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Yaagoob E, Lee R, Stubbs M, Shuaib F, Johar R, Chan S. WhatsApp-based intervention for people with type 2 diabetes: A randomized controlled trial. Nurs Health Sci 2024; 26:e13117. [PMID: 38566413 DOI: 10.1111/nhs.13117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024]
Abstract
Diabetes mellitus is a metabolic disease characterized by prolonged elevated blood glucose levels. Diabetes self-management education and support programs are widely used in western countries. The impact of social media education and support interventions such as a WhatsApp-based program and the nurses' role in supporting and implementing this self-management program unclear. Using a WhatsApp-based program, we evaluated the effects of a 6-week program in improving self-efficacy and education among people with type 2 diabetes mellitus in Saudi Arabia. Eligible participants (n = 80) were recruited with the support of nurses into a randomized controlled trial and randomly assigned into self-management intervention and control groups. The intervention group (n = 40) received the self-management program support and the usual care. The control group (n = 40) received only the usual care with nurses' support. Results from generalized estimating equation analysis showed a significant increase in self-efficacy, self-management, and education in the WhatsApp-based intervention support group compared with the control group at 6 and 12 weeks (follow-up). Implementing the program via social media improves self-efficacy. The use of social media platforms should be promoted for global diabetes management.
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Affiliation(s)
- Esmaeel Yaagoob
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Regina Lee
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Australia
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michelle Stubbs
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Fatimah Shuaib
- Diabetic Education Clinic, Jizan Diabetes Center, Jazan, Saudi Arabia
| | - Raja Johar
- Diabetic Education Clinic, Jizan Diabetes Center, Jazan, Saudi Arabia
| | - Sally Chan
- President's Office, Tung Wah College, Homantin, Hong Kong
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den Brok EJ, Svensson CH, Panagiotou M, van Greevenbroek MMJ, Mertens PR, Vazeou A, Mitrakou A, Makrilakis K, Franssen GHLM, van Kuijk S, Proennecke S, Mougiakakou S, Pedersen-Bjergaard U, de Galan BE. The effect of bolus advisors on glycaemic parameters in adults with diabetes on intensive insulin therapy: A systematic review with meta-analysis. Diabetes Obes Metab 2024; 26:1950-1961. [PMID: 38504142 DOI: 10.1111/dom.15521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 03/21/2024]
Abstract
AIM To conduct a systematic review with meta-analysis to provide a comprehensive synthesis of randomized controlled trials (RCTs) and prospective cohort studies investigating the effects of currently available bolus advisors on glycaemic parameters in adults with diabetes. MATERIALS AND METHODS An electronic search of PubMed, Embase, CINAHL, Cochrane Library and ClinicalTrials.gov was conducted in December 2022. The risk of bias was assessed using the revised Cochrane Risk of Bias tool. (Standardized) mean difference (MD) was selected to determine the difference in continuous outcomes between the groups. A random-effects model meta-analysis and meta-regression were performed. This systematic review was registered on PROSPERO (CRD42022374588). RESULTS A total of 18 RCTs involving 1645 adults (50% females) with a median glycated haemoglobin (HbA1c) concentration of 8.45% (7.95%-9.30%) were included. The majority of participants had type 1 diabetes (N = 1510, 92%) and were on multiple daily injections (N = 1173, 71%). Twelve of the 18 trials had low risk of bias. The meta-analysis of 10 studies with available data on HbA1c showed that the use of a bolus advisor modestly reduced HbA1c compared to standard treatment (MD -011%, 95% confidence interval -0.22 to -0.01; I2 = 0%). This effect was accompanied by small improvements in low blood glucose index and treatment satisfaction, but not with reductions in hypoglycaemic events or changes in other secondary outcomes. CONCLUSION Use of a bolus advisor is associated with slightly better glucose control and treatment satisfaction in people with diabetes on intensive insulin treatment. Future studies should investigate whether personalizing bolus advisors using artificial intelligence technology can enhance these effects.
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Affiliation(s)
- Elisabeth J den Brok
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Cecilie H Svensson
- Department of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark
| | - Maria Panagiotou
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | | | - Peter R Mertens
- Department of Kidney and Hypertension Diseases, Diabetology and Endocrinology, Otto-Von-Guericke-Univeristat Magdeburg, Magdeburg, Germany
| | | | - Asimina Mitrakou
- Diabetes Center, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Gregor H L M Franssen
- University Library, Department Education, Content & Support, Maastricht University, Maastricht, The Netherlands
| | - Sander van Kuijk
- Clinical epidemiology & Medical Technology Assessment (KEMTA), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Stavroula Mougiakakou
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Ulrik Pedersen-Bjergaard
- Department of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Lausanne, Denmark
| | - Bastiaan E de Galan
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
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Ali SA, Salih SM, Abdelmola A, Makeen AM, Solan YM, Mohammed Ali MM. Association of Anxiety and Depressive Symptoms and Treatment Adherence Among Patients With Type 2 Diabetes Mellitus in Jazan, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e56068. [PMID: 38618389 PMCID: PMC11009697 DOI: 10.7759/cureus.56068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Diabetes mellitus is a serious public health concern. It is associated with many psychological problems, such as depression, anxiety, and eating disorders. These co-morbidities are associated with improper adherence to treatment, self-care, poor glycemic control, more complications, and worse outcomes. METHODS This study aimed to measure the level of medication adherence among type 2 diabetics in Jazan, Saudi Arabia, and to find its association with their psychological status (specifically, depression and anxiety). A cross-sectional descriptive design was used among adults with type 2 diabetes at the Diabetes and Endocrinology Center in Jazan, Saudi Arabia. The estimated sample size was 480 patients. The General Medication Adherence Scale and Patient Health Questionnaire-4 (PHQ-4) were used as tools to achieve the study objectives. RESULTS A total of 449 diabetic patients completed the survey (93.5% response rate). Patients with poor, low, and partial adherence account for 337 (75%) of patients and only 112 (25%) have good and high medication adherence. Employment and duration of illness were highly significant with a positive relationship to treatment adherence (p = 0.010 and 0.000, respectively). On the other hand, age and disease duration had a significant relationship with psychological disorders (p = 0.029 and 0.002, respectively). Of the patients, 64 (14.3%) had high scores on the PHQ-4, with depressive symptoms in 46 (10.24%) and anxiety symptoms in 75 (16.7%). Correlation analysis reveals that there is a highly significant negative correlation between psychological disorders and adherence to medications (r = -0.288, p = 0.000). CONCLUSION A negative correlation between psychological disorders and adherence to medications was found. The findings indicate the importance of psychological support for diabetic patients for better treatment adherence.
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Affiliation(s)
- Suhaila A Ali
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Sarah M Salih
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Amani Abdelmola
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Anwar M Makeen
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Yahia M Solan
- Department of Family Medicine, Jazan Diabetes and Endocrinology Center, Jazan, SAU
| | - Mona M Mohammed Ali
- Department of Pediatric Endocrinology, Jazan Diabetes and Endocrinology Center, Jazan, SAU
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Anwar A, Faisal F, Elahi W, Illahi A, Alam SM, Adnan STA, Batool SA, Bhagwandas S, Hashmi AA. Correlation of Blood Urea and Creatinine Levels With Thiamin Levels in Type 1 and Type 2 Diabetic Patients. Cureus 2024; 16:e57022. [PMID: 38681462 PMCID: PMC11046357 DOI: 10.7759/cureus.57022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Serum urea and creatinine levels are the most commonly recognized parameters for evaluating renal impairment in patients with diabetes mellitus (DM). Therefore, this study evaluated the correlation between urea and creatinine levels and thiamin levels in patients with type 1 DM (T1DM) and type 2 DM (T2DM). Methods This multi-center, cross-sectional study was conducted at diabetic outpatient clinics in Karachi. The duration of the study was six months, from 1st January 2023 to 30th June 2023. A total of 60 patients were enrolled and divided into two groups, i.e., T1DM and T2DM, each containing 30 patients of both genders between the ages of 24 and 42 years. Demographic data and biochemical variables, such as urea, creatinine, random blood sugar, fasting blood sugar, hemoglobin A1c, and serum thiamin levels, were assessed. The Mann-Whitney U test and independent t-test were used to associate the means between the two study groups. The chi-square test and Spearman's correlation coefficient were used to determine the associations between the variables and T1DM and T2DM. Results The study results revealed that patients with T2DM had a significantly higher frequency of hypertension (p = 0.039), neuropathy (p = 0.038), and coronary artery disease (p = 0.010) than those with T1DM, in both genders. The level of serum thiamin was found to be significantly higher (p < 0.001) in T2DM (14.8 ± 4.82) than in T1DM patients (7.34 ± 1.90). Similarly, serum creatinine was higher in T2DM than in T1DM patients (0.83 ± 0.12 vs. 0.76 ± 0.17, p = 0.025). Moreover, the correlation of urea and creatinine with thiamin levels in T1DM and T2DM patients revealed that in T1DM and T2DM patients, urea and creatinine showed an insignificant positive correlation with thiamin levels. Conclusion We found a significantly higher level of serum creatinine and thiamin levels in T2DM patients than in T1DM; however, there was no significant correlation between urea and creatinine levels and thiamin status in T1DM and T2DM patients. Therefore, we conclude that although serum urea, creatinine, and serum thiamin are important disease biomarkers in diabetic patients, there is no correlation between them.
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Affiliation(s)
- Adnan Anwar
- Physiology, Hamdard College of Medicine and Dentistry, Karachi, PAK
- Internal Medicine, Essa General Hospital, Karachi, PAK
| | | | - Wajeeha Elahi
- Nephrology, Hamdard University Hospital, Karachi, PAK
| | - Ahsan Illahi
- Community Medicine, Field Epidemiology Training Program, Sindh Government Hospital, Karachi, PAK
| | | | | | - Syed Asra Batool
- Medicine, Hamdard College of Medicine and Dentistry, Karachi, PAK
| | | | - Atif A Hashmi
- Pathology, Liaquat National Hospital and Medical College, Karachi, PAK
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Been RA, Noordstar E, Helmink MAG, van Sloten TT, de Ranitz-Greven WL, van Beek AP, Houweling ST, van Dijk PR, Westerink J. HbA 1c and fasting plasma glucose levels are equally related to incident cardiovascular risk in a high CVD risk population without known diabetes. Diagnosis (Berl) 2024; 0:dx-2024-0017. [PMID: 38414181 DOI: 10.1515/dx-2024-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/07/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES Type 2 diabetes (T2DM) is associated with increased risk for cardiovascular disease (CVD). Whether screen-detected T2DM, based on fasting plasma glucose (FPG) or on HbA1c, are associated with different risks of incident CVD in high-risk populations and which one is preferable for diabetes screening in these populations, remains unclear. METHODS 8,274 high-risk CVD participants were included from the UCC-SMART cohort. Participants were divided into groups based on prior T2DM diagnosis, and combinations of elevated/non-elevated FPG and HbA1c (cut-offs at 7 mmol/L and 48 mmol/mol, respectively): Group 0: known T2DM; group 1: elevated FPG/HbA1c; group 2: elevated FPG, non-elevated HbA1c; group 3: non-elevated FPG, elevated HbA1c; group 1 + 2: elevated FPG, regardless of HbA1c; group 1 + 3: elevated HbA1c, regardless of FPG; and group 4 (reference), non-elevated FPG/HbA1c. RESULTS During a median follow-up of 6.3 years (IQR 3.3-9.8), 712 cardiovascular events occurred. Compared to the reference (group 4), group 0 was at increased risk (HR 1.40; 95 % CI 1.16-1.68), but group 1 (HR 1.16; 95 % CI 0.62-2.18), 2 (HR 1.18; 95 % CI 0.84-1.67), 3 (HR 0.61; 95 % CI 0.15-2.44), 1 + 2 (HR 1.17; 95 % CI 0.86-1.59) and 1 + 3 (HR 1.01; 95 % CI 0.57-1.79) were not. However, spline interpolation showed a linearly increasing risk with increasing HbA1c/FPG, but did not allow for identification of other cut-off points. CONCLUSIONS Based on current cut-offs, FPG and HbA1c at screening were equally related to incident CVD in high-risk populations without known T2DM. Hence, neither FPG, nor HbA1c, is preferential for diabetes screening in this population with respect to risk of incident CVD.
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Affiliation(s)
- Riemer A Been
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ellen Noordstar
- Department of Internal Medicine, Isala Hospital, Zwolle, The Netherlands
| | - Marga A G Helmink
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Thomas T van Sloten
- Department of Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - André P van Beek
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Peter R van Dijk
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan Westerink
- Department of Internal Medicine, Isala Hospital, Zwolle, The Netherlands
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Alkahtani A, Anderson P, Baysan A. The impact of sociodemographic determinants and diabetes type-2 on oral health outcomes: An analytical cross-sectional study. Clin Exp Dent Res 2024; 10:e846. [PMID: 38345485 PMCID: PMC10828913 DOI: 10.1002/cre2.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/03/2024] [Accepted: 01/12/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES This study compared adults with type 2 diabetes (T2DM) and those without diabetes (ND) from East London in terms of sociodemographic characteristics, oral health behaviors, dietary practices, and alcohol and tobacco-related habits. MATERIALS AND METHODS A total of 182 participants (n = 91 for each group) were recruited and requested to complete the validated questionnaire with 33 items. RESULTS Results showed that the mean ± SD age was 61 ± 11.7 in the T2DM, while 51 ± 11.2 in the ND group. The mean ± SD age at T2DM diagnosis was 43 ± 10. There was a significant gender difference, with more males in the T2DM group (67.7%) and more females in the ND group (64.8%). Asian-British (38.4%) were significantly high in the T2DM group when compared to other ethnicities. 92.3% of T2DM participants were significantly more likely to use medications in comparison to the ND group (29.7%). The T2DM participants' personal statements on general health were fair (34%) and good (46.2%) when compared with the ND group (15.4% and 59.3%, respectively). The majority of T2DM and ND participants (98%) lacked dental insurance. In the T2DM group, 31.8% were receiving benefits, and 39.5% were retired, while 46% of the ND group were full-time employees. Tooth brushing twice a day was slightly less common in T2DM (68%) when compared to the ND group (78%). Nearly half of the participants in both groups failed to carry out interdental cleaning (T2DM = 52%; ND = 47%), and 38.5% of the T2DM group used mouthwash occasionally, while 30% of the ND group had it twice daily. There was a weak association between chewing paan and annual income in ND participants (r = .90, p = .49). There were significant differences in the presence of removable prostheses, juice, and sweetened juice consumptions between the two groups (p < .05). CONCLUSION Within the confines of this study, being male, Asian British, retired due to disability, polypharmacy, and the presence of removable prostheses were all significant factors for T2DM.
