoprotein cholesterol), SGOT (serum glutamic-oxaloacetic transaminase), SGPT (serum glutamic-pyruvic transaminase) and creatinine. RESULTS The extract lowered fasting glucose, HbA1c, total cholesterol, triglyceride and LDL-C but increased HDL-C compared to baseline at endpoint. Percent difference mean (95% confidence interval) between the extract and placebo groups in terms of effects on fasting glucose, HbA1c, total cholesterol, triglyceride, LDL-C and HDL-C at endpoint were 32.2 (26.5, 37.9), 22.7 (16.8, 28.6), 16.9 (9.7, 24.1), 56.4 (36.1, 76.7), 35.6 (29.9, 41.3) and 27.6 (15.8, 39.4) (P=0.001, P=0.01, P=0.01, P=0.009, P<0.001 and P=0.008), respectively. Moreover, the extract did not have any significant effects on the other parameters compared to the placebo group at endpoint (P>0.05). No adverse effects were reported. CONCLUSIONS S. officinalis leaves may be safe and have anti-hyperglycemic and lipid profile improving effects in hyperlipidemic type 2 diabetic patients.
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Affiliation(s)
- S Kianbakht
- Department of Pharmacology and Applied Medicine, Research Institute of Medicinal Plants, ACECR, Karaj, Iran.
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26
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Heise T, Seewaldt-Becker E, Macha S, Hantel S, Pinnetti S, Seman L, Woerle HJ. Safety, tolerability, pharmacokinetics and pharmacodynamics following 4 weeks' treatment with empagliflozin once daily in patients with type 2 diabetes. Diabetes Obes Metab 2013; 15:613-21. [PMID: 23356556 DOI: 10.1111/dom.12073] [Citation(s) in RCA: 203] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 09/27/2012] [Accepted: 12/28/2012] [Indexed: 12/23/2022]
Abstract
AIM To investigate the safety, tolerability, pharmacokinetics and pharmacodynamics of empagliflozin in patients with type 2 diabetes following oral administration of 10, 25 or 100 mg doses once daily over 28 days. METHODS A total of 78 patients were assigned to empagliflozin 10 mg (n = 16), 25 mg (n = 16) or 100 mg (n = 30) or placebo (n = 16) for 28 days. Assessments included adverse events (AEs) and pharmacokinetic and pharmacodynamic endpoints. RESULTS Empagliflozin exposure increased dose-proportionally over the dose range 10-100 mg and showed linear pharmacokinetics with respect to time. Urinary glucose excretion (UGE) increased from baseline to day 1 by 74, 90 and 81 g with empagliflozin 10, 25 and 100 mg, respectively. The increases in UGE were maintained over 28 days with multiple dosing. Virtually no change in UGE was observed in the placebo group. Significant reductions from baseline in mean daily plasma glucose and fasting plasma glucose were observed with empagliflozin compared with placebo. The incidence of AEs was similar in the empagliflozin and placebo groups (50.0, 56.3 and 66.7% with empagliflozin rising doses and 62.5% with placebo). The most frequently reported AEs were pollakiuria (10.3%), nasopharyngitis (9.0%), constipation (9.0%) and headache (7.7%). CONCLUSIONS Oral administration of empagliflozin at doses of 10, 25 or 100 mg once daily over 28 days resulted in significant increases in UGE and reductions in blood glucose compared with placebo, and were well tolerated in patients with type 2 diabetes.
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Affiliation(s)
- T Heise
- Profil, Hellersbergstrasse 9, Neuss, Germany.
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Giorgino F, Leonardini A, Laviola L. Cardiovascular disease and glycemic control in type 2 diabetes: now that the dust is settling from large clinical trials. Ann N Y Acad Sci 2013; 1281:36-50. [PMID: 23387439 PMCID: PMC3715107 DOI: 10.1111/nyas.12044] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The relationship between glucose control and cardiovascular outcomes in type 2 diabetes has been a matter of controversy over the years. Although epidemiological evidence exists in favor of an adverse role of poor glucose control on cardiovascular events, intervention trials have been less conclusive. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, the Action in Diabetes and Vascular Disease (ADVANCE) study, and the Veterans Affairs Diabetes Trial (VADT) have shown no beneficial effect of intensive glucose control on primary cardiovascular endpoints in type 2 diabetes. However, subgroup analysis has provided evidence suggesting that the potential beneficial effect largely depends on patients’ characteristics, including age, diabetes duration, previous glucose control, presence of cardiovascular disease, and risk of hypoglycemia. The benefit of strict glucose control on cardiovascular outcomes and mortality may be indeed hampered by the extent and frequency of hypoglycemic events and could be enhanced if glucose-lowering medications, capable of exerting favorable effects on the cardiovascular system, were used. This review examines the relationship between intensive glucose control and cardiovascular outcomes in type 2 diabetes, addressing the need for individualization of glucose targets and careful consideration of the benefit/risk profile of antidiabetes medications.