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Affiliation(s)
- Ashwaq Alkahtani
- Institute of Dentistry, Bart's and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
- The College of Applied Medical Sciences (CAMS)King Saud UniversityRiyadhSaudi Arabia
| | - Paul Anderson
- Institute of Dentistry, Bart's and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Aylin Baysan
- Institute of Dentistry, Bart's and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
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Alblowi JA, Farid ZS, Attia MS. Comparative Study of Azithromycin Versus Doxycycline Effect on the Resistin Level in Periodontitis Patients With Type 2 Diabetes: A Randomized Controlled Clinical Trial. Cureus 2024; 16:e54849. [PMID: 38533160 PMCID: PMC10964125 DOI: 10.7759/cureus.54849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
AIM The present study aimed to determine if azithromycin (AZM) and doxycycline therapy, as an adjunct to scaling and root planning (SRP), modulate host response and improve clinical outcomes in periodontitis patients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS Forty-five periodontal sites in 15 periodontitis patients with T2DM received nonsurgical periodontal therapy (NSPT). In Group I, patients were placebo (not receiving any medication), Group II patients received systemic AZM therapy (AZM 250 mg/day for five days), and Group III patients received doxycycline (20 mg twice per day for three months. The resistin level was collected and measured by enzyme-linked immunosorbent assay (ELISA). Gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, one-month, and three-month intervals. RESULTS All groups showed improvement in clinical parameters and resistin levels throughout the study. The mean resistin level at three months was the highest in Group I and the lowest in Group III. Patients in Group II showed a larger decrease in mean PD than those in Group I and III. Group III had the highest gain in mean CAL, with an increase of 1.78 mm in attachment. CONCLUSION Resistin might be a useful indicator of current disease status. In addition, benefits from adjunctive systemic use of AZM and doxycycline have been administered with non-surgical periodontal therapy.
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Affiliation(s)
- Jazia A Alblowi
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Zienab S Farid
- Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Faculty of Dental Medicine, Al-Azhar University (Girls Branch), Cairo, EGY
| | - Mai S Attia
- Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Faculty of Dental Medicine, Al-Azhar University (Girls Branch), Cairo, EGY
- Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Faculty of Dental Medicine, Misr International University, Cairo, EGY
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Błaszczyk R, Petniak A, Bogucki J, Kocki J, Wysokiński A, Głowniak A. Association between Resistant Arterial Hypertension, Type 2 Diabetes, and Selected microRNAs. J Clin Med 2024; 13:542. [PMID: 38256676 PMCID: PMC10816137 DOI: 10.3390/jcm13020542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION In recent years, a very close relationship between miRNA and cardiovascular diseases has been found. RAH and T2DM are accompanied by a change in the microRNA expression spectrum. OBJECTIVES This study aimed to evaluate the clinical characteristics and expression of selected microRNAs in patients with idiopathic RAH and T2DM. PATIENTS AND METHODS A total of 115 patients with RAH were included in this study. Among them were 53 patients (46.09%) with T2DM. miRNA levels were determined using quantitative real-time polymerase chain reaction. The expression of the examined genes was calculated from the formula RQ = 2-ΔΔCT. RESULTS Analysis using the Mann-Whitney U test showed a statistically significant (p < 0.05) difference in the expression of MIR1-1 (p = 0.031) and MIR195 (p = 0.042) associated with the occurrence of T2DM in the subjects. The value of MIR1-1 gene expression was statistically significantly higher in patients with T2DM (median: 0.352; mean: 0.386; standard deviation: 0.923) compared to patients without T2DM (median: 0.147; mean: -0.02; standard deviation: 0.824). The value of MIR195 gene expression was statistically significantly higher in patients with T2DM (median: 0.389, mean: 0.442; standard deviation: 0.819) compared to patients without T2DM (median: -0.027; mean: 0.08; standard deviation: 0.942). CONCLUSIONS The values of MIR1-1 and MIR195 gene expression were statistically significantly higher in patients with RAH and T2DM compared to patients with RAH and without T2DM. Further studies are necessary to precisely clarify the roles of miRNAs in patients with RAH and T2DM. They should demonstrate the utility of these genetic markers in clinical practice.
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Affiliation(s)
- Robert Błaszczyk
- Department of Cardiology, Medical University of Lublin, 20-090 Lublin, Poland
| | - Alicja Petniak
- Department of Clinical Genetics, Medical University of Lublin, 20-080 Lublin, Poland
| | - Jacek Bogucki
- Department of Organic Chemistry, Medical University of Lublin, 20-093 Lublin, Poland
| | - Janusz Kocki
- Department of Clinical Genetics, Medical University of Lublin, 20-080 Lublin, Poland
| | - Andrzej Wysokiński
- Department of Cardiology, Medical University of Lublin, 20-090 Lublin, Poland
| | - Andrzej Głowniak
- Department of Cardiology, Medical University of Lublin, 20-090 Lublin, Poland
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Josefsson C, Liljeroos T, Hellgren M, Pöder U, Hedström M, Olsson EMG. The Sukaribit Smartphone App for Better Self-Management of Type 2 Diabetes: Randomized Controlled Feasibility Study. JMIR Form Res 2024; 8:e46222. [PMID: 38198200 PMCID: PMC10809162 DOI: 10.2196/46222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 09/15/2023] [Accepted: 11/24/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND A new app, Sukaribit, was designed to enable contact between the caregiver and the patient with the intent to improve self-care and glycemic control (hemoglobin A1c [HbA1c]). OBJECTIVE This study investigated the feasibility of the study methodology and the intervention in preparation for a larger effectiveness study. METHODS Adults with type 2 diabetes were recruited in this randomized controlled feasibility study with a mixed methods design. The intervention group (n=28) tried Sukaribit for 2 months. They were encouraged to report blood glucose levels and medications, and they received feedback from a physician. The control group (n=31) received standard care. Both groups were evaluated with pre and postmeasurements of glycemic control (HbA1c), diabetes distress, physical activity, and self-care. Feasibility was evaluated against 5 progression criteria regarding recruitment, study methods, and active participation. RESULTS Of the 5 progression criteria, only 2 were met or partially met. The recruitment process exceeded expectations, and data collection worked well for self-reported data but not for HbA1c measured with a home testing kit. The participants were less active than anticipated, and the effect sizes were small. Only the number of blood glucose tests per day was positively affected by the intervention, with 0.6 more tests per day in the intervention group. CONCLUSIONS Recruitment of participants to a future fully powered study may work with minor adjustments. The collection of HbA1c using home testing constituted a major problem, and an alternative strategy is warranted. Finally, the app was not used as intended. In order to proceed with a larger study, the app and study procedures need improvement.
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Affiliation(s)
- Cecilia Josefsson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Thea Liljeroos
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Ulrika Pöder
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mariann Hedström
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Erik M G Olsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Hakami AM, Almutairi B, Alanazi AS, Alzahrani MA. Effect of Mobile Apps on Medication Adherence of Type 2 Diabetes Mellitus: A Systematic Review of Recent Studies. Cureus 2024; 16:e51791. [PMID: 38192533 PMCID: PMC10772302 DOI: 10.7759/cureus.51791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 01/10/2024] Open
Abstract
Medication adherence is a critical aspect of managing type 2 diabetes mellitus (T2DM) and achieving optimal clinical outcomes. Mobile app-based interventions have emerged as a promising tool to enhance adherence and glycemic control in T2DM patients. This systematic review aims to evaluate the effectiveness of mobile app interventions in improving medication adherence and glycated hemoglobin among T2DM patients. A comprehensive search was conducted in PubMed, Cochrane Library, and Google Scholar for studies published between September 2018 and September 2023. Studies were included if they were published in English and investigated the effectiveness of mobile apps in enhancing medication adherence among patients with T2DM. Studies were excluded if they included additional interventions, such as electronic pillboxes, phone calls, or SMS text messages, or if they focused on populations with chronic illnesses other than T2DM. Five studies involving 527 participants from diverse geographic locations were included in the review. The findings from the included studies show that mobile-based app interventions can significantly improve medication adherence in patients with T2DM. From the included studies, the mean HbA1c change for the intervention group was -0.664 (95%CI -0.823 to -0.506), while the mean change in HbA1c for the control group was -0.103 (95%CI -0.305 to 0.099). Studies have demonstrated the potential of mobile app-based interventions to enhance medication adherence and improve glycemic control in T2DM; further research is needed to determine the long-term effects of these interventions.
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Affiliation(s)
| | - Bader Almutairi
- Family Medicine, King Fahad Military Medical Complex, Dammam, SAU
| | - Ahmad S Alanazi
- Family Medicine, King Fahad Military Medical Complex, Dammam, SAU
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11
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Satarug S. Is Environmental Cadmium Exposure Causally Related to Diabetes and Obesity? Cells 2023; 13:83. [PMID: 38201287 PMCID: PMC10778334 DOI: 10.3390/cells13010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
Cadmium (Cd) is a pervasive toxic metal, present in most food types, cigarette smoke, and air. Most cells in the body will assimilate Cd, as its charge and ionic radius are similar to the essential metals, iron, zinc, and calcium (Fe, Zn, and Ca). Cd preferentially accumulates in the proximal tubular epithelium of the kidney, and is excreted in urine when these cells die. Thus, excretion of Cd reflects renal accumulation (body burden) and the current toxicity of Cd. The kidney is the only organ other than liver that produces and releases glucose into the circulation. Also, the kidney is responsible for filtration and the re-absorption of glucose. Cd is the least recognized diabetogenic substance although research performed in the 1980s demonstrated the diabetogenic effects of chronic oral Cd administration in neonatal rats. Approximately 10% of the global population are now living with diabetes and over 80% of these are overweight or obese. This association has fueled an intense search for any exogenous chemicals and lifestyle factors that could induce excessive weight gain. However, whilst epidemiological studies have clearly linked diabetes to Cd exposure, this appears to be independent of adiposity. This review highlights Cd exposure sources and levels associated with diabetes type 2 and the mechanisms by which Cd disrupts glucose metabolism. Special emphasis is on roles of the liver and kidney, and cellular stress responses and defenses, involving heme oxygenase-1 and -2 (HO-1 and HO-2). From heme degradation, both HO-1 and HO-2 release Fe, carbon monoxide, and a precursor substrate for producing a potent antioxidant, bilirubin. HO-2 appears to have also anti-diabetic and anti-obese actions. In old age, HO-2 deficient mice display a symptomatic spectrum of human diabetes, including hyperglycemia, insulin resistance, increased fat deposition, and hypertension.
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Affiliation(s)
- Soisungwan Satarug
- Kidney Disease Research Collaborative, Translational Research Institute, Woolloongabba, Brisbane, QLD 4102, Australia
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12
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Hellstrand Tang U, Scandurra I, Sundberg L, Annersten Gershater M, Zügner R. Patients' Expectations of Evidence-Based Service at the Pharmacy Regarding Information on Self-Care of the Feet for Persons with Diabetes at Risk of Developing Foot Ulcers - A Cross-Sectional Observational Study in Sweden. Patient Prefer Adherence 2023; 17:3557-3576. [PMID: 38169667 PMCID: PMC10758569 DOI: 10.2147/ppa.s435632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose Self-care of the feet is one of the cornerstones in the prevention of diabetic foot ulcers (DFU). Often, individuals with diabetes seek help at the pharmacy, but it is still unclear whether the service meets their expectations and needs. The aims were to explore patients' expectations of support from the pharmacy regarding self-care of their feet and explore how patients with diabetes felt that they managed the self-care of their feet. Patients and Methods The included participants (n = 17), aged 70 ± 9 years, answered surveys regarding their expectations of support from the pharmacy related to self-care of the feet and how they felt that they managed the self-care of their feet. By using software, MyFoot Diabetes, they assessed their risk of developing DFU (ranging from 1 = no risk to 4 = DFU). In addition, a healthcare professional assessed the risk grade. Results Sixteen patients had not received any information from the pharmacy regarding how to take care of their feet. Several suggestions for ways the pharmacy could help patients with diabetes to take care of their feet were registered. They included having the necessary skills and competence, giving advice regarding self-care, giving information regarding the products they market and have for sale and giving advice on ointments/creams. The participants gave several examples of how they self-managed their feet: by wearing shoes indoors and outdoors, wearing socks and compression stockings as often as possible, being physically active, inspecting their feet, being aware of the fact that their feet have no problems, washing, moisturising their feet, cutting their nails and finally seeking help to prevent DFU. Conclusion The participants thought that they should receive competent information from the personnel at the pharmacy to improve the self-care of their feet, eg, being given information about which ointments/creams to use. Clinical Trial NCT05692778.
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Affiliation(s)
- Ulla Hellstrand Tang
- Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy,University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Isabella Scandurra
- Centre of Empirical Research in Information Systems, Örebro University, Örebro, Sweden
| | | | | | - Roland Zügner
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy,University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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13
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Song Y, Beltran Puerta J, Medina-Aedo M, Canelo-Aybar C, Valli C, Ballester M, Rocha C, Garcia ML, Salas-Gama K, Kaloteraki C, Santero M, Niño de Guzmán E, Spoiala C, Gurung P, Willemen F, Cools I, Bleeker J, Poortvliet R, Laure T, van der Gaag M, Pacheco-Barrios K, Zafra-Tanaka J, Mavridis D, Angeliki Veroniki A, Zevgiti S, Seitidis G, Alonso-Coello P, Groene O, González-González AI, Sunol R, Orrego C, Heijmans M. Self-Management Interventions for Adults Living with Type II Diabetes to Improve Patient-Important Outcomes: An Evidence Map. Healthcare (Basel) 2023; 11:3156. [PMID: 38132046 PMCID: PMC10742682 DOI: 10.3390/healthcare11243156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/03/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
Self-management interventions (SMIs) may be promising in the treatment of Diabetes Mellitus Type 2 (T2DM). However, accurate comparisons of their relative effectiveness are challenging, partly due to a lack of clarity and detail regarding the intervention content being evaluated. This study summarizes intervention components and characteristics in randomized controlled trials (RCTs) related to T2DM using a taxonomy for SMIs as a framework and identifies components that are insufficiently incorporated into the design of the intervention or insufficiently reported. Following evidence mapping methodology, we searched MEDLINE, CINAHL, Embase, Cochrane, and PsycINFO from 2010 to 2018 for randomized controlled trials (RCTs) on SMIs for T2DM. We used the terms 'self-management', 'adult' and 'T2DM' for content. For data extraction, we used an online platform based on the taxonomy for SMIs. Two independent reviewers assessed eligible references; one reviewer extracted data, and a second checked accuracy. We identified 665 RCTs for SMIs (34% US, 21% Europe) including 164,437 (median 123, range 10-14,559) adults with T2DM. SMIs highly differed in design and content, and characteristics such as mode of delivery, intensity, location and providers involved were poorly described. The majority of interventions aimed to improve clinical outcomes like HbA1c (83%), weight (53%), lipid profile (45%) or blood pressure (42%); 27% (also) targeted quality of life. Improved knowledge, health literacy, patient activation or satisfaction with care were hardly used as outcomes (<16%). SMIs most often used education (98%), self-monitoring (56%), goal-setting (48%) and skills training (42%) to improve outcomes. Management of emotions (17%) and shared decision-making (5%) were almost never mentioned. Although diabetes is highly prevalent in some minority groups, in only 13% of the SMIs, these groups were included. Our findings highlight the large heterogeneity that exists in the design of SMIs for T2DM and the way studies are reported, making accurate comparisons of their relative effectiveness challenging. In addition, SMIs pay limited attention to outcomes other than clinical, despite the importance attached to these outcomes by patients. More standardized and streamlined research is needed to better understand the effectiveness and cost-effectiveness of SMIs of T2DM and benefit patient care.
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Affiliation(s)
- Yang Song
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
| | - Jessica Beltran Puerta
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
| | - Melixa Medina-Aedo
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
| | - Carlos Canelo-Aybar
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
| | - Claudia Valli
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain; (M.B.); (K.P.-B.); (J.Z.-T.); (A.I.G.-G.); (R.S.); (C.O.)
- Faculty of Medicine, Universitat Autὸnoma de Barcelona (UAB), 08025 Barcelona, Spain
| | - Marta Ballester
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain; (M.B.); (K.P.-B.); (J.Z.-T.); (A.I.G.-G.); (R.S.); (C.O.)
- Faculty of Medicine, Universitat Autὸnoma de Barcelona (UAB), 08025 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Claudio Rocha
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
| | - Montserrat León Garcia
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
| | - Karla Salas-Gama
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
| | - Chrysoula Kaloteraki
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
| | - Marilina Santero
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
| | - Ena Niño de Guzmán
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
| | - Cristina Spoiala
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (C.S.); (P.G.); (F.W.); (I.C.); (J.B.); (R.P.); (T.L.)
| | - Pema Gurung
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (C.S.); (P.G.); (F.W.); (I.C.); (J.B.); (R.P.); (T.L.)
| | - Fabienne Willemen
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (C.S.); (P.G.); (F.W.); (I.C.); (J.B.); (R.P.); (T.L.)
| | - Iza Cools
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (C.S.); (P.G.); (F.W.); (I.C.); (J.B.); (R.P.); (T.L.)
| | - Julia Bleeker
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (C.S.); (P.G.); (F.W.); (I.C.); (J.B.); (R.P.); (T.L.)
| | - Rune Poortvliet
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (C.S.); (P.G.); (F.W.); (I.C.); (J.B.); (R.P.); (T.L.)
| | - Tajda Laure
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (C.S.); (P.G.); (F.W.); (I.C.); (J.B.); (R.P.); (T.L.)
| | - Marieke van der Gaag
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (C.S.); (P.G.); (F.W.); (I.C.); (J.B.); (R.P.); (T.L.)
| | - Kevin Pacheco-Barrios
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain; (M.B.); (K.P.-B.); (J.Z.-T.); (A.I.G.-G.); (R.S.); (C.O.)
| | - Jessica Zafra-Tanaka
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain; (M.B.); (K.P.-B.); (J.Z.-T.); (A.I.G.-G.); (R.S.); (C.O.)
| | - Dimitris Mavridis
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (D.M.); (S.Z.); (G.S.)
| | - Areti Angeliki Veroniki
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada;
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON M5S 3G8, Canada
| | - Stella Zevgiti
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (D.M.); (S.Z.); (G.S.)
| | - Georgios Seitidis
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (D.M.); (S.Z.); (G.S.)
| | - Pablo Alonso-Coello
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain; (Y.S.); (J.B.P.); (M.M.-A.); (C.C.-A.); (C.V.); (C.R.); (M.L.G.); (K.S.-G.); (M.S.); (E.N.d.G.); (P.A.-C.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Oliver Groene
- OptiMedis, 20095 Hamburg, Germany;
- Faculty of Management, Economics and Society, University of Witten/Herdecke, 58455 Witten, Germany
| | - Ana Isabel González-González
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain; (M.B.); (K.P.-B.); (J.Z.-T.); (A.I.G.-G.); (R.S.); (C.O.)
- Faculty of Medicine, Universitat Autὸnoma de Barcelona (UAB), 08025 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Rosa Sunol
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain; (M.B.); (K.P.-B.); (J.Z.-T.); (A.I.G.-G.); (R.S.); (C.O.)
- Faculty of Medicine, Universitat Autὸnoma de Barcelona (UAB), 08025 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Carola Orrego
- Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain; (M.B.); (K.P.-B.); (J.Z.-T.); (A.I.G.-G.); (R.S.); (C.O.)
- Faculty of Medicine, Universitat Autὸnoma de Barcelona (UAB), 08025 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | - Monique Heijmans
- Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands; (C.S.); (P.G.); (F.W.); (I.C.); (J.B.); (R.P.); (T.L.)
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Polhuis KCMM, Koelen MA, Bouwman LI, Vaandrager L. Qualitative evaluation of a Salutogenic Healthy Eating Programme for Dutch people with type 2 diabetes. Health Promot Int 2023; 38:daad170. [PMID: 38109459 PMCID: PMC10727492 DOI: 10.1093/heapro/daad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Abstract
The salutogenic model of health (SMH) is a health-promoting theory that focuses on resources, strengths, and coping capacities in everyday life as a way to improve health and wellbeing. The SMH was applied to develop a programme for enabling healthy eating practices among people with type 2 diabetes mellitus (T2DM): the SALUD programme. This study aims to gain insight in how participants with T2DM experienced the content and meaning of the SALUD programme. Three focus groups with participants (six to eight participants/group) that finished the SALUD programme were conducted. The focus groups were video-recorded, transcribed ad verbatim and thematically analysed. The SALUD programme was perceived by the participants as a positive, meaningful learning experience. Key factors why the participants described the programme as positive were that they felt a sense of social-belonging and (emotionally) safe (theme 1). The SALUD programme's positive encouraging approach presented by the coach invited participants to join an active learning process (theme 2). Performing trial-and-error experiments and weekly reflecting on goals is what characterized active learning. The meaningfulness of the learning process (theme 3) was derived from (i) positive self-confrontation; (ii) exploring mind-body connections and perceiving improved health and (iii) noticing positive changes in their social environment (theme 3). To conclude, the study uncovered that the SALUD programme incited a positive, meaningful learning process for healthy eating and the contextual factors important in this. Potential leads to further improve the SALUD programme are discussed in order to maximize the chance of inciting an inclusive, active learning process.
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Affiliation(s)
- Kristel C M M Polhuis
- Health and Society, Social Sciences, Wageningen University and Research, Hollandseweg 1, P.O. Box 8130, 6707 KN, Wageningen, The Netherlands
| | - Maria A Koelen
- Health and Society, Social Sciences, Wageningen University and Research, Hollandseweg 1, P.O. Box 8130, 6707 KN, Wageningen, The Netherlands
| | - Laura I Bouwman
- Health and Society, Social Sciences, Wageningen University and Research, Hollandseweg 1, P.O. Box 8130, 6707 KN, Wageningen, The Netherlands
| | - Lenneke Vaandrager
- Health and Society, Social Sciences, Wageningen University and Research, Hollandseweg 1, P.O. Box 8130, 6707 KN, Wageningen, The Netherlands
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15
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Zaw E, Bies JJ, Zay H, Massebo E, Hassan M, Prakash S, Htay T, Lane M. A Rare Case of Page Kidney With Superimposed Infection. Cureus 2023; 15:e50842. [PMID: 38249211 PMCID: PMC10798362 DOI: 10.7759/cureus.50842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Page kidney (PK) is a rare renal condition characterized by external compression of the kidney, typically by a subcapsular hematoma, leading to resistant secondary hypertension due to hypoperfusion and ischemia. This hypertension is caused by the external compression of the kidney by a chronic subcapsular hematoma that activates the renin-angiotensin-aldosterone system (RAAS) system. Hematoma formation can result from external or internal trauma. The resolution of the hematoma can take months, and, in some cases, may necessitate a nephrectomy. Unresolved subcapsular hematomas can be complicated by infection, leading to sepsis, hospitalization, and the need for surgical drainage. This report presents a unique case of a 67-year-old female with a spontaneous left renal subcapsular hematoma that did not resolve with conservative measures and was complicated by superimposed infection requiring percutaneous drainage.
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Affiliation(s)
- Emerald Zaw
- Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Jared J Bies
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Hein Zay
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Eyoab Massebo
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Mariam Hassan
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Swathi Prakash
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Thwe Htay
- Medical Education, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Mariela Lane
- Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
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16
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Albeshry AM, Abdulrahman Alasmari M, Alshahrani JA, Alshahrani AM, Saad Almusma A, Alfaya MA, Alfaifi AJ, Alshahrani MA, Alharbi HKD, Ali Etwdi AS, Aldawsari E, Zakir Hiyat Moazam SM, Alshaiban M, Al-Harthi SN. Prevalence of Non-alcoholic Fatty Liver Disease (NAFLD) Among Diabetic Mellitus Patients in Saudi Arabia: Systematic Review and Meta-Analysis. Cureus 2023; 15:e51092. [PMID: 38283461 PMCID: PMC10810724 DOI: 10.7759/cureus.51092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2023] [Indexed: 01/30/2024] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a burgeoning global health concern, closely associated with the rising prevalence of type 2 diabetes mellitus (T2DM) and obesity. This systematic review and meta-analysis aim to comprehensively evaluate the prevalence of NAFLD in DM patients in Saudi Arabia, a country undergoing rapid socioeconomic changes. Our multifaceted search strategy identified four high-quality studies conducted between 2003 and 2022, covering hospital and community settings. The aggregate prevalence rate of NAFLD in DM patients was notably high, ranging from 47.8% to 72.8%. However, substantial heterogeneity (I² = 90.6%) was observed, indicating variability attributed to diverse study characteristics. The uniform application of ultrasound for diagnosis was noteworthy but raised concerns regarding sensitivity. This analysis underscores the urgency of public health measures for early detection and management of NAFLD in DM-prone populations in Saudi Arabia.
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Affiliation(s)
| | | | | | | | | | - Mohammed A Alfaya
- Family Medicine, Armed Forces Hospital Southern Region, Khamis Mushit, SAU
| | - Ali J Alfaifi
- Family and Community Medicine, King Khalid University, Abha, SAU
| | - Mastoor A Alshahrani
- Family Medicine, Primary Health Care Corporation (PHCC) Khamis Mushait Sector, Ministry of Health, Khamis Mushit, SAU
| | | | - Ali S Ali Etwdi
- Laboratory, Armed Forces Hospital Southern Region, Khamis Mushit, SAU
| | - Eyad Aldawsari
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Tewari J, Roy S, Rana A, Tewari A. Cost-Effective Offloading of Diabetic Foot Ulcer in a Resource-Crunch Setting: A Case Report. Cureus 2023; 15:e51173. [PMID: 38283420 PMCID: PMC10815781 DOI: 10.7759/cureus.51173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Diabetic foot ulcers (DFUs) pose a significant threat to people with diabetes, particularly in regions with limited healthcare resources, such as India. This case report focuses on a cost-effective offloading strategy for managing a chronic non-healing heel ulcer in a 55-year-old female with uncontrolled type 2 diabetes mellitus. While the gold standard for DFU management often involves total contact casts, this method may not be practical for all patients. Our approach involved repurposing used gloves and surgical paper tape for offloading, resulting in quick healing of the ulcer within six weeks. Achieving euglycemic status and sufficient wound debridement were key components of the treatment. This case highlights the importance of resource-efficient strategies in DFU management, especially in settings where traditional methods face practical limitations. Future research is needed to validate the efficacy of such approaches and pave the way for more accessible and effective treatments for DFUs.
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Affiliation(s)
- Jay Tewari
- Internal Medicine, King George's Medical University, Lucknow, IND
| | - Shubhajeet Roy
- Faculty of Medicine, King George's Medical University, Lucknow, IND
| | - Anadika Rana
- Internal Medicine, King George's Medical University, Lucknow, IND
| | - Ajoy Tewari
- Diabetes and Endocrinology, Jai Clinic & Diabetes Care Center, Lucknow, IND
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18
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Zikou E, Dovrolis N, Dimosthenopoulos C, Gazouli M, Makrilakis K. The Effect of Probiotic Supplements on Metabolic Parameters of People with Type 2 Diabetes in Greece-A Randomized, Double-Blind, Placebo-Controlled Study. Nutrients 2023; 15:4663. [PMID: 37960315 PMCID: PMC10647535 DOI: 10.3390/nu15214663] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/16/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
The role of probiotic supplementation in type 2 diabetes (T2D) treatment is controversial. The present study aimed to assess the effects of a multi-strain probiotic supplement (LactoLevureR (containing Lactobacillus acidophilus, Lactobacillus plantarum, Bifidobacterium lactis, and Saccharomyces boulardii)) over 6 months, primarily on glycemic control as well as on lipid levels and alterations in the gut microbiome, among individuals with T2D residing in Greece. A total of 91 adults with T2D (mean age [±SD] 65.12 ± 10.92 years, 62.6% males) were randomized to receive the probiotic supplement or a matching placebo capsule, once daily, for 6 months. Blood chemistries and anthropometric parameters were conducted every 3 months, and stool samples were collected at baseline and at 6 months. Significant reductions in HbA1c, fasting blood glucose, and total cholesterol were observed in participants treated with the probiotic supplement (n = 46) compared to the controls (n = 45), even after adjustment for a greater decrease in adiposity (waist circumference). Although there were no statistically significant differences in the diversity of the gut microbiome (α and β diversity), the administration of probiotics did influence several genera, metabolites, and key enzymes associated with diabetes. Overall, the administration of the multi-strain probiotic LactoLevureR over a 6-month period in individuals with T2D was well-tolerated and had a positive impact on metabolic parameters, alongside improvements in indices of adiposity.