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Affiliation(s)
- Francesco Giorgino
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
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Briggs Early K, Armstrong Shultz J, Evans M, Corbett CF, Nicholson Butkus S, Massey L. Dietary goal attainment measures and psychosocial factors among Mexican Americans and non-Hispanic whites with type 2 diabetes. Ecol Food Nutr 2012; 51:227-46. [PMID: 22632062 DOI: 10.1080/03670244.2012.674446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Diabetes education programs need improved measures of goal setting for dietary control of diabetes. Additionally, measures of patient experiences with dietary goal setting are needed to better prepare patients for diabetes self-management. Measures of dietary goals and strategies were investigated via survey of 100 Mexican Americans and non-Hispanic whites with type 2 diabetes at a community clinic. Analyses tested novel goal measures as stages of change and goal attainment with a food plan compared to a traditional measure of food plan adherence. Ethnic groups varied in some reported experiences with goal setting education and goal attainment, but did not differ in most clinical characteristics of diabetes. Results indicated that different measures of goal setting vary in their psychosocial predictors, suggesting changes in how health care providers use and monitor goal setting for patients. At the time this research was conducted, Dr. Briggs Early was a doctoral candidate in the Department of Food Science and Human Nutrition at Washington State University. She is currently an Assistant Professor of Biochemistry and Nutrition at Pacific Northwest University of Health Sciences - College of Osteopathic Medicine, and a certified diabetes educator, and insulin pump trainer in Yakima, Washington.
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Affiliation(s)
- Kathaleen Briggs Early
- Pacific Northwest University of Health Sciences - College of Osteopathic Medicine, Yakima, WA 98901, USA.
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Vijayvergiya R, Garg D, Sinha SK. Percutaneous panvascular intervention in an unusual case of extensive atherosclerotic disease. World J Cardiol 2012; 4:48-53. [PMID: 22379537 PMCID: PMC3289893 DOI: 10.4330/wjc.v4.i2.48] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Revised: 12/11/2011] [Accepted: 12/18/2011] [Indexed: 02/06/2023] Open
Abstract
It is common to see patients with atherosclerotic coronary disease and peripheral arterial disease in routine clinical practice. One needs to have a comprehensive and integrated multi-speciality approach and panvascular revascularization in such patients. We report a 54-year-old diabetic hypertensive male with extensive atherosclerotic coronary and peripheral arterial disease, who presented with congestive heart failure, claudication of both lower limbs and mesenteric ischemia. He underwent successful percutaneous panvascular revascularization of coronary, renal, mesenteric, aorto-iliac and superficial femoral arteries. Long-term patency of all the stents was also documented.
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Affiliation(s)
- Rajesh Vijayvergiya
- Rajesh Vijayvergiya, Dheeraj Garg, Advanced Cardiac Centre, Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160 012, India
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31
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Yavari R, McEntee E, McEntee M, Brines M. Anthropometric variables accurately predict dual energy x-ray absorptiometric-derived body composition and can be used to screen for diabetes. PLoS One 2011; 6:e24017. [PMID: 21915276 PMCID: PMC3167829 DOI: 10.1371/journal.pone.0024017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 07/29/2011] [Indexed: 12/16/2022] Open
Abstract
The current world-wide epidemic of obesity has stimulated interest in developing simple screening methods to identify individuals with undiagnosed diabetes mellitus type 2 (DM2) or metabolic syndrome (MS). Prior work utilizing body composition obtained by sophisticated technology has shown that the ratio of abdominal fat to total fat is a good predictor for DM2 or MS. The goals of this study were to determine how well simple anthropometric variables predict the fat mass distribution as determined by dual energy x-ray absorptometry (DXA), and whether these are useful to screen for DM2 or MS within a population. To accomplish this, the body composition of 341 females spanning a wide range of body mass indices and with a 23% prevalence of DM2 and MS was determined using DXA. Stepwise linear regression models incorporating age, weight, height, waistline, and hipline predicted DXA body composition (i.e., fat mass, trunk fat, fat free mass, and total mass) with good accuracy. Using body composition as independent variables, nominal logistic regression was then performed to estimate the probability of DM2. The results show good discrimination with the receiver operating characteristic (ROC) having an area under the curve (AUC) of 0.78. The anthropometrically-derived body composition equations derived from the full DXA study group were then applied to a group of 1153 female patients selected from a general endocrinology practice. Similar to the smaller study group, the ROC from logistical regression using body composition had an AUC of 0.81 for the detection of DM2. These results are superior to screening based on questionnaires and compare favorably with published data derived from invasive testing, e.g., hemoglobin A1c. This anthropometric approach offers promise for the development of simple, inexpensive, non-invasive screening to identify individuals with metabolic dysfunction within large populations.
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Affiliation(s)
- Reza Yavari
- Beyond Care, LLC, Guilford, Connecticut, United States of America
- Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Erin McEntee
- Physician Assistant Program, School of Medicine and Health Sciences, The George Washington University, Washington, D.C., United States of America
| | - Michael McEntee
- Impact Health Biometric Testing, Inc., King of Prussia, Pennsylvania, United States of America
| | - Michael Brines
- Research and Development, The Kenneth S. Warren Institute, Ossining, New York, United States of America
- * E-mail:
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Davidson JA. The increasing role of primary care physicians in caring for patients with type 2 diabetes mellitus. Mayo Clin Proc 2010; 85:S3-4. [PMID: 21106869 PMCID: PMC2996164 DOI: 10.4065/mcp.2010.0466] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jaime A Davidson
- Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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