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Affiliation(s)
- Eva Zikou
- First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 11527 Athens, Greece; (E.Z.); (C.D.)
| | - Nikolas Dovrolis
- Department of Basic Medical Sciences, Laboratory of Biology, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece; (N.D.); (M.G.)
| | - Charilaos Dimosthenopoulos
- First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 11527 Athens, Greece; (E.Z.); (C.D.)
| | - Maria Gazouli
- Department of Basic Medical Sciences, Laboratory of Biology, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece; (N.D.); (M.G.)
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 11527 Athens, Greece; (E.Z.); (C.D.)
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Haddadin R, Tonna RF, Iqbal H, Valenta J, Iraninezhad H. A Rare Case of Sodium-Glucose Cotransporter-2 Inhibitor-Induced Acute Pancreatitis. Cureus 2023; 15:e49369. [PMID: 38146577 PMCID: PMC10749287 DOI: 10.7759/cureus.49369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2023] [Indexed: 12/27/2023] Open
Abstract
Acute pancreatitis is an acute inflammatory process of the pancreas that requires hospital admission and treatment. There are many causes of pancreatitis, the most common being gallstone and alcohol-induced; other reasons include metabolic, infectious, and medication-induced. A new medication that has come to the market is empagliflozin, which is a sodium-glucose cotransporter-2 inhibitor that is common in managing type 2 diabetes mellitus and congestive heart failure. Although generally considered safe and effective, rare adverse effects have been reported. In this case, we present a 67-year-old female patient who presented with severe acute pancreatitis after two weeks of starting empagliflozin to treat her type 2 diabetes. This case report highlights the importance of considering rare adverse events associated with empagliflozin and the need for close monitoring of patients receiving this medication.
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Affiliation(s)
| | - Roger F Tonna
- Internal Medicine, MountainView Hospital, Las Vegas, USA
| | - Humzah Iqbal
- Internal Medicine, University of California San Francisco, Fresno, Fresno, USA
| | - Jordan Valenta
- Internal Medicine, MountainView Hospital, Las Vegas, USA
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20
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Ekomwereren O, Sunkara V, Grezenko H, Hamid YH, Faran N, Abubakar M. Orbital Onset: The Intricate Journey From Ear Abscess to Cavernous Sinus Thrombosis in a Diabetic Male. Cureus 2023; 15:e48922. [PMID: 38106764 PMCID: PMC10725519 DOI: 10.7759/cureus.48922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 12/19/2023] Open
Abstract
Cavernous sinus thrombosis (CST) is a rare, yet severe condition often linked to infections in the nasal and facial areas. We present a case of a 43-year-old male farmer with diabetes who initially showed ear abscess symptoms that progressed to vision loss and CST-like symptoms. Self-treatment and an unidentified medication regimen may have worsened his condition. Advanced diagnostic evaluations, particularly magnetic resonance imaging with magnetic resonance venography, confirmed CST, likely originating from the ear infection spreading to the eyes, causing bilateral orbital cellulitis. Treatment with antibiotics, anticoagulants, and supportive therapy stabilized the patient's condition. This case emphasizes the importance of early detection and intervention in CST, especially in atypical presentations, and the need for comprehensive diagnostic and therapeutic approaches.
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Affiliation(s)
- Osatohanmwen Ekomwereren
- Trauma and Orthopaedics, Royal Shrewsbury Hospital, Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, GBR
| | | | - Han Grezenko
- Medicine and Surgery, Guangxi Medical University, Nanning, CHN
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Yusra H Hamid
- Community Medicine, University of Khartoum Faculty of Medicine, Khartoum, SDN
| | - Nuzhat Faran
- Internal Medicine, Fatima Memorial Hospital, Lahore, PAK
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21
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Mondal A, Debnath A, Dhandapani G, Sharma A, Lukhmana S, Yadav G. Prevalence of High and Moderate Risk of Liver Fibrosis Among Patients With Diabetes at a Noncommunicable Diseases (NCD) Clinic in a Primary Healthcare Center in Northern India. Cureus 2023; 15:e49286. [PMID: 38143613 PMCID: PMC10747424 DOI: 10.7759/cureus.49286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Background Diabetes is a known entity that contributes to increased incidence and progress of liver fibrosis. Despite the integration of nonalcoholic fatty liver disease (NAFLD) into the NP-NCD program (National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke [NPCDCS]), screening individuals in primary healthcare settings for liver fibrosis remains uncommon. The objective of this study was to determine the prevalence of the risk of liver fibrosis in individuals with diabetes. Methodology The secondary data analysis was conducted among patients with diabetes attending the noncommunicable diseases (NCD) clinic at the Primary Health Center (PHC) Najafgarh, Delhi, from January 2023 to June 2023. We used the Fibrosis-4 (FIB-4) score to assess the risk of liver fibrosis. The data analysis was carried out using Stata 17.0 software (StataCorp, College Station, TX). Results Out of 394 individuals screened, 158 (39.5%) were male and 236 (60.5%) were female. Among the study participants, 64.9% (95% confidence interval [CI] 60.0%-69.7%) were of low risk, 30.5% (95% CI 25.9%-35.3%) were of intermediate risk, and 4.6% (95% CI 2.7%-7.1%) were of high risk of developing liver fibrosis based on FIB-4 scoring. The increased risk was associated with increased age, duration of diabetes, and dyslipidemia. Conclusions The prevalence of high risk of liver fibrosis among patients with diabetes was 4.6% (95% CI 2.7%-7.1%), whereas an intermediate risk of developing liver fibrosis was observed in 30.5%. The study advocates integrating these screening tools into primary healthcare settings, alleviating the strain on larger healthcare facilities. It also underscores the importance of early detection and management of liver fibrosis in patients with diabetes.
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Affiliation(s)
- Anubhav Mondal
- Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Aninda Debnath
- Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Ghurumourthy Dhandapani
- Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Abhishek Sharma
- Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Shveta Lukhmana
- Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
| | - Geeta Yadav
- Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
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22
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Akhaury K, Wanjari A, Sinha AH, Kumar M. Hypoglycemia and Cardiovascular Disease: Exploring the Connections. Cureus 2023; 15:e47784. [PMID: 38022365 PMCID: PMC10676516 DOI: 10.7759/cureus.47784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
It has long been known that administering insulin or insulin secretagogues to treat diabetes has the unfavorable side effect of hypoglycemia. Because hypoglycemia can disrupt normal brain function, it can have a profound impact on people's lives. Studies have shown a connection between hypoglycemia and a higher risk of death and cardiovascular disease. Through experimental studies, numerous potential reasons for the start of cardiovascular events have been discovered. In addition, studies on people have demonstrated that hypoglycemia can result in ventricular arrhythmias. According to recent studies, a number of factors may affect the relationship between hypoglycemia, cardiovascular events, and mortality. Confounding factors may explain the apparent correlation, at least in part. People with comorbidities may experience more hypoglycemia, increasing their risk of mortality. Those who have type 1 or type 2 diabetes, however, seem to be more susceptible to the negative effects of hypoglycemia on the cardiovascular system. When choosing appropriate glucose-lowering treatments and setting glycemic objectives with patients, clinicians should be aware of this risk.
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Affiliation(s)
- Kishan Akhaury
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anil Wanjari
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Arya Harshyt Sinha
- Anatomy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mayank Kumar
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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23
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Grygiel-Górniak B, Skoczek W. Molecular Background and Clinical Implications of Glucose Disorders in Patients with Psoriatic Arthritis. J Clin Med 2023; 12:5814. [PMID: 37762754 PMCID: PMC10532042 DOI: 10.3390/jcm12185814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 08/22/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease characterized by joint and entheses involvement. This condition is often associated with an increased prevalence of obesity, encompassing more than one-third of all patients. Given the presence of metabolic disorders, it becomes crucial to enhance clinical oversight of metabolic parameters. An early diagnosis of glucose irregularities in PsA allows for the assessment of an effective treatment strategy. The approach proves valuable in preventing the development of insulin resistance (IR) or diabetes mellitus type 2 (DMt2). Similar pathways characterize the pathomechanism of PsA and DMt2, offering an innovative perspective on treatment management. The cytokines and adipokines synthesized in the course of PsA significantly impact the development process of IR and DMt2 in different mechanisms of action. Conversely, glucose disorders influence the activity of PsA and therapy outcomes. Given the chronic inflammatory background shared by PsA, obesity, and DMt2, it is evident that inadequate management of any of the mentioned conditions can exacerbate the others. Thus, when PsA coincides with DMt2, a comprehensive multidimensional approach is necessary. This includes an effective immunosuppressive regimen complemented by appropriate anti-diabetic and insulin therapies. Moreover, often overlooked recommendations concerning overall well-being and lifestyle adjustments hold significance. This manuscript explores the connections and the relationship between the molecular background of PsA and glucose disorders. It provides a detailed exposition of specific therapeutic approaches for both conditions.
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Affiliation(s)
- Bogna Grygiel-Górniak
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland
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24
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Alghamdi A, Alsaeddi A, Malki H, Alsaedi A. A Case Report of a Pregnant Woman With Type 2 Diabetes Mellitus Using Dulaglutide During the First Trimester of Pregnancy. Cureus 2023; 15:e44644. [PMID: 37809127 PMCID: PMC10552061 DOI: 10.7759/cureus.44644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Among women of childbearing age, type 2 diabetes mellitus (T2DM) is becoming more prevalent, increasing the likelihood of abortion, congenital anomalies, and neonatal death. Dulaglutide has not been adequately studied to determine if it causes birth defects or miscarriages during pregnancy. According to animal studies, the fetus is at risk from the use of dulaglutide during pregnancy. We report the case of a 39-year-old woman with T2DM who used dulaglutide (1.5 mg/week) along with glargine and aspart before conception. During the third month of pregnancy, she was seen in the clinic for the first time during which dulaglutide was stopped and basal-bolus insulin therapy was retained with dosing titration. The newborn was a male with a normal birth weight for his gestational age. Dulaglutide did not affect development. No minor or major malformations were noted in the fetus except for mild bilateral renal pyelectasis. Moreover, no maternal or fetal complications were observed. It is not possible to ascertain the safety of glucagon-like peptide-1 receptor agonists in pregnancy, despite the normal outcome in the present pregnancy; however, the data described here may be of value in further considering this issue.
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Affiliation(s)
- Adel Alghamdi
- Diabetes and Endocrinology, Diabetes Center of Hera General Hospital, Makkah, SAU
| | - Abeer Alsaeddi
- Family Medicine, Al-Awali Primary Health Care, Makkah, SAU
| | - Hashem Malki
- Diabetes and Endocrinology, Diabetes Center of Hera General Hospital, Makkah, SAU
| | - Ameerah Alsaedi
- Endocrinology, Diabetes Center of Al-Noor Hospital, Makkah, SAU
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25
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Sundaram SG, Ramakrishnan T, Krishnan SG, Narayan KV, Shankar S, Kanimozhi G. Effect of Non-Surgical Periodontal Therapy on Systemic Inflammatory Markers, Glycemic Status and Levels of Proteinuria in Type 2 Diabetic and Non-Diabetic Patients With Chronic Periodontitis. Cureus 2023; 15:e44757. [PMID: 37809241 PMCID: PMC10556791 DOI: 10.7759/cureus.44757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
AIMS AND OBJECTIVES The present study aimed to evaluate the effect of non-surgical periodontal therapy (NSPT) on systemic inflammatory markers, glycemic status, and levels of proteinuria in Type 2 diabetic and non-diabetic individuals with chronic periodontitis. METHODOLOGY A total of 120 patients, categorized into three groups of 40 each, were included in this randomized observational study. Group 1 comprised patients with chronic periodontitis; Group 2 had chronic periodontitis with controlled diabetes; and Group 3 represented patients with chronic periodontitis with uncontrolled diabetes based on fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) levels. Periodontal clinical parameters like plaque index, gingival index, bleeding on probing, pocket depth, and clinical attachment levels were evaluated. Blood samples and urine samples were collected and assessed for the levels of FBS, HbA1c, total protein, albumin, globulin, and proteinuria. All parameters recorded at baseline and three months after non-surgical periodontal therapy were analyzed for statistical significance at p <.05 using SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc. RESULTS A significant reduction in the periodontal clinical parameters within the groups, except for the clinical attachment level in Group 1 patients (p = 0.05), was observed. Glycemic status revealed a significant reduction after non-surgical periodontal therapy (p < 0.001), and on intragroup comparison, the total protein, albumin, globulin, and microprotein blood and urine levels showed significance among the evaluated groups (p < 0.001). CONCLUSION Non-surgical periodontal treatment can effectively improve the periodontal and circulating inflammatory status. Results of our study showed improved glycemic control and a reduction in systemic inflammatory markers and proteinuria after performing non-surgical periodontal treatment in patients with type 2 diabetes.
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Affiliation(s)
- S Gopalakrishnan Sundaram
- Periodontology, Thai Moogambigai Dental College and Hospital, Dr MGR Educational and Research Institute, Chennai, IND
| | | | - Sneha G Krishnan
- Dentistry, Sri Ramaswamy Memorial (SRM) Dental College and Hospital, Chennai, IND
| | - Keerthi V Narayan
- Oral and Maxillofacial Pathology, Axon Anaesthesia Associates, Hyderabad, IND
| | - Siva Shankar
- Periodontology, Tamil Nadu Government Dental College and Hospital, Chennai, IND
| | - G Kanimozhi
- Dentistry, Private Dental Clinic, Chennai, IND
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Abstract
Background: Studies on humans have revealed the beneficial effects of zinc (Zn) supplementation in patients with type-2 diabetes. Aim: The present study was designed to investigate the effects of zinc supplementation on blood glucose level in type-2 diabetic patients and determine the interaction between age and zinc supplementation on type-2 diabetic patients. Methods: A randomized placebo-control trial conducted in Bashir Hospital of Sialkot, Allama Iqbal Memorial Hospital Sialkot and Civil Hospital of Daska, Sialkot. 144 diabetic patients were selected including an expected drop-out rate of 20%. All the participants were randomly divided into Group 1 (Treatment group with intervention given Zn tablets 20 mg/day) and Group 2 (control group with placebo effect). Each group was further divided into 2 age categories Category 1 (30-50 years of age) and Category 2 (51-70 Years of age). Demographic data, Anthropometric measurements, 24-h dietary recall, serum blood glucose analysis, HbA1C, and serum zinc levels were recorded at the beginning (0 day) and end of the study (60 days). Results: Final fasting serum glucose levels were significantly lowered in group 1 with (p < 0.05) as compared to group 2, but interestingly, results were significant (p < 0.05) in the older age group (51-70 years) as compared to their younger age counterparts (30-50 years) of group2. A similar trend was also found in the HbA1c, serum Zn levels and BMI of the participants. Conclusion: Results implied the possible phenomenon of better response to Zn supplementation among aged patients as compared to younger counterparts, which may suggest higher Zn demands with advanced age.
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Affiliation(s)
| | | | - Aurang Zeb
- The University of Lahore, Lahore, Punjab, Pakistan
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27
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Chitrala S, Butta N, Immadisetty SK, Suvvari TK, Thomas V. Unilateral Phrenic Nerve Palsy as a Presentation of Diabetes Mellitus: A Rare Case Report. Clin Med Insights Endocrinol Diabetes 2023; 16:11795514231189038. [PMID: 37529302 PMCID: PMC10387670 DOI: 10.1177/11795514231189038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/26/2023] [Indexed: 08/03/2023] Open
Abstract
Diabetes mellitus is one of the most debilitating diseases, diabetic neuropathy happens to be the most common and perhaps the most serious complication of diabetes mellitus, often leading to morbidity and mortality. A 60 year old female presented with disorientation, history of vomiting, shortness of breath, respiratory failure initially. Blood reports revealed that she was positive for ketone bodies with elevated HbA1c and general random blood sugar. Chest radiogram revealed atelectasis of the right lung with prominent involvement of right middle and lower lobes. High-resolution computed tomography of chest confirmed the findings and unilateral diaphragmatic paralysis due to phrenic nerve neuropathy due to undetected type 2 diabetes was diagnosed. Although phrenic nerve paralysis is a rare occurrence with diabetes, the possibility shouldn't be overlooked as a presentation of diabetes mellitus.
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Affiliation(s)
- Sruthi Chitrala
- Department of General Medicine, Nimra Institute of Medical Sciences, Vijayawada, Andhra Pradesh, India
| | - Nikhil Butta
- Department of General Medicine, Guntur Medical College, Guntur, Andhra Pradesh, India
| | - Sandeep Kumar Immadisetty
- Department of General Medicine, Nimra Institute of Medical Sciences, Vijayawada, Andhra Pradesh, India
| | | | - Vimal Thomas
- Tbilisi State Medical University, Tbilisi, Georgia
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Andonova M, Dzhelebov P, Trifonova K, Yonkova P, Kostadinov N, Nancheva K, Ivanov V, Gospodinova K, Nizamov N, Tsachev I, Chernev C. Metabolic Markers Associated with Progression of Type 2 Diabetes Induced by High-Fat Diet and Single Low Dose Streptozotocin in Rats. Vet Sci 2023; 10:431. [PMID: 37505836 PMCID: PMC10386364 DOI: 10.3390/vetsci10070431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023] Open
Abstract
Science is still searching for readily available, cost-effective biomarkers to assess metabolic disorders occurring before the onset and during the development of type-2 diabetes (T2DM). The aim of the present study was to induce T2DM in rats through a high-fat diet, followed by a single administration of low dose streptozotocin (STZ), and make an assessment of the development of the disease. The rats were divided into two groups-experimental and control-and were monitored for a period of 10 days. Changes in anthropometric parameters, glucose, insulin, lipids, uric acid, advanced oxidation protein products (AOPP), as well as the histological changes in the liver and pancreas, were recorded. To assess insulin resistance, we used the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and beta cell function (HOMA-β) and visceral obesity-adiposity index (AI). The data demonstrate that the increasing values of glucose, HOMA-IR, AI, total cholesterol, triacylglycerols, low- and very-low-density lipoproteins are important markers of the pre-diabetic state. The stable hyperglycemia and increased levels of TC, TG, VLDL, LDL, uric acid and AOPP in experimental rats strongly suggest the development of T2DM. HOMA-IR, HOMA-β, AI, and uric acid are reliable criteria for T2DM in rats.
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Affiliation(s)
- Maria Andonova
- Department of General and Clinical Pathology, Faculty of Veterinary Medicine, Trakia University, Stara Zagora 6000, Bulgaria
| | - Petko Dzhelebov
- Department of General and Clinical Pathology, Faculty of Veterinary Medicine, Trakia University, Stara Zagora 6000, Bulgaria
| | - Krastina Trifonova
- Department of General and Clinical Pathology, Faculty of Veterinary Medicine, Trakia University, Stara Zagora 6000, Bulgaria
| | - Penka Yonkova
- Department of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, Trakia University, Stara Zagora 6000, Bulgaria
| | - Nikola Kostadinov
- Department of General and Clinical Pathology, Faculty of Veterinary Medicine, Trakia University, Stara Zagora 6000, Bulgaria
| | - Krasimira Nancheva
- Clinical Laboratory, University Multiprofile Hospital for Active Treatment "Professor Stoyan Kirkovich", Stara Zagora 6000, Bulgaria
| | - Veselin Ivanov
- Department of Social Medicine, Health Management and Disaster Medicine, Faculty of Medicine, Trakia University, Stara Zagora 6000, Bulgaria
| | - Krasimira Gospodinova
- Department of Veterinary Microbiology, Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, Trakia University, Stara Zagora 6000, Bulgaria
| | - Nikola Nizamov
- Department of Veterinary Microbiology, Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, Trakia University, Stara Zagora 6000, Bulgaria
| | - Ilia Tsachev
- Department of Veterinary Microbiology, Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, Trakia University, Stara Zagora 6000, Bulgaria
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29
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Kumar S, Diwan N, Mishra A, Bhadoria AS. Assessment of Risk Factor Progression Due to the COVID-19 Pandemic Among Diagnosed Cases of Hypertension and Diabetes Under the Field Practice Area of Urban Primary Health Centre, Rishikesh, Uttarakhand. Cureus 2023; 15:e42048. [PMID: 37602091 PMCID: PMC10432847 DOI: 10.7759/cureus.42048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
INTRODUCTION Hypertension and diabetes were the two pertinent comorbidities of non-communicable disease which was most deadly affected during the COVID-19 pandemic, globally. Therefore, the present study was carried out to assess the progression of risk factors in patients with hypertension and diabetes, and behavioural risk factors during the COVID-19 pandemic. MATERIAL AND METHODS A community-based longitudinal study was carried out for a period of one year in patients with pre-existing hypertension and diabetes in the field practise area of urban primary health centres (UPHC) in Rishikesh. The sample size is estimated to be 274, Only 100 study participants could be enrolled due to the COVID-19 pandemic. A convenience sampling method was used. Data were analysed using SPSS Version 23 (IBM Corp., Armonk, NY). Mean ± SD was calculated for continuous variables. The Chi-square test and the Fischer exact test were employed as appropriate to examine the association. To compare the means, the paired "T-test" was utilised. RESULT Mean age of 100 study participants was 56 years ± 11SD. A significant difference (p=0.03) in random blood sugar and diastolic blood pressure was observed before and during the pandemic Proportion of tobacco users and alcoholics was 33% and 22%, respectively. The progression of hypertension and diabetes was reported to be significant among the participants with unhealthy diets and unhealthy lifestyles. CONCLUSION COVID-19 pandemic poses an increase in risk factors like the adoption of unhealthy and sedentary lifestyles, tobacco, and alcohol consumption. All these factors were significantly (p=0.02) associated with the progression of diabetes and hypertension.
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Affiliation(s)
- Santosh Kumar
- Community and Family Medicine, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND
| | - Naveen Diwan
- Epidemiology and Public Health, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND
| | - Ashutosh Mishra
- Community and Family Medicine, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND
| | - Ajeet S Bhadoria
- Community and Family Medicine, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND
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Echevarría-Castro N, Matayoshi-Pérez A, Silva-Parra KA, Rojo-García D, Cucho Espinoza C. Cutaneous Infection Associated With Myroides odoratimimus Bacteremia in a Diabetic Patient. Cureus 2023; 15:e41328. [PMID: 37539412 PMCID: PMC10396317 DOI: 10.7759/cureus.41328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
In daily medical practice, there exist multidrug resistance bacteria that are not widely recognized. One example of that is the Myroides spp., a Gram-negative bacillus causing skin, urinary, and bloodstream infections, especially in immunocompromised patients. In recent years, multiple cases of difficult hospital management have been reported. Currently, there are no specific guidelines for the prevention and treatment of this infection. This case report presents a patient with type 2 diabetes mellitus with a severe skin infection caused by this microorganism. This is the first case report in Peru of a severe skin infection related to Myroides odoratimimus bacteremia.
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Affiliation(s)
| | | | | | | | - Carolina Cucho Espinoza
- Pathology and Laboratory Medicine, Hospital Nacional Dos de Mayo, Lima, PER
- Medical Education, Universidad Ricardo Palma, Lima, PER
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Alenezi YM, Harris R, Morling J, Card T. Prevalence of Non-alcoholic Fatty Liver Disease (NAFLD) in Saudi Arabia: Systematic Review and Meta-analysis. Cureus 2023; 15:e40308. [PMID: 37448425 PMCID: PMC10337700 DOI: 10.7759/cureus.40308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Liver disease is fast emerging as a global health priority. Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries, with an increasing prevalence associated with the rising prevalence of diabetes mellitus and obesity. The worldwide prevalence of NAFLD may be in the order of 25%, but in the Middle East, it may be even higher. This study aimed to estimate the prevalence of NAFLD in the Kingdom of Saudi Arabia (KSA). A systematic review and meta-analysis were undertaken. Electronic searches were carried out through Medline, EMBASE, CINAHL, Web of Science, and Google Scholar, for articles from inception to April 2020. Studies conducted on adult populations in any setting reporting NAFLD prevalence were included. Pooled proportions and associated 95% confidence intervals (CIs) were presented in forest plots using a random effect model. Eight studies, including 4045 participants, were included. The pooled prevalence of NAFLD among all adult populations in KSA was 16.8% (11.1%-22.5%). Amongst those with type 2 diabetes, the prevalence was 58.0% (45.0%-70.9%). There were no true general population studies of the prevalence of NAFLD in KSA available. This review suggests that NAFLD is common in the KSA, and that type 2 diabetes is a risk factor in KSA as identified elsewhere in the world.
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Affiliation(s)
- Yusef M Alenezi
- Lifespan and Population Health, University of Nottingham, Nottingham, GBR
- Family and Community Medicine, College of Medicine, Northern Borders University, Arar, SAU
| | - Rebecca Harris
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, GBR
| | - Joanne Morling
- Lifespan and Population Health, University of Nottingham, Nottingham, GBR
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, GBR
| | - Tim Card
- Lifespan and Population Health, University of Nottingham, Nottingham, GBR
- NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, GBR
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Kaze AD, Yuyun MF, Fonarow GC, Echouffo-Tcheugui JB. Blood Pressure Variability and Risk of Atrial Fibrillation in Adults With Type 2 Diabetes. JACC Adv 2023; 2:100382. [PMID: 37427148 PMCID: PMC10328185 DOI: 10.1016/j.jacadv.2023.100382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND There is a paucity of epidemiological data on the association between long-term variability of blood pressure (BP) and incident atrial fibrillation (AF). OBJECTIVES The purpose of this study was to evaluate the association of BP variability with incident AF in a large sample of adults with type 2 diabetes. METHODS We included participants who had ≥5 BP measurements in the first 24 months of action to control cardiovascular risk in diabetes. The visit-to-visit variability of systolic blood pressure (SBP) and diastolic blood pressure (DBP) was estimated using the coefficient of variation, SD, and variability independent of the mean. Incident AF was recorded using follow-up electrocardiograms. Modified Poisson regression was used to generate risk ratios (RRs) and 95% CI for AF. RESULTS A total of 8,399 participants were included (average age 62.6 ± 6.5 years, 38.8% women, 63.2% White). Over a median follow-up of 5 years, 155 developed AF. Compared to the lowest quartile, the highest quartile of BP variability was associated with an increased risk of AF (RR: 1.85 [95% CI: 1.13-3.03] and 1.63 [95% CI: 1.01-2.65] for coefficient of variation of SBP and DBP, respectively). Participants in the highest quartile of both SBP and DBP had a 2-fold higher risk of AF compared to those in the lowest 3 quartiles of both SBP and DBP (RR: 1.94; 95% CI: 1.29-2.93). CONCLUSIONS In a large cohort of adults with type 2 diabetes, higher variability in SBP and DBP was independently associated with an increased risk of AF.
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Affiliation(s)
- Arnaud D. Kaze
- Department of Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Matthew F. Yuyun
- Department of Medicine, Harvard Medical School & Veteran Affairs Boston Healthcare System, Boston, Massachusetts, USA
| | - Gregg C. Fonarow
- Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA
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Alver A, Batra K, Basu A, Izuora K. Food Diary Completion Does Not Significantly Impact Glycemic Control in an Observational Single-Institution Pilot Study of Patients with Type 2 Diabetes Mellitus. Cureus 2023; 15:e40596. [PMID: 37469812 PMCID: PMC10353833 DOI: 10.7759/cureus.40596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 07/21/2023] Open
Abstract
INTRODUCTION Hemoglobin A1c is frequently used to monitor glycemic control in patients with type 2 diabetes mellitus (T2DM). There is an association between dietary habits and hemoglobin A1c. Food diaries are often used to assist in dietary management and have been associated with modification of dietary habits. We aimed to investigate the impact of completing a seven-day food diary on hemoglobin A1c in subjects with T2DM. We hypothesized that patients who completed a food diary might independently modify their dietary habits, resulting in a clinically significant change in hemoglobin A1c. METHODS Forty-five subjects with T2DM who completed a seven-day food diary were included in this observational study. Subjects had a mean hemoglobin A1c at baseline of 7.56 ± 1.43 and a body mass index of 33.6 ± 7.6 kg/m². A majority were female (57.8%) and insulin-dependent (71.1%). The primary outcome of interest was a clinically significant change in hemoglobin A1c (≥0.5%). Outcomes were assessed before and within six months after the food diary completion. Chi-square, independent-sample t-tests, and logistic regression were used to analyze the data. RESULTS Twelve patients demonstrated a clinically significant decrease in hemoglobin A1c; however, this was not statistically significant regardless of gender (p = 0.5), baseline body mass index (p = 0.5), insulin use (p = 0.3), or community needs index (p = 0.7). CONCLUSIONS Although some patients had clinically significant improvements in their hemoglobin A1c, our findings suggest that the use of food diaries alone without goal-directed initiatives is insufficient to achieve differences in hemoglobin A1c in patients with T2DM and an average A1c within the range of 6%-8%.
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Affiliation(s)
- Amalie Alver
- Endocrinology, Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas, Las Vegas, USA
- Emergency Medicine, University of Washington, Seattle, USA
| | - Kavita Batra
- Research, Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas, Las Vegas, USA
| | - Arpita Basu
- Kinesiology and Nutrition Sciences, Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas, Las Vegas, USA
| | - Kenneth Izuora
- Endocrinology, Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas, Las Vegas, USA
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Velázquez López L, Muñoz Torres AV, Klünder Klünder M, Gómez OSM. Editorial: Diabetes management through lifestyle and the social determinants of health. Front Nutr 2023; 10:1158322. [PMID: 37234550 PMCID: PMC10206315 DOI: 10.3389/fnut.2023.1158322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Affiliation(s)
- Lubia Velázquez López
- Unidad de Investigación en Epidemiología Clínica, Hospital General Regional No 1, “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Abril Violeta Muñoz Torres
- Departamento de Salud Publica, Escuela de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Miguel Klünder Klünder
- Departamento de Investigación, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
| | - Oswaldo Sinoe Medina Gómez
- Unidad de Investigación en Epidemiología Clínica, Hospital General Regional No 1, “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
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Khan Z, Gul A. Gout in an Obese Patient with Nonalcoholic Steatohepatitis on a Thiazide Diuretic and Association Between Hyperuricemia and Nonalcoholic Steatohepatitis: A Case Report. Cureus 2023; 15:e39207. [PMID: 37378123 PMCID: PMC10292010 DOI: 10.7759/cureus.39207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 06/29/2023] Open
Abstract
Gout is a common inflammatory arthritis caused by increased uric acid crystals in and around various joints, mainly the big toe in adults. It happens due to the increase of urate or uric acid levels either because of increased production or decreased excretion from the body. Uric acid is the final product of purine metabolism, and many patients with hyperuricemia may remain asymptomatic. We present a case of a 46-year-old male who presented to the ambulatory care unit with the clinical features of acute pharyngitis and left toe pain for the past three days. On further questioning, he added that he had pain in the left lumber region and left side of the toe for the past few months. He also had a known case of type 2 diabetes mellitus, hypertension, and gastritis, for which he has been taking the thiazide diuretic, angiotensin-converting enzyme (ACE) inhibitors, metformin, sitagliptin, aspirin, and atorvastatin. Laboratory tests showed elevated uric acid along with raised inflammatory markers. As a result, he was referred to the specialist for arthrocentesis in order to confirm the diagnosis, and the thiazide diuretic was replaced with calcium channel blockers. He also suffered from nonalcoholic steatohepatitis (NASH) based on his ultrasound abdomen. On the follow-up visit, his symptoms had resolved, and his uric acid level had normalized.
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Affiliation(s)
- Zahid Khan
- Acute Medicine, Mid and South Essex National Health Service (NHS) Foundation Trust, Southend-on-Sea, GBR
- Cardiology, Barts Heart Centre, London, GBR
- Cardiology and General Medicine, Barking, Havering and Redbridge University Hospitals National Health Service (NHS) Trust, London, GBR
- Cardiology, Royal Free Hospital, London, GBR
| | - Amresh Gul
- General Practice, Lifeline Hospital, Salalah, OMN
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Sawarthia S, Patel R, Patil PP. A Cross-Sectional Study to Determine the Association of Corrected QT Interval With Microalbuminuria in Type 2 Diabetes Mellitus. Cureus 2023; 15:e38967. [PMID: 37313082 PMCID: PMC10260269 DOI: 10.7759/cureus.38967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2023] [Indexed: 06/15/2023] Open
Abstract
Introduction Cardiac autonomic neuropathy (CAN) is a frequent and life-threatening complication of type 2 diabetes. Failure to diagnose can lead to high mortality and morbidity. In patients who have diabetes mellitus, microalbuminuria is an independent marker for cardiovascular disease. This study aimed to assess the corrected QT interval with microalbuminuria in type 2 diabetes mellitus. The objective of this study was to estimate the corrected QT interval in subjects with type 2 diabetes mellitus and to determine the association of the corrected QT interval with microalbuminuria type 2 diabetes mellitus. Methodology Ninety-five adult patients (>18 years to 65 years) diagnosed with type 2 diabetes mellitus with microalbuminuria were included in this study. Data were collected on the proforma through history taking and a general physical and systemic examination. An electrocardiograph was taken on the day of admission; the most prolonged QT interval was measured, and the RR interval was calculated. The data were statistically analyzed using IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York, United States). Results There was a significant difference in the corrected QT interval prolongation prevalence between diabetic patients with microalbuminuria and without microalbuminuria (P-value <0.001). The mean corrected QT interval distribution did not differ significantly across various age groups of cases studied with microalbuminuria (P-value 0.98). The distribution of mean corrected QT interval did not differ significantly between the group of male cases and group of female cases studied with microalbuminuria (P-value 0.66). The mean corrected QT interval distribution did not differ significantly across various duration of diabetes groups among the cases studied with microalbuminuria (P-value 0.60). The mean corrected QT interval distribution did not differ significantly across different types of anti-diabetic treatment groups among the cases studied with microalbuminuria (P-value 0.64). Conclusion Type 2 diabetes has been prevalent in Indian and Asian populations. The early management of type 2 diabetes is necessary since the early stages of the disease can reduce the risk of CAN. Therefore, these patients should be diagnosed as early as possible and treated to reduce associated mortality and risk and to improve quality of care.
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Affiliation(s)
- Sonali Sawarthia
- Internal Medicine, Bharati Vidyapeeth Medical College and Hospital, Pune, IND
| | - Rishi Patel
- Internal Medicine, Bharati Vidyapeeth Medical College and Hospital, Pune, IND
| | - Prajakta P Patil
- Internal Medicine, Bharati Vidyapeeth Medical College and Hospital, Pune, IND
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Mubeen M, Masood A, Khan MU, Chohan HK, Jamal A, Chohan MK, Abbassey SS, Anwar A, Hashmi AA. Neurological Features and Their Association With Gender in Diabetes Mellitus Patients. Cureus 2023; 15:e39687. [PMID: 37398721 PMCID: PMC10308448 DOI: 10.7759/cureus.39687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Understanding the wide range of clinical signs and symptoms associated with diabetes mellitus (DM) is crucial because people with DM are frequently misdiagnosed, given incorrect care, or poorly controlled. Therefore, the purpose of this study was to evaluate the neurological symptoms associated with type 1 and type 2 DM patients with respect to patient gender. Methods This was a cross-sectional multicenter study that was conducted at different hospitals using a non-probability sampling method. The duration of the study was eight months, from January 2022 to August 2022. The study involved 525 type 1 and type 2 DM patients with an age range from 35 to 70 years. Demographic details such as age, gender, socioeconomic status, past medical history, presence of comorbidities, type, and duration of DM, and neurological features were recorded as frequencies and percentages. A Chi-square test was used to determine the association between neurological symptoms associated with type 1 and type 2 DM and gender. Results The study findings showed that of 525 diabetic patients, 210 (40.0%) were females and 315 (60.0%) were males. The mean male and female mean ages were 57.36±14.99 and 50.52±14.8 years, respectively, with a significant difference with respect to gender (p<0.001). The prevalence of neurological manifestations showed that irritability or mood swings were reported by most of the male 216 (68.6%) and 163 (77.6%) female diabetic patients, with a significant association noticed (p=0.022). Moreover, a significant association was observed between both genders in terms of swelling of feet, ankles, hands, and eyes (p=0.042), confusion or difficulty in concentration (p=0.040), burning pain in feet or legs (p=0.012), and muscular pain or cramps in legs or feet (p=0.016). Conclusion This study concluded that the prevalence of neurological manifestations was high among diabetic patients. Most of the neurological symptoms were significantly more pronounced in female diabetic patients. Moreover, most of the neurological symptoms were associated with the type (type 2 DM) and duration of DM. The presence of hypertension, dyslipidemia, and smoking also influenced some neurological manifestations.
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Affiliation(s)
- Muhammad Mubeen
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Ahsan Masood
- Internal Medicine, Gomel State Medical University, Gomel, BLR
| | | | | | - Aisha Jamal
- Internal Medicine, Army Medical College, Rawalpindi, PAK
| | | | | | - Adnan Anwar
- Physiology, Hamdard College of Medicine and Dentistry, Karachi, PAK
- Internal Medicine, Essa General Hospital, Karachi, PAK
| | - Atif A Hashmi
- Pathology, Liaquat National Hospital and Medical College, Karachi, PAK
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Stojanovic J, Andjelic-Jelic M, Vuksanovic M, Marjanovic-Petkovic M, Jojic B, Stojanovic M, Beljic-Zivkovic T. The effects of early short-term insulin treatment vs. glimepiride on beta cell function in newly diagnosed type 2 diabetes with HbA1c above 9. Turk J Med Sci 2023; 53:552-562. [PMID: 37476884 PMCID: PMC10387975 DOI: 10.55730/1300-0144.5616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 01/20/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2D) is a complex metabolic impairment. Beta cell (BC) failure is the most challenging among its pathogenetic mechanisms. Recognizing reversible contributors to BC failure could guide individualized approach to early T2D treatment. The aim of this study was to compare early short-term insulin treatment vs. glimepiride, both added to metformin, on BC function, glycemic and lipid control, during 12-month follow-up. METHODS Eighty newly diagnosed T2D patients, 30-65 years of age, presenting with HbA1c ≥ 9% were enrolled in the study. They were randomly assigned to single-month initial insulin therapy (INS) added to metformin, or to glimepiride and metformin (OAD) as only treatment. Subjects assigned to initial insulin intervention were thereafter switched to OAD. C-peptide (C-Pep) was analyzed at baseline and 2 hours after standardized test meal (STM). All subjects were STM-retested after 3 and 12 months. HbA1c, serum lipids, BMI, HOMA IR, and HOMA B were assessed over follow-up. RESULTS HbA1c was lower in INS vs OAD at 3-months: 6.26 ± 0.18% vs 6.78 ± 0.10% (p = 0.016), remaining so by 12 months (p =0.056). BMI-adjusted ΔC-Pep was greater in INS vs. OAD at 3 months (4.60 ± 0.59 vs. 3.21 ± 0.34 m2 /kg; p = 0.044), persisting by 12months (4.57 ± 0.56 vs. 3.04 ± 0.34 m2/kg; p = 0.023). Average ΔC-Pep improvement from recruitment to 3 months was 100.8% in INS,vs. 51.3% in OAD. Prevalence of STM-ΔC-Pep response greater than 2.4 ng/mL had risen 3.2-fold by 12 months in the INS, vs. 2.4-fold only in the OAD group (p = 0.018). DISCUSSION Early short-term insulin intervention in newly diagnosed T2D improves beta cell function more than glimepiride, both added to metformin, resulting in a superior and longer lasting glycemic and lipid control.
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Affiliation(s)
- Jelena Stojanovic
- Division of Endocrinology, Diabetes and Metabolic Disorders, Department of Internal Medicine, Zvezdara University Medical Center, Belgrade, Serbia
| | - Marina Andjelic-Jelic
- Department of Internal Medicine, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia ; Division of Endocrinology, Diabetes and Metabolic Disorders, Department of Internal Medicine,Zvezdara University Medical Center, Belgrade, Serbia
| | - Miljanka Vuksanovic
- Department of Internal Medicine, Medical Faculty,University of Belgrade, Belgrade, Serbia ; Division of Endocrinology, Diabetes and Metabolic Disorders, Department of Internal Medicine,Zvezdara University Medical Center, Belgrade, Serbia
| | - Milica Marjanovic-Petkovic
- Department of Internal Medicine, Medical Faculty,University of Belgrade, Belgrade, Serbia; Division of Endocrinology, Diabetes and Metabolic Disorders, Department of Internal Medicine,Zvezdara University Medical Center, Belgrade, Serbia
| | - Biljana Jojic
- Division of Endocrinology, Diabetes and Metabolic Disorders, Department of Internal Medicine,Zvezdara University Medical Center, Belgrade, Serbia
| | - Marko Stojanovic
- Department of Internal Medicine, Medical Faculty,University of Belgrade, Belgrade, Serbia ; Department of Neuroendocrinology, Clinic for Endocrinology, Diabetes and Metabolic Diseases,University Clinical Center of Serbia, Belgrade, Serbia
| | - Teodora Beljic-Zivkovic
- Department of Internal Medicine, Medical Faculty,University of Belgrade, Belgrade, Serbia;Division of Endocrinology, Diabetes and Metabolic Disorders, Department of Internal Medicine,Zvezdara University Medical Center, Belgrade, Serbia
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Polhuis KCMM, Vaandrager L, Koelen MA, Geleijnse JM, Soedamah-Muthu SS. Effects of a Salutogenic Healthy Eating Program in Type 2 Diabetes (the SALUD Study): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e40490. [PMID: 36943335 PMCID: PMC10131793 DOI: 10.2196/40490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Healthy eating can improve the course of type 2 diabetes mellitus (T2DM) considerably. As changing eating behaviors in everyday is challenging, there is a need for a nutritional strategy with an eye for everyday life of people with T2DM. A theory centered around the everyday life context is salutogenesis. Salutogenic principles have been operationalized in a new nutritional program for T2DM on food literacy and well-being: the Salutogenic Intervention for Type 2 Diabetes (SALUD) program. OBJECTIVE This study aims to describe the protocol of the invention study that will examine the quantitative and qualitative effects of the SALUD program. METHODS A semiblinded randomized controlled trial will be performed in the Netherlands. A sample size of 56 (including a 30% dropout rate) people with T2DM has been calculated, of whom half (n=28, 50%) will follow the SALUD program (intervention) and half (n=28, 50%) will receive usual care (control). Recruitment strategies consist of advertisement via local health care professionals, posters, social media, and local newspapers. The SALUD program consists of 12 weekly web-based group sessions under the supervision of a certified lifestyle coach. Fidelity of the delivery is guaranteed by selecting a salutogenic coach, use of an intervention manual, training of the coach, weekly evaluation forms, and recording several sessions. The theoretical salutogenic principle of the intervention is mobilizing 2 important psychosocial resources required for organizing healthy eating in everyday life: self-identity and social support. Measurements will be performed at 3 times: at baseline (T0), after 12 weeks (postintervention; T1), and after 24 weeks (follow-up; T2). The primary outcome is food literacy, measured with the self-perceived food literacy scale questionnaire (expected effect size=0.9). Secondary outcomes are self-efficacy, quality of life, sense of coherence, diet quality, body weight, BMI, and waist-hip ratio. All outcomes will be tested with linear mixed models, following an intention-to-treat approach and standard principles of randomized controlled trials. In addition, a qualitative analysis will be performed. RESULTS The proposed study will provide useful information on the effects of a salutogenic program on healthy eating and well-being in people with T2DM in everyday life. Recruitment started on October 1, 2021. The intervention participants followed the SALUD program between January and August, 2022. The acquisition of the data was completed on August 1, 2022; publications are expected in 2023. CONCLUSIONS This study will be one of the first salutogenic interventions for T2DM, which will provide valuable information on what salutogenic intervention entail. The SALUD program may serve as a concrete, web-based tool. The combination of quantitative and qualitative measures allows a comprehensive evaluation of effects. These insights can be used for further optimalization of T2DM interventions. TRIAL REGISTRATION Netherlands Trial Registry, NL8963; https://trialsearch.who.int/Trial2.aspx?TrialID=NL8963. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40490.
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Affiliation(s)
| | - Lenneke Vaandrager
- Health & Society, Wageningen University & Research, Wageningen, Netherlands
| | - Maria A Koelen
- Health & Society, Wageningen University & Research, Wageningen, Netherlands
| | - Johanna M Geleijnse
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Sabita S Soedamah-Muthu
- Department of Medical and Clinical Psychology, Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, Netherlands
- Institute for Food, Nutrition and Health (IFNH), University of Reading, Reading, United Kingdom
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Ochoa Esteban D, Martin-Ridaura C, Berlinches-Zapero C, Ruiz-Fernández D, Sanz-Martín V, Gavira-Izquierdo R, Muñoz-Haba A, March S, Ceinos-Arcones M; ALAS Project Working Group. Impact of COVID-19 Confinement on the Health-Related Habits of People at High Risk of Type 2 Diabetes. Nutrients 2023; 15. [PMID: 36839200 DOI: 10.3390/nu15040841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
The general lockdown decreed in Spain due to the COVID-19 pandemic interrupted the ALAS health promotion intervention aimed at the population at high risk of suffering from type 2 diabetes. We conducted a descriptive study in 2020 through a telephone survey and a comparison with baseline data to determine the impact of confinement on the lifestyles of the participants. We collected sociodemographic variables and conducted assessments before/after confinement on general health status and lifestyle (sleep, physical activity and diet). Additionally, weight, BMI and adherence to a Mediterranean diet were assessed. Descriptive statistical analyses, comparisons of pre-post confinement data and logistic regression were carried out. A total of 387 individuals responded. Among them, 31.8% reported a worse perception of health after confinement, and 63,1% reported no change. Regarding exercise, 61.1% reduced their weekly physical activity time. Regarding diet, 34,4% perceived worse quality, and 53.4% reported no change, despite the fact that 89.4% declared changes in their eating practices. Weight and BMI decreased by 3,1%, and adherence to the Mediterranean diet improved from baseline. Confinement had a negative impact on the general health, diet, sleep and physical activity of this population (at risk of diabetes); however, weight and BMI decreased, and adherence to a Mediterranean diet improved.
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Khot S, Chakraborty A, Vijaykumar S. Utilization of Hypolipidemic Drugs, Patterns, and Factors Affecting Dyslipidemia Among Type 2 Diabetes Mellitus at a Tertiary Care Teaching Hospital in South India. Cureus 2023; 15:e34748. [PMID: 36909102 PMCID: PMC9998133 DOI: 10.7759/cureus.34748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/09/2023] Open
Abstract
Background The prevalence of dyslipidemia is higher in type 2 diabetes mellitus (T2DM) and hypolipidemic drugs like statins are effective for the primary and secondary prevention of cardiovascular events. Most of the patients with type 2 diabetes have a mixed type of dyslipidemia. This study aimed to evaluate the utilization of hypolipidemic drugs, patterns, and factors affecting dyslipidemia in T2DM participants. Methods This cross-sectional observational study was approved by the institutional ethics committee (IEC) of the Vydehi Institute of Medical Sciences and Research Center. It was conducted for a period of one year from July 2021 to June 2022. Participants with T2DM visiting the Department of General Medicine and Endocrinology were enrolled after obtaining informed consent. Demographic details, medication history, and laboratory data were recorded in case report form and statistical measures were applied. Results Out of 237 participants enrolled in the study, the predominance (n=133, 56%) was males. The mean age of the study population was 47.92±9.17 years, and the mean duration of diabetes was 6.8±5.3 years. Out of the total participants, 164 (69%) had deranged lipid profiles. Out of them, 129 (78.65%) were on hypolipidemic drugs. Regarding drug utilization, 122 (94.6%) received statins either rosuvastatin (54%) or atorvastatin (40%). In the deranged lipid profiles pattern, 24% (58) participants had one abnormal lipid parameter and the majority 70% (166) had combined lipid profile abnormality. Factors like increased BMI were significantly associated with dyslipidemia (p=0.004). Utilization of hypolipidemic drugs was also significantly associated with the control of dyslipidemia (p<0.001). It was observed that participants who were not on lipid-lowering drugs had 5.38 times more chance of dyslipidemia (OR=5.38; CI=2.82-10.28; p<0.001). Conclusion A high prevalence of dyslipidemia was observed among diabetic patients. Statins were the most prescribed drug in the study. BMI and lack of pharmacotherapy were found to have a statistically significant association with dyslipidemia in diabetic patients.
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Affiliation(s)
- Sandeep Khot
- Pharmacology and Therapeutics, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Ananya Chakraborty
- Pharmacology and Therapeutics, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Savitha Vijaykumar
- Pharmacology and Therapeutics, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
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Khan RA, Patel N, Folajimi A, Raveena Bai B, Patel V, Komminni PK, Palleti SK, Hirani S. Comparison of the Efficacy and Safety of Metformin-Based Combination Therapy Versus Metformin Alone in Children and Adolescents With Type 2 Diabetes Mellitus: A Meta-Analysis. Cureus 2023; 15:e35014. [PMID: 36938239 PMCID: PMC10022241 DOI: 10.7759/cureus.35014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 02/17/2023] Open
Abstract
The aim of this meta-analysis is to synthesize and critically evaluate the available evidence on the comparison of the efficacy and safety of metformin-based combination therapy versus metformin alone in children and adolescents with type 2 diabetes mellitus (T2DM). We performed the present meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Eligible studies were identified using electronic searches for randomized controlled trials (RCTs) using PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and clinicaltrial.gov from inception to 31 January 2023. The outcomes examined in this meta-analysis included change from baseline in glycated hemoglobin (HbA1C) (%), fasting plasma sugar (FPG) (mg/dl), and the number of individuals experiencing adverse events. Three studies met the criteria and were included in the meta-analysis. The reduction of HbA1C was significantly higher in metformin-based combination therapy (MD: -1.19, 95% CI: -2.05, -0.33, p-value: 0.007). No significant difference was reported between patients randomized in metformin-based combination therapy and metformin alone (MD: -18.67, 95% CI: -50.17, 12.84, p-value: 0.25). In conclusion, the present meta-analysis found that the reduction in HbA1C was significantly higher in patients receiving metformin-based combination therapy compared to metformin alone. No significant difference was found between the two groups in terms of the change in fasting plasma glucose (FPG) from the baseline. In relation to safety, no significant difference was found in the incidence of adverse events and serious adverse events between the two groups.
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Affiliation(s)
- Raza A Khan
- General Medicine, The University Hospital of South Manchester NHS Foundation Trust, Manchester, GBR
| | - Nidhi Patel
- Internal Medicine, Gujarat Medical & Education Research Society (GMERS), Vadodara, IND
| | | | - Bansari Raveena Bai
- Internal Medicine, Peoples University of Medical and Health Sciences For Women, Nawabshah, PAK
| | - Vrushak Patel
- Internal Medicine, Gujarat Medical & Education Research Society (GMERS), Vadodara, IND
| | | | - Sujith K Palleti
- Nephrology, Edward Hines Jr. Veterans Administration Hospital, Hines, USA
- Nephrology, Loyola University Medical Center, Maywood, USA
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Fatani B, Alfhaed NK, Alkhemshi AA, Alomireeni AA, Albarrak MS, Alquhayz MF, Alzahrani SG. Behavioral Changes in Patients With Diabetes During the COVID-19 Pandemic in Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e34956. [PMID: 36938276 PMCID: PMC10019933 DOI: 10.7759/cureus.34956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 02/16/2023] Open
Abstract
On March 2, 2020, the first case of coronavirus disease 2019 (COVID-19) was dedicated in Saudi Arabia. The government established partial quarantine, and all precautions were mandatory on March 23, 2020. This in turn forced people to spend more time at home, leading to changes in the physical activity and dietary habits of individuals. In this study, we aimed to assess the behavioral changes of Saudi diabetic individuals during the COVID-19 pandemic and measure the effectiveness of the behavioral changes of Saudi diabetic individuals during the COVID-19 pandemic on the control of the glucose level. A cross-sectional study was conducted through an online questionnaire sent to diabetic patients in Riyadh, Saudi Arabia. Participants ranging from 18 years old and above of both genders were selected. Diabetic patients (type 1 and 2) were included. All collected data for this study were analyzed using Stata 17 (StataCorp LLC, College Station, Texas, USA). A total of 223 people responded. For 45% of individuals, doctor visits significantly decreased (p<0.05), and the percentage of doctor visits also decreased for individuals who previously visited their doctor more regularly. Furthermore, the number of hours spent on tablets increased significantly during COVID-19 (p<0.05). Our findings demonstrate that there are no significant changes in lifestyle factors or glycemic control during the pandemic compared with the pre-pandemic year in individuals with diabetes. However, the rate of patient visits to the doctor was lower than pre-pandemic, with an increase in the rate of physical activity.
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Affiliation(s)
- Bader Fatani
- Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Nawaf K Alfhaed
- Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Aseel A Alkhemshi
- Medicine and Surgery, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Aseel A Alomireeni
- Medicine and Surgery, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Maha S Albarrak
- Medicine and Surgery, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Mohammed F Alquhayz
- Medicine and Surgery, College of Medicine, King Saud University, Riyadh, SAU
| | - Saeed G Alzahrani
- Public Health, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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Tichler A, Hertroijs DFL, Ruwaard D, Brouwers MCGJ, Hiligsmann M, de Jong JD, Elissen AMJ. Preferred Conversation Topics with Respect to Treatment Decisions Among Individuals with Type 2 Diabetes. Patient Prefer Adherence 2023; 17:719-729. [PMID: 36960182 PMCID: PMC10029372 DOI: 10.2147/ppa.s397647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/14/2023] [Indexed: 03/19/2023] Open
Abstract
PURPOSE Greater knowledge of individuals' needs and preferences can enhance shared decision-making, which is associated with improved quality of decisions and increased satisfaction. This study aimed to identify and prioritize the attributes (ie conversation topics) that individuals with type 2 diabetes find it most important to discuss with their healthcare provider regarding treatment decisions. PATIENTS AND METHODS First, small group interviews were organized with adults with type 2 diabetes (N=8) treated in primary care to identify the attributes that they find important to discuss regarding treatment decisions. A five-step nominal group technique was applied during the interviews. An object best-worst scaling (BWS) survey was subsequently distributed to individuals with self-reported diabetes participating in the Dutch Health Care Consumer Panel of the Netherlands Institute for Health Services Research (N=600) to determine the relative importance score (RIS) of the identified attributes. A higher RIS indicates a higher level of perceived importance. Subgroup and latent class analyses were performed to explore whether individuals' demographic and disease characteristics influenced their attribute preferences. RESULTS A total of 21 attributes were identified during three small group interviews with individuals with type 2 diabetes. Respondents in the BWS survey (N=285) viewed "quality of life" (RIS=11.97), "clinical outcomes" (RIS=10.40), "long-term diabetes complications" (RIS=9.83) and "short-term adverse medication" (RIS=7.72) as the most important in the decision-making process for the treatment of type 2 diabetes. Some differences in attribute preferences were identified according to demographic and disease characteristics. CONCLUSION In general, individuals with type 2 diabetes not only want to discuss the biological effects of treatments, but also the impact of treatment on their quality of life. Healthcare providers should be aware that attributes are viewed differently by different individuals. This emphasizes the need for tailor-made healthcare decisions, which means eliciting and responding to individual preferences in the decision-making process.
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Affiliation(s)
- Anna Tichler
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Correspondence: Anna Tichler, Department of Health Services Research, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, P.O. Box 616, Maastricht, 6200 MD, the Netherlands, Tel +31433882193, Email
| | - Dorijn F L Hertroijs
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Dirk Ruwaard
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Martijn C G J Brouwers
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Judith D de Jong
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- The Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - Arianne M J Elissen
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Ram D, Wilensky A, Zur D, Almoznino G. The Triangle of Nonalcoholic Fatty Liver Disease, Metabolic Dysfunction, and Periodontitis: Analysis of the Dental, Oral, Medical and Epidemiological (DOME) Records-Based Nationwide Research. Metabolites 2022; 12:metabo12121212. [PMID: 36557250 PMCID: PMC9780834 DOI: 10.3390/metabo12121212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/11/2022] Open
Abstract
This study aimed to analyze the associations of nonalcoholic fatty liver disease (NAFLD) with dental parameters, while controlling for socio-demographics, health-related habits, and each of the metabolic syndrome (MetS) components, consequences, and related conditions among a nationally representative sample of young and middle-aged adults. To that end, we analyzed data from the dental, oral, medical epidemiological (DOME) cross-sectional records-based study that combined comprehensive socio-demographic, medical, and dental databases of a nationally representative sample of military personnel. Included were 132,529 subjects aged 18-50 who attended military dental clinics for one year. The prevalence of NAFLD in the study population was 0.7% (938/132,529). The following parameters maintained a statistically positive association with NAFLD in the multivariate analysis (from highest to lowest OR): male sex (OR = 3.91 (2.29-6.66)), hyperlipidemia (OR = 3.69 (2.75-4.95)), diabetes Type 2 (OR = 3.14 (2.21-4.46)), hypertension (OR = 1.67 (1.30-2.14)), periodontitis (OR = 1.42 (1.06-1.89)), body mass index (BMI) (OR = 1.15 (1.13-1.18)), and age (OR = 1.08 (1.06-1.09)). The multivariate analysis established a profile of the "patient vulnerable to NAFLD", including older age, male sex, and other MetS components, including diabetes type 2, hypertension, hyperlipidemia, BMI, and periodontitis. This profile aligns with the current new definition of metabolic dysfunction-associated fatty liver disease (MAFLD). We also analyzed the associations of the sum of the standard dental unit (SDU) scores of planned (SDU-P) and delivered (SDU-D) dental procedures per patient with NAFLD using receiver operating characteristic (ROC) analysis. The SDU-P (planned) score exhibited excellent discrimination for NAFLD (area under the curve (AUC) = 0.718 (0.703-0.734)). Overall, the results confirmed the hypothesis of this research, i.e., that NAFLD is associated with dental morbidity, particularly with periodontitis.
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Affiliation(s)
- Doron Ram
- In Partial Fulfillment DMD Thesis, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Asaf Wilensky
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Periodontology, Hadassah Medical Center, Jerusalem 91120, Israel
| | - Dorit Zur
- Medical Information Department, General Surgeon Headquarter, Medical Corps, Israel Defense Forces, Tel Hashomer 02149, Israel
| | - Galit Almoznino
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Big Biomedical Data Research Laboratory; Dean’s Office, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Endodontics, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hadassah Medical Center, Jerusalem 91120, Israel
- Correspondence: ; Tel.: +97-226-776-194; Fax: +97-226-447-919
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Muacevic A, Adler JR, Saravanan T, Seshiah V, Jain N. Use of Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitor Remogliflozin and Possibility of Acute Kidney Injury in Type-2 Diabetes. Cureus 2022; 14:e32573. [PMID: 36654590 PMCID: PMC9840745 DOI: 10.7759/cureus.32573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
The major trials, e.g., EMPA-REG OUTCOME, CANVAS, and CREDENCE, showed the renal and cardiovascular benefit of sodium-glucose transport protein 2 (SGLT2) inhibitors. The SGLT2 inhibitors, Empagliflozin, Dapagliflozin, and Canagliflozin, have shown no significant adverse renal effects. Still, our patients with type 2 diabetes on Remogliflozin, a type of SGLT2 inhibitor approved in India for the treatment of diabetes, seems to cause acute tubular necrosis as confirmed by clinical and pathological evidence in our study. The two critical findings in our research include a consistent rise in hs-CRP and a pathologist's biopsy report, excluding other causes. Therefore, we need sizeable cardiovascular-renal outcome trials to ascertain the safety of Remogliflozin in future studies.
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Alkhemeiri A, Al Zaabi S, Lakshmanan J, El-Khatib Z, Awofeso N. COVID-19 Case Management Outcomes Amongst Diabetes and Hypertensive Patients in the United Arab Emirates: A Prospective Study. Int J Environ Res Public Health 2022; 19:15967. [PMID: 36498037 PMCID: PMC9738357 DOI: 10.3390/ijerph192315967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
The global pandemic of the novel Coronavirus infection 2019 (COVID-19) challenged the care of comorbid patients. The risk imposed by COVID-19 on diabetes patients is multisystemic, exponential, and involves glucose dysregulation. The increased burden for diabetes patients infected with COVID-19 is substantial in countries with a high prevalence of diabetics, such as the United Arab Emirates (UAE). This study aims to explore the prevalence of diabetes, clinical characteristic, and outcomes of patients admitted for COVID-19 treatment with or without a concurrent preadmission diagnosis of diabetes. A prospective study was performed on 1199 adults admitted with confirmed COVID-19 from December 2020 to April 2021 to a single hospital in the UAE. The study compared the demographics, clinical characteristics, and outcomes in COVID-19-infected patients with diabetes to patients without diabetes. The study endpoints include the development of new-onset diabetes, admission to ICU, trends in the blood glucose levels, and death. A total of 1199 patients (390 with diabetes) were included in the study. A diabetes prevalence was detected among 9.8% of the study population. Among the diabetes group, 10.8% were morbidly obese, 65.4% had associated hypertension, and 18.9% had coronary artery disease. Diabetes patients showed higher rates of ICU admission (11.1% vs. 7.1%), NIV requirement (9.6% vs. 6.4%), and intubation (5.45% vs. 2%) compared to the non-diabetes group. Advanced age was a predictor of a worsening COVID-19 course, while diabetes (p < 0.050) and hypertension (p < 0.025) were significant predictors of death from COVID-19. Nearly three-fourths (284 (73.4%)) of the diabetic patients developed worsened hyperglycemia as compared to one-fifth (171 (20.9%)) of the nondiabetic patients. New-onset diabetes was detected in 9.8% of COVID-19 patients. COVID-19 severity is higher in the presence of diabetes and is associated with worsening hyperglycemia and poor clinical outcomes. Preexisting hypertension is a predictor of COVID-19 severity and death.
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Affiliation(s)
- Aysha Alkhemeiri
- Department of Medicine, Tawam Hospital, Abu Dhabi P.O. Box 15258, United Arab Emirates
| | - Shaikha Al Zaabi
- Internal Medicine Department, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
| | - Jeyaseelan Lakshmanan
- Biostatistics Department, Mohammed Bin Rashed University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
| | - Ziad El-Khatib
- Department of Global Public Health, Karolinska Institutet, 17176 Stockholm, Sweden
| | - Niyi Awofeso
- School of Health and Environmental Studies, Hamdan Bin Muhammed Smart University, Dubai P.O. Box 71400, United Arab Emirates
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Ziarniak K, Yang T, Boycott C, Beetch M, Sassek M, Grzeda E, Ma Y, Sliwowska JH, Stefanska B. DNA hypermethylation of Kiss1r promoter and reduction of hepatic Kiss1r in female rats with type 2 diabetes. Epigenetics 2022; 17:2332-2346. [PMID: 36094166 PMCID: PMC9665141 DOI: 10.1080/15592294.2022.2119120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Kisspeptin, produced from the brain and peripheral tissues, may constitute an important link in metabolic regulation in response to external cues, such as diet. The kisspeptin system is well described in the brain. However, its function and regulation in the peripheral tissues, especially in relation to metabolic disease and sex differences, remain to be elucidated. As Kiss1 and Kiss1r, encoding for kisspeptin and kisspeptin receptors, respectively, are altered by overnutrition/fasting and regulated by DNA methylation during puberty and cancer, epigenetic mechanisms in metabolic disorders are highly probable. In the present study, we experimentally induced type 2 diabetes mellitus (DM2) in female Wistar rats using high-fat diet/streptozocin. We analysed expression and DNA methylation of Kiss1 and Kiss1r in the peripheral tissues, using quantitative-reverse-transcription PCR (qRT-PCR) and pyrosequencing. We discovered differential expression of Kiss1 and Kiss1r in peripheral organs in DM2 females, as compared with healthy controls, and the profile differed from patterns reported earlier in males. DM2 in females was linked to the increased Kiss1 mRNA in the liver and increased Kiss1r mRNA in the liver and adipose tissue. However, Kiss1r promoter was hypermethylated in the liver, suggesting gene silencing. Indeed, the increase in DNA methylation of Kiss1r promoter was accompanied by a reduction in Kiss1r protein, implying epigenetic or translational gene repression. Our results deliver novel evidence for tissue-specific differences in Kiss1 and Kiss1r expression in peripheral organs in DM2 females and suggest DNA methylation as a player in regulation of the hepatic kisspeptin system in DM2.
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Affiliation(s)
- Kamil Ziarniak
- Laboratory of Neurobiology, Department of Zoology, Faculty of Veterinary Medicine and Animal Sciences, Poznan University of Life Sciences, Poznan, Poland.,Molecular and Cell Biology Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Tony Yang
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, the University of British Columbia, Vancouver, BC, Canada
| | - Cayla Boycott
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, the University of British Columbia, Vancouver, BC, Canada
| | - Megan Beetch
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, the University of British Columbia, Vancouver, BC, Canada
| | - Maciej Sassek
- Department of Animal Physiology, Biochemistry and Biostructure, Poznan University of Life Sciences, Poznan, Poland
| | - Emilia Grzeda
- Laboratory of Neurobiology, Department of Zoology, Faculty of Veterinary Medicine and Animal Sciences, Poznan University of Life Sciences, Poznan, Poland
| | - Yuexi Ma
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, the University of British Columbia, Vancouver, BC, Canada
| | - Joanna H Sliwowska
- Laboratory of Neurobiology, Department of Zoology, Faculty of Veterinary Medicine and Animal Sciences, Poznan University of Life Sciences, Poznan, Poland
| | - Barbara Stefanska
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, the University of British Columbia, Vancouver, BC, Canada
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Alalwani J, Eljazzar S, Basil M, Tayyem R. The impact of health status, diet and lifestyle on non-alcoholic fatty liver disease: Narrative review. Clin Obes 2022; 12:e12525. [PMID: 35412016 DOI: 10.1111/cob.12525] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 12/13/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is defined as the abnormal accumulation of triglycerides in the liver. NAFLD has a global prevalence of almost 30%, while incidence is rising with increasing levels of obesity, type 2 diabetes mellitus (T2DM) and metabolic syndrome. Nutrition plays a significant role in both the prevention and treatment of NAFLD. Therefore, the aim of this literature review is to explore the associations between dietary, lifestyle and other risk factors and the risk for developing NAFLD. Dietary patterns, lifestyle behaviours, comorbidities, or a combination of any may contribute to either the progression or prevention of NAFLD. Having diabetes, hypertension, or having obesity might increase the progression of NAFLD if not well treated and controlled. Diet influences the progression of NAFLD; following a western diet or simply a high-fat diet may contribute to the worsening of NAFLD and further progression to non-alcoholic steatohepatitis (NASH) and cirrhosis in later stages. On the other hand, the Mediterranean diet is the gold standard for both the treatment and prevention of NAFLD. Social behaviours, such as smoking, caffeine consumption and physical activity also play a role in the pathophysiology of NAFLD. Nutrition contributes significantly to the prevention or treatment of NAFLD, since this disease can be managed by diet and physical activity. However, further studies are still needed for a better understanding of the mechanisms of action. Randomized control trials are also needed to confirm findings in observational studies.
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Affiliation(s)
- Joud Alalwani
- Human Nutrition Department, College of Health Sciences, Qatar University, Doha, Qatar
| | - Sereen Eljazzar
- Human Nutrition Department, College of Health Sciences, Qatar University, Doha, Qatar
| | - Maya Basil
- Human Nutrition Department, College of Health Sciences, Qatar University, Doha, Qatar
| | - Reema Tayyem
- Human Nutrition Department, College of Health Sciences, Qatar University, Doha, Qatar
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Abu-Kheit R, Kotev-Emeth S, Hiram-Bab S, Gabet Y, Savion N. S-allylmercapto- N-acetylcysteine protects bone cells from oxidation and improves femur microarchitecture in healthy and diabetic mice. Exp Biol Med (Maywood) 2022; 247:1489-1500. [PMID: 35658550 PMCID: PMC9493761 DOI: 10.1177/15353702221095047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Oxidative stress is involved in the deterioration of bone quality and mechanical strength in both diabetic and aging adults. Therefore, we studied the ability of the antioxidant compound, S-allylmercapto-N-acetylcysteine (ASSNAC) to protect bone marrow stromal cells (BMSCs) from advanced glycation end-products (AGEs) cytotoxicity and improve bone microarchitecture of adult healthy and obese/diabetic (db/db) female mice. ASSNAC effect on AGEs-treated cultured rat BMSCs was evaluated by Neutral Red and XTT cell survival and reactive oxygen species (ROS) level assays. Its effect on healthy (C57BL/6) and obese/diabetic (C57BLKS/J Leprdb+/+; db/db) female mice femur parameters, such as (1) number of adherent BMSCs, (2) percentage of CD73+/CD45- cells in bone marrow (BM), (3) glutathione level in BM cells, and (4) femur microarchitecture parameters by microcomputed tomography, was studied. ASSNAC treatment protected BMSCs by significantly decreasing AGEs-induced ROS production and increasing their cellular resistance to the cytotoxic effect of AGEs. ASSNAC treatment of healthy female mice (50 mg/kg/day; i.p.; age 12-20 weeks) significantly increased the number of BMSCs (+60%), CD73+/CD45- cells (+134%), and glutathione level (+110%) in the femur bone marrow. Furthermore, it increased the femur length (+3%), cortical diameter (+3%), and cortical areal moment of inertia (Ct.MOI; +10%) a surrogate for biomechanical strength. In db/db mice that demonstrated a compromised trabecular bone and growth plate microarchitecture, ASSNAC treatment restored the trabecular number (Tb.N, +29%), bone volume fraction (Tb.BV/TV, +130%), and growth plate primary spongiosa volumetric bone mineral density (PS-vBMD, +7%) and thickness (PS-Th, +18%). In conclusion, this study demonstrates that ASSNAC protects bone marrow cells from oxidative stress and may improve bone microarchitecture in adult healthy and diabetic female mice.
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Affiliation(s)
- Reem Abu-Kheit
- Department of Human Molecular Genetics and
Biochemistry and Goldschleger Eye Research Institute, Sackler Faculty of Medicine, Tel Aviv
University, Tel Aviv 6997801, Israel
| | - Shlomo Kotev-Emeth
- Department of Human Molecular Genetics and
Biochemistry and Goldschleger Eye Research Institute, Sackler Faculty of Medicine, Tel Aviv
University, Tel Aviv 6997801, Israel
| | - Sahar Hiram-Bab
- Department of Anatomy and Anthropology,
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Yankel Gabet
- Department of Anatomy and Anthropology,
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Naphtali Savion
- Department of Human Molecular Genetics and
Biochemistry and Goldschleger Eye Research Institute, Sackler Faculty of Medicine, Tel Aviv
University, Tel Aviv 6997801, Israel;,Naphtali Savion.
